WorldWideScience

Sample records for systolic blood pressure

  1. Reducing maternal mortality: Systolic blood pressure

    African Journals Online (AJOL)

    2006-03-21

    Mar 21, 2006 ... While deaths due to fluid overload have ... of better fluid balance management, we have made .... systolic blood pressure plays a significant role in the .... one looks at the work of Martin et al.5 ... Promoting Healthy Life.

  2. Dairy consumption, systolic blood pressure, and risk of hypertension

    DEFF Research Database (Denmark)

    Ding, Ming; Huang, Tao; Bergholdt, Helle Km

    2017-01-01

    Objective To examine whether previous observed inverse associations of dairy intake with systolic blood pressure and risk of hypertension were causal.Design Mendelian randomization study using the single nucleotide polymorphism rs4988235 related to lactase persistence as an instrumental variable...... blood pressure but not risk of hypertension (odds ratio 0.98, 0.97 to 1.00; P=0.11).Conclusion The weak inverse association between dairy intake and systolic blood pressure in observational studies was not supported by a comprehensive instrumental variable analysis and systematic review of existing...

  3. Automatic noninvasive measurement of systolic blood pressure using photoplethysmography

    Directory of Open Access Journals (Sweden)

    Glik Zehava

    2009-10-01

    Full Text Available Abstract Background Automatic measurement of arterial blood pressure is important, but the available commercial automatic blood pressure meters, mostly based on oscillometry, are of low accuracy. Methods In this study, we present a cuff-based technique for automatic measurement of systolic blood pressure, based on photoplethysmographic signals measured simultaneously in fingers of both hands. After inflating the pressure cuff to a level above systolic blood pressure in a relatively slow rate, it is slowly deflated. The cuff pressure for which the photoplethysmographic signal reappeared during the deflation of the pressure-cuff was taken as the systolic blood pressure. The algorithm for the detection of the photoplethysmographic signal involves: (1 determination of the time-segments in which the photoplethysmographic signal distal to the cuff is expected to appear, utilizing the photoplethysmographic signal in the free hand, and (2 discrimination between random fluctuations and photoplethysmographic pattern. The detected pulses in the time-segments were identified as photoplethysmographic pulses if they met two criteria, based on the pulse waveform and on the correlation between the signal in each segment and the signal in the two neighboring segments. Results Comparison of the photoplethysmographic-based automatic technique to sphygmomanometry, the reference standard, shows that the standard deviation of their differences was 3.7 mmHg. For subjects with systolic blood pressure above 130 mmHg the standard deviation was even lower, 2.9 mmHg. These values are much lower than the 8 mmHg value imposed by AAMI standard for automatic blood pressure meters. Conclusion The photoplethysmographic-based technique for automatic measurement of systolic blood pressure, and the algorithm which was presented in this study, seems to be accurate.

  4. Invasively Measured Aortic Systolic Blood Pressure and Office Systolic Blood Pressure in Cardiovascular Risk Assessment: A Prospective Cohort Study

    DEFF Research Database (Denmark)

    Laugesen, Esben; Knudsen, Søren T; Hansen, Klavs W

    2016-01-01

    Aortic systolic blood pressure (BP) represents the hemodynamic cardiac and cerebral burden more directly than office systolic BP. Whether invasively measured aortic systolic BP confers additional prognostic value beyond office BP remains debated. In this study, office systolic BP and invasively......) and with myocardial infarction in patients without diabetes mellitus (hazard ratio, 1.07 [95% confidence interval, 1.02-1.12] and 1.05 [95% confidence interval, 1.01-1.10], respectively). In models including both BP measurements, aortic BP lost statistical significance and aortic BP did not confer improvement...

  5. [Development of an automatic pneumatic tourniquet system that determines pressures in synchrony with systolic blood pressure].

    Science.gov (United States)

    Liu, Hongyun; Li, Kaiyuan; Zhang, Zhengbo; Guo, Junyan; Wang, Weidong

    2012-11-01

    The correlation coefficients between arterial occlusion pressure and systolic blood pressure, diastolic blood pressure, limb circumference, body mass etc were obtained through healthy volunteer experiments, in which tourniquet were applied on upper/lower extremities. The prediction equations were derived from the data of experiments by multiple regression analysis. Based on the microprocessor C8051F340, a new pneumatic tourniquet system that can determine tourniquet pressure in synchrony with systolic blood pressure was developed and verified the function and stability of designed system. Results showed that the pneumatic tourniquet which automatically adjusts occlusion pressure in accordance with systolic blood pressure could stop the flow of blood to get a bloodless field.

  6. Contributions of social context to blood pressure: findings from a multilevel analysis of social capital and systolic blood pressure.

    Science.gov (United States)

    Hamano, Tsuyoshi; Fujisawa, Yoshikazu; Yamasaki, Masayuki; Ito, Katsuhisa; Nabika, Toru; Shiwaku, Kuninori

    2011-06-01

    In recent years, few studies have quantified the effect of residential context on blood pressure. Although these studies have emphasized the importance of socioeconomic influences such as education or poverty levels, the association between the features of social structure such as social capital and blood pressure remain unclear. Therefore, we investigated whether social capital was associated with systolic blood pressure after controlling for individual potential confounders. We analyzed data from the Shimane Study conducted from 2006 to 2008 in rural mountainous regions of Japan. After excluding the missing data and data of participants taking hypertension medication, we conducted a multilevel analysis of the data for 335 individuals nested within 30 postcode sectors. Systolic blood pressure increased with increasing age and body mass index. We also found that a higher systolic blood pressure was observed among smokers and those taking medication for diabetes. Regarding the contextual effects of social capital, systolic blood pressure increased with an increasing proportion of lack of fairness, after adjustment for individual confounders. To the best of our knowledge, this study is the first to investigate the association between social capital and systolic blood pressure by using a multilevel methodological framework. Surprisingly, we found that lack of fairness had a strong effect on systolic blood pressure. However, we could not find any significant associations between other items of social capital and systolic blood pressure. Further studies are needed to clarify the mechanism by which lack of fairness may have an effect on systolic blood pressure.

  7. Analysis of the progression of systolic blood pressure using imputation of missing phenotype values

    OpenAIRE

    Vaitsiakhovich, Tatsiana; Drichel, Dmitriy; Angisch, Marina; Becker, Tim; Herold, Christine; Lacour, André

    2014-01-01

    We present a genome-wide association study of a quantitative trait, "progression of systolic blood pressure in time," in which 142 unrelated individuals of the Genetic Analysis Workshop 18 real genotype data were analyzed. Information on systolic blood pressure and other phenotypic covariates was missing at certain time points for a considerable part of the sample. We observed that the dropout process causing missingness is not independent of the initial systolic blood pressure; that is, the ...

  8. Valuation of Normal Range of Ankle Systolic Blood Pressure in Subjects with Normal Arm Systolic Blood Pressure.

    Science.gov (United States)

    Gong, Yi; Cao, Kai-wu; Xu, Jin-song; Li, Ju-xiang; Hong, Kui; Cheng, Xiao-shu; Su, Hai

    2015-01-01

    This study aimed to establish a normal range for ankle systolic blood pressure (SBP). A total of 948 subjects who had normal brachial SBP (90-139 mmHg) at investigation were enrolled. Supine BP of four limbs was simultaneously measured using four automatic BP measurement devices. The ankle-arm difference (An-a) on SBP of both sides was calculated. Two methods were used for establishing normal range of ankle SBP: the 99% method was decided on the 99% reference range of actual ankle BP, and the An-a method was the sum of An-a and the low or up limits of normal arm SBP (90-139 mmHg). Whether in the right or left side, the ankle SBP was significantly higher than the arm SBP (right: 137.1 ± 16.9 vs 119.7 ± 11.4 mmHg, P<0.05). Based on the 99% method, the normal range of ankle SBP was 94~181 mmHg for the total population, 84~166 mmHg for the young (18-44 y), 107~176 mmHg for the middle-aged(45-59 y) and 113~179 mmHg for the elderly (≥ 60 y) group. As the An-a on SBP was 13 mmHg in the young group and 20 mmHg in both middle-aged and elderly groups, the normal range of ankle SBP on the An-a method was 103-153 mmHg for young and 110-160 mmHg for middle-elderly subjects. A primary reference for normal ankle SBP was suggested as 100-165 mmHg in the young and 110-170 mmHg in the middle-elderly subjects.

  9. Effect of hematocrit and systolic blood pressure on cerebral blood flow in newborn infants

    International Nuclear Information System (INIS)

    Younkin, D.P.; Reivich, M.; Jaggi, J.L.; Obrist, W.D.; Delivoria-Papadopoulos, M.

    1987-01-01

    The effects of hematocrit and systolic blood pressure on cerebral blood flow were measured in 15 stable, low birth weight babies. CBF was measured with a modification of the xenon-133 ( 133 Xe) clearance technique, which uses an intravenous bolus of 133 Xe, an external chest detector to estimate arterial 133 Xe concentration, eight external cranial detectors to measure cephalic 133 Xe clearance curves, and a two-compartmental analysis of the cephalic 133 Xe clearance curves to estimate CBF. There was a significant inverse correlation between hematocrit and CBF, presumably due to alterations in arterial oxygen content and blood viscosity. Newborn CBF varied independently of systolic blood pressure between 60 and 84 mm Hg, suggesting an intact cerebrovascular autoregulatory mechanism. These results indicate that at least two of the factors that affect newborn animal CBF are operational in human newborns and may have important clinical implications

  10. Second measurement of morning systolic blood pressure is more closely associated with albuminuria.

    Science.gov (United States)

    Sakabe, Kazumi; Fukui, Michiaki; Ushigome, Emi; Hamaguchi, Masahide; Tanaka, Toru; Atsuta, Haruhiko; Ohnishi, Masayoshi; Oda, Yohei; Hasegawa, Goji; Nakamura, Naoto

    2012-08-01

    It is important to control blood pressure as well as to control blood glucose for the prevention of diabetic nephropathy. However, to our knowledge, there are no reports investigating which blood pressure, including morning, evening and clinic, is more closely associated with albuminuria and whether one measurement is sufficient or not in patients with Type 2 diabetes. We measured morning, evening and clinic blood pressure and compared the area under the curve (AUC) of blood pressure for urinary albumin excretion equal to or more than 30 mg/g creatinine using receiver-operating characteristic curve analyses and odds ratio for albuminuria defined as urinary albumin excretion equal to or more than 30 mg/g creatinine in 858 patients with Type 2 diabetes. Odds ratio (95% confidence interval (CI)) of morning, evening and clinic systolic blood pressure for albuminuria was 1.034 (1.024 - 1.044), 1.033 (1.023 - 1.043) and 1.013 (1.055 - 1.021), respectively (p AUC of morning, evening and clinic systolic blood pressure was 0.644 (0.628 - 0.700) (p AUC of the second morning systolic blood pressure was greater than the first (p = 0.033). The second measurement of morning systolic blood pressure is more closely associated with albuminuria than the first measurement of the morning in addition to clinic systolic blood pressure.

  11. Effects of parental smoking on exercise systolic blood pressure in adolescents.

    Science.gov (United States)

    Hacke, Claudia; Weisser, Burkhard

    2015-05-11

    In adults, exercise blood pressure seems to be more closely related to cardiovascular risk than resting blood pressure; however, few data are available on the effects of familial risk factors, including smoking habits, on exercise blood pressure in adolescents. Blood pressure at rest and during exercise, parental smoking, and other familial risk factors were investigated in 532 adolescents aged 12 to 17 years (14.6±1.5 years) in the Kiel EX.PRESS. (EXercise PRESSure) Study. Exercise blood pressure was determined at 1.5 W/kg body weight using a standardized submaximal cycle ergometer test. Mean resting blood pressure was 113.1±12.8/57.2±7.1 mm Hg, and exercise blood pressure was 149.9±19.8/54.2±8.6 mm Hg. Parental smoking increased exercise systolic blood pressure (+4.0 mm Hg, 3.1 to 4.9; P=0.03) but not resting blood pressure of the subjects (adjusted for age, sex, height, body mass index percentile, fitness). Parental overweight and familial hypertension were related to both higher resting and exercise systolic blood pressure values, whereas associations with an inactive lifestyle and a low educational level of the parents were found only with adolescents' blood pressure during exercise. The cumulative effect of familial risk factors on exercise systolic blood pressure was more pronounced than on blood pressure at rest. Parental smoking might be a novel risk factor for higher blood pressure, especially during exercise. In addition, systolic blood pressure during a submaximal exercise test was more closely associated with familial risk factors than was resting blood pressure, even in adolescents. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  12. The systolic blood pressure difference between arms and cardiovascular disease in the Framingham Heart Study.

    Science.gov (United States)

    Weinberg, Ido; Gona, Philimon; O'Donnell, Christopher J; Jaff, Michael R; Murabito, Joanne M

    2014-03-01

    An increased interarm systolic blood pressure difference is an easily determined physical examination finding. The relationship between interarm systolic blood pressure difference and risk of future cardiovascular disease is uncertain. We described the prevalence and risk factor correlates of interarm systolic blood pressure difference in the Framingham Heart Study (FHS) original and offspring cohorts and examined the association between interarm systolic blood pressure difference and incident cardiovascular disease and all-cause mortality. An increased interarm systolic blood pressure difference was defined as ≥ 10 mm Hg using the average of initial and repeat blood pressure measurements obtained in both arms. Participants were followed through 2010 for incident cardiovascular disease events. Multivariable Cox proportional hazards regression analyses were performed to investigate the effect of interarm systolic blood pressure difference on incident cardiovascular disease. We examined 3390 (56.3% female) participants aged 40 years and older, free of cardiovascular disease at baseline, mean age of 61.1 years, who attended a FHS examination between 1991 and 1994 (original cohort) and from 1995 to 1998 (offspring cohort). The mean absolute interarm systolic blood pressure difference was 4.6 mm Hg (range 0-78). Increased interarm systolic blood pressure difference was present in 317 (9.4%) participants. The median follow-up time was 13.3 years, during which time 598 participants (17.6%) experienced a first cardiovascular event, including 83 (26.2%) participants with interarm systolic blood pressure difference ≥ 10 mm Hg. Compared with those with normal interarm systolic blood pressure difference, participants with an elevated interarm systolic blood pressure difference were older (63.0 years vs 60.9 years), had a greater prevalence of diabetes mellitus (13.3% vs 7.5%,), higher systolic blood pressure (136.3 mm Hg vs 129.3 mm Hg), and a higher total cholesterol

  13. Lack of association between systolic blood pressure and blood viscosity in normotensive healthy subjects.

    Science.gov (United States)

    Irace, Concetta; Carallo, Claudio; Scavelli, Faustina; Loprete, Antonio; Merante, Valentina; Gnasso, Agostino

    2012-01-01

    A direct relationship between blood pressure and viscosity has frequently been reported, although clear data are not available. To better understand the relationship between these two variables, we evaluated blood viscosity and blood pressure in a group of healthy subjects without cardiovascular risk factors. Healthy subjects were selected from participants in a campaign of prevention of cardiovascular disease (n = 103). They underwent blood sampling for measurement of plasma and blood viscosity, haematocrit, blood lipids and glucose. The quantity and distribution of body fat was assessed by body mass index and waist/hip ratio, respectively. Systolic blood pressure (SBP) correlated significantly with age (r = 0.222) and waist/hip ratio (r = 0.374). Diastolic blood pressure (DBP) correlated significantly with waist/hip ratio (r = 0.216), haematocrit (r = 0.333) and blood viscosity (r = 0.258). Multiple linear regression analyses demonstrated that the only variable significantly associated with SBP was age, while haematocrit was the only variable significantly associated with DBP. Blood viscosity was closely related to waist/hip ratio. These findings show that SBP, in healthy subjects, is not influenced by haematocrit and blood viscosity. In contrast, DBP is related to the values of haematocrit. Among classical cardiovascular risk factors, waist/hip ratio is closely related to blood viscosity.

  14. Euglycemic clamp insulin sensitivity and longitudinal systolic blood pressure

    DEFF Research Database (Denmark)

    Petrie, John R; Malik, Muhammad Omar; Balkau, Beverley

    2013-01-01

    and Cardiovascular disease (RISC) study, we measured insulin sensitivity (M/I) using the euglycemic clamp technique in 1073 healthy European adults (587 women, 486 men) aged 30 to 60 years followed up 3 years later. Systolic BP (SBP) at baseline was higher in insulin-resistant women (ie, those in the low sex...

  15. Target blood pressure for treatment of isolated systolic hypertension in the elderly: valsartan in elderly isolated systolic hypertension study.

    Science.gov (United States)

    Ogihara, Toshio; Saruta, Takao; Rakugi, Hiromi; Matsuoka, Hiroaki; Shimamoto, Kazuaki; Shimada, Kazuyuki; Imai, Yutaka; Kikuchi, Kenjiro; Ito, Sadayoshi; Eto, Tanenao; Kimura, Genjiro; Imaizumi, Tsutomu; Takishita, Shuichi; Ueshima, Hirotsugu

    2010-08-01

    In this prospective, randomized, open-label, blinded end point study, we aimed to establish whether strict blood pressure control ( or =140 mm Hg to or =2 years. The strict control (1545 patients) and moderate control (1534 patients) groups were well matched (mean age: 76.1 years; mean blood pressure: 169.5/81.5 mm Hg). Median follow-up was 3.07 years. At 3 years, blood pressure reached 136.6/74.8 mm Hg and 142.0/76.5 mm Hg, respectively. The blood pressure difference between the 2 groups was 5.4/1.7 mm Hg. The overall rate of the primary composite end point was 10.6 per 1000 patient-years in the strict control group and 12.0 per 1000 patient-years in the moderate control group (hazard ratio: 0.89; [95% CI: 0.60 to 1.34]; P=0.38). In summary, blood pressure targets of or = 70 years of age with isolated systolic hypertension, although our trial was underpowered to definitively determine whether strict control was superior to less stringent blood pressure targets.

  16. Systolic blood pressure is superior to other haemodynamic predictors of outcome in community acquired pneumonia.

    Science.gov (United States)

    Chalmers, J D; Singanayagam, A; Hill, A T

    2008-08-01

    Admission blood pressure (BP) assessment is a central component of severity assessment for community acquired pneumonia. The aim of this study was to establish which readily available haemodynamic measure on admission is most useful for predicting severity in patients admitted with community acquired pneumonia. A prospective observational study of patients admitted with community acquired pneumonia was conducted in Edinburgh, UK. The measurements compared were systolic and diastolic BP, mean arterial pressure and pulse pressure. The outcomes of interest were 30 day mortality and the requirement for mechanical ventilation and/or inotropic support. Admission systolic BP pressure pressure AUC values for each predictor of 30 day mortality were as follows: systolic BP pressure pressure AUC values for each predictor of need for mechanical ventilation and/or inotropic support were as follows: systolic BP pressure pressure blood pressure AUC 0.76 vs 0.74) and to the standard CURB65 score (0.76 vs 0.76) for the prediction of 30 day mortality. The simplified CRB65 score was equivalent for prediction of mechanical ventilation and/or inotropic support to standard CRB65 (0.77 vs 0.77) and to CURB65 (0.77 vs 0.78). Systolic BP is superior to other haemodynamic predictors of 30 day mortality and need for mechanical ventilation and/or inotropic support in community acquired pneumonia. The CURB65 score can be simplified to a modified CRB65 score by omission of the diastolic BP criterion without compromising its accuracy.

  17. Urinary albumin excretion is associated with nocturnal systolic blood pressure in resistant hypertensives.

    Science.gov (United States)

    Oliveras, Anna; Armario, Pedro; Martell-Clarós, Nieves; Ruilope, Luis M; de la Sierra, Alejandro

    2011-03-01

    Microalbuminuria is a known marker of subclinical organ damage. Its prevalence is higher in patients with resistant hypertension than in subjects with blood pressure at goal. On the other hand, some patients with apparently well-controlled hypertension still have microalbuminuria. The current study aimed to determine the relationship between microalbuminuria and both office and 24-hour ambulatory blood pressure. A cohort of 356 patients (mean age 64 ± 11 years; 40.2% females) with resistant hypertension (blood pressure ≥ 140 and/or 90 mm Hg despite treatment with ≥ 3 drugs, diuretic included) were selected from Spanish hypertension units. Patients with estimated glomerular filtration rate <30 mL/min/1.73 m(2) were excluded. All patients underwent clinical and demographic evaluation, complete laboratory analyses, and good technical-quality 24-hour ambulatory blood pressure monitoring. Urinary albumin/creatinine ratio was averaged from 3 first-morning void urine samples. Microalbuminuria (urinary albumin/creatinine ratio ≥ 2.5 mg/mmol in males or ≥ 3.5 mg/mmol in females) was detected in 46.6%, and impaired renal function (estimated glomerular filtration rate <60 mL/min/1.73 m(2)) was detected in 26.8%. Bivariate analyses showed significant associations of microalbuminuria with older age, reduced estimated glomerular filtration rate, increased nighttime systolic blood pressure, and elevated daytime, nighttime, and 24-hour diastolic blood pressure. In a logistic regression analysis, after age and sex adjustment, elevated nighttime systolic blood pressure (multivariate odds ratio, 1.014 [95% CI, 1.001 to 1.026]; P=0.029) and reduced estimated glomerular filtration rate (multivariate odds ratio, 2.79 [95% CI, 1.57 to 4.96]; P=0.0005) were independently associated with the presence of microalbuminuria. We conclude that microalbuminuria is better associated with increased nighttime systolic blood pressure than with any other office and 24-hour ambulatory blood

  18. Decreasing systolic blood pressure and declining mortality rates in an untreated population

    DEFF Research Database (Denmark)

    Andersen, Ulla O; Marott, Jacob L; Jensen, Gorm B

    2011-01-01

    The aim of the present study was to evaluate developments in 30 years mortality risk that may be associated with developments in population systolic blood pressure (SBP) and to evaluate possible secular trends in BP-associated mortality risk in the untreated population....

  19. Systolic blood pressure reactivity during submaximal exercise and acute psychological stress in youth

    Science.gov (United States)

    Background: Studies in youth show an association between systolic blood-pressure (SBP) reactivity to acute psychological stress and carotid artery intima-media thickness (CIMT). However, it has not yet been determined whether SBP reactivity during submaximal exercise is also associated with CIMT i...

  20. Dairy consumption, systolic blood pressure, and risk of hypertension: Mendelian randomization study

    Science.gov (United States)

    This study examined whether previous observed inverse associations of dairy intake with systolic blood pressure and risk of hypertension were causal. A Mendelian randomization study was employed, using the single nucleotide polymorphism rs4988235 related to lactase persistence as an instrumental var...

  1. Systolic blood pressure estimation using PPG and ECG during physical exercise

    NARCIS (Netherlands)

    Sun, S.; Bezemer, R.; Long, X.; Muehlsteff, J.; Aarts, R.M.

    2016-01-01

    In this work, a model to estimate systolic blood pressure (SBP) using photoplethysmography (PPG) and electrocardiography (ECG) is proposed. Data from 19 subjects doing a 40 min exercise was analyzed. Reference SBP was measured at the finger based on the volume-clamp principle. PPG signals were

  2. Systolic Blood Pressure Accuracy Enhancement in the Electronic Palpation Method Using Pulse Waveform

    National Research Council Canada - National Science Library

    Sorvoja, H

    2001-01-01

    .... Systolic pressure errors were defined and correlations with other specific values, like pressure rise time, pulse wave velocity, systolic pressure, augmentation, arm circumference and body mass index were calculated...

  3. Total flying hours and risk of high systolic blood pressure in the civilian pilot in Indonesia

    Directory of Open Access Journals (Sweden)

    Ferdi Afian

    2016-07-01

    Full Text Available Abstrak Latar belakang: Tekanan darah sistolik tinggi di antara pilot sipil antara lain akan menyebabkan gangguan kardiovaskular sehingga akan mengganggu kelancaran penerbangan. Tujuan penelitian ini ialah untuk mengetahui faktor-faktor dominan terhadap tekanan darah sistolik tinggi pada pilot sipil. Metode: Penelitian potong lintang dengan metode sampling purposif pada pilot yang melakukan pemeriksaan kesehatan berkala di Balai Kesehatan Penerbangan pada tanggal 18-29 Mei 2015. Data yang dikumpulkan adalah karakteristik demografi dan pekerjaan, klinis, kebiasaan olahraga, kebiasaan makan, indeks massa tubuh dan riwayat penyakit. Tekanan darah sistolik tinggi ialah tekanan darah sistolik140 mmHg atau lebih. Hasil: Dari 690 pilot yang melakukan pemeriksaan kesehatan berkala, 428 pilot laki-laki bersedia berpartisipasi mengikuti penelitian ini. Usia dan riwayat penyakit hipertensi merupakan faktor risiko dominan yang berhubungan dengan tekanan darah sistolik tinggi. Jika dibandingkan dengan pilot usia 19-39 tahun, yang berusia 40-65 tahun mempunyai 15,1 kali lipat lebih besar risiko terkena tekanan darah sistolik tinggi [rasio odds suaian (ORa= 15,12; p= 0,001]. Pilot dengan riwayat penyakit hipertensi dibandingkan dengan yang tidak ada riwayat memiliki risiko tekanan darah sistolik tinggi 93,2 kali lipat lebih besar (ORa= 93,21; p= 0,001 Kesimpulan: Usia 40-65 tahun dan memiliki riwayat hipertensi meningkatkan risiko tekanan darah sistolik tinggi di antara pilot sipil di Indonesia. Kata kunci: tekanan darah sistolik, total jam terbang, pilot sipil, Indonesia.  Abstract Background: Systolic high blood pressure among civilian pilots among others will cause cardiovascular disease and this condition will disrupt the flight.The purpose of this study was to identified the dominant factors related to high systolic blood pressure in the civilian pilots. Methods: A cross-sectional study with a purposive sampling method on a pilot who performed periodic

  4. Central aortic systolic blood pressure can predict prolonged QTc duration better than brachial artery systolic blood pressure in rural community residents.

    Science.gov (United States)

    Huang, Yuqing; Tang, Songtao; Chen, Ji-Yan; Huang, Cheng; Li, Jie; Cai, An-Ping; Feng, Yingqing

    2018-01-01

    Previous studies have suggested that prolonged electrocardiogram QTc duration was independent risk factor for both increased cardiovascular and all-cause mortality, but there was no dating about the relationship between central aortic systolic blood pressure (CASP) and QTc duration. The aim of this study was to analyze the relationship between CASP and QTc duration, and assess whether CASP can predict prolonged QTc duration more than BSBP. A total of 500 patients were enrolled in this study, central and brachial aortic blood pressure and electrocardiogram QTc duration were measured. Pearson correlation was assessed for determining the associations of QTc duration with clinical conditions. Multivariate logistic regression analyses were performed to determine the independent predictor of prolonged QTc duration. Receiver operating characteristic (ROC) curve was used to evaluate the utility of blood pressure for prolonged QTc duration. We found QTc durations were significantly positive with CASP (r = 0.308, p AUC: 0.771 vs. 0.646, p < 0.001) BSBP. Our results suggested that the non-invasive CASP is independently correlated with QTc duration, and CASP can predict prolonged QTc duration more than BSBP.

  5. Microalbuminuria in patients with non-insulin-dependent diabetes mellitus relates to nocturnal systolic blood pressure.

    LENUS (Irish Health Repository)

    Mitchell, T H

    2012-02-03

    PURPOSE: Microalbuminuria predicts early mortality in non-insulin-dependent-diabetes mellitus patients (NIDDM). Our objective in the present study was to compare and assess the relationship between 24-hour, day and nocturnal ambulatory blood pressure (BP) and urinary albumin excretion rate (UAE) in microalbuminuric and normoalbuminuric NIDDM and in normal control subjects. PATIENTS AND METHODS: In the present cross-sectional study, 24 hour ambulatory BP (daytime BP and nocturnal BP) and HbA1c were compared in microalbuminuric (n = 10) and nonmicroalbuminuric NIDDM patients (n = 10) and in nondiabetic controls (n = 9). None of the patients were taking antihypertensive agents. RESULTS: In the microlbuminuric group, whereas 24 hour and daytime systolic BP differed significantly from control values (P < 0.025 and P < 0.05 respectively), there was no difference between diabetic groups. However, nocturnal systolic BP in the microalbuminuric group was significantly higher than in the normoalbuminuric diabetic patients (139 vs. 125) (P < 0.05) and a significant difference was also found between the NIDDM patients and the control group (139, 125 vs. 114) (P < 0.025). In multiple regression analysis, only nocturnal systolic BP showed a significant relationship with UAE (P < 0.05). CONCLUSIONS: We suggest that the higher nocturnal systolic blood pressure seen in our microalbuminuric NIDDM patients may contribute to the increased morbidity in this group.

  6. Aircraft vibration and other factors related to high systolic blood pressure in Indonesian Air Force pilots

    Directory of Open Access Journals (Sweden)

    Minarma Siagian

    2013-05-01

    Full Text Available AbstrakLatar belakang: Penerbangan dapat berdampak pada sistem kardiovaskular manusia. Penerbang terpajan antara lain pada bising dan vibrasi pesawat. Penelitian bertujuan untuk mengetahui pengaruh beberapa faktor penerbangan pada tekanan darah sistolik.Metode: Penelitian nested case-control dilakukan pada penerbang Angkatan Udara Republik Indonesia yang melakukan pemeriksaan fisik tahunan di Lembaga Kesehatan Penerbangan dan Ruang Angkasa (LAKESPRA Saryanto tahun 2003–2008. Data yang diperoleh dari rekam medik berupa umur, jumlah jam terbang, jenis pesawat, kadar glukosa puasa dan kadar kholesterol darah, lingkaran pinggang, tinggi dan berat badan, tinggi badan, serta tekanan darah.Hasil: Dari 336 penerbang, terdapat 16 penerbanga dengan tekanan sistolik ³ 140 mmHg. Penerbang dengan rata-rata jam penerbangan 300-622 jam per tahun dibandingkan dengan 29-299 jam per tahun mempunyai risiko peningkatan tekanan darah sistolik tinggi sebesarf 5 kali [rasio odds suaian (ORa = 5,05, 95% interval kepercayaan (CI = 0,88 -23,30, P = 0,070]. Menurut jam terbang total, mereka yang memiliki 1.401-1,1125 jam dibandingkan 147-1.400 jam berisiko 3,6 kali mengalami tekanan darah sistolik tinggi (ORa = 3,58, 95% CI = 1,24-10,38. Selain itu, mereka dengan denyut nadi istirahat tinggi dibandingkan dengan denyut nadi normal istirahat memiliki 2,4 kali mengalami tekanan darah sistolik tinggi (ORa = 2,37, CI = 0,74-7,50 95, P = 0,147].Kesimpulan: Vibrasi pesawat terbang tinggi, rata-rata jam terbang per tahun tinggi, dan frekuensi nadi istirahat yang tinggi meningkatkan risiko tekanan sistolik tinggi.Kata kunci:tekanan darah sistolik, vibrasi pesawat terbang, frekuensi nadi istirahat, pilotAbstractBackground:Flight may affect the human cardiovascular system. Pilots are exposed among others to aircraft noise and vibration. This study aimed to investigate the effects of aircraft flight on systolic blood pressure.Methods:A nested case-control study was conducted on

  7. Relationship Between 24-Hour Ambulatory Central Systolic Blood Pressure and Left Ventricular Mass: A Prospective Multicenter Study.

    Science.gov (United States)

    Weber, Thomas; Wassertheurer, Siegfried; Schmidt-Trucksäss, Arno; Rodilla, Enrique; Ablasser, Cornelia; Jankowski, Piotr; Lorenza Muiesan, Maria; Giannattasio, Cristina; Mang, Claudia; Wilkinson, Ian; Kellermair, Jörg; Hametner, Bernhard; Pascual, Jose Maria; Zweiker, Robert; Czarnecka, Danuta; Paini, Anna; Salvetti, Massimo; Maloberti, Alessandro; McEniery, Carmel

    2017-12-01

    We investigated the relationship between left ventricular mass and brachial office as well as brachial and central ambulatory systolic blood pressure in 7 European centers. Central systolic pressure was measured with a validated oscillometric device, using a transfer function, and mean/diastolic pressure calibration. M-mode images were obtained by echocardiography, and left ventricular mass was determined by one single reader blinded to blood pressure. We studied 289 participants (137 women) free from antihypertensive drugs (mean age: 50.8 years). Mean office blood pressure was 145/88 mm Hg and mean brachial and central ambulatory systolic pressures were 127 and 128 mm Hg, respectively. Mean left ventricular mass was 93.3 kg/m 2 , and 25.6% had left ventricular hypertrophy. The correlation coefficient between left ventricular mass and brachial office, brachial ambulatory, and central ambulatory systolic pressure was 0.29, 0.41, and 0.47, respectively ( P =0.003 for comparison between brachial office and central ambulatory systolic pressure and 0.32 for comparison between brachial and central ambulatory systolic pressure). The results were consistent for men and women, and young and old participants. The areas under the curve for prediction of left ventricular hypertrophy were 0.618, 0.635, and 0.666 for brachial office, brachial, and central ambulatory systolic pressure, respectively ( P =0.03 for comparison between brachial and central ambulatory systolic pressure). In younger participants, central ambulatory systolic pressure was superior to both other measurements. Central ambulatory systolic pressure, measured with an oscillometric cuff, shows a strong trend toward a closer association with left ventricular mass and hypertrophy than brachial office/ambulatory systolic pressure. URL: https://www.clinicaltrials.gov. Unique identifier: NCT01278732. © 2017 American Heart Association, Inc.

  8. Older Women with Controlled Isolated Systolic Hypertension: Exercise and Blood Pressure.

    Science.gov (United States)

    Ubolsakka-Jones, Chulee; Sangthong, Benjarat; Aueyingsak, Sahachat; Jones, David A

    2016-06-01

    Exercise is generally regarded as beneficial for health, but the consequent increases in blood pressure might pose a risk for hypertensive subjects. The purpose of this study was to determine blood pressure responses to dynamic exercise and sustained handgrip in patients with isolated systolic hypertension (ISH) who were stable on medication. Nineteen female ISH patients (66 ± 5 yr) and 19 age-matched normotensive (NT) female controls undertook a 5-min cycle exercise (60% heart rate reserve [HRR]) and a 2-min handgrip exercise (30% maximum voluntary contraction). Blood pressure responses were measured using an oscillometric cuff, together with heart rate and resting brachial pulse transit times. Systolic blood pressure (SBP) levels after cycle exercise were 194 ± 18 and 153 ± 19 mm Hg for ISH and NT, respectively, with the increase above resting being greater for ISH (P exercise, SBP rose to 168 ± 19 and 140 ± 8 mm Hg for ISH and NT, respectively. The increases above baseline were greater for ISH both during the exercise and postexercise circulatory occlusion (P = 0.017). The increase in DBP levels during exercise and postexercise occlusion were similar in ISH and NT, suggesting little difference in metaboreflex sensitivity. Pulse transit time was shorter for ISH compared with NT (166 ± 6 ms and 242 ± 24 ms, respectively, P exercises, which may constitute a risk for cardiovascular incidents.

  9. Life course path analysis of birth weight, childhood growth, and adult systolic blood pressure

    DEFF Research Database (Denmark)

    Gamborg, Michael; Andersen, Per Kragh; Baker, Jennifer L

    2009-01-01

    body size, and thereby the total effect, of size and changes in size on later outcomes. Using data on childhood body size and adult systolic blood pressure from a sample of 1,284 Danish men born between 1936 and 1970, the authors compared results from path analysis with results from 3 standard...... regression methods. Path analysis produced easily interpretable results, and compared with standard regression methods it produced a noteworthy gain in statistical power. The effect of change in relative body size on adult blood pressure was more pronounced after age 11 years than in earlier childhood....... These results suggest that increases in body size prior to age 11 years are less harmful to adult blood pressure than increases occurring after this age....

  10. Recruitment strategies and challenges in a large intervention trial: Systolic Blood Pressure Intervention Trial.

    Science.gov (United States)

    Ramsey, Thomas M; Snyder, Joni K; Lovato, Laura C; Roumie, Christianne L; Glasser, Steven P; Cosgrove, Nora M; Olney, Christine M; Tang, Rocky H; Johnson, Karen C; Still, Carolyn H; Gren, Lisa H; Childs, Jeffery C; Crago, Osa L; Summerson, John H; Walsh, Sandy M; Perdue, Letitia H; Bankowski, Denise M; Goff, David C

    2016-06-01

    The Systolic Blood Pressure Intervention Trial is a multicenter, randomized clinical trial of 9361 participants with hypertension who are ≥50 years old. The trial is designed to evaluate the effect of intensive systolic blood pressure control (systolic blood pressure goal recruitment strategies and lessons learned during recruitment of the Systolic Blood Pressure Intervention Trial cohort and five targeted participant subgroups: pre-existing cardiovascular disease, pre-existing chronic kidney disease, age ≥75 years, women, and minorities. In collaboration with the National Institutes of Health Project Office and Systolic Blood Pressure Intervention Trial Coordinating Center, five Clinical Center Networks oversaw clinical site selection, recruitment, and trial activities. Recruitment began on 8 November 2010 and ended on 15 March 2013 (about 28 months). Various recruitment strategies were used, including mass mailing, brochures, referrals from healthcare providers or friends, posters, newspaper ads, radio ads, and electronic medical record searches. Recruitment was scheduled to last 24 months to enroll a target of 9250 participants; in just over 28 months, the trial enrolled 9361 participants. The trial screened 14,692 volunteers, with 33% of initial screens originating from the use of mass mailing lists. Screening results show that participants also responded to recruitment efforts through referral by Systolic Blood Pressure Intervention Trial staff, healthcare providers, or friends (45%); brochures or posters placed in clinic waiting areas (15%); and television, radio, newspaper, Internet ads, or toll-free numbers (8%). The overall recruitment yield (number randomized/number screened) was 64% (9361 randomized/14,692 screened), 77% for those with cardiovascular disease, 79% for those with chronic kidney disease, 70% for those aged ≥75 years, 55% for women, and 61% for minorities. As recruitment was observed to lag behind expectations, additional

  11. Reciprocal Interaction of 24-Hour Blood Pressure Variability and Systolic Blood Pressure on Outcome in Stroke Thrombolysis.

    Science.gov (United States)

    Kellert, Lars; Hametner, Christian; Ahmed, Niaz; Rauch, Geraldine; MacLeod, Mary J; Perini, Francesco; Lees, Kennedy R; Ringleb, Peter A

    2017-07-01

    Significance and management of blood pressure (BP) changes in acute stroke care are unclear. Here, we aimed to investigate the impact of 24-hour BP variability (BPV) on outcome in patients with acute ischemic stroke treated with intravenous thrombolysis. From the Safe Implementation of Treatment in Stroke International Stroke Thrombolysis registry, 28 976 patients with documented pre-treatment systolic BP at 2 and 24 hours were analyzed. The primary measure of BP variability was successive variability. Data were preprocessed using coarsened exact matching. We assessed early neurological improvement, symptomatic intracerebral hemorrhage (SICH), and long-term functional outcome (modified Rankin Scale [mRS] at 90 days) by binary and ordinal regression analyses. Attempts to explain successive variation for analysis of BPV with patients characteristics at admission found systolic BP (5.5% variance) to be most influential, yet 92% of BPV variance remained unexplained. Independently from systolic BP, successive variation for analysis of BPV was associated with poor functional outcome mRS score of 0 to 2 (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.90-0.98), disadvantage across the shift of mRS (OR, 1.04; 95% CI, 1.01-1.08), mortality (OR, 1.10; 95% CI, 1.01-1.08), SICH SITS (OR, 1.14; 95% CI, 1.06-1.23), and SICH ECASS (OR, 1.24; 95% CI, 1.10-1.40; ECASS [European Cooperative Acute Stroke Study 2]). Analyzing successive variation for analysis of BPV as a function of pre-treatment, systolic BP significantly improved the prediction of functional outcome (mRS score of 0-1, mRS score of 0-2, neurological improvement, mRS-shift: all P interaction accounting for pre-treatment BP and the acute BP course (ie, BPV) to achieve best possible outcome for the patient. © 2017 American Heart Association, Inc.

  12. Longitudinal Patterns of Change in Systolic Blood Pressure and Incidence of Cardiovascular Disease: The Atherosclerosis Risk in Communities Study.

    Science.gov (United States)

    Petruski-Ivleva, Natalia; Viera, Anthony J; Shimbo, Daichi; Muntner, Paul; Avery, Christy L; Schneider, Andrea L C; Couper, David; Kucharska-Newton, Anna

    2016-06-01

    Elevated blood pressure in midlife contributes significantly to the risk of cardiovascular disease. However, patterns of blood pressure increase may differ among individuals and may result in differential risk. Our goal was to examine the contribution of longitudinal patterns of blood pressure change to incidence of heart failure, coronary heart disease, stroke, and cardiovascular disease mortality. Latent class growth models were used to identify patterns of change in blood pressure across 4 clinical examinations (1987-1998) among 9845 Atherosclerosis Risk in Communities (ARIC) cohort participants (mean age, 53.7 [SD 5.7] years). Patterns of change in systolic blood pressure included slowly and steeply increasing, a decreasing and a sustained elevated blood pressure. Changes in diastolic and mid-blood pressuresystolic+½ diastolic) were less pronounced. The association of blood pressure pattern group membership with incidence of clinical outcomes was examined in follow-up from the fourth clinical examination (1996-1998) to December 31, 2011, using Poisson regression models adjusted for demographic and metabolic characteristics, and hypertension medication use. A gradient of rates of all events was observed across the identified patterns. Associations were attenuated after adjustment for covariates. Cumulative systolic blood pressure load, rather than the temporal pattern of change in systolic blood pressure itself, plays a role in determining the risk of cardiovascular disease, in particular, of heart failure and cardiovascular disease mortality, independent of blood pressure level measured at one point in time. © 2016 American Heart Association, Inc.

  13. Increased postdialysis systolic blood pressure is associated with extracellular overhydration in hemodialysis outpatients.

    Science.gov (United States)

    Nongnuch, Arkom; Campbell, Neil; Stern, Edward; El-Kateb, Sally; Fuentes, Laura; Davenport, Andrew

    2015-02-01

    Recently, intradialytic hypertension was reported to be associated with increased mortality for hemodialysis patients. To determine whether volume status plays a role in dialysis-associated hypertension, we prospectively audited 531 patients that had volume assessments measured by multiple-frequency bioelectrical impedance during their midweek dialysis session. Mean pre- and postdialysis weights were 73.2 vs 71.7 kg, and systolic blood pressures (SBPs) 140.5 vs. 130.3 mm Hg, respectively. Patients were divided into groups based on a fall in SBP of 20 mm Hg or more (32%), an increased SBP of 10 mm Hg or more (18%), and a stable group (50%). There were no differences in patient demographics, dialysis prescriptions, predialysis weight, total body (TBW), and extracellular (ECW) and intracellular water (ICW). However, the change in weight was significantly less in the increased blood pressure group (1.01 kg vs. stable 1.65, and 1.7 hypotensive). The ratio of ECW to TBW was significantly higher in the increased blood pressure group, particularly post dialysis (39.1 vs. stable 38.7% and fall in blood pressure group 38.7%). ECW overhydration was significantly greater in the increased blood pressure group post dialysis (0.7 (0.17 to 1.1) vs. stable 0.39 (-0.2 to 0.95) and fall in blood pressure group 0.38 (-0.19 to 0.86) liter). We found that patients who had increased blood pressure post dialysis had greater hydration status, particularly ECW. Thus, patients who increase their blood pressure post dialysis should have review of target weight, consideration of lowering the post-dialysis weight, and may benefit from increasing dialysis session time or frequency.

  14. The measurement of digital systolic blood pressure by strain gauge technique

    DEFF Research Database (Denmark)

    Nielsen, P E; Bell, G; Lassen, N A

    1972-01-01

    The systolic blood pressure on the finger, toe, and ankle has been measured by a strain gauge technique in 10 normal subjects aged 17-31 years and 14 normal subjects aged 43-57 years. The standard deviation in repeated measurements lies between 2 and 6 mm Hg. The finger pressure in the younger...... group was significantly higher than the corresponding arm pressure (+ 9.3 mm Hg, S.D. 6.8), but equalled this in the older group (- 0.5 mm Hg, S.D. 6.6). In the two groups the ankle pressures were + 19.3 mm Hg (S.D. 7.5) and + 23.6 mm Hg (S.D. 9.5) higher than the systolic arm pressures. The toe...... pressures were lower than the arm pressures, in the two groups - 4.8 mm Hg (S.D. 6.6) and - 9.8 mm Hg (S.D. 10.7) respectively. The ankle-toe gradient was in the younger group 24.3 mm Hg (S.D. 7.3) and in the older group 33.3 mm Hg (S.D. 12.1). Using mean minus 2.5 X S.D. as the lower limit of normality...

  15. Different systolic blood pressure targets for people with history of stroke or transient ischaemic attack: PAST-BP (Prevention After Stroke—Blood Pressure) randomised controlled trial

    Science.gov (United States)

    McManus, Richard J; Roalfe, Andrea; Fletcher, Kate; Taylor, Clare J; Martin, Una; Virdee, Satnam; Greenfield, Sheila; Hobbs, F D Richard

    2016-01-01

    Objective To assess whether using intensive blood pressure targets leads to lower blood pressure in a community population of people with prevalent cerebrovascular disease. Design Open label randomised controlled trial. Setting 99 general practices in England, with participants recruited in 2009-11. Participants People with a history of stroke or transient ischaemic attack whose systolic blood pressure was 125 mm Hg or above. Interventions Intensive systolic blood pressure target (different target, patients in both arms were actively managed in the same way with regular reviews by the primary care team. Main outcome measure Change in systolic blood pressure between baseline and 12 months. Results 529 patients (mean age 72) were enrolled, 266 to the intensive target arm and 263 to the standard target arm, of whom 379 were included in the primary analysis (182 (68%) intensive arm; 197 (75%) standard arm). 84 patients withdrew from the study during the follow-up period (52 intensive arm; 32 standard arm). Mean systolic blood pressure dropped by 16.1 mm Hg to 127.4 mm Hg in the intensive target arm and by 12.8 mm Hg to 129.4 mm Hg in the standard arm (difference between groups 2.9 (95% confidence interval 0.2 to 5.7) mm Hg; P=0.03). Conclusions Aiming for target below 130 mm Hg rather than 140 mm Hg for systolic blood pressure in people with cerebrovascular disease in primary care led to a small additional reduction in blood pressure. Active management of systolic blood pressure in this population using a blood pressure. Trial registration Current Controlled Trials ISRCTN29062286. PMID:26919870

  16. 6A.03: THE RELATIONSHIP BETWEEN INTER-ARM SYSTOLIC BLOOD PRESSURE AND CARDIOVASCULAR RISK FACTORS.

    Science.gov (United States)

    Ma, W; Zhang, B; Yang, Y; Qi, L; Meng, L; Zhang, Y; Huo, Y

    2015-06-01

    To analyze the relationship between the inter arm blood pressure difference (IASBPD) and other cardiovascular risk factors. To identify what factors are associated with this difference in a general population. The study subjects were 1426 individuals. The BP was measured simultaneously in both arms by VP1000 vascular profiler (Omron Colin, Japan). The inter-arm BP difference was expressed as the absolute difference (|R - L|). The various risk factors, ba-PWV, carotid IMT and plaque were compared between IASBPD more than 10mmHg group and IASBPD less than 10mmHg group. The relationship between IASBPD more than 10mmHg and various cardiovascular risk factors were analyzed by multivariate logistic analysis. Left upper limb systolic blood pressure was higher than the right upper limb, while right upper limb diastolic pressure was higher than the left upper limb. The prevalence of hypertension was higher in IASBPD increasing group than normal group (40.5% vs 22.6%, p blood pressure were also higher in IASBPD increasing group(p blood pressure, BMI and ABI independently, which may partly explain the mechanism that increasing IASBPD is associated with cardiovascular disease.

  17. The Relationship Between the Metabolic Syndrome and Systolic Inter-Arm Systolic Blood Pressure Difference in Korean Adults.

    Science.gov (United States)

    Yoon, Hyun; Choi, Seong Woo; Park, Jong; Ryu, So Yeon; Han, Mi Ah; Kim, Gwang Seok; Kim, Sung Gil; Oh, Hye Jong; Choi, Cheol Won

    2015-10-01

    The present study was conducted to assess the relationship between metabolic syndrome and systolic inter-arm blood pressure difference (sIAD) in Korean adults. This study included 410 adults (235 males, 175 females) who were over 30 years old and had undergone a health check from July to December in 2013. The incidence of high sIAD and metabolic syndrome were 23.4% and 23.2%, respectively. Key study results were as follows: First, the sIAD levels increased significantly with an increase in metabolic syndrome score (p<0.001), shown by sIAD levels after adjusted the variables that affect sIAD levels (age, gender, smoking, drinking, exercising, total cholesterol, and body mass index). These were 4.6±0.7 mmHg for metabolic syndrome score (MSS) 0; 5.8±0.5 mmHg for MSS 1; 6.2±0.6 mmHg for MSS 2, 9.2±0.8 mmHg for MSS 3; and 9.9±1.2 mmHg for MSS ≥4 (p<0.001). Second, the sIAD level of the metabolic syndrome group (9.3±0.7 mmHg) was significantly higher (p<0.001) than for the nonmetabolic syndrome group (5.7±0.3 mmHg). In conclusion, metabolic syndrome and an increased number of its components are associated with the sIAD levels in Korean adults.

  18. Cholecalciferol treatment to reduce blood pressure in older patients with isolated systolic hypertension: the VitDISH randomized controlled trial.

    Science.gov (United States)

    Witham, Miles D; Price, Rosemary J G; Struthers, Allan D; Donnan, Peter T; Messow, Claudia-Martina; Ford, Ian; McMurdo, Marion E T

    2013-10-14

    Observational data link low 25-hydroxyvitamin D levels to both prevalent blood pressure and incident hypertension. No clinical trial has yet examined the effect of vitamin D supplementation in isolated systolic hypertension, the most common pattern of hypertension in older people. To test whether high-dose, intermittent cholecalciferol supplementation lowers blood pressure in older patients with isolated systolic hypertension. Parallel group, double-blind, placebo-controlled randomized trial. Primary care clinics and hospital clinics. Patients 70 years and older with isolated systolic hypertension (supine systolic blood pressure >140 mm Hg and supine diastolic blood pressure blood pressure, 24-hour blood pressure, arterial stiffness, endothelial function, cholesterol level, insulin resistance, and b-type natriuretic peptide level during 12 months. A total of 159 participants were randomized (mean age, 77 years). Mean baseline office systolic blood pressure was 163/78 mm Hg. Mean baseline 25-hydroxyvitamin D level was 18 ng/mL. 25-Hydroxyvitamin D levels increased in the treatment group compared with the placebo group (+8 ng/mL at 1 year, P blood pressure (−1 [−6 to 4]/−2 [−4 to 1] mm Hg at 3 months and 1 [−2 to 4]/0 [−2 to 2] mm Hg overall treatment effect). No significant treatment effect was evident for any of the secondary outcomes (24-hour blood pressure, arterial stiffness, endothelial function, cholesterol level, glucose level, and walking distance). There was no excess of adverse events in the treatment group, and the total number of falls was nonsignificantly lower in the group receiving vitamin D (36 vs 46, P = .24). Vitamin D supplementation did not improve blood pressure or markers of vascular health in older patients with isolated systolic hypertension. isrctn.org Identifier: ISRCTN92186858.

  19. Admission Systolic Blood Pressure Predicts the Number of Blood Pressure Medications at Discharge in Patients With Primary Intracerebral Hemorrhage.

    Science.gov (United States)

    Khawaja, Ayaz M; Shiue, Harn; Boehme, Amelia K; Albright, Karen C; Venkatraman, Anand; Kumar, Gyanendra; Lyerly, Michael J; Hays-Shapshak, Angela; Mirza, Maira; Gropen, Toby I; Harrigan, Mark R

    2018-03-01

    Control of systolic blood pressure (SBP) after primary intracerebral hemorrhage improves outcomes. Factors determining the number of blood pressure medications (BPM) required for goal SBP<160 mm Hg at discharge are unknown. We hypothesized that higher admission-SBPs require a greater number of BPM for goal discharge-SBP<160 mm Hg, and investigated factors influencing this goal. We conducted a retrospective review of 288 patients who presented with primary intracerebral hemorrhage. Admission-SBP was obtained. Primary outcome was the number of BPM at discharge. Comparison was made between patients presenting with and without a history of hypertension, and patients discharged on <3 and ≥3 BPM. Patients with hypertension history had a higher median admission-SBP compared with those without (180 vs. 157 mm Hg, P=0.0001). In total, 133 of 288 (46.2%) patients were discharged on <3 BPM; 155/288 (53.8%) were discharged on ≥3 BPM. Hypertension history (P<0.0001) and admission-SBP (P<0.0001) predicted the number of BPM at discharge. In patients without hypertension history, every 10 mm Hg increase in SBP resulted in an absolute increase of 0.5 BPM at discharge (P=0.0011), whereas in those with hypertension, the absolute increase was 1.3 BPM (P=0.0012). In comparison with patients discharged on <3 BPM, patients discharged on ≥3 BPM were more likely to have a higher median admission-SBP, be younger in age, belong to the African-American race, have a history of diabetes, have higher median admission-National Institutes of Health Stroke Scale and modified Rankin Scale of 4 to 5 at discharge. An understanding of the factors influencing BPM at discharge may help clinicians better optimize blood pressure control both before and after discharge.

  20. Hypertension Treatment and Concern About Falling: Baseline Data from the Systolic Blood Pressure Intervention Trial.

    Science.gov (United States)

    Berlowitz, Dan R; Breaux-Shropshire, Tonya; Foy, Capri G; Gren, Lisa H; Kazis, Lewis; Lerner, Alan J; Newman, Jill C; Powell, James R; Riley, William T; Rosman, Robert; Wadley, Virginia G; Williams, Julie A

    2016-11-01

    To determine the extent of concern about falling in older adults with hypertension, whether lower blood pressure (BP) and greater use of antihypertensive medications are associated with greater concern about falling, and whether lower BP has a greater effect on concern about falling in older and more functionally impaired individuals. Secondary analysis involving cross-sectional study of baseline characteristics of participants enrolled in the Systolic Blood Pressure Intervention Trial (SPRINT). Approximately 100 outpatient sites. SPRINT enrollees aged 50 and older (mean age 69) diagnosed with hypertension (N = 2,299). Concern about falling was determined using the shortened version of the Falls Efficacy Scale International as measured at the baseline examination. Mild concern about falling was present in 29.3% of participants and moderate to severe concern in 17.9%. Neither low BP (systolic BPconcern about falling (P > .10). Participants with moderate to severe concern about falling were taking significantly more antihypertensive medications than those with mild or no concern. After adjusting for baseline characteristics, no associations were evident between BP, medications, and concern about falling. Results were similar in older and younger participants; interactions between BP and age and functional status were not significantly associated with concern about falling. Although concern about falling is common in older adults with hypertension, it was not found to be associated with low BP or use of more antihypertensive medications in baseline data from SPRINT. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  1. Perceived Social Standing, Medication Nonadherence, and Systolic Blood Pressure in the Rural South.

    Science.gov (United States)

    Cummings, Doyle M; Wu, Jia-Rong; Cene, Crystal; Halladay, Jacquie; Donahue, Katrina E; Hinderliter, Alan; Miller, Cassandra; Garcia, Beverly; Penn, Dolly; Tillman, Jim; DeWalt, Darren

    2016-01-01

    Little is known about how perceived social standing versus traditional socioeconomic characteristics influence medication adherence and blood pressure (BP) among African American and white patients with hypertension in the rural southeastern United States. Perceived social standing, socioeconomic characteristics, self-reported antihypertensive medication adherence, and BP were measured at baseline in a cohort of rural African American and white patients (n = 495) with uncontrolled hypertension attending primary care practices. Multivariate models examined the relationship of perceived social standing and socioeconomic indicators with medication adherence and systolic BP. Medication nonadherence was reported by 40% of patients. Younger age [β = 0.20; P = .001], African American race [β = -0.30; P = .03], and lower perceived social standing [β = 0.08; P = .002] but not sex or traditional socioeconomic characteristics including education and household income, were significantly associated with lower medication adherence. Race-specific analyses revealed that this pattern was limited to African Americans and not observed in whites. In stepwise modeling, older age [β = 0.57, P = .001], African American race [β = 4.4; P = .03], and lower medication adherence [β = -1.7, P = .01] but not gender, education, or household income, were significantly associated with higher systolic BP. Lower perceived social standing and age, but not traditional socioeconomic characteristics, were significantly associated with lower medication adherence in African Americans. Lower medication adherence was associated with higher systolic BP. These findings suggest the need for tailored, culturally relevant medication adherence interventions in rural communities. © 2015 National Rural Health Association.

  2. On-Treatment Blood Pressure and Cardiovascular Outcomes in Older Adults With Isolated Systolic Hypertension.

    Science.gov (United States)

    Yano, Yuichiro; Rakugi, Hiromi; Bakris, George L; Lloyd-Jones, Donald M; Oparil, Suzanne; Saruta, Takao; Shimada, Kazuyuki; Matsuoka, Hiroaki; Imai, Yutaka; Ogihara, Toshio

    2017-02-01

    Our aim was to assess optimal on-treatment blood pressure (BP) at which cardiovascular disease (CVD) and all-cause mortality risks are minimized in Japanese older adults with isolated systolic hypertension. We used data from the VALISH study (Valsartan in Elderly Isolated Systolic Hypertension) that recruited older adults (n=3035; mean age, 76 years) with systolic BP (SBP) of ≥160 mm Hg and diastolic BP of secondary outcome being all-cause mortality. Cox proportional hazards models were used to assess the CVD risk for each group. Over a median 3-year follow-up (8022 person-years), 93 CVD events and 52 deaths occurred. Using the on-treatment SBP of 130 to hypertension, SBP in the range between 130 and 144 mm Hg was associated with minimal adverse outcomes and a reduction in CVD and all-cause mortality. The BP range will need to be confirmed in randomized controlled trials. URL: https://www.clinicaltrials.gov. Unique identifier: NCT00151229. © 2017 American Heart Association, Inc.

  3. NSAID-antihypertensive drug interactions: Which outpatients are at risk for a rise in systolic blood pressure?

    NARCIS (Netherlands)

    Floor-Schreudering, Annemieke; De Smet, Peter Agm; Buurma, Henk; Kramers, Cornelis; Tromp, P. Chris; Belitser, Svetlana V.; Bouvy, Marcel L.

    2015-01-01

    Background: Management guidelines for drug-drug interactions between non-steroidal anti-inflammatory drugs (NSAIDs) and antihypertensives recommend blood pressure monitoring in hypertensive patients. We measured the short-term effect of initiating NSAIDs on systolic blood pressure (SBP) in users of

  4. NSAID-antihypertensive drug interactions: which outpatients are at risk for a rise in systolic blood pressure?

    NARCIS (Netherlands)

    Floor-Schreudering, A.; Smet, P.A.G.M. de; Buurma, H.; Kramers, C.; Tromp, P.C.; Belitser, S.V.; Bouvy, M.L.

    2015-01-01

    BACKGROUND: Management guidelines for drug-drug interactions between non-steroidal anti-inflammatory drugs (NSAIDs) and antihypertensives recommend blood pressure monitoring in hypertensive patients. We measured the short-term effect of initiating NSAIDs on systolic blood pressure (SBP) in users of

  5. 2014 Hypertension Guideline: Recommendation for a Change in Goal Systolic Blood Pressure

    Science.gov (United States)

    Handler, Joel

    2015-01-01

    The 2014 Kaiser Permanente Care Management Institute National Hypertension Guideline was developed to assist primary care physicians and other health care professionals in the outpatient treatment of uncomplicated hypertension in adult men and nonpregnant women aged 18 years and older. The new guideline reflects general acceptance, with minor modifications, of the “Evidence-Based Guideline” report by the panel members appointed to the National Heart, Lung, and Blood Institute 8th Joint National Committee. A major practice change is the recommendation for goal systolic blood pressure less than 150 mmHg in patients aged 60 years and older who are treated for hypertension in the absence of diabetes or chronic kidney disease. This article describes the reasons for, evidence for, and consequences of the change, and is followed by the National Guidelines handout. PMID:26057683

  6. Validity of Some Anthropometric Indicators in the Prediction of High Systolic Blood Pressure among Indian Adolescents

    Directory of Open Access Journals (Sweden)

    Shobha Rao

    2008-01-01

    Full Text Available Background In view of the increasing prevalence of obesity in children, it is necessary to investigate the relative performance of different indicators used for its assessment and health consequences. Objectives To examine concordance between various indicators used for assessing obesity among adolescents and to examine their ability to predict risk of high systolic blood pressure. Design Cross-sectional study, from two schools catering to affluent class. Subjects Children in age 9–16 yr (n = 1146 boys and 1036 girls. Measurements Body weight, height, skinfold thickness at triceps (TSFT and body fat percent by trained investigators and blood pressure measurement by a pediatrician using sphygmomanometer. Results Prevalence of overweight was lowest with criterion of TSFT (11.7% in boys; 7.6% in girls and was highest using criterion of body fat percent (53.7% in boys and 28.4% in girls. Body mass index (BMI had high significant correlation with each of the indicator and with systolic blood pressure (SBP as well, in both sexes. All the indicators with conventional cut offs showed poor sensitivity for predicting high SBP. However, receiver operating characteristics (ROC cut-offs improved sensitivity considerably, but the values were much lower compared to conventional cut-offs. Conclusions There is considerable disparity in the estimates of overweight children obtained by different indicators. Lower values of ROC cut-offs highlights the need for population specific customized classification systems for assessing obesity in view of the probable population differences in relative risks of non-communicable adult diseases.

  7. Melodic algorithms for pulse oximetry to allow audible discrimination of abnormal systolic blood pressures.

    Science.gov (United States)

    Chima, Ranjit S; Ortega, Rafael; Connor, Christopher W

    2014-12-01

    An anesthesiologist must remain vigilant of the patient's clinical status, incorporating many independent physiological measurements. Oxygen saturation and heart rate are represented by continuous audible tones generated by the pulse oximeter, a mandated monitoring device. Other important clinical parameters--notably blood pressure--lack any audible representation beyond arbitrarily-configured threshold alarms. Attempts to introduce further continuous audible tones have apparently foundered; the complexity and interaction of these tones have exceeded the ability of clinicians to interpret them. Instead, we manipulate the tonal and rhythmic structure of the accepted pulse oximeter tone pattern melodically. Three melodic algorithms were developed to apply tonal and rhythmic variations to the continuous pulse oximeter tone, dependent on the systolic blood pressure. The algorithms distort the original audible pattern minimally, to facilitate comprehension of both the underlying pattern and the applied variations. A panel of anesthesia practitioners (attending anesthesiologists, residents and nurse anesthetists) assessed these algorithms in characterizing perturbations in cardiopulmonary status. Twelve scenarios, incorporating combinations of oxygen desaturation, bradycardia, tachycardia, hypotension and hypertension, were tested. A rhythmic variation in which additional auditory information was conveyed only at halftime intervals, with every other "beat" of the pulse oximeter, was strongly favored. The respondents also strongly favored the use of musical chords over single tones. Given three algorithms of tones embedded in the pulse oximeter signal, anesthesiologists preferred a melodic tone to signal a significant change in blood pressure.

  8. Measuring systolic arterial blood pressure. Possible errors from extension tubes or disposable transducer domes.

    Science.gov (United States)

    Rothe, C F; Kim, K C

    1980-11-01

    The purpose of this study was to evaluate the magnitude of possible error in the measurement of systolic blood pressure if disposable, built-in diaphragm, transducer domes or long extension tubes between the patient and pressure transducer are used. Sinusoidal or arterial pressure patterns were generated with specially designed equipment. With a long extension tube or trapped air bubbles, the resonant frequency of the catheter system was reduced so that the arterial pulse was amplified as it acted on the transducer and, thus, gave an erroneously high systolic pressure measurement. The authors found this error to be as much as 20 mm Hg. Trapped air bubbles, not stopcocks or connections, per se, lead to poor fidelity. The utility of a continuous catheter flush system (Sorenson, Intraflow) to estimate the resonant frequency and degree of damping of a catheter-transducer system is described, as are possibly erroneous conclusions. Given a rough estimate of the resonant frequency of a catheter-transducer system and the magnitude of overshoot in response to a pulse, the authors present a table to predict the magnitude of probable error. These studies confirm the variability and unreliability of static calibration that may occur using some safety diaphragm domes and show that the system frequency response is decreased if air bubbles are trapped between the diaphragms. The authors conclude that regular procedures should be established to evaluate the accuracy of the pressure measuring systems in use, the transducer should be placed as close to the patient as possible, the air bubbles should be assiduously eliminated from the system.

  9. Recruitment strategies and challenges in a large intervention trial: Systolic Blood Pressure Intervention Trial (SPRINT)

    Science.gov (United States)

    Ramsey, Thomas M; Snyder, Joni K; Lovato, Laura C; Roumie, Christianne L; Glasser, Steven P; Cosgrove, Nora M; Olney, Christine M; Tang, Rocky H; Johnson, Karen C; Still, Carolyn H; Gren, Lisa H; Childs, Jeffery C; Crago, Osa L; Summerson, John H; Walsh, Sandy M; Perdue, Letitia H; Bankowski, Denise M; Goff, David C

    2016-01-01

    Background The Systolic Blood Pressure Intervention Trial (SPRINT) is a multicenter, randomized clinical trial of 9,361 participants with hypertension who are ≥ 50 years old. The trial is designed to evaluate the effect of intensive systolic blood pressure control (systolic blood pressure goal recruitment strategies and lessons learned during recruitment of the SPRINT cohort and five targeted participant subgroups: pre-existing cardiovascular disease, pre-existing chronic kidney disease, age ≥ 75 years, women, and minorities. Methods In collaboration with the National Institutes of Health Project Office and SPRINT Coordinating Center, five Clinical Center Networks oversaw clinical site selection, recruitment, and trial activities. Recruitment began November 8, 2010 and ended March 15, 2013 (about 28 months). Various recruitment strategies were used, including mass mailing, brochures, referrals from healthcare providers or friends, posters, newspaper ads, radio ads, and electronic medical record searches. Results Recruitment was scheduled to last 24 months to enroll a target of 9,250 participants; in just over 28 months, the trial enrolled 9,361 participants. The trial screened 14,692 volunteers, with 33% of initial screens originating from the use of mass mailing lists. Screening results show that participants also responded to recruitment efforts through referral by SPRINT staff, healthcare providers, or friends (45%); brochures or posters placed in clinic waiting areas (15%); and television, radio, newspaper, internet ads, or toll-free numbers (8%). The overall recruitment yield (number randomized /number screened) was 64% (9,361 randomized /14,692 screened), 77% for those with cardiovascular disease, 79% for those with chronic kidney disease, 70% for those age ≥ 75 years, 55% for women, and 61% for minorities. As recruitment was observed to lag behind expectations, additional clinics were included and inclusion criteria were broadened, keeping event rates

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

    Science.gov (United States)

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

    2011-02-01

    The combination of benazepril plus amlodipine was shown to be more effective than benazepril plus hydrochlorothiazide in reducing cardiovascular events in the Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH) trial. There was a small difference in clinic systolic blood pressure between the treatment arms favoring benazepril plus amlodipine. Ambulatory blood pressure monitoring provides a more rigorous estimate of blood pressure effects. A subset of 573 subjects underwent ambulatory blood pressure monitoring during year 2. Readings were obtained every 20 minutes during a 24-hour period. Between-treatment differences (benazepril plus amlodipine versus benazepril plus hydrochlorothiazide) in mean values were analyzed using ANOVA. Treatment comparisons with respect to categorical variables were made using Pearson's χ². At year 2, the treatment groups did not differ significantly in 24-hour mean daytime or nighttime blood pressures (values of 123.9, 125.9, and 118.1 mm Hg for benazepril plus amlodipine group versus 122.3, 124.1, and 116.9 for the benazepril plus hydrochlorothiazide group), with mean between-group differences of 1.6, 1.8, and 1.2 mm Hg, respectively. Blood pressure control rates (24-hour mean systolic blood pressure <130 mm Hg on ambulatory blood pressure monitoring) were greater than 80% in both groups. Nighttime systolic blood pressure provided additional risk prediction after adjusting for the effects of drugs. The 24-hour blood pressure control was similar in both treatment arms, supporting the interpretation that the difference in cardiovascular outcomes favoring a renin angiotensin system blocker combined with amlodipine rather than hydrochlorothiazide shown in the ACCOMPLISH trial was not caused by differences in blood pressure, but instead intrinsic properties (metabolic or hemodynamic) of the combination therapies.

  11. Higher ambulatory systolic blood pressure independently associated with enlarged perivascular spaces in basal ganglia.

    Science.gov (United States)

    Yang, Shuna; Yuan, Junliang; Zhang, Xiaoyu; Fan, Huimin; Li, Yue; Yin, Jiangmei; Hu, Wenli

    2017-09-01

    Enlarged perivascular spaces (EPVS) have been identified as a marker of cerebral small vessel diseases (CSVD). Ambulatory blood pressure (ABP) is the strongest predictor of hypertension-related brain damage. However, the relationship between ABP levels and EPVS is unclear. This study aimed to investigate the association between ABP levels and EPVS by 24-hour ambulatory blood pressure monitoring (ABPM). We prospectively recruited inpatients for physical examinations in our hospital from May 2013 to Jun 2016. 24-hour ABPM data and cranial magnetic resonance imaging information were collected. EPVS in basal ganglia (BG) and centrum semiovale (CSO) were identified and classified into three categories by the severity. White matter hyperintensities were scored by Fazekas scale. Spearman correlation analysis and multiple logistic regression analysis were used to determine the relationship between ABP levels and EPVS. A total of 573 subjects were enrolled in this study. 24-hour, day and night systolic blood pressure (SBP) levels were positively related to higher numbers of EPVS in BG (24-hour SBP: r = 0.23, p blood pressure (DBP) levels increased with an increasing degree of EPVS in CSO (p = 0.04 and 0.049, respectively). But the association disappeared after adjusting for confounders. Spearman correlation analysis indicated that ABP levels were not associated with higher numbers of EPVS in CSO (p > 0.05). DBP levels were not independently associated with the severity of EPVS in BG and CSO. Higher SBP levels were independently associated with EPVS in BG, but not in CSO, which supported EPVS in BG to be a marker of CSVD. Pathogenesis of EPVS in BG and CSO might be different.

  12. Non-constrained monitoring of systolic blood pressure on a weighing scale

    International Nuclear Information System (INIS)

    Shin, Jae Hyuk; Lee, Kang Moo; Park, Kwang Suk

    2009-01-01

    In this study, we developed a novel technique for estimating non-constrained and cuffless blood pressure (BP) that was based on electrocardiogram (ECG) and ballistocardiogram (BCG). The BCG was non-invasively measured using a common electronic weighing scale when a subject was standing on it. The ECG was measured using three different methods: on the chest using Ag/AgCl electrodes, on the hands using dry electrodes and on the feet also using dry electrodes. For a BP correlated parameter, a time interval parameter, which was defined as the time difference between the ECG R-peak and BCG J-peak, was employed for evaluating and estimating beat-to-beat BP. Under a BP varying experiment with a Valsalva manoeuvre, the R–J intervals were extracted at every beat cycle and a systolic blood pressure (SBP) estimation equation was established using linear regression analysis for each subject. In the case of feet delivered ECG (F-ECG), an ensemble average technique synchronized at the BCG J-peak point was applied to extract the ECG signal from the feet. The performance of the proposed method was evaluated using Finapres, a non-invasive blood pressure measurement system, as a reference BP signal, and a scatter plot was used to find the regression line between the reference values and estimated BPs. A moving-window averaging technique was applied to remove the high-frequency noise in the R–J intervals and was applied to enhance the accuracy of the SBP estimation. For all individuals, the estimated SBP was similar to the measured SBP with a reliable correlation, which makes the proposed method suitable for use in a home healthcare system to monitor blood pressure on a weighing scale at the same time as measuring weight

  13. Environmental lead exposure is associated with visit-to-visit systolic blood pressure variability in the US adults.

    Science.gov (United States)

    Faramawi, Mohammed F; Delongchamp, Robert; Lin, Yu-Sheng; Liu, Youcheng; Abouelenien, Saly; Fischbach, Lori; Jadhav, Supriya

    2015-04-01

    The association between environmental lead exposure and blood pressure variability, an important risk factor for cardiovascular disease, is unexplored and unknown. The objective of the study was to test the hypothesis that lead exposure is associated with blood pressure variability. American participants 17 years of age or older from National Health and Nutrition Examination Survey III were included in the analysis. Participants' blood lead concentrations expressed as micrograms per deciliter were determined. The standard deviations of visit-to-visit systolic and diastolic blood pressure were calculated to determine blood pressure variability. Multivariable regression analyses adjusted for age, gender, race, smoking and socioeconomic status were employed. The participants' mean age and mean blood lead concentration were 42.72 years and 3.44 mcg/dl, respectively. Systolic blood pressure variability was significantly associated with environmental lead exposure after adjusting for the effect of the confounders. The unadjusted and adjusted means of visit-to-visit systolic blood pressure variability and the β coefficient of lead exposure were 3.44, 3.33 mcg/dl, β coefficient = 0.07, P variability. Screening adults with fluctuating blood pressure for lead exposure could be warranted.

  14. Ratio of Systolic Blood Pressure to Right Atrial Pressure, a Novel Marker to Predict Morbidity and Mortality in Acute Systolic Heart Failure.

    Science.gov (United States)

    Omar, Hesham R; Charnigo, Richard; Guglin, Maya

    2017-04-01

    Congestion is the main contributor to heart failure (HF) morbidity and mortality. We assessed the combined role of congestion and decreased forward flow in predicting morbidity and mortality in acute systolic HF. The Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness trial data set was used to determine if the ratio of simultaneously measured systolic blood pressure (SBP)/right atrial pressure (RAP) on admission predicted HF rehospitalization and 6-month mortality. One hundred ninety-five patients (mean age 56.5 years, 75% men) who received pulmonary artery catheterization were studied. The RAP, SBP, and SBP/RAP had an area under the curve (AUC) of 0.593 (p = 0.0205), 0.585 (p = 0.0359), and 0.621 (p = 0.0026), respectively, in predicting HF rehospitalization. The SBP/RAP was a superior marker of HF rehospitalization compared with RAP alone (difference in AUC 0.0289, p = 0.0385). The optimal criterion of SBP/RAP AUC 0.622, p = 0.0108, and a cut-off value of SBP/RAP <8 had a sensitivity of 61.9% and specificity 64.1% in predicting mortality. Multivariate analysis showed that an SBP/RAP <11 independently predicted rehospitalization for HF (estimated odds ratio 3.318, 95% confidence interval 1.692 to 6.506, p = 0.0005) and an SBP/RAP <8 independently predicted mortality (estimated hazard ratio 2.025, 95% confidence interval 1.069 to 3.833, p = 0.030). In conclusion, SBP/RAP ratio is a marker that identifies a spectrum of complications after hospitalization of patients with decompensated systolic HF, starting with increased incidence of HF rehospitalization at SBP/RAP <11 to increased mortality with SBP/RAP <8. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Retinopathy of Prematurity Is Associated with Increased Systolic Blood Pressure in Adults Who Were Born Preterm.

    Science.gov (United States)

    Kistner, Anna; Jacobson, Lena; Östergren, Jan; Hellström, Ann

    2017-01-01

    Adults born preterm are at risk of developing cardiovascular morbidities. The aim of this study was to evaluate the relationship between retinopathy of prematurity (ROP) and blood pressure (BP) and salivary cortisol levels during adulthood. Sixty-nine subjects (mean age 22.6 years) were included. Subjects were adults who were: (a) ex-preterm infants with severe ROP (n = 22), born at gestational age (GA) <30 weeks with a birth weight (BW) <1,000 g, (b) ex-preterm infants with no/mild ROP (n = 21), born at GA <28 weeks with a BW <1,000 g, or (c) full-term controls (n = 26). Anthropometric data, office BP, ambulatory BP, and morning and evening salivary cortisol were analyzed. As adults, ex-preterm infants with severe ROP had on average 7.4 mm Hg higher systolic office BP than those with no/mild ROP (p = 0.019) and controls (p = 0.007). A high cortisol level, tall height, and severe ROP were independent predictors of higher ambulatory systolic BP during adulthood in forward stepwise regression analysis, independent of GA. Our results indicate that preterm infants with severe abnormal retinal vascular development during the neonatal period may be at an increased risk for increased BP during adulthood. We found no differences between those with no/mild ROP as infants and controls with regard to BP data. © 2017 The Author(s) Published by S. Karger AG, Basel.

  16. Prevalence and implications of a difference in systolic blood pressure between one arm and the other in vascular surgical patients.

    Science.gov (United States)

    Durrand, J W; Batterham, A M; O'Neill, B R; Danjoux, G R

    2013-12-01

    Inter-arm differences in blood pressure may confound haemodynamic management in vascular surgery. We evaluated 898 patients in the vascular pre-assessment clinic to determine the prevalence of inter-arm differences in systolic and mean arterial pressure, quantify the consequent risk of clinical error in siting monitoring peri-operatively and evaluate systolic inter-arm difference as a predictor of all-cause mortality (median follow-up 49 months). The prevalence of a systolic inter-arm difference ≥ 15 mmHg was 26% (95% CI 23-29%). The prevalence of an inter-arm mean arterial pressure difference ≥ 10 mmHg was 26% (95% CI 23-29%) and 11% (95% CI 9-13%) for a difference ≥ 15 mmHg. Monitoring could be erroneously sited in an arm reading lower for systolic pressure once in every seven to nine patients. The hazard ratio for a systolic inter-arm difference ≥ 15 mmHg vs arm blood pressure differences are common in this population, with a high potential for monitoring errors. Systolic inter-arm difference was not associated with medium-term mortality. [Correction added on 17 October 2013, after first online publication: In the Summary the sentence beginning 'We evaluated 898 patients' was corrected from (median (IQR [range]) follow-up 49 months) to read (median follow up 49 months)]. © 2013 The Association of Anaesthetists of Great Britain and Ireland.

  17. Heart Rate and Systolic Blood Pressure Variability on Recently Diagnosed Diabetics

    Directory of Open Access Journals (Sweden)

    Anaclara Michel-Chávez

    2015-01-01

    Full Text Available Background: Diabetes affects approximately 250 million people in the world. Cardiovascular autonomic neuropathy is a common complication of diabetes that leads to severe postural hypotension, exercise intolerance, and increased incidence of silent myocardial infarction. Objective: To determine the variability of heart rate (HR and systolic blood pressure (SBP in recently diagnosed diabetic patients. Methods: The study included 30 patients with a diagnosis of type 2 diabetes of less than 2 years and 30 healthy controls. We used a Finapres® device to measure during five minutes beat-to-beat HR and blood pressure in three experimental conditions: supine position, standing position, and rhythmic breathing at 0.1 Hz. The results were analyzed in the time and frequency domains. Results: In the HR analysis, statistically significant differences were found in the time domain, specifically on short-term values such as standard deviation of NN intervals (SDNN, root mean square of successive differences (RMSSD, and number of pairs of successive NNs that differ by more than 50 ms (pNN50. In the BP analysis, there were no significant differences, but there was a sympathetic dominance in all three conditions. The baroreflex sensitivity (BRS decreased in patients with early diabetes compared with healthy subjects during the standing maneuver. Conclusions: There is a decrease in HR variability in patients with early type 2 diabetes. No changes were observed in the BP analysis in the supine position, but there were changes in BRS with the standing maneuver, probably due to sympathetic hyperactivity.

  18. Association of Interarm Systolic Blood Pressure Difference with Atherosclerosis and Left Ventricular Hypertrophy

    Science.gov (United States)

    Su, Ho-Ming; Lin, Tsung-Hsien; Hsu, Po-Chao; Chu, Chun-Yuan; Lee, Wen-Hsien; Chen, Szu-Chia; Lee, Chee-Siong; Voon, Wen-Chol; Lai, Wen-Ter; Sheu, Sheng-Hsiung

    2012-01-01

    An interarm systolic blood pressure (SBP) difference of 10 mmHg or more have been associated with peripheral artery disease and adverse cardiovascular outcomes. We investigated whether an association exists between this difference and ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), and echocardiographic parameters. A total of 1120 patients were included in the study. The bilateral arm blood pressures were measured simultaneously by an ABI-form device. The values of ABI and baPWV were also obtained from the same device. Clinical data, ABIdifference ≥10 mmHg were compared and analyzed. We performed two multivariate forward analyses for determining the factors associated with an interarm SBP difference ≥10 mmHg [model 1: significant variables in univariate analysis except left ventricular mass index (LVMI); model 2: significant variables in univariate analysis except ABIdifference ≥10 mmHg. Female, hypertension, and high body mass index were also associated with an interarm SBP difference ≥10 mmHg. Our study demonstrated that ABIdifference of 10 mmHg or more. Detection of an interarm SBP difference may provide a simple method of detecting patients at increased risk of atherosclerosis and left ventricular hypertrophy. PMID:22927905

  19. Mozart, but not the Beatles, reduces systolic blood pressure in patients with myocardial infarction.

    Science.gov (United States)

    Gruhlke, Luiza Carolina; Patrício, Marcelo Coelho; Moreira, Daniel Medeiros

    2015-12-01

    Music reduces systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) in various clinical situations, but it is unclear whether these changes occur in post-infarction patients. The aim is to evaluate the effects of music on patients with acute myocardial infarction (MI). We evaluated patients with MI and we measured SBP, DBP, HR and double product (DP) two times before the intervention and one time every fifteen minutes with an ambulatory blood pressure monitor. We divided the patients into 3 groups: a group listening to music by Mozart; another listening to a Beatles collection and a third one listening to the radio news. Outcomes were the change in mean SBP, DBP, HR and DP with intervention. We enrolled 60 patients (20 in each group). SBP was significantly reduced in the Mozart group (variation of –7.2 ± 8.5 mmHg) compared to the Beatles group (–1.3 ± 6.2 mmHg) (P = 0.021) and the radio news group (0.6 ± 8.7 mmHg) (P = 0.003). DP was significantly reduced in the Mozart group compared with the News group (–668.5 ± 773.2 vs 31.6 ± 722.1 mmHg) (P = 0.006). There were no differences in DBP and HR. Patients with MI who listened Mozart had a reduction in SBP and DP compared to those who listened to the Beatles or the news.

  20. Interarm systolic blood pressure difference is associated with myocardial injury after noncardiac surgery.

    Science.gov (United States)

    Belen, Erdal; Ozal, Ender; Bayyigit, Akif; Gunaydın, Senay; Helvacı, Aysen

    Myocardial injury after non-cardiac surgery (MINS) is closely related to increased cardiovascular mortality. To evaluate the relationship between MINS and interarm systolic blood pressure difference (IASBPD), which has previously been shown to correlate with the frequency of cardiovascular events and arterial arteriosclerotic processes. This observational, single-centre cohort study included 240 consecutive noncardiac surgery patients aged ≥ 45 years. Simultaneous blood pressure recordings were taken preoperatively and IASBPD was calculated. Patients' electrocardiography recordings and high sensitivity cardiac troponin T (hscTnT) levels were obtained for a period of three days postoperatively. Postoperatively, 27 (11.3%) patients were found to have MINS when hscTnT ≥ 14 ng/L was taken as a cut-off value. IASBPD > 10 mm Hg was found in 44 (18.3%) patients. When IASBPD was accepted to be a continuous variable, there was a higher IASBPD value in the MINS group (9.4 ± 5.0 vs. 4.5 ± 3.8, p 10 mm Hg and those not, exaggerate IASBPD was found to be more frequent in patients developing MINS (16 [59.3%] vs. 28 [13.1%], respectively, p 10 mm Hg to be independently associated with the development of MINS (OR: 30.82; CI: 9.14-103.98; p AUC = 0.79; 95% CI 0.71-0.87). Increased IASBPD is closely related to development of MINS. The preoperative measurement of blood pressure from both arms may be an important and easy to use clinical tool in determining cardiovascular risk.

  1. Phenomenon of declining blood pressure in elderly - high systolic levels are undervalued with Korotkoff method

    Directory of Open Access Journals (Sweden)

    Elmståhl Sölve

    2011-10-01

    Full Text Available Abstract Background Systolic blood pressure (SBP decline has been reported in octogenarians. The aim was to study if it could be observed while measuring SBP with two methods: Korotkoff (K-BP and Strain-Gauge-Finger-Pletysmography (SG-BP, and which of them were more reliable in expressing vascular burden. Methods A cohort of 703 men from a population of Malmö, Sweden, were included in "Men born in 1914-study" and followed-up at ages: 68 and 81 years. 176 survivors were examined with K-BP and SG-BP at both ages, and 104 of them with Ambulatory Blood Pressure at age 81/82. Ankle Brachial Index (ABI was measured on both occasions, and Carotid Ultrasound at age 81. Results From age 68 to 81, mean K-BP decreased in the cohort with mean 8.3 mmHg, while SG-BP increased with 13.4 mmHg. K-BP decreased in 55% and SG-BP in 31% of the subjects. At age 81, K-BP was lower than SG-BP in 72% of subjects, and correlated to high K-BP at age 68 (r = --.22; p Conclusion In contrast to K-BP, values of SG-BP in octogenarians strongly correlated with Ambulatory Blood Pressure. The SG-BP decline in the last decade was rare, and increasing SG-BP better than K-BP reflected advanced atherosclerosis. It should be aware, that K-BP underdetected 46% of subjects with SG-BP equal/higher than 140 mmHg at age 81, which may lead to biased associations with risk factors due to differential misclassification by age.

  2. Blood Pressure, Sexual Activity, and Dysfunction in Women With Hypertension: Baseline Findings From the Systolic Blood Pressure Intervention Trial (SPRINT).

    Science.gov (United States)

    Foy, Capri G; Newman, Jill C; Berlowitz, Dan R; Russell, Laurie P; Kimmel, Paul L; Wadley, Virginia G; Thomas, Holly N; Lerner, Alan J; Riley, William T

    2016-09-01

    Sexual function, an important component of quality of life, is gaining increased research and clinical attention in older women with hypertension. To assess the association between systolic blood pressure (SBP) and other variables, and sexual activity and sexual dysfunction in hypertensive women. Baseline analysis of 635 women participants of a larger randomized clinical trial of 9361 men and women. Self-reported sexual activity (yes/no), and sexual function using the Female Sexual Function Inventory (FSFI). 452 participants (71.2%) reported having no sexual activity during the previous 4 weeks. The mean (SD) FSFI score for sexually active participants was 25.3 (6.0), and 52.6% of the sample reported a FSFI score ≤26.55 designating sexual dysfunction. In logistic regression models, SBP was not significantly associated with sexual activity (AOR = 1.002; P > .05). Older age (AOR = 0.95, P sexually active, as was living alone versus living with others (AOR = 0.56, P sexually active (AOR = 1.39; P sexually active participants, SBP was not associated with sexual dysfunction (AOR = 1.01; P > .05). Higher depressive symptoms from the Patient Health Questionnaire-9 (PHQ-9) was associated with higher odds of sexual dysfunction (AOR = 1.24, P sexually active in participants with chronic kidney disease (AOR = 0.33, P sexually active in a sample of middle-aged and older women with hypertension. Increased depressive symptoms and increased physical comorbidities were significantly associated with increased odds of sexual dysfunction. SBP was not significantly associated with sexual activity or sexual dysfunction. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  3. Effect of tender coconut water on systolic and diastolic blood pressure in prehypertensive women

    Directory of Open Access Journals (Sweden)

    Farapti Farapti

    2014-02-01

    . Dietary intakes of high potassium will decrease blood pressure (BP. Tender coconut water (TCW is a typical drink high in potassium. This study aimed to investigate the effect of TCW on BP in female teachers and employees prehypertension. Methods: The research was a parallel single blind randomized clinical trial. A total of 32 female prehypertension subjects aged 25-44 years. The subjects were selected using certain criteria and randomly allocated to one of two groups using block randomized, 16 subjects each. The treatment group received TCW 300 ml twice daily for 14 days and nutritional counseling, and the control group received water 300 ml twice daily for 14 days and nutritional counseling. Assessment of BP was done on day 0, day 8, and day 15. Statistical analysis were done using t-test and Mann-Whitney test. Results: Mean dietary intakes of potassium were 1420.28±405.54 mg/day or 30.22±8.63% compared to Recommended Dietary Allowance (RDA. During treatment period, potassium intake increased significantly in the treatment group. There were decreased BP in both groups, which were greater in the treatment group, but not statistically significant different (P > 0.05. The mean decrease of systolic BP was significant in treatment group (P = 0.031, meanwhile the mean decrease of diastolic BP was not significant (P=0.134. Conclusion: Tender coconut water 300 ml twice daily for 14 consecutive days has tendency to decrease systolic BP, but not diastolic blood pressure. (Health Science Indones 2013;2: 64-8Key words: coconut water, systolic and diastolic blood pressure

  4. Interankle systolic blood pressure difference and renal outcomes in patients with chronic kidney disease.

    Science.gov (United States)

    Chen, Szu-Chia; Tsai, Yi-Chun; Huang, Jiun-Chi; Lee, Su-Chu; Chang, Jer-Ming; Hwang, Shang-Jyh; Chen, Hung-Chun

    2016-05-01

    Interankle blood pressure (BP) difference has been associated with peripheral artery disease and adverse cardiovascular outcomes. However, the relationship between interankle BP difference and renal outcomes in chronic kidney disease (CKD) has never been evaluated. The purpose of this study was to determine whether interankle BP difference is associated with the rate of renal function decline and progression to renal end points in patients with stage 3-5 CKD. We enrolled 144 patients with CKD from one regional hospital. The BP in four limbs was simultaneously measured using an ABI-form device. The decline in renal function was evaluated using an estimated glomerular filtration rate (eGFR) slope. Rapid renal progression was defined as an eGFR slope < -3 mL/min per 1.73 m(2) per year. The renal end points were defined as ≥ 25% decline in eGFR or commencement of dialysis during the follow-up period. During a mean follow-up period of 3.1 years, 90 patients (62.5%) reached renal end points. Multivariate analysis showed that an increased interankle systolic BP difference (per 5 mmHg) was associated with a worse eGFR slope (regression β, -0.292; 95% confidence interval [CI], -0.482 to -0.102; P = 0.003), rapid renal progression (odds ratio, 1.189; 95% CI, 1.015-1.394; P = 0.032), and an increased risk of progression to renal end points (hazard ratio, 1.126; 95% CI, 1.052-1.204, P = 0.001). Interankle systolic BP difference was associated with rapid renal progression and progression to renal end points in patients with stage 3-5 CKD in our study. © 2015 Asian Pacific Society of Nephrology.

  5. Traditional systolic blood pressure targets underestimate hypotension-induced secondary brain injury.

    Science.gov (United States)

    Brenner, Megan; Stein, Deborah M; Hu, Peter F; Aarabi, Bizhan; Sheth, Kevin; Scalea, Thomas M

    2012-05-01

    Vital signs, particularly blood pressure, are often manipulated to maximize perfusion and optimize recovery from severe traumatic brain injury (sTBI). We investigated the utility of automated continuously recorded vital signs to predict outcomes after sTBI. Sixty patients with head Abbreviated Injury Scale score ≥ 3, age >14 years, "isolated" TBI, and need for intracranial pressure monitoring were prospectively enrolled at a single, large urban tertiary care facility. Outcome was measured by mortality and extended Glasgow Outcome Scale (GOSE) at 12 months. Continuous, automated, digital data were collected every 6 seconds for 72 hours after admission, and 5-minute means of systolic blood pressure (SBP) were recorded. We calculated SBP as pressure × time dose (PTD) to describe the cumulative amplitude and duration of episodes above and below clinical thresholds. The extent and duration of the insults were calculated as percent time (%time), PTD, and PTD per day (PTD/D) of defined thresholds (SBP: 100 bpm and >120 bpm; and SpO(2): GOSE by receiver operator characteristics. Mean age was 33.9 (range, 16-83) years, mean admission Glasgow Coma Scale score 6.4 ± 3, and mean head Abbreviated Injury Scale score 4.2 ± 0.72. The 30-day mortality rate was 13.3%. Of the 45 patients in whom GOSE at 12 months was available, 28 (62%) had good neurologic outcomes (GOSE score >4). Traditional markers of poor outcome (admission SBP, admission Glasgow Coma Scale, and Marshall score) were not different between groups with good or poor outcome. PTD, PTD/D, and %time SBP GOSE (p = 0.02). PTD/D SBP GOSE (p < 0.05). Within the first 48 hours of intensive care unit admission, hypotension was found to be predictive of mortality and functional outcomes at higher thresholds than traditionally defined. Systemic blood pressure targets closer to 120 mm Hg may be more efficacious in minimizing secondary insults and particularly useful in settings without invasive intracranial monitoring

  6. Predictors of high central blood pressure in young with isolated systolic hypertension

    Directory of Open Access Journals (Sweden)

    Radchenko GD

    2016-08-01

    Full Text Available G D Radchenko, O O Torbas, Yu M Sirenko State Institute National Scientific Center, M.D. Strazhesko Institute of Cardiology, National Academy of Medical Science, Kyiv, Ukraine Objective: According to the European Society of Cardiology/European Society of Hypertension 2013 guidelines, evaluation of aortic blood pressure (BP is needed in young with isolated systolic hypertension (ISH, but using special devices is not common, especially in Ukraine, where only a few centers have these devices. The purpose of our study was to identify the simple clinical predictors for differentiation (with or without elevated aortic systolic BP [SBP] of the young with ISH without the need for further extensive work-up. Patients and methods: The study included 44 young men (mean age: 32.2±1.3 years with office SBP ≥140 mmHg and office diastolic BP (DBP <90 mmHg (average: 153.4±2.1 mmHg and 83.4±1.7 mmHg, respectively. The following procedures were performed in all the subjects: body weight and height evaluation; measurement of office SBP, DBP, and heart rate; ambulatory BP monitoring; measurement of pulse wave velocity in arteries of elastic and muscle types and central SBP (cSBP; biochemical blood tests; electrocardiography; echocardiography; and carotid ultrasound investigations. Step-by-step multifactor regression analyses were used for finding the predictors of high cSBP. Results: Depending on the cSBP level, all the patients were divided into two groups: first group (n=17, subjects with normal cSBP, and second group (n=27, subjects with elevated cSBP. Patients in the second group were significantly older, with less height and higher body mass index; they had significantly higher levels of office SBP and DBP. Characteristics of target organ damage were within normal limits in both groups and did not differ significantly. Only pulse wave velocity in arteries of elastic type was significantly higher in the second group. The independent predictors of

  7. Blood pressure, left ventricular geometry, and systolic function in children exposed to inorganic arsenic.

    Science.gov (United States)

    Osorio-Yáñez, Citlalli; Ayllon-Vergara, Julio C; Arreola-Mendoza, Laura; Aguilar-Madrid, Guadalupe; Hernández-Castellanos, Erika; Sánchez-Peña, Luz C; Del Razo, Luz M

    2015-06-01

    Inorganic arsenic (iAs) is a ubiquitous element present in the groundwater worldwide. Cardiovascular effects related to iAs exposure have been studied extensively in adult populations. Few epidemiological studies have been focused on iAs exposure-related cardiovascular disease in children. In this study we investigated the association between iAs exposure, blood pressure (BP), and functional and anatomical echocardiographic parameters in children. A cross-sectional study of 161 children between 3 and 8 years was conducted in Central Mexico. The total concentration of arsenic (As) species in urine (U-tAs) was determined by hydride generation-cryotrapping-atomic absorption spectrometry and lifetime iAs exposure was estimated by multiplying As concentrations measured in drinking water by the duration of water consumption in years (LAsE). BP was measured by standard protocols, and M-mode echocardiographic parameters were determined by ultrasonography. U-tAs concentration and LAsE were significantly associated with diastolic (DBP) and systolic blood pressure (SBP) in multivariable linear regression models: DBP and SBP were 0.013 (95% CI: 0.002, 0.024) and 0.021 (95% CI: 0.004, 0.037) mmHg higher in association with each 1-ng/mL increase in U-tAs (p 620 compared with 41% (95% CI: -6.44, -0.37) lower, respectively, in children with U-tAs > 70 ng/mL compared with iAs was significantly associated with higher BP and LVM and with lower EF in our study population of Mexican children.

  8. Association of physical activity with a systolic blood pressure difference between arms in older people.

    Science.gov (United States)

    Sato, Koichi; Sugiura, Tomonori; Ohte, Nobuyuki; Dohi, Yasuaki

    2018-01-01

    A increase in interarm systolic blood pressure difference (IASBPD) is believed to lead to increased risk of cardiovascular disease and to be a predictor of future cardiovascular events. The purpose of the present study was to test the hypothesis that an increased IASBPD is associated with reduced physical activity in older people. Older people who used a geriatric health services facility (n = 147, mean age 83.3 years) were enrolled. The prevalence of IASBPD in individuals with different levels of physical activity and factors that have a crucial effect on IASBPD were investigated. The study participants were divided into three groups according to their physical activity; ambulant persons (group A), wheelchair users (group B) and bedridden persons (group C). Blood pressure around the both brachiums was simultaneously measured using two automated devices. An IASBPD of ≥10 mmHg was considered to be significant IASBPD. The median IASBPD was 4.5 mmHg in the present study participants, and 28 participants (19.0%) had an IASBPD ≥10 mmHg. The IASBPD in group C was greater than that in group A or B. Multivariate linear regression analysis showed that physical activity was the independent predictor of IASBPD after adjustment for possible factors. Furthermore, a logistic regression analysis with the end-point of significant IASBPD showed that physical activity is an independent predictor of significant IASBPD. Physical activity simply assessed by moving ability can predict IASBPD in older individuals. In older people, reduced physical activity might indicate the progression of silent or clinical atherosclerosis and an increased risk of cardiovascular disease. Geriatr Gerontol Int 2018; 18: 95-100. © 2017 Japan Geriatrics Society.

  9. Correlation between the trajectory of systolic blood pressure and new renal damage in a nonhypertensive population.

    Science.gov (United States)

    Wang, Zhi-Jun; Jia, Dao; Tian, Jun; Liu, Jie; Li, Li-Jie; Huang, Yu-Ling; Cao, Xin-Ying; Ning, Chun-Hong; Zhao, Quan-Hui; Yu, Jun-Xing; Zhang, Rui-Ying; Zhang, Ya-Jing; Gao, Jing-Sheng; Wu, Shou-Ling

    2017-10-01

    This study aims to investigate the correlation between the trajectory of systolic blood pressure (SBP) and new renal damage in a nonhypertensive population. This prospective cohort study included a total of 14 382 nonhypertensive individuals, employees of Kailuan Group of Companies, who took part in five healthy examinations in 2006-2007, 2008-2009, 2010-2011, 2012-2013, and 2014-2015, and had complete data. These individuals were divided into four groups according to the different trajectories of SBP: low-low, low-stable, middle-high, and high-high groups. The correlation between the trajectory of SBP and new renal damage in a nonhypertensive population was analyzed using a multivariate Cox's proportional hazard regression model. (a) A total of 14 382 individuals had complete data and the average age of these individuals was 44.6±10.8 years. Among these, 10 888 (75.7%) individuals were men and 3494 (24.3%) individuals were women. (b) These individuals were divided into four groups according to different trajectories of blood pressure: low-low group, accounting for 13.15% (blood pressure was group, accounting for 53.91% (blood pressure was between 115 and 116 mmHg); middle-high group, accounting for 28.77% (blood pressure was between 125 and 131 mmHg); and high-high group, accounting for 4.6% (blood pressure was between 126 and 151 mmHg). (c) With the increase in the trajectory of SBP, the detection rate of renal damage increased gradually. From the low-low group to the high-high group, the detection rates of estimated glomerular filtration rate (eGFR) less than 60 ml/min/1.73 m were 2.3, 2.4, 3.6, and 4.3%, respectively; the positive rates of urinary protein were 1.7, 2.9, 3.8, and 5.5%, respectively; and the detection rates of eGFR less than 60 ml/min/1.73 m or positive urinary protein were 4, 5.2, 7.3, and 9.3%, respectively (Pgroup, the risk of eGFR less than 60 ml/min/1.73 m increased by nearly 1.5 times in the high-high group and in

  10. Closure of digital arteries in high vascular tone states as demonstrated by measurement of systolic blood pressure in the fingers

    DEFF Research Database (Denmark)

    Krähenbühl, B; Nielsen, S L; Lassen, N A

    1977-01-01

    Finger systolic blood pressure (FSP) was measured indirectly in normal subjects and patients with primary Raynaud phenomenon by applying a thin-walled plastic cuff around the finger and a strain gauge more distally to detect volume changes. Inducing a high vascular tone in one or more fingers by ...

  11. Closure of digital arteries in high vascular tone states as demonstrated by measurement of systolic blood pressure in the fingers

    DEFF Research Database (Denmark)

    Krähenbühl, B; Nielsen, S L; Lassen, N A

    1977-01-01

    by direct cooling or intra-arterial noradrenaline infusion caused a marked drop in FSP in the exposed fingers, but not in the non-exposed fingers of the same hand. The fact that the non-exposed fingers retained the normal (arm systolic) pressure level is taken to indicate that palmar arch blood pressure......Finger systolic blood pressure (FSP) was measured indirectly in normal subjects and patients with primary Raynaud phenomenon by applying a thin-walled plastic cuff around the finger and a strain gauge more distally to detect volume changes. Inducing a high vascular tone in one or more fingers...... also remained normal. In the high vascular tone state, a large transmural pressure difference must apparently be established before the digital arteries are forced open. The lowered opening pressure constitutes a manifestation of the closure phenomenon of the digital arteries described in patients...

  12. Tilting-induced decrease in systolic blood pressure in bedridden hypertensive elderly inpatients: effects of azelnidipine.

    Science.gov (United States)

    Morimoto, Shigeto; Takahashi, Takashi; Okaishi, Kohya; Nakahashi, Takeshi; Nomura, Kohji; Kanda, Tsugiyasu; Okuro, Masashi; Murai, Hiroshi; Nishino, Tomoichi; Matsumoto, Masayuki

    2006-12-01

    The object of this study was to examine blood pressure (BP) variability due to postural change in elderly hypertensive patients. The subjects studied were 154 elderly inpatients in a hospital for the elderly (48 male and 106 female; median age: 82 years), consisting of age- and sex-matched bedridden (n=39) and non-bedridden (n=39) normotensive controls and bedridden (n=38) and non-bedridden (n=38) hypertensive patients. BP and pulse rate (PR) were measured in the supine position, then again after a 2-min, 45 deg head-up tilt with the legs horizontal. The decrease in systolic BP (SBP) on tilting in the bedridden hypertensive group (median: -10 mmHg; range: -32 to 9 mmHg) was significantly (pbedridden hypertensive group. Our findings indicate that tilt-induced decrease in SBP is a rather common phenomenon in bedridden elderly hypertensive patients, and that treatment with azelnidipine attenuates tilt-induced decrease in SBP, probably through an improvement of baroreceptor sensitivity.

  13. Interarm differences in systolic blood pressure and mortality among US army veterans

    DEFF Research Database (Denmark)

    White, James; Mortensen, Laust Hvas; Kivimäki, Mika

    2014-01-01

    BACKGROUND: Differences between the arms in systolic blood pressure (SBP) of ≥10 mmHg have been associated with an increased risk of mortality in patients with hypertensive and chronic renal disease. For the first time, we examined these relationships in a non-clinical population. DESIGN: Cohort...... an interarm difference of ≥10 and 2.4% of ≥15 mmHg. A 15-year follow-up period gave rise to 246 deaths (64 from cardiovascular disease, CVD). Interarm differences of ≥10 mmHg were associated with an elevated risk of all-cause mortality (hazard ratio, HR, 1.49, 95% confidence interval, CI, 1.04-2.14) and CVD...... mortality (HR 1.93, 95% CI 1.01-3.69). After adjusting for SBP, DBP, lipids, fasting glucose, and erythrocyte sedimentation rate, associations between interarm differences of ≥10 mmHg and all-cause mortality (HR 1.35, 95% CI 0.94-1.95) and CVD mortality (1.62, 95% CI 0.84-3.14) were significantly attenuated...

  14. Spectral analyses of systolic blood pressure and heart rate variability and their association with cognitive performance in elderly hypertensive subjects.

    Science.gov (United States)

    Santos, W B; Matoso, J M D; Maltez, M; Gonçalves, T; Casanova, M; Moreira, I F H; Lourenço, R A; Monteiro, W D; Farinatti, P T V; Soares, P P; Oigman, W; Neves, M F T; Correia, M L G

    2015-08-01

    Systolic hypertension is associated with cognitive decline in the elderly. Altered blood pressure (BP) variability is a possible mechanism of reduced cognitive performance in elderly hypertensives. We hypothesized that altered beat-to-beat systolic BP variability is associated with reduced global cognitive performance in elderly hypertensive subjects. In exploratory analyses, we also studied the correlation between diverse discrete cognitive domains and indices of systolic BP and heart rate variability. Disproving our initial hypothesis, we have shown that hypertension and low education, but not indices of systolic BP and heart rate variability, were independent predictors of lower global cognitive performance. However, exploratory analyses showed that the systolic BP variability in semi-upright position was an independent predictor of matrix reasoning (B = 0.08 ± .03, P-value = 0.005), whereas heart rate variability in semi-upright position was an independent predictor of the executive function score (B = -6.36 ± 2.55, P-value = 0.02). We conclude that myogenic vascular and sympathetic modulation of systolic BP do not contribute to reduced global cognitive performance in treated hypertensive subjects. Nevertheless, our results suggest that both systolic BP and heart rate variability might be associated with modulation of frontal lobe cognitive domains, such as executive function and matrix reasoning.

  15. Reliability of Doppler and stethoscope methods of determining systolic blood pressures: considerations for calculating an ankle-brachial index.

    Science.gov (United States)

    Chesbro, Steven B; Asongwed, Elmira T; Brown, Jamesha; John, Emmanuel B

    2011-01-01

    The purposes of this study were to: (1) identify the interrater and intrarater reliability of systolic blood pressures using a stethoscope and Doppler to determine an ankle-brachial index (ABI), and (2) to determine the correlation between the 2 methods. Peripheral arterial disease (PAD) affects approximately 8 to 12 million people in the United States, and nearly half of those with this disease are asymptomatic. Early detection and prompt treatment of PAD will improve health outcomes. It is important that clinicians perform tests that determine the presence of PAD. Two individual raters trained in ABI procedure measured the systolic blood pressures of 20 individuals' upper and lower extremities. Standard ABI measurement protocols were observed. Raters individually recorded the systolic blood pressures of each extremity using a stethoscope and a Doppler, for a total of 640 independent measures. Interrater reliability of Doppler measurements to determine SBP at the ankle was very strong (intraclass correlation coefficient [ICC], 0.93-0.99) compared to moderate to strong reliability using a stethoscope (ICC, 0.64-0.87). Agreement between the 2 devices to determine SBP was moderate to very weak (ICC, 0.13-0.61). Comparisons of the use of Doppler and stethoscope to determine ABI showed weak to very weak intrarater correlation (ICC, 0.17-0.35). Linear regression analysis of the 2 methods to determine ABI showed positive but weak to very weak correlations (r2 = .013, P = .184). A Doppler ultrasound is recommended over a stethoscope for accuracy in systolic pressure readings for ABI measurements.

  16. Choice of marker for assessment of RV dysfunction in acute pulmonary embolism : NT-proBNP, pulmonary artery systolic pressure, mean arterial pressure, or blood pressure index.

    Science.gov (United States)

    Ates, H; Ates, I; Kundi, H; Yilmaz, F M

    2017-12-01

    We aimed to examine the value of NT-proBNP, pulmonary artery systolic pressure (PASP), blood pressure index (BPI), and mean arterial pressure (MAP) in the determination of right ventricular dysfunction (RVD) in patients with acute pulmonary embolism (APE). A total of 547 patients diagnosed with APE were included in the study. Demographic characteristics and comorbid conditions of patients were recorded in patient files. For blood pressure measurement, a calibrated digital blood pressure monitor was used at regular intervals. Blood samples were taken from patients at the time of admission for hemogram, biochemical, and hemostasis blood tests. Echocardiography was performed on all patients to detect RVD and evaluate pulmonary artery pressure. PASP (p blood pressure (p blood cell (p AUC ± SE = 0.975 ± 0.006; p < 0.001) was found to be the best predictor of RVD with a higher sensitivity (92.8%) and specificity (100%). We found that BPI had a better diagnostic discrimination for RVD compared with PASP and NT-proBNP.

  17. Resistance training alone reduces systolic and diastolic blood pressure in prehypertensive and hypertensive individuals: meta-analysis.

    Science.gov (United States)

    de Sousa, Evitom Corrêa; Abrahin, Odilon; Ferreira, Ana Lorena Lima; Rodrigues, Rejane Pequeno; Alves, Erik Artur Cortinhas; Vieira, Rodolfo Paula

    2017-11-01

    The purpose of this study was to evaluate the effects of resistance training alone on the systolic and diastolic blood pressure in prehypertensive and hypertensive individuals. Our meta-analysis, followed the guidelines of PRISMA. The search for articles was realized by November 2016 using the following electronic databases: BIREME, PubMed, Cochrane Library, LILACS and SciELO and a search strategy that included the combination of titles of medical affairs and terms of free text to the key concepts: 'hypertension' 'hypertensive', 'prehypertensive', 'resistance training', 'strength training', and 'weight-lifting'. These terms were combined with a search strategy to identify randomized controlled trials (RCTs) and identified a total of 1608 articles: 644 articles BIREME, 53 SciELO, 722 PubMed, 122 Cochrane Library and 67 LILACS. Of these, five RCTs met the inclusion criteria and provided data on 201 individuals. The results showed significant reductions for systolic blood pressure (-8.2 mm Hg CI -10.9 to -5.5;I 2 : 22.5% P valor for heterogeneity=0.271 and effect size=-0.97) and diastolic blood pressure (-4.1 mm Hg CI -6.3 to -1.9; I 2 : 46.5% P valor for heterogeneity=0.113 and effect size=-0.60) when compared to group control. In conclusion, resistance training alone reduces systolic and diastolic blood pressure in prehypertensive and hypertensive subjects. The RCTs studies that investigated the effects of resistance training alone in prehypertensive and hypertensive patients support the recommendation of resistance training as a tool for management of systemic hypertension.

  18. Exercise capacity in young adults with hypertension and systolic blood pressure difference between right arm and leg after repair of coarctation of the aorta.

    Science.gov (United States)

    Instebø, Arne; Norgård, Gunnar; Helgheim, Vegard; Røksund, Ola Drange; Segadal, Leidulf; Greve, Gottfried

    2004-10-01

    Coarctation of the aorta represents 5-7% of congenital heart defects. Symptoms and prognosis depend on the degree of stenosis, age at surgery, surgical method and the presence of other heart defects. Postoperative complications are hypertension, restenosis and an abnormal blood pressure response during exercise. This study includes 41 patients, 15-40 years old, operated in the period 1975-1996. All were exercised on a treadmill until maximal oxygen consumption was achieved. Blood pressure was measured in the right arm and leg before and immediately after exercise, and in the right arm during exercise. Oxygen consumption was monitored and we defined an aerobic phase, an isocapnic buffering phase and a hypocapnic hyperventilation phase. The resting systolic blood pressure correlates with the resting systolic blood pressure difference between right arm and leg. A resting systolic blood pressure difference between the right arm and leg of 0.13 kPa (1 mmHg) to 2.67 kPa (20 mmHg) corresponds with a slight increase in resting systolic blood pressure. This rise in blood pressure increases the aerobic phase of the exercise test, helping the patients to achieve higher maximal oxygen consumption. A resting systolic blood pressure difference of more than 2.67 kPa (20 mmHg) corresponds with severe hypertension and causes reduction in the aerobic phase and maximal oxygen consumption. Resting systolic blood pressure and resting systolic blood pressure difference between the right arm and leg are not indicators for blood pressure response during exercise. Exercise testing is important to reveal exercise-induced hypertension and to monitor changes in transition from aerobic to anaerobic exercise and limitation to exercise capacity.

  19. Increased systolic ambulatory blood pressure and microalbuminuria in treated and non-treated hypertensive smokers

    DEFF Research Database (Denmark)

    Sørensen, Kaspar; Kristensen, Kjeld S; Bang, Lia E

    2004-01-01

    The primary aim of the present study was to evaluate the impact of smoking status on both clinic and ambulatory blood pressure (BP) and heart rate (HR) by using 24-h ambulatory BP monitoring in treated and non-treated hypertensive smokers and non-smokers. A secondary aim was to evaluate...

  20. 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.

  1. Effects of garlic on blood pressure in patients with and without systolic hypertension: a meta-analysis.

    Science.gov (United States)

    Reinhart, Kurt M; Coleman, Craig I; Teevan, Colleen; Vachhani, Payal; White, C Michael

    2008-12-01

    Garlic has been suggested to lower blood pressure; however, studies evaluating this parameter have provided conflicting results. To examine the effect of garlic on blood pressure in patients with and without elevated systolic blood pressure (SPB) through meta-analyses of randomized controlled trials. A systematic search of MEDLINE, CINAHL, and the Cochrane Central Register of Controlled Trials was conducted to identify randomized controlled trials in humans evaluating garlic's effect on blood pressure. All databases were searched from their inception through June 26, 2008, using the key words garlic, Allium sativum, and allicin. A manual search of published literature was used to identify additional relevant studies. To be included in the analysis, studies must have been written in English or German and reported endpoints of SBP or diastolic blood pressure (DBP). Studies whose population had a mean baseline SBP greater than 140 mm Hg were evaluated separately from those whose population had lower baseline blood pressures. Garlic's effect on SBP and DBP was treated as a continuous variable and weighted mean differences were calculated using a random-effects model. Ten trials were included in the analysis; 3 of these had patients with elevated SBP. Garlic reduced SBP by 16.3 mm Hg (95% CI 6.2 to 26.5) and DBP by 9.3 mm Hg (95% CI 5.3 to 13.3) compared with placebo in patients with elevated SBP. However, the use of garlic did not reduce SBP or DBP in patients without elevated SBP. There was only a minor degree of heterogeneity in the analyses and publication bias did not appear to influence the results. This meta-analysis suggests that garlic is associated with blood pressure reductions in patients with an elevated SBP although not in those without elevated SBP. Future research should focus on the impact of garlic on clinical events and the assessment of the long-term risk of harm.

  2. Systolic Blood Pressure Accuracy Enhancement in the Electronic Palpation Method Using Pulse Waveform

    Science.gov (United States)

    2001-10-25

    adrenalin) or vasodilating (Nipride or Nitromex) medicines. Also painkillers and anesthetics (Oxanest, Diprivan, Fentanyl and Rapifen) may have affected...the measurements. It is hard to distinguish the effects of medication and assess their relation to blood pressure errors and pulse shapes...CONCLUSION During this study, 51 cardiac operated patients were measured to define the effects of arterial stiffening on the accuracy of the

  3. Global Burden of Hypertension and Systolic Blood Pressure of at Least 110 to 115 mm Hg, 1990-2015

    DEFF Research Database (Denmark)

    Forouzanfar, Mohammad H; Liu, Patrick; Roth, Gregory A

    2017-01-01

    Importance: Elevated systolic blood (SBP) pressure is a leading global health risk. Quantifying the levels of SBP is important to guide prevention policies and interventions. Objective: To estimate the association between SBP of at least 110 to 115 mm Hg and SBP of 140 mm Hg or higher and the bur......Importance: Elevated systolic blood (SBP) pressure is a leading global health risk. Quantifying the levels of SBP is important to guide prevention policies and interventions. Objective: To estimate the association between SBP of at least 110 to 115 mm Hg and SBP of 140 mm Hg or higher...... and the burden of different causes of death and disability by age and sex for 195 countries and territories, 1990-2015. Design: A comparative risk assessment of health loss related to SBP. Estimated distribution of SBP was based on 844 studies from 154 countries (published 1980-2015) of 8.69 million participants...... in the primary analysis. Main Outcomes and Measures: Mean SBP level, cause-specific deaths, and health burden related to SBP (≥110-115 mm Hg and also ≥140 mm Hg) by age, sex, country, and year. Results: Between 1990-2015, the rate of SBP of at least 110 to 115 mm Hg increased from 73 119 (95% uncertainty...

  4. Combination of Glasgow Coma Scale, Age, and Systolic Blood Pressure in Assessing Patients’ Outcomes with Decreased Consciousness

    Directory of Open Access Journals (Sweden)

    Amir S Madjid

    2017-04-01

    Full Text Available Glasgow Coma Scale (GCS is commonly used to assess outcomes of patients with loss of consciousness, but it is insufficient in predicting the outcome of some cases. This study aimed to assess the combination of GCS, systolic blood pressure and age to predict the outcome of patients with decreased consciousness. This was a retrospective cohort observational study of 76 loss of consciousness patients that comes into the Emergency Department of Dr. Cipto Mangunkusumo General Hospital in June-August 2014. Data was obtained from the medical records . GCS, systolic blood pressure and age were recorded when patients were admitted to the triage. Outcome was assessed two weeks after admission in the emergency department. Bivariate analysis on the GCS and age showed significant different between patients with poor outcome group with good outcome group (p<0.05 and no significant different of the systolic blood pressure between both groups (p>0.05. Multivariate analysis on the GCS and age showed good probability equation based on the calibration test and discrimination. The combination of Glasgow Coma Scale and age was accurate in assessing the outcomes of patients with loss of consciousness. Keywords. Glasgow Coma Scale, systolic, age, outcomes     Gabungan Glasgow Coma Scale, Umur, dan Tekanan Darah Sistolik Sebagai Penilai Luaran Pasien Penurunan Kesadaran   Abstrak Glasgow Coma Scale (GCS telah menjadi salah satu penilaian yang digunakan untuk menilai luaran pasien penurunan kesadaran, tetapi dinilai masih belum mampu memprediksi luaran yang terjadi. Penelitian ini bertujuan untuk menilai gabungan GCS, tekanan darah sistolik dan umur untuk memprediksi luaran pasien dengan penurunan kesadaran. Penelitian ini merupakan studi observasional kohort retrospektif yang melibatkan 76 pasien dengan penurunan kesadaran yang datang ke IGD RSUPN Dr. Cipto Mangunkusumo selama bulan Juni-Agustus 2014. Data diambil dari rekam medik. GCS, tekanan darah sistolik dan

  5. A Calibrated Method of Massage Therapy Decreases Systolic Blood Pressure Concomitant With Changes in Heart Rate Variability in Male Rats.

    Science.gov (United States)

    Spurgin, Kurt A; Kaprelian, Anthony; Gutierrez, Roberto; Jha, Vidyasagar; Wilson, Christopher G; Dobyns, Abigail; Xu, Karen H; Curras-Collazo, Margarita C

    2017-02-01

    The purpose of this study was to develop a method for applying calibrated manual massage pressures by using commonly available, inexpensive sphygmomanometer parts and validate the use of this approach as a quantitative method of applying massage therapy to rodents. Massage pressures were monitored by using a modified neonatal blood pressure (BP) cuff attached to an aneroid gauge. Lightly anesthetized rats were stroked on the ventral abdomen for 5 minutes at pressures of 20 mm Hg and 40 mm Hg. Blood pressure was monitored noninvasively for 20 minutes following massage therapy at 5-minute intervals. Interexaminer reliability was assessed by applying 20 mm Hg and 40 mm Hg pressures to a digital scale in the presence or absence of the pressure gauge. With the use of this method, we observed good interexaminer reliability, with intraclass coefficients of 0.989 versus 0.624 in blinded controls. In Long-Evans rats, systolic BP dropped by an average of 9.86% ± 0.27% following application of 40 mm Hg massage pressure. Similar effects were seen following 20 mm Hg pressure (6.52% ± 1.7%), although latency to effect was greater than at 40 mm Hg. Sprague-Dawley rats behaved similarly to Long-Evans rats. Low-frequency/high-frequency ratio, a widely-used index of autonomic tone in cardiovascular regulation, showed a significant increase within 5 minutes after 40 mm Hg massage pressure was applied. The calibrated massage method was shown to be a reproducible method for applying massage pressures in rodents and lowering BP. Copyright © 2016. Published by Elsevier Inc.

  6. Effect of Self-monitoring and Medication Self-titration on Systolic Blood Pressure in Hypertensive Patients at High Risk of Cardiovascular Disease

    OpenAIRE

    McManus, Richard J.; Mant, Jonathan; Haque, M. Sayeed; Bray, Emma P.; Bryan, Stirling; Greenfield, Sheila M.; Jones, Miren I.; Jowett, Sue; Little, Paul; Penaloza, Cristina; Schwartz, Claire; Shackleford, Helen; Shovelton, Claire; Varghese, Jinu; Williams, Bryan

    2014-01-01

    IMPORTANCE: Self-monitoring of blood pressure with self-titration of antihypertensives (self-management) results in lower blood pressure in patients with hypertension, but there are no data about patients in high-risk groups.\\ud \\ud OBJECTIVE: To determine the effect of self-monitoring with self-titration of antihypertensive medication compared with usual care on systolic blood pressure among patients with cardiovascular disease, diabetes, or chronic kidney disease.\\ud \\ud DESIGN, SETTING, AN...

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

    Directory of Open Access Journals (Sweden)

    Felício João S

    2006-09-01

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

  8. Determination of Relations between Systolic Blood Pressure and Heart Attack in Patients with Type 2 Diabetes with Association Rules

    Directory of Open Access Journals (Sweden)

    Seyyed Payam Shariatpanahi

    2018-03-01

    Full Text Available Abstract Background: Today, the high prevalence of diabetes and its complications are one of the most important public health issues worldwide. For this reason, finding relations between diabetes risk factors is very effective in preventing and reducing complications. For discovering these relations, the data mining methods can be used. By extracting association rules, which is one of the data mining techniques, we can discover the relations between a large numbers of variables in a disease. Materials and Methods: The population of this study was 1046 patients with type 2 diabetes, whose data had recorded between 2011 and 2014 at the Special Clinic for Diabetes in Tehran's Imam Khomeini Hospital. After pre-processing step with SPSS19 software, 573 people entered the analysis phase. The FP-Growth algorithm was applied to the data set to discover the relations between heart attack and other risk factors using Rapid miner5 software. Relations, after extraction, were given to the doctor to confirm clinical validation. Results: The obtained results of studying these 573 people (Including 292 (51% women and 281 (49% men, with age range 27 to 82 years showed that the lack of blood pressure, creatinine and diastolic blood pressure at its normal level, despite higher systolic blood pressure level than normal, doesn't increase the probability of heart attack. Conclusion: Using association rules is a good way of identifying relations between the risk factors of a disease. Also, it can provide new hypotheses to do epidemiological studies for researchers.

  9. A CROSS SECTIONAL STUDY TO FIND THE DIFFERENCE IN SYSTOLIC BLOOD PRESSURE BETWEEN ARMS AS A RISK MARKER FOR DIABETIC NEPHROPATHY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Uday Subhash Bande

    2016-08-01

    Full Text Available BACKGROUND Diabetic nephropathy is the commonest cause of end-stage renal disease in the developed world. Recent studies have demonstrated that a difference in systolic blood pressure between arms is associated with cardiovascular disease and microalbuminuria. It is considered a predictor for cardiovascular disease and a surrogate marker for early kidney damage among patients with both type 2 diabetes and hypertension. AIMS AND OBJECTIVES The aim was to investigate an association between arm difference in systolic blood pressure and microalbuminuria which can serve as a marker for diabetic nephropathy. MATERIALS AND METHOD This study was conducted on 200 patients with diabetes mellitus and an inter-arm difference in systolic blood pressure was present in 35.7% of the study population. Presence of systolic blood pressure difference of more than 10 mmHg between arms correlated with microalbuminuria and duration of diabetes mellitus with a p value of <0.001. We also found a correlation between arm difference in blood pressure and duration of diabetes mellitus, presence of hypertension and body mass index. CONCLUSION The inter-arm difference in blood pressure could serve as a risk marker for renal damage in diabetes mellitus.

  10. Can a central blood volume deficit be detected by systolic pressure variation during spontaneous breathing?

    DEFF Research Database (Denmark)

    Dahl, Michael; Hayes, Chris; Steen Rasmussen, Bodil

    2016-01-01

    BACKGROUND: Whether during spontaneous breathing arterial pressure variations (APV) can detect a volume deficit is not established. We hypothesized that amplification of intra-thoracic pressure oscillations by breathing through resistors would enhance APV to allow identification of a reduced card...

  11. THE EFFECTIVENESS OF CHRONOTHERAPY IN HYPERTENSIVE PATIENTS WITH AN INSUFFICIENT DEGREE OF SLEEP-TIME SYSTOLIC BLOOD PRESSURE DECLINE

    Directory of Open Access Journals (Sweden)

    Petrenko O. V.

    2017-12-01

    Full Text Available Blood pressure (BP circadian rhythm violation, manifested as an insufficient degree of its sleep-time relative decline, is an independent cardiovascular risk factor. The main method of the correction is chronotherapeutic approach, when at least one antihypertensive drug is taken at bedtime. However, most researchers focus on normalizing the daily profile of systolic blood pressure (SBP and do not pay enough attention to changes in the daily profile of diastolic blood pressure (DBP and blood pressure in general. The aim of the study was to evaluate the influence of the chronotherapeutic approach on the SBP and DBP levels and the DBP daily profile in hypertensive patients with an insufficient degree of sleep-time relative SBP decline. The study included 12 patients with arterial hypertension (AH with an insufficient degree of sleep-time relative SBP decline. Participants were divided into two groups: group 1 included patients who take at least one antihypertensive drug at bedtime, group 2 – patients who take all antihypertensive drugs in the morning. All patients underwent 24-hour blood pressure monitoring using the computer system «Cardiosens» (KhAI Medica, Ukraine, with the oscillometric method of BP measuring when enrolling in the study and after 3 months. The type of SBP and DBP diurnal profile, the mean values of SBP, DBP and hyperbaric indices were determined and compared between groups 1 and 2 at each visit, as well as within groups between visits. The results showed that the SBP daily profile normalization in patients with insufficient degree of sleep-time relative SBP decline from group 2 was achieved only in 11 % of cases, and in group 1 SBP and DBP daily profile normalized in 1/3 patients. In some patients from group 2 SBP and DBP daily profile converted into the overdipper type, while in group 1 overdippers did not appear at the end of the study. It was concluded that conversion of daily DBP profile to overdipper as a consequence

  12. Serum proatrial natriuretic peptide does not increase with higher systolic blood pressure in obese men

    DEFF Research Database (Denmark)

    Asferg, Camilla L; Andersen, Ulrik B; Linneberg, Allan

    2017-01-01

    ventricular mass (LVM). METHODS: We examined 103 obese healthy medication-free men. We measured 24-hour ambulatory BP (ABP). LVM was calculated using the Cornell voltage-duration product method. Fasting serum concentrations of midregional proatrial NP (MR-proANP), a surrogate for active ANP, were measured....... Linear regression analysis was used to calculate age-adjusted standardised regression coefficients (β). RESULTS: LVM and BP increased across systolic ABP quartiles (mean LVM±SD: 1599.1±387.2 mm ms in first vs 2188.5±551.3 mm ms in fourth quartile, pABP±SD: 114.5±4.2 mm Hg in first...... vs 149.0±7.7 mm Hg in fourth quartile, pABP was robustly associated with LVM (ß=0.48, pABP (ß=-0.32, p=0.004) and with diastolic ABP (ß=-0.45, p

  13. Morning pulse pressure is associated more strongly with elevated albuminuria than systolic blood pressure in patients with type 2 diabetes mellitus: post hoc analysis of a cross-sectional multicenter study.

    Science.gov (United States)

    Ushigome, Emi; Fukui, Michiaki; Hamaguchi, Masahide; Matsumoto, Shinobu; Mineoka, Yusuke; Nakanishi, Naoko; Senmaru, Takafumi; Yamazaki, Masahiro; Hasegawa, Goji; Nakamura, Naoto

    2013-09-01

    Recently, focus has been directed toward pulse pressure as a potentially independent risk factor for micro- and macrovascular disease. This study was designed to examine the relationship between pulse pressure taken at home and elevated albuminuria in patients with type 2 diabetes. This study is a post hoc analysis of a cross-sectional multicenter study. Home blood pressure measurements were performed for 14 consecutive days in 858 patients with type 2 diabetes. We investigated the relationship between systolic blood pressure or pulse pressure in the morning or in the evening and urinary albumin excretion using univariate and multivariate analyses. Furthermore, we measured area under the receiver-operating characteristic curve (AUC) to compare the ability to identify elevated albuminuria, defined as urinary albumin excretion equal to or more than 30 mg/g creatinine, of systolic blood pressure or pulse pressure. Morning systolic blood pressure (β=0.339, Ppressure (β=0.378, PAUC for elevated albuminuria in morning systolic blood pressure and morning pulse pressure were 0.668 (0.632-0.705; PAUC of morning pulse pressure was significantly greater than that of morning systolic blood pressure (P=0.040). Our findings implicate that morning pulse pressure is associated with elevated albuminuria in patients with type 2 diabetes, which suggests that lowering morning pulse pressure could prevent the development and progression of diabetic nephropathy. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  14. Thalidomide ameliorates portal hypertension via nitric oxide synthase independent reduced systolic blood pressure.

    Science.gov (United States)

    Theodorakis, Nicholas G; Wang, Yining N; Korshunov, Vyacheslav A; Maluccio, Mary A; Skill, Nicholas J

    2015-04-14

    Portal hypertension is a common complication of liver cirrhosis and significantly increases mortality and morbidity. Previous reports have suggested that the compound thalidomide attenuates portal hypertension (PHT). However, the mechanism for this action is not fully elucidated. One hypothesis is that thalidomide destabilizes tumor necrosis factor α (TNFα) mRNA and therefore diminishes TNFα induction of nitric oxide synthase (NOS) and the production of nitric oxide (NO). To examine this hypothesis, we utilized the murine partial portal vein ligation (PVL) PHT model in combination with endothelial or inducible NOS isoform gene knockout mice. Wild type, inducible nitric oxide synthase (iNOS)(-/-) and endothelial nitric oxide synthase (eNOS)(-/-) mice received either PVL or sham surgery and were given either thalidomide or vehicle. Serum nitrate (total nitrate, NOx) was measured daily for 7 d as a surrogate of NO synthesis. Serum TNFα level was quantified by enzyme-linked immunosorbent assay. TNFα mRNA was quantified in liver and aorta tissue by reverse transcription-polymerase chain reaction. PHT was determined by recording splenic pulp pressure (SPP) and abdominal aortic flow after 0-7 d. Response to thalidomide was determined by measurement of SPP and mean arterial pressure (MAP). SPP, abdominal aortic flow (Qao) and plasma NOx were increased in wild type and iNOS(-/-) PVL mice when compared to sham operated control mice. In contrast, SPP, Qao and plasma NOx were not increased in eNOS(-/-) PVL mice when compared to sham controls. Serum TNFα level in both sham and PVL mice was below the detection limit of the commercial ELISA used. Therefore, the effect of thalidomide on serum TNFα levels was undetermined in wild type, eNOS(-/-) or iNOS(-/-) mice. Thalidomide acutely increased plasma NOx in wild type and eNOS(-/-) mice but not iNOS(-/-) mice. Moreover, thalidomide temporarily (0-90 min) decreased mean arterial pressure, SPP and Qao in wild type, e

  15. Between-visit reproducibility of inter-arm systolic blood pressure differences in treated hypertensive patients: the coconet study.

    Science.gov (United States)

    Kim, Jang Young; Kim, Eung Ju; Namgung, June; Cho, Byung-Ryul; Nam, Chang-Wook; Kim, Young-Kwon; Park, Jeong Bae

    2017-05-01

    Inter-arm systolic blood pressure (BP) differences (sIADs) have recently been recognized as a risk factor for cardiovascular mortality. However, sIAD reproducibility remains unresolved from a controlled trial perspective. We evaluated the between-visit reproducibility of sIADs in hypertensive patients. We examined 1875 hypertensive participants aged 20 years and older (mean age: 62.3 years, 45.4% female) from nine primary clinics and 27 secondary and tertiary hospitals. The BPs in both arms were automatically and simultaneously measured in triplicate with a cuff-oscillometric BP device. BP measurements were obtained at baseline and at 3-month follow-up time points. Increased sIAD was defined as an absolute difference of ⩾10 mm Hg in the average systolic BPs between the left and right arms. The overall mean sIAD was 4.33±4.17 mm Hg. The prevalences of increased sIAD at baseline and at the 3-month measurements were 7.6% and 7.1%, respectively. The intraclass correlation coefficient for the between-visit sIADs was 0.304 (95% confidence interval (CI) 0.262-0.344). The κ-value between the baseline and follow-up increased sIADs was 0.165 (95% CI 0.096-0.234). The percentage of patients who exhibited an increased sIAD at 3 months compared with the initially increased sIAD at baseline was 21.8%. The reproducibility of sIAD determination between baseline and the 3-month follow-up measurements lacked agreement in the hypertensive patients. Further studies should identify the relevant variables and characteristics of this poor reproducibility (CRIS number; KCT0001235).

  16. Systolic blood pressure reduction during the first 24 h in acute heart failure admission: friend or foe?

    Science.gov (United States)

    Cotter, Gad; Metra, Marco; Davison, Beth A; Jondeau, Guillaume; Cleland, John G F; Bourge, Robert C; Milo, Olga; O'Connor, Christopher M; Parker, John D; Torre-Amione, Guillermo; van Veldhuisen, Dirk J; Kobrin, Isaac; Rainisio, Maurizio; Senger, Stefanie; Edwards, Christopher; McMurray, John J V; Teerlink, John R

    2018-02-01

    Changes in systolic blood pressure (SBP) during an admission for acute heart failure (AHF), especially those leading to hypotension, have been suggested to increase the risk for adverse outcomes. We analysed associations of SBP decrease during the first 24 h from randomization with serum creatinine changes at the last time-point available (72 h), using linear regression, and with 30- and 180-day outcomes, using Cox regression, in 1257 patients in the VERITAS study. After multivariable adjustment for baseline SBP, greater SBP decrease at 24 h from randomization was associated with greater creatinine increase at 72 h and greater risk for 30-day all-cause death, worsening heart failure (HF) or HF readmission. The hazard ratio (HR) for each 1 mmHg decrease in SBP at 24 h for 30-day death, worsening HF or HF rehospitalization was 1.01 [95% confidence interval (CI) 1.00-1.02; P = 0.021]. Similarly, the HR for each 1 mmHg decrease in SBP at 24 h for 180-day all-cause mortality was 1.01 (95% CI 1.00-1.03; P = 0.038). The associations between SBP decrease and outcomes did not differ by tezosentan treatment group, although tezosentan treatment was associated with a greater SBP decrease at 24 h. In the current post hoc analysis, SBP decrease during the first 24 h was associated with increased renal impairment and adverse outcomes at 30 and 180 days. Caution, with special attention to blood pressure monitoring, should be exercised when vasodilating agents are given to AHF patients. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

  17. Systolic Blood Pressure Trajectory, Frailty, and All-Cause Mortality >80 Years of Age: Cohort Study Using Electronic Health Records.

    Science.gov (United States)

    Ravindrarajah, Rathi; Hazra, Nisha C; Hamada, Shota; Charlton, Judith; Jackson, Stephen H D; Dregan, Alex; Gulliford, Martin C

    2017-06-13

    Clinical trials show benefit from lowering systolic blood pressure (SBP) in people ≥80 years of age, but nonrandomized epidemiological studies suggest lower SBP may be associated with higher mortality. This study aimed to evaluate associations of SBP with all-cause mortality by frailty category >80 years of age and to evaluate SBP trajectories before death. A population-based cohort study was conducted using electronic health records of 144 403 participants ≥80 years of age registered with family practices in the United Kingdom from 2001 to 2014. Participants were followed for ≤5 years. Clinical records of SBP were analyzed. Frailty status was classified using the e-Frailty Index into the categories of fit, mild, moderate, and severe. All-cause mortality was evaluated by frailty status and mean SBP in Cox proportional-hazards models. SBP trajectories were evaluated using person months as observations, with mean SBP and antihypertensive treatment status estimated for each person month. Fractional polynomial models were used to estimate SBP trajectories over 5 years before death. During follow-up, 51 808 deaths occurred. Mortality rates increased with frailty level and were greatest at SBP mortality was 7.7 per 100 person years at SBP 120 to 139 mm Hg, 15.2 at SBP 110 to 119 mm Hg, and 22.7 at SBP mortality may be accounted for by reverse causation if participants with lower blood pressure values are closer, on average, to the end of life. © 2017 The Authors.

  18. Inter-arm systolic blood pressure differences, relations with future vascular events and mortality in patients with and without manifest vascular disease

    NARCIS (Netherlands)

    Kranenburg, Guido; Spiering, Wilko; de Jong, Pim A.; Kappelle, L. Jaap; de Borst, Gert Jan; Cramer, Maarten J.; Visseren, Frank L.J.; Aboyans, Victor; Westerink, Jan

    2017-01-01

    Background Inter-arm systolic blood pressure difference (SBPD) is an easily obtained patient characteristic which relates to vascular disease. We aimed to identify determinants of large inter-arm SBPD and to investigate the relation between inter-arm SBPD and vascular events in patients with and

  19. The effect of comorbidity on glycemic control and systolic blood pressure in type 2 diabetes: a cohort study with 5 year follow-up in primary care.

    NARCIS (Netherlands)

    Luijks, H.; Biermans, M.; Bor, H.; Weel, C. van; Lagro-Janssen, T.; Grauw, W. de; Schermer, T.

    2017-01-01

    Aims: To explore the longitudinal effect of chronic comorbid diseases on glycemic control (HbA1C) and systolic blood pressure (SBP) in type 2 diabetes patients. Methods: In a representative primary care cohort of patients with newly diagnosed type 2 diabetes in The Netherlands (n = 610), we tested

  20. Dose related anxiolytic effects of diazepam: relation with serum electrolytes, plasma osmolality and systolic blood pressure (sbp) in rats

    International Nuclear Information System (INIS)

    Farooq, R.; Haleem, D.J.; Haleem, M.A.

    2008-01-01

    Diazepam is an anxiolytic and anticonvulsant drug that also induces hypnosis. Changes in serum electrolyte balance, plasma osmolality and systolic blood pressure (SBP) are often associated with stress-induced anxiety. Administration of diazepam has been show to decrease stress-induced enhancement of hypothalamic pituitary adrenal cortical (HPA) axis. The present is designed to monitor the anxiolytic effects of different doses of diazepam (1 mg/kg, 2.5 mg/kg and 5 mg/kg) and its association with changes of serum electrolyte balance, plasma osmolality and SBP in rats. Administration of diazepam at doses of 1 mg/kg, 2.5 mg/kg and 5 mg/kg elicited anxiolytic effects monitored in light-dark transition test and increased serum concentration of electrolytes and plasma osmolality. Serum levels of magnesium as well as SBP decreased. The results are discussed in context of anxiolytic effects of diazepam to be mediated via a modulation of stress-induced increase in the activity of HPA-axis arid electrolytes balance. (author)

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

    Science.gov (United States)

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

    2017-12-01

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

  2. [Systolic blood pressure and functional outcome in patients with acute stroke: a Mexican registry of acute cerebrovascular disease (RENAMEVASC)].

    Science.gov (United States)

    Baños-González, Manuel; Cantú-Brito, Carlos; Chiquete, Erwin; Arauz, Antonio; Ruiz-Sandoval, José Luís; Villarreal-Careaga, Jorge; Barinagarrementeria, Fernando; Lozano, José Juan

    2011-01-01

    To analyze the association between the admission systolic blood pressure (SBP) and 30-day outcome in patients with acute cerebrovascular disease. The REgistro NAcional Mexicano de Enfermedad VAScular Cerebral (RENAMEVASC) is a hospital-based multicenter registry performed between November 2002 and October 2004. A total of 2000 patients with clinical syndromes of acute cerebrovascular disease confirmed by neuroimaging were registered. The modified Rankin scale was used for outcome stratification. We analyzed 1721 patients who had registered their SBP: 78 (4.5%) had transient ischemic attack, 894 (51.9%) brain infarction, 534 (30.9%) intracerebral hemorrhage, 165 (9.6%) subarachnoid hemorrhage and 50 (2.9%) cerebral venous thrombosis. Among 1036 (60.2%) patients with the antecedent of hypertension, only 32.4% had regular treatment. The 30-day case fatality rate presented a J pattern with respect to SBP, so that the risk of death was highest in 65 years (RR: 2.16, IC 95%: 1.74 - 2.67). Both hypotension and significant arterial hypertension at hospital admission are associated with an adverse outcome after acute cerebrovascular disease. Nevertheless, a good functional outcome can be attained in a wide range of SBP.

  3. Validation of the inverse pulse wave transit time series as surrogate of systolic blood pressure in MVAR modeling.

    Science.gov (United States)

    Giassi, Pedro; Okida, Sergio; Oliveira, Maurício G; Moraes, Raimes

    2013-11-01

    Short-term cardiovascular regulation mediated by the sympathetic and parasympathetic branches of the autonomic nervous system has been investigated by multivariate autoregressive (MVAR) modeling, providing insightful analysis. MVAR models employ, as inputs, heart rate (HR), systolic blood pressure (SBP) and respiratory waveforms. ECG (from which HR series is obtained) and respiratory flow waveform (RFW) can be easily sampled from the patients. Nevertheless, the available methods for acquisition of beat-to-beat SBP measurements during exams hamper the wider use of MVAR models in clinical research. Recent studies show an inverse correlation between pulse wave transit time (PWTT) series and SBP fluctuations. PWTT is the time interval between the ECG R-wave peak and photoplethysmography waveform (PPG) base point within the same cardiac cycle. This study investigates the feasibility of using inverse PWTT (IPWTT) series as an alternative input to SBP for MVAR modeling of the cardiovascular regulation. For that, HR, RFW, and IPWTT series acquired from volunteers during postural changes and autonomic blockade were used as input of MVAR models. Obtained results show that IPWTT series can be used as input of MVAR models, replacing SBP measurements in order to overcome practical difficulties related to the continuous sampling of the SBP during clinical exams.

  4. The inter-arm systolic blood pressure difference and risk of cardiovascular mortality: A meta-analysis of cohort studies.

    Science.gov (United States)

    Zhou, Ming; Gao, Zhen; Chen, Fei; Xu, Haijun; Dong, Xiao; Ma, Li

    2016-01-01

    The inter-arm systolic blood pressure difference (SBPD) is recommended to be in relation to potential cardiovascular disease (CVD). Previous studies yielded controversial results about the association between an inter-arm SBPD ≥ 10 mmHg or ≥15 mmHg and the risk of cardiovascular mortality. Therefore, we conducted this meta-analysis to investigate this association. We searched PubMed and Embase databases through December 31, 2014, and examined the references of retrieved articles to identify relevant cohort studies. We utilized Newcastle-Ottawa scale to assess the quality of included studies and calculated the summary risk estimates in a fixed/random-effect model. All data analyses were conducted using STATA version 11.0. A total of seven studies were identified. Compared with participants with an inter-arm SBPD arm SBPD ≥ 10 mmHg was 1.58 (95% CI: 1.3-1.93), and the pooled HR of cardiovascular mortality of participants with an inter-arm SBPD ≥ 15 mmHg versus those with an inter-arm SBPD arm SBPD may define a subpopulation at high risk of CVD events.

  5. Systolic blood pressure, routine kidney variables and renal ultrasonographic findings in cats naturally infected with feline immunodeficiency virus.

    Science.gov (United States)

    Taffin, Elien Rl; Paepe, Dominique; Ghys, Liesbeth Fe; De Roover, Katrien; Van de Maele, Isabel; Saunders, Jimmy H; Duchateau, Luc; Daminet, Sylvie

    2017-06-01

    Objectives Hypertension is a common cause of proteinuria in HIV-infected people. In cats, feline immunodeficiency virus (FIV) infection appears to be associated with proteinuria. Therefore, the results from systolic blood pressure (SBP) measurements in naturally infected FIV-positive cats were reviewed to assess whether hypertension contributes to the observed proteinuria in these cats. Ultrasonographic findings in FIV-positive cats were reviewed to complete renal assessment and to extend the scant knowledge on renal ultrasonography in cats. Methods Data from client-owned, naturally infected FIV-positive cats were retrospectively reviewed. To obtain a control group, records were reviewed from age-matched, privately owned, FIV-negative cats. Results Data from 91 FIV-infected and 113 control cats were compared. FIV-infected cats showed a significantly lower SBP ( P 0.4) occurred more frequently in FIV-infected cats ( P <0.001). Renal ultrasonography showed abnormalities in 60/91 FIV-infected cats, with hyperechogenic cortices in 39/91 and enlarged kidneys in 31/91. Conclusions and relevance Hypertension can be excluded as a common cause of renal damage leading to proteinuria in FIV-infected cats. Proteinuria and poorly concentrated urine are common in naturally infected FIV-positive cats, in contrast to azotaemia. Clinicians should cautiously interpret ultrasonographic abnormalities as these occur in over half of FIV-infected cats.

  6. Dietary sodium restriction reverses vascular endothelial dysfunction in middle-aged/older adults with moderately elevated systolic blood pressure

    Science.gov (United States)

    Jablonski, Kristen L.; Racine, Matthew L.; Geolfos, Candace J.; Gates, Phillip E.; Chonchol, Michel; McQueen, Matthew B.; Seals, Douglas R.

    2013-01-01

    Objectives We determined the efficacy of dietary sodium restriction (DSR) for improving vascular endothelial dysfunction in middle-aged/older adults with moderately elevated systolic blood pressure (SBP; 130–159 mmHg) and the associated physiological mechanisms. Background Vascular endothelial dysfunction develops with advancing age and elevated SBP, contributing to increased cardiovascular risk. DSR lowers BP, but its effect on vascular endothelial function and mechanisms involved are unknown. Methods Seventeen subjects (11M/6F; 62±7 yrs, mean±S.D.) completed a randomized, crossover study of 4 weeks of both low and normal sodium intake. Vascular endothelial function (endothelium-dependent dilation; EDD), nitric oxide (NO)/tetrahydrobiopterin (BH4) bioavailability and oxidative stress-associated mechanisms were assessed following each condition. Results Urinary sodium excretion was reduced by ~50% (to 70±30 mmol/day), and conduit (brachial artery flow-mediated dilation [FMDBA]) and resistance (forearm blood flow responses to acetylcholine [FBFACh]) artery EDD were 68% and 42% (peak FBFACh) higher following the low sodium diet (psodium markedly enhanced NO- mediated EDD (greater ΔFBFACh with endothelial NO synthase [eNOS] inhibition) without changing eNOS expression/activation (Ser1177 phosphorylation), restored BH4 bioactivity (less ΔFMDBA with acute BH4), abolished tonic superoxide suppression of EDD (less ΔFMDBA and ΔFBFACh with ascorbic acid infusion), and increased circulating superoxide dismutase activity (p<0.05). These effects were independent of ΔSBP. Other subject characteristics/dietary factors and endothelium-independent dilation were unchanged. Conclusions DSR largely reverses both macro- and microvascular endothelial dysfunction by enhancing NO and BH4 bioavailability and reducing oxidative stress. Our findings support the emerging concept that DSR induces “vascular protection” beyond that attributable to its BP-lowering effects. PMID

  7. Skin perfusion pressure measured by isotope washout in legs with arterial occlusive disease. Evaluation of different tracers, comparison to segmental systolic pressure, angiography and transcutaneous oxygen tension and variations during changes in systemic blood pressure

    DEFF Research Database (Denmark)

    Holstein, P; Trap-Jensen, J; Bagger, H

    1983-01-01

    Hg (range 18-98) (P less than 0.02). The average washout constant for the three different tracers were approximately equal and correlated statistically significant with the SPP; (2) In 59 legs with AOD, segmental SPP was compared to segmental systolic blood pressures on the thigh, calf, ankle and first...... digit (strain gauge technique). The two different methods correlated statistically significant at all four levels, but the systolic blood pressures were higher than the SPP in particular in diabetic legs; (3) Angiograms in 35 legs with AOD showed that the SPP on the ankle was only consistently decreased...

  8. Comparison of noninvasive assessments of central blood pressure using general transfer function and late systolic shoulder of the radial pressure wave.

    Science.gov (United States)

    Wohlfahrt, Peter; Krajcoviechová, Alena; Seidlerová, Jitka; Mayer, Otto; Filipovsky, Jan; Cífková, Renata

    2014-02-01

    Central systolic blood pressure (cSBP) can be derived by the general transfer function of the radial pressure wave, as used in the SphygmoCor device, or by regression equation from directly measured late systolic shoulder of the radial pressure wave (pSBP2), as used in the Omron HEM-9000AI device. The aim of this study was to compare the SphygmoCor estimates of cSBP with 2 estimates of cSBP provided by the Omron HEM-9000AI (cSBP, pSBP2) in a large cohort of the white population. In 391 patients aged 52.3±13.5 years (46% men) from the Czech post-MONICA Study, cSBP was measured using the SphygmoCor and Omron HEM-9000AI devices in random order. Omron cSBP and pSBP2 were perfectly correlated (r = 1.0; P wave provides a comparable accuracy with the validated general transfer function. When comparing Omron HEM-9000AI and SphygmoCor estimates of cSBP, Omron pSBP2 should be used. The difference between both devices in cSBP may be explained by differences in calibration.

  9. Cognitive Function and Kidney Disease: Baseline Data From the Systolic Blood Pressure Intervention Trial (SPRINT).

    Science.gov (United States)

    Weiner, Daniel E; Gaussoin, Sarah A; Nord, John; Auchus, Alexander P; Chelune, Gordon J; Chonchol, Michel; Coker, Laura; Haley, William E; Killeen, Anthony A; Kimmel, Paul L; Lerner, Alan J; Oparil, Suzanne; Saklayen, Mohammad G; Slinin, Yelena M; Wright, Clinton B; Williamson, Jeff D; Kurella Tamura, Manjula

    2017-09-01

    Chronic kidney disease is common and is associated with cardiovascular disease, cerebrovascular disease, and cognitive function, although the nature of this relationship remains uncertain. Cross-sectional cohort using baseline data from the Systolic Blood Pressure Intervention Trial (SPRINT). Participants in SPRINT, a randomized clinical trial of blood pressure targets in older community-dwelling adults with cardiovascular disease, chronic kidney disease, or high cardiovascular disease risk and without diabetes or known stroke, who underwent detailed neurocognitive testing in the cognition substudy, SPRINT-Memory and Cognition in Decreased Hypertension (SPRINT-MIND). Urine albumin-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR). Cognitive function, a priori defined as 5 cognitive domains based on 11 cognitive tests using z scores, and abnormal white matter volume quantified by brain magnetic resonance imaging. Of 9,361 SPRINT participants, 2,800 participated in SPRINT-MIND and 2,707 had complete data; 637 had brain imaging. Mean age was 68 years, 37% were women, 30% were black, and 20% had known cardiovascular disease. Mean eGFR was 70.8±20.9mL/min/1.73m 2 and median urine ACR was 9.7 (IQR, 5.7-22.5) mg/g. In adjusted analyses, higher ACR was associated with worse global cognitive function, executive function, memory, and attention, such that each doubling of urine ACR had the same association with cognitive performance as being 7, 10, 6, and 14 months older, respectively. Lower eGFR was independently associated with worse global cognitive function and memory. In adjusted models, higher ACR, but not eGFR, was associated with larger abnormal white matter volume. Cross-sectional only, no patients with diabetes were included. In older adults, higher urine ACR and lower eGFR have independent associations with global cognitive performance with different affected domains. Albuminuria concurrently identifies a higher burden of abnormal brain

  10. Decreased systolic blood pressure is associated with increased risk of all-cause mortality in patients with type 2 diabetes and renal impairment: A nationwide longitudinal observational study of 27,732 patients based on the Swedish National Diabetes Register.

    Science.gov (United States)

    Svensson, Maria K; Afghahi, Henri; Franzen, Stefan; Björk, Staffan; Gudbjörnsdottir, Soffia; Svensson, Ann-Marie; Eliasson, Björn

    2017-05-01

    Previous studies have shown a U-shaped relationship between systolic blood pressure and risk of all-cause of mortality in patients with type 2 diabetes and renal impairment. To evaluate the associations between time-updated systolic blood pressure and time-updated change in systolic blood pressure during the follow-up period and risk of all-cause mortality in patients with type 2 diabetes and renal impairment. A total of 27,732 patients with type 2 diabetes and renal impairment in the Swedish National Diabetes Register were followed for 4.7 years. Time-dependent Cox models were used to estimate risk of all-cause mortality. Time-updated mean systolic blood pressure is the average of the baseline and the reported post-baseline systolic blood pressures. A time-updated systolic blood pressure blood pressure > 10 mmHg between the last two observations was associated with higher risk of all-cause mortality (-10 to -25 mmHg; hazard ratio: 1.24, 95% confidence interval: 1.17-1.32). Both low systolic blood pressure and a decrease in systolic blood pressure during the follow-up are associated with a higher risk of all-cause mortality in patients with type 2 diabetes and renal impairment.

  11. Global Burden of Hypertension and Systolic Blood Pressure of at Least 110 to 115 mm Hg, 1990-2015.

    Science.gov (United States)

    Forouzanfar, Mohammad H; Liu, Patrick; Roth, Gregory A; Ng, Marie; Biryukov, Stan; Marczak, Laurie; Alexander, Lily; Estep, Kara; Hassen Abate, Kalkidan; Akinyemiju, Tomi F; Ali, Raghib; Alvis-Guzman, Nelson; Azzopardi, Peter; Banerjee, Amitava; Bärnighausen, Till; Basu, Arindam; Bekele, Tolesa; Bennett, Derrick A; Biadgilign, Sibhatu; Catalá-López, Ferrán; Feigin, Valery L; Fernandes, Joao C; Fischer, Florian; Gebru, Alemseged Aregay; Gona, Philimon; Gupta, Rajeev; Hankey, Graeme J; Jonas, Jost B; Judd, Suzanne E; Khang, Young-Ho; Khosravi, Ardeshir; Kim, Yun Jin; Kimokoti, Ruth W; Kokubo, Yoshihiro; Kolte, Dhaval; Lopez, Alan; Lotufo, Paulo A; Malekzadeh, Reza; Melaku, Yohannes Adama; Mensah, George A; Misganaw, Awoke; Mokdad, Ali H; Moran, Andrew E; Nawaz, Haseeb; Neal, Bruce; Ngalesoni, Frida Namnyak; Ohkubo, Takayoshi; Pourmalek, Farshad; Rafay, Anwar; Rai, Rajesh Kumar; Rojas-Rueda, David; Sampson, Uchechukwu K; Santos, Itamar S; Sawhney, Monika; Schutte, Aletta E; Sepanlou, Sadaf G; Shifa, Girma Temam; Shiue, Ivy; Tedla, Bemnet Amare; Thrift, Amanda G; Tonelli, Marcello; Truelsen, Thomas; Tsilimparis, Nikolaos; Ukwaja, Kingsley Nnanna; Uthman, Olalekan A; Vasankari, Tommi; Venketasubramanian, Narayanaswamy; Vlassov, Vasiliy Victorovich; Vos, Theo; Westerman, Ronny; Yan, Lijing L; Yano, Yuichiro; Yonemoto, Naohiro; Zaki, Maysaa El Sayed; Murray, Christopher J L

    2017-01-10

    Elevated systolic blood (SBP) pressure is a leading global health risk. Quantifying the levels of SBP is important to guide prevention policies and interventions. To estimate the association between SBP of at least 110 to 115 mm Hg and SBP of 140 mm Hg or higher and the burden of different causes of death and disability by age and sex for 195 countries and territories, 1990-2015. A comparative risk assessment of health loss related to SBP. Estimated distribution of SBP was based on 844 studies from 154 countries (published 1980-2015) of 8.69 million participants. Spatiotemporal Gaussian process regression was used to generate estimates of mean SBP and adjusted variance for each age, sex, country, and year. Diseases with sufficient evidence for a causal relationship with high SBP (eg, ischemic heart disease, ischemic stroke, and hemorrhagic stroke) were included in the primary analysis. Mean SBP level, cause-specific deaths, and health burden related to SBP (≥110-115 mm Hg and also ≥140 mm Hg) by age, sex, country, and year. Between 1990-2015, the rate of SBP of at least 110 to 115 mm Hg increased from 73 119 (95% uncertainty interval [UI], 67 949-78 241) to 81 373 (95% UI, 76 814-85 770) per 100 000, and SBP of 140 mm Hg or higher increased from 17 307 (95% UI, 17 117-17 492) to 20 526 (95% UI, 20 283-20 746) per 100 000. The estimated annual death rate per 100 000 associated with SBP of at least 110 to 115 mm Hg increased from 135.6 (95% UI, 122.4-148.1) to 145.2 (95% UI 130.3-159.9) and the rate for SBP of 140 mm Hg or higher increased from 97.9 (95% UI, 87.5-108.1) to 106.3 (95% UI, 94.6-118.1). For loss of DALYs associated with systolic blood pressure of 140 mm Hg or higher, the loss increased from 95.9 million (95% uncertainty interval [UI], 87.0-104.9 million) to 143.0 million (95% UI, 130.2-157.0 million) [corrected], and for SBP of 140 mm Hg or higher, the loss increased from 5.2 million (95% UI, 4.6-5.7 million) to 7

  12. Association Between Short-Term Systolic Blood Pressure Variability and Carotid Intima-Media Thickness in ELSA-Brasil Baseline.

    Science.gov (United States)

    Ribeiro, Adèle H; Lotufo, Paulo A; Fujita, André; Goulart, Alessandra C; Chor, Dora; Mill, José G; Bensenor, Isabela M; Santos, Itamar S

    2017-10-01

    Blood pressure (BP) is associated with carotid intima-media thickness (CIMT), but few studies have explored the association between BP variability and CIMT. We aimed to investigate this association in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline. We analyzed data from 7,215 participants (56.0% women) without overt cardiovascular disease (CVD) or antihypertensive use. We included 10 BP readings in varying positions during a 6-hour visit. We defined BP variability as the SD of these readings. We performed a 2-step analysis. We first linearly regressed the CIMT values on main and all-order interaction effects of the variables age, sex, body mass index, race, diabetes diagnosis, dyslipidemia diagnosis, family history of premature CVD, smoking status, and ELSA-Brasil site, and calculated the residuals (residual CIMT). We used partial least square path analysis to investigate whether residual CIMT was associated with BP central tendency and BP variability. Systolic BP (SBP) variability was significantly associated with residual CIMT in models including the entire sample (path coefficient [PC]: 0.046; P < 0.001), and in women (PC: 0.046; P = 0.007) but not in men (PC: 0.037; P = 0.09). This loss of significance was probably due to the smaller subsample size, as PCs were not significantly different according to sex. We found a small but significant association between SBP variability and CIMT values. This was additive to the association between SBP central tendency and CIMT values, supporting a role for high short-term SBP variability in atherosclerosis. © American Journal of Hypertension, Ltd 2017. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  13. DIETARY FIBER AND SERUM 16α-HYDROXYESTRONE, AN ESTROGEN METABOLITE ASSOCIATED WITH LOWER SYSTOLIC BLOOD PRESSURE

    Science.gov (United States)

    Patel, Shawn; Hawkley, Louise C.; Cacioppo, John T.; Masi, Christopher M.

    2010-01-01

    Objective We recently identified an inverse relationship between systolic blood pressure (SBP) and serum 16α-hydroxyestrone, a metabolite of 17β-estradiol, in postmenopausal women. Formation of 16α-hydroxyestrone is catalyzed primarily by CYP1A2, a cytochrome P450 enzyme. The objective of this study was to evaluate the relationships between known modifiers of CYP1A2 activity and serum 16α-hydroxyestrone in postmenopausal women. We hypothesized that fruits, vegetables, and grains, which contain more soluble fiber (a known inducer of CYP1A2) as a proportion of total fiber, would be more positively associated with serum 16α-hydroxyestrone than legumes, which contain less soluble fiber as a proportion of total fiber. Materials and Methods Serum from a population-based sample of 42 postmenopausal women aged 55–69 living in Cook County, Illinois, was assayed for 16α-hydroxyestrone using mass spectrometry. Ordinal logistic regression was used to evaluate the cross-sectional relationship between dietary fiber and serum 16α-hydroxyestrone after adjusting for multiple covariates. Results Relative to dietary fiber from legumes, dietary fiber from fruits and vegetables was associated with a greater log odds (B = 0.201, p = 0.036) of having higher serum concentrations of 16α-hydroxyestrone. The log odds of having higher serum concentrations of 16α-hydroxyestrone was also lower among African-American women (B = −2.300, p = .030) compared to white women. Conclusion These results are consistent with previous studies demonstrating a negative relationship between SBP and dietary fruits and vegetables and a positive relationship between African-American race and SBP. Further research is needed regarding dietary factors that may influence the serum concentration of 16α-hydroxyestrone. PMID:21035306

  14. Systolic blood pressure target in systemic arterial hypertension: Is lower ever better? Results from a community-based Caucasian cohort.

    Science.gov (United States)

    Di Nora, Concetta; Cioffi, Giovanni; Iorio, Annamaria; Rivetti, Luigi; Poli, Stefano; Zambon, Elena; Barbati, Giulia; Sinagra, Gianfranco; Di Lenarda, Andrea

    2018-02-01

    Extensive evidence exists about the prognostic role of systolic blood pressure (SBP) reduction ≤140mmHg. Recently, the SPRINT trial successfully tested the strategy of lowering SBP<120mmHg in patients with arterial hypertension (AH). To assess whether the SPRINT results are reproducible in a real world community population. Cross-sectional, population-based study analyzing data of 24,537 Caucasian people with AH from the Trieste Observatory of CV disease, 2010 to 2015. We selected and divided 2306 subjects with AH according to the SPRINT trial criteria; similarly, SPRINT clinical outcomes were considered. Study patients median age was 75±8years, two third male, one third had ischemic heart disease. They were older, with lower body mass index, higher SBP and Framingham CV risk score than the SPRINT patients. Three-hundred-sixty-eight patients (16%) had SBP<120mmHg. During 48 [36-60] months of follow-up, 751 patients (32%) experienced a major adverse cardiac event (MACE). The SBP <120mmHg group had higher incidence of MACE, CV deaths and all-cause death than SBP≥120mmHg group (37% vs 31%; 10% vs 4%; 19% vs 10%, all p<0.05). The condition of SBP<120mmHg was an independent predictor of MACE in multivariate Cox analysis together with older age, male gender, higher Charlson score. In our experience, the SBP<120mmHg condition is associated with worse clinical outcomes, suggesting the SPRINT results are not reproducible tout court in Caucasian community populations. These differences should be taken as a warning against aggressive reducing of SBP<120mmHg. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Ágnes A. Fekete

    2015-01-01

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

  16. Association of Inter-Arm Systolic Blood Pressure Difference with Coronary Atherosclerotic Disease Burden Using Calcium Scoring.

    Science.gov (United States)

    Her, Ae Young; Cho, Kyoung Im; Garg, Scot; Kim, Yong Hoon; Shin, Eun Seok

    2017-09-01

    There are no sufficient data on the correlation between inter-arm blood pressure (BP) difference and coronary atherosclerosis found using coronary artery calcium score (CACS). We aimed to investigate if the increased difference in inter-arm BP is independently associated with severity of CACS. Patients who had ≥3 cardiovascular risk factors or an intermediate Framingham Risk Score (FRS; ≥10) were enrolled. Inter-arm BP difference was defined as the absolute difference in BP in both arms. Quantitative CACS was measured by using coronary computed tomography angiography with the scoring system. A total of 261 patients were included in this study. Age (r=0.256, parm systolic BP (SBP; r=0.172, p=0.005), mean of left arm SBP (r=0.190, p=0.002), inter-arm SBP difference (r=0.152, p=0.014), and the FRS (r=0.278, parm SBP difference (≥6 mm Hg) was significantly associated with CACS ≥300 [odds ratio (OR) 2.17, 95% confidence interval (CI) 1.12-4.22; p=0.022]. In multivariable analysis, the inter-arm SBP difference ≥6 mm Hg was also significantly associated with CACS ≥300 after adjusting for clinical risk factors (OR 2.34, 95 % CI 1.06-5.19; p=0.036). An increased inter-arm SBP difference (≥6 mm Hg) is associated with coronary atherosclerotic disease burden using CACS, and provides additional information for predicting severe coronary calcification, compared to models based on traditional risk factors. © Copyright: Yonsei University College of Medicine 2017

  17. Systolic blood pressure reactions to acute stress are associated with future hypertension status in the Dutch Famine Birth Cohort Study

    NARCIS (Netherlands)

    Carroll, Douglas; Ginty, Annie T.; Painter, Rebecca C.; Roseboom, Tessa J.; Phillips, Anna C.; de Rooij, Susanne R.

    2012-01-01

    These analyses examined the association between blood pressure reactions to acute psychological stress and subsequent hypertension status in a substantial Dutch cohort. Blood pressure was recorded during a resting baseline and during three acute stress tasks, Stroop colour word, mirror tracing and

  18. Mediation and Moderation of the Association between Cynical Hostility and Systolic Blood Pressure in Low-Income Women

    Science.gov (United States)

    Versey, H. Shellae; Kaplan, George A.

    2012-01-01

    Hostility may be related to risk factors for cardiovascular disease (CVD), such as blood pressure. However, the process by which hostility affects blood pressure is not fully understood. The current study sought to evaluate abdominal obesity (waist-to-hip ratio [WHR]) as a potential mediator and modifier of the relationship between cynical…

  19. A CROSS SECTIONAL STUDY TO FIND THE DIFFERENCE IN SYSTOLIC BLOOD PRESSURE BETWEEN ARMS AS A RISK MARKER FOR DIABETIC NEPHROPATHY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

    OpenAIRE

    Uday Subhash Bande; Anish Anthony Tekkinadath

    2016-01-01

    BACKGROUND Diabetic nephropathy is the commonest cause of end-stage renal disease in the developed world. Recent studies have demonstrated that a difference in systolic blood pressure between arms is associated with cardiovascular disease and microalbuminuria. It is considered a predictor for cardiovascular disease and a surrogate marker for early kidney damage among patients with both type 2 diabetes and hypertension. AIMS AND OBJECTIVES The aim was to investigate an associ...

  20. HbA1c, systolic blood pressure variability and diabetic retinopathy in Asian type 2 diabetics.

    Science.gov (United States)

    Foo, Valencia; Quah, Joanne; Cheung, Gemmy; Tan, Ngiap Chun; Ma Zar, Kyi Lin; Chan, Choi Mun; Lamoureux, Ecosse; Tien Yin, Wong; Tan, Gavin; Sabanayagam, Charumathi

    2017-02-01

    The aim of the present study was to examine the association between variability in HbA1c or systolic blood pressure (SBP) and diabetes-specific moderate retinopathy in Asians with type 2 diabetes (T2D). A retrospective study was conducted of 172 cases of moderate diabetic retinopathy (DR) cases and 226 controls without DR, matched for age, sex, and ethnicity. Serial HbA1c and SBP (range 3-6 readings) over the 2 years prior to photographic screening of DR were collected. Intrapersonal mean and SD values for HbA1c (iM-HbA1c and iSD-HbA1c) and SBP (iM-SBP and iSD-SBP) were derived. Moderate DR was assessed from digital retinal photographs and defined as levels >43 using the Early Treatment Diabetic Retinopathy Study scale. Cases of moderate DR had higher iM-HbA1c (8.2 % vs 7.3 %; P = 0.001), iSD-HbA1c (1.22 vs 0.64; P = 0.001), iM-SBP (136.8 vs 129.6 mmHg; P = 0.001) and iSD-SBP (13.3 vs 11.1; P = 0.002) than controls. In the multivariate regression model adjusted for age, gender, ethnicity, duration of diabetes, SBP, and HbA1c, iM-HbA1c and iM-SBP were significantly associated with moderate DR (odds ratio [OR] 1.80, 95 % confidence interval [CI] 1.37-2.36; and OR 1.03, 95 % CI 1.01-1.05, respectively). Neither iSD-HbA1c nor iSD-SBP were associated with moderate DR. When stratified by HbA1c HbA1c levels and SBP, but not their variability, were associated with moderate DR. Among those with good glycemic control, wider variability of SBP is associated with moderate DR. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  1. Effects of patient-controlled abdominal compression on standing systolic blood pressure in adults with orthostatic hypotension.

    Science.gov (United States)

    Figueroa, Juan J; Singer, Wolfgang; Sandroni, Paola; Sletten, David M; Gehrking, Tonette L; Gehrking, Jade A; Low, Phillip; Basford, Jeffrey R

    2015-03-01

    To assess the effects of patient-controlled abdominal compression on postural changes in systolic blood pressure (SBP) associated with orthostatic hypotension (OH). Secondary variables included subject assessments of their preferences and the ease-of-use. Randomized crossover trial. Clinical research laboratory. Adults with neurogenic OH (N=13). Four maneuvers were performed: moving from supine to standing without abdominal compression; moving from supine to standing with either a conventional or an adjustable abdominal binder in place; application of subject-determined maximal tolerable abdominal compression while standing; and while still erect, subsequent reduction of abdominal compression to a level the subject believed would be tolerable for a prolonged period. The primary outcome variable included postural changes in SBP. Secondary outcome variables included subject assessments of their preferences and ease of use. Baseline median SBP in the supine position was not affected by mild (10mmHg) abdominal compression prior to rising (without abdominal compression: 146mmHg; interquartile range, 124-164mmHg; with the conventional binder: 145mmHg; interquartile range, 129-167mmHg; with the adjustable binder: 153mmHg, interquartile range, 129-160mmHg; P=.85). Standing without a binder was associated with an -57mmHg (interquartile range, -40 to -76mmHg) SBP decrease. Levels of compression of 10mmHg applied prior to rising with the conventional and adjustable binders blunted these drops to -50mmHg (interquartile range, -33 to -70mmHg; P=.03) and -46mmHg (interquartile range, -34 to -75mmHg; P=.01), respectively. Increasing compression to subject-selected maximal tolerance while standing did not provide additional benefit and was associated with drops of -53mmHg (interquartile range, -26 to -71mmHg; P=.64) and -59mmHg (interquartile range, -49 to -76mmHg; P=.52) for the conventional and adjustable binders, respectively. Subsequent reduction of compression to more

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

    Science.gov (United States)

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

  3. Association of systolic blood pressure drop with intravenous administration of itraconazole in children with hemato-oncologic disease

    Directory of Open Access Journals (Sweden)

    Lee HJ

    2015-12-01

    Full Text Available Hyeong Jin Lee,1,* Bongjin Lee,2,* June Dong Park,2 Hyung Joo Jeong,2 Yu Hyeon Choi,2 Hee Young Ju,1 Che Ry Hong,1 Ji Won Lee,1 Hyery Kim,1 Dong In Suh,3 Kyung Duk Park,1 Hyoung Jin Kang,1 Hee Young Shin,1 Hyo Seop Ahn1 1Department of Pediatrics, Cancer Research Institute, 2Division of Pediatric Intensive Care, Department of Pediatrics, 3Division of Pulmonology, Department of Pediatrics, Seoul National University College of Medicine, Seoul National University, Seoul, South Korea *These authors contributed equally to this work Purpose: Although few adverse effects have been reported for itraconazole, a widely used antifungal therapy for febrile neutropenia, we found intravenous (IV itraconazole to be associated with serious cases of blood pressure (BP drop. We therefore evaluated the incidence and risk factors for BP drop during IV administration of the drug.Materials and methods: We reviewed the medical records of children with hemato-oncologic disease who were treated with IV itraconazole from January 2012 to December 2013. By analyzing systolic BP (SBP measurements made from 4 hours before through to 4 hours after itraconazole administration, we evaluated the changes in SBP and the risk factors for an SBP drop, especially clinically meaningful (≥20% drops.Results: Itraconazole was administered 2,627 times to 180 patients. The SBP during the 4 hours following itraconazole administration was lower than during the 4 hours before administration (104 [53.0–160.33 mmHg] versus 105 [59.8–148.3 mmHg]; P<0.001. The decrease in SBP was associated with the application of continuous renal replacement therapy (CRRT (P=0.012 and the use of inotropic (P=0.005 and hypotensive drugs (P=0.021. A clinically meaningful SBP drop was seen in 5.37% (141 out of 2,627 of the administrations, and the use of inotropics (odds ratio [OR] 6.70, 95% confidence interval [CI] 3.22–13.92; P<0.001, reducing the dose of inotropics (OR 8.08; 95% CI 1.39–46.94; P=0

  4. The effects of increasing levels of dietary garlic bulb on growth performance, systolic blood pressure, hematology, and ascites syndrome in broiler chickens.

    Science.gov (United States)

    Varmaghany, Saifali; Karimi Torshizi, Mohammad Amir; Rahimi, Shaban; Lotfollahian, Houshang; Hassanzadeh, Mohammad

    2015-08-01

    The effects of dietary garlic bulb were studied separately on hematological parameters, ascites incidence, and growth performance of an ascites susceptible broiler hybrid under both standard temperature conditions ( STC: ) and cold temperature conditions ( CTC: ). A total of 336 one-day-old male broiler chickens were allocated to 4 experimental groups with 4 replicates of 21 birds each under STC. In addition, the same grouping with another 336 birds was used for CTC. Under CTC, the birds were exposed to cold temperatures for induction of ascites. Experimental groups were defined by the inclusion of 0 (control), 5, 10 or 15 g/kg garlic bulbs in the diets under both STC and CTC. Growth performance, systolic blood pressure (as a measure of systemic arterial blood pressure), physiological and biochemical parameters, as well as ascites indices (right ventricle [ RV: ], total ventricle [ TV: ] weights, and RV/TV: ) were evaluated. Systolic blood pressure was determined using an indirect method with a sphygmomanometer, a pediatric cuff, and a Doppler device. The final body weight decreased quadratically (P = 0.003), with increasing garlic bulb levels in the diets under STC. The feed conversion ratio showed no significant differences among all groups under both STC and CTC. No significant differences were observed in total mortality and ascites-related mortality in all groups under STC, although total mortality (L: P = 0.01; Q: P = 0.001) and ascites-related mortality (L: P = 0.007; Q: P = 0.001) were significantly different among the diets under CTC. Under STC, the systolic blood pressure, packed cell volume, hemoglobin, RV, TV, and RV/TV did not vary significantly among the diets. However, red blood cell count and erythrocyte osmotic fragility decreased linearly (P garlic bulb levels in the diets under STC. Under CTC, the systolic blood pressure, packed cell volume, red blood cell count, and erythrocyte osmotic fragility decreased (P garlic levels. It is

  5. Evaluation of the effect of systolic blood pressure and pulse pressure on cognitive function: the Women's Health and Aging Study II.

    Directory of Open Access Journals (Sweden)

    Sevil Yasar

    Full Text Available Evidence suggests that elevated systolic blood pressure (SBP and pulse pressure (PP in midlife is associated with increased risk for cognitive impairment later in life. There is mixed evidence regarding the effects of late life elevated SBP or PP on cognitive function, and limited information on the role of female gender.Effects of SBPand PPon cognitive abilities at baseline and over a 9-year period were evaluated in 337 non-demented community-dwelling female participants over age 70 in the Women's Health and Aging Study II using logistic and Cox proportional hazards regression analyses. Participants aged 76-80 years with SBP≥160 mmHg or PP≥84 mmHg showed increased incidence of impairment on Trail Making Test-Part B (TMT, Part B, a measure of executive function, over time when compared to the control group that included participants with normal and pre-hypertensive SBP (<120 and 120-139 mmHg or participants with low PP (<68 mmHg (HR = 5.05 [95%CI = 1.42, 18.04], [HR = 5.12 [95%CI = 1.11; 23.62], respectively. Participants aged 70-75 years with PP≥71 mmHg had at least a two-fold higher incidence of impairment on HVLT-I, a measure of verbal learning, over time when compared to participants with low PP (<68 mmHg (HR = 2.44 [95%CI = 1.11, 5.39].Our data suggest that elevated SBP or PP in older non-demented women increases risk for late-life cognitive impairment and that PP could be used when assessing the risk for impairment in cognitive abilities. These results warrant further, larger studies to evaluate possible effects of elevated blood pressure in normal cognitive aging.

  6. Observation of the pulse oximeter trace to estimate systolic blood ...

    African Journals Online (AJOL)

    Background: The estimation of systolic blood pressure by disappearance and reappearance of the pulse oximeter trace during cuff inflation and deflation was compared with non-invasive blood pressure (NIBP) measurement, across the range of body mass index (BMI), during spinal anaesthesia for Caesarean section.

  7. Systolic blood pressure criteria in the National Trauma Triage Protocol for geriatric trauma: 110 is the new 90.

    Science.gov (United States)

    Brown, Joshua B; Gestring, Mark L; Forsythe, Raquel M; Stassen, Nicole A; Billiar, Timothy R; Peitzman, Andrew B; Sperry, Jason L

    2015-02-01

    Undertriage is a concern in geriatric patients. The National Trauma Triage Protocol (NTTP) recognized that systolic blood pressure (SBP) less than 110 mm Hg may represent shock in those older than 65 years. The objective was to evaluate the impact of substituting an SBP of less than 110 mm Hg for the current SBP of less than 90 mm Hg criterion within the NTTP on triage performance and mortality. Subjects undergoing scene transport in the National Trauma Data Bank (2010-2012) were included. The outcome of trauma center need was defined as Injury Severity Score (ISS) greater than 15, intensive care unit admission, urgent operation, or emergency department death. Geriatric (age > 65 years) and adult (age, 16-65 years) cohorts were compared. Triage characteristics and area under the curve (AUC) were compared between SBP of less than 110 mm Hg and SBP of less than 90 mm Hg. Hierarchical logistic regression was used to determine whether geriatric patients newly triaged positive under this change (SBP, 90-109 mm Hg) have a risk of mortality similar to those triaged positive with SBP of less than 90 mm Hg. There were 1,555,944 subjects included. SBP of less than 110 mm Hg had higher sensitivity but lower specificity in geriatric (13% vs. 5%, 93% vs. 99%) and adult (23% vs. 10%, 90% vs. 98%) cohorts. AUC was higher for SBP of less than 110 mm Hg individually in both geriatric and adult (p AUC was similar for SBP of less than 110 mm Hg and SBP of less than 90 mm Hg in geriatric subjects but was higher for SBP of less than 90 mm Hg in adult subjects (p < 0.01). Substituting SBP of less than 110 mm Hg resulted in an undertriage reduction of 4.4% with overtriage increase of 4.3% in the geriatric cohort. Geriatric subjects with SBP of 90 mm Hg to 109 mm Hg had an odds of mortality similar to those of geriatric patients with SBP of less than 90 mm Hg (adjusted odds ratio, 1.03; 95% confidence interval, 0.88-1.20; p = 0.71). SBP of less than 110 mm Hg increases sensitivity. SBP of

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

    DEFF Research Database (Denmark)

    Li, Shuxia; Pang, Zengchang; Zhang, Dongfeng

    2014-01-01

    with Danish twins. The estimated contribution from unique environmental factors suggests that promoting healthy lifestyles may provide an efficient way of controlling high blood pressure, particularly in the Chinese population.Hypertension Research advance online publication, 15 May 2014; doi:10.1038/hr.2014.95....

  9. Hemodynamic variables during exercise in childhood and resting systolic blood pressure levels 6 years later in adolescence: the European Youth Heart Study

    DEFF Research Database (Denmark)

    Grøntved, Anders; Andresen, Brage Storstein; Møller, N C

    2011-01-01

    of Danish children followed longitudinally for 6 years. The study comprised 226 children randomly sampled at age 9, who had their blood pressure and HR measured during ergometer exercise to exhaustion and was reassessed in adolescence. SBP and RPP during exercise in stage two of the test were positively......The aim of this study was to analyze whether systolic blood pressure (SBP), heart rate (HR) and rate pressure product (RPP) during exercise in childhood can predict resting SBP levels in adolescence independent of resting SBP and conventional cardiovascular risk factors. We studied this in a sample...... remained significant (P=0.059 and P=0.012, respectively). No significant independent associations were observed for HR during exercise, but associations were in the same direction. Our results supports that measuring SBP and RPP, during a standard acute ergometer exercise test in children, improves...

  10. Simultaneous inter-arm and inter-leg systolic blood pressure differences to diagnose peripheral artery disease: a diagnostic accuracy study.

    Science.gov (United States)

    Herráiz-Adillo, Ángel; Soriano-Cano, Alba; Martínez-Hortelano, José Alberto; Garrido-Miguel, Miriam; Mariana-Herráiz, Julián Ángel; Martínez-Vizcaíno, Vicente; Notario-Pacheco, Blanca

    2018-04-01

    Inter-arm systolic blood pressure differences (IASBPD) and inter-leg systolic blood pressure differences (ILSBPD) have arisen as potential tools to detect peripheral artery disease (PAD) and individuals at high cardiovascular risk. This study aims to evaluate the diagnostic accuracy of IASBPD and ILSBPD to detect PAD, and whether IASBPD or ILSBPD improves diagnostic accuracy of the oscillometric ankle-brachial index (ABI). In this prospective study, eligible for inclusion were consecutive adults, with at least one of the following cardiovascular risk factors: diabetes, dyslipidemia, hypertension, smoking habit or age ≥65. IASBPD, ILSBPD and ankle-brachial index (ABI) were measured in all participants through four-limb simultaneous oscillometric measurements and compared with Doppler ABI (reference test, positive cut-off: ≤ 0.9). Of 171 subjects included, PAD was confirmed in 23 and excluded in 148. Thirteen and 38 subjects had IASBPD and ILSBPD ≥10 mmHg, respectively. Pearson correlation with Doppler ABI of IASBPD and ILSBPD was 0.073 (P = .343) and -0.628 (P blood pressure measurements in upper limbs are not possible.

  11. Slow loaded breathing training improves blood pressure, lung capacity and arm exercise endurance for older people with treated and stable isolated systolic hypertension.

    Science.gov (United States)

    Ublosakka-Jones, Chulee; Tongdee, Phailin; Pachirat, Orathai; Jones, David A

    2018-03-28

    Hypertension and reduced lung function are important features of aging. Slow loaded breathing training reduces resting blood pressure and the question is whether this can also improve lung function. Thirty-two people (67 ± 5 years, 16 male) with controlled isolated systolic hypertension undertook an eight weeks randomised controlled training trial with an inspiratory load of 25% maximum inspiratory pressure (MIP) at 6 breaths per minute (slow loaded breathing; SLB) or deep breathing control (CON). Outcome measures were resting blood pressure (BP) and heart rate; MIP; lung capacity; chest and abdominal expansion; arm cranking exercise endurance at 50% heart rate reserve. Home based measurement of resting systolic BP decreased by 20 mm Hg (15 to 25) (Mean and 95%CI) for SLB and by 5 mm Hg (1 to 7) for CON. Heart rate and diastolic BP also decreased significantly for SLB but not CON. MIP increased by 15.8 cm H 2 O (11.8 to 19.8) and slow vital capacity by 0.21 L (0.15 to 0.27) for SLB but not for CON. Chest and abdominal expansion increased by 2.3 cm (2.05 to 2.55) and 2.5 cm (2.15 to 2.85), respectively for SLB and by 0.5 cm (0.26 to 0.74) and 1.7 cm (1.32 to 2.08) for CON. Arm exercise time increased by 4.9 min (3.65 to 5.15) for SLB with no significant change for CON. Slow inspiratory muscle training is not only effective in reducing resting BP, even in older people with well controlled isolated systolic hypertension but also increases inspiratory muscle strength, lung capacity and arm exercise duration. Copyright © 2018. Published by Elsevier Inc.

  12. Prevalence of systolic inter-arm differences in blood pressure for different primary care populations: systematic review and meta-analysis.

    Science.gov (United States)

    Clark, Christopher E; Taylor, Rod S; Shore, Angela C; Campbell, John L

    2016-11-01

    Various prevalence figures have been reported for inter-arm differences in blood pressure (IAD); variation may be explained by differing population vascular risk and by measurement method. To review the literature to derive robust estimates of IAD prevalence relevant to community populations. Systematic review and meta-analysis. MEDLINE, Embase, and CINAHL were searched for cross-sectional studies likely to represent general or primary care populations, reporting prevalence of IAD and employing a simultaneous method of measurement. Using study-level data, pooled estimates of mean prevalence of systolic IADs were calculated and compared using a random effects model. Eighty IAD studies were identified. Sixteen met inclusion criteria: pooled estimates of prevalence for systolic IAD ≥10 mmHg were 11.2% (95% confidence interval [CI] = 9.1 to 13.6) in hypertension, 7.4% (95% CI = 5.8 to 9.2) in diabetes, and 3.6% (95% CI = 2.3 to 5.0) for a general adult population (Pdifferences). Differences persisted for higher cut-off values. Prevalences were lower for East Asian than for Western populations and were overestimated by sequential measurement where this could be compared with simultaneous measurement within studies (relative risk for IAD: 2.9 [95% CI = 2.1 to 4.1]). Studies with higher mean absolute systolic pressures had higher prevalences for a systolic IAD ≥10 mmHg (P = 0.04). Prevalences of IADs rise in relation to underlying cardiovascular comorbidities of the population studied, and are overestimated threefold when sequential measurement is used. Population-specific variation in prevalences of IAD should be taken into account in delivering clinical care and in planning future studies. © British Journal of General Practice 2016.

  13. Blood pressure

    Science.gov (United States)

    Normal blood pressure is important for proper blood flow to the body's organs and tissues. The force of the blood on the walls of the arteries is called blood pressure. Blood pressure is measured both as the heart ...

  14. Nesfatin-1 and Vitamin D levels may be associated with systolic and diastolic blood pressure values and hearth rate in polycystic ovary syndrome.

    Science.gov (United States)

    Sahin, Figen Kir; Sahin, Serap Baydur; Ural, Ulku Mete; Cure, Medine Cumhur; Senturk, Senol; Tekin, Yesim Bayoglu; Balik, Gulsah; Cure, Erkan; Yuce, Suleyman; Kirbas, Aynur

    2015-07-09

    Obesity, insulin resistance (IR), inflammation, and hyperandrogenism may lead to polycystic ovary syndrome (PCOS) and hypertension. Nesfatin-1 (N1) may be related to IR, obesity, and hypertension. Furthermore, a vitamin D (VD) deficiency is associated with hypertension and PCOS. We aimed to investigate N1 and VD levels in PCOS that have an effect on systolic and diastolic blood pressure (BP) and heart rate (HR).This study included 54 patients with PCOS and 48 age-body mass index (BMI)-matched healthy controls. PCOS was diagnosed according to clinical practice guidelines. Ferriman-Gallwey scores (FGS) were calculated, while N1, VD, and other hormonal and biochemical parameters were measured for all subjects. Systolic and diastolic BP was measured as well. HR was calculated using an electrocardiogram.The levels of N1 (p < 0.001), high-sensitivity C-reactive protein (hs-CRP) (p = 0.036), homeostasis model assessment as an index of insulin resistance (HOMA-IR) (p < 0.001), systolic (p < 0.001) and diastolic (p < 0.001) BP and HR (p < 0.001) in the PCOS group were significantly higher than in the control group. However, the VD levels of the PCOS group were lower than the control group (p = 0.004). N1 had a strong positive correlation with BMI, HOMA-IR, hs-CRP, luteinizing hormone, systolic and diastolic BP, and HR. VD levels were negatively correlated with HOMA-IR and luteinizing hormone.Elevated N1 and decreased VD levels may be related to the presence of high-normal BP or hypertension in PCOS subjects.  N1 level may be associated with an increased BP due to its relation to inflammation and IR.

  15. How well can blood pressure be controlled? Progress report on the Systolic Hypertension in Europe Follow-Up Study (Syst-Eur 2

    Directory of Open Access Journals (Sweden)

    Sarti Cinzia

    2001-10-01

    Full Text Available Abstract Background The randomised, double-blind, placebo-controlled Systolic Hypertension in Europe trial (Syst-Eur 1 proved that blood pressure (BP lowering therapy starting with nitrendipine reduces the risk of cardiovascular complications in elderly patients with isolated systolic hypertension. In an attempt to confirm the safety of long-term antihypertensive therapy based on a dihydropyridine, the Syst-Eur patients remained in open follow-up after the end of Syst-Eur 1. This paper presents the second progress report of this follow-up study (Syst-Eur 2. It describes BP control and adherence to study medications. Methods After the end of Syst-Eur 1 all patients, treated either actively or with placebo, were invited either to continue or to start antihypertensive treatment with the same drugs as previously used in the active treatment arm. In order to reach the target BP (sitting SBP Results Of the 3787 eligible patients, 3516 (93% entered Syst-Eur 2. At the last available visit, 72% of the patients were taking nitrendipine. SBP/DBP at entry in Syst-Eur 2 averaged 160/83 mmHg in the former placebo group and 151/80 mmHg in the former active-treatment group. At the last follow-up visit SBP/DBP in the patients previously randomised to placebo or active treatment had decreased by 16/5 mmHg and 7/5 mmHg, respectively. The target BP was reached by 74% of the patients. Conclusion Substantial reductions in systolic BP may be achieved in older patients with isolated systolic hypertension with a treatment strategy starting with the dihydropyridine calcium-channel blocker, nitrendipine, with the possible addition of enalapril and/or hydrochlorothiazide.

  16. Comparing systolic and diastolic Blood pressure changes and heartbeat rate following administration of anesthetics containing epinephrine and felypressin

    Directory of Open Access Journals (Sweden)

    M. Jafari

    1998-05-01

    Full Text Available   Complex mechanisms have been known for keeping blood pressure in normal level. In fact, these mechanisms have inter-related functions and can be dysregulated by both internal and external stimuli while cardiovascular system functions to minimize these changes. Vasoconstrictors can cause clinical and hemodynamical changes as 1-2 cartridges of epinephrine containing lidocaine can has no considerable effects in a normal individual ( unless administered IV but 3 cartridges can bring about some clinical symptoms, according to a number of investigations. In current study, epinephrine’s effect on heartbeat rate was found more potent than felypressin which is considered as a disadvantage. on the other hand, epinephrine acts on arteries and can cause less bleeding, less drug toxicity and deeper and longer anesthesia. Therefore, it is preferred to felypressin due to its better action. It should be noted that the changes resulted by epinephrine and felypressin are of no significant importance in healthy individuals.

  17. Aging increases oxidative stress and renal expression of oxidant and antioxidant enzymes that are associated with an increased trend in systolic blood pressure.

    Science.gov (United States)

    Gomes, Pedro; Simão, Sónia; Silva, Elisabete; Pinto, Vanda; Amaral, João S; Afonso, Joana; Serrão, Maria Paula; Pinho, Maria João; Soares-da-Silva, Patrício

    2009-01-01

    The aim of this study was to investigate whether the effects of aging on oxidative stress markers and expression of major oxidant and antioxidant enzymes associate with impairment of renal function and increases in blood pressure. To explore this, we determined age-associated changes in lipid peroxidation (urinary malondialdehyde), plasma and urinary hydrogen peroxide (H(2)O(2)) levels, as well as renal H(2)O(2) production, and the expression of oxidant and antioxidant enzymes in young (13 weeks) and old (52 weeks) male Wistar Kyoto (WKY) rats. Urinary lipid peroxidation levels and H(2)O(2) production by the renal cortex and medulla of old rats were higher than their young counterparts. This was accompanied by overexpression of NADPH oxidase components Nox4 and p22(phox) in the renal cortex of old rats. Similarly, expression of superoxide dismutase (SOD) isoforms 2 and 3 and catalase were increased in the renal cortex from old rats. Renal function parameters (creatinine clearance and fractional excretion of sodium), diastolic blood pressure and heart rate were not affected by aging, although slight increases in systolic blood pressure were observed during this 52-week period. It is concluded that overexpression of renal Nox4 and p22(phox) and the increases in renal H(2)O(2) levels in aged WKY does not associate with renal functional impairment or marked increases in blood pressure. It is hypothesized that lack of oxidative stress-associated effects in aged WKY rats may result from increases in antioxidant defenses that counteract the damaging effects of H(2)O(2).

  18. Cardiovascular disease mortality and years of life lost attributable to non-optimal systolic blood pressure and hypertension in northeastern Iran.

    Science.gov (United States)

    Sepanlou, Sadaf G; Newson, Roger B; Poustchi, Hossein; Malekzadeh, Masoud M; Rezanejad Asl, Parisa; Etemadi, Arash; Khademi, Hooman; Islami, Farhad; Pourshams, Akram; Pharoah, Paul D; Abnet, Christian C; Brennan, Paul; Bofetta, Paolo; Dawsey, Sanford M; Kamangar, Farin; Malekzadeh, Reza

    2015-03-01

    High blood pressure is the second most important risk factor of cardiovascular diseases (CVDs) in Iran. It is imperative to estimate the burden of CVDs that can be averted if high blood pressure is controlled at the population level. The aim of the current study was to estimate the avertable CVD mortality in the setting of Golestan Cohort Study (GCS). Over 50,000 participants were recruited and followed for a median of 7 years. The exposures of interest in this study were non-optimal systolic blood pressure (SBP) and hypertension measured at baseline. Deaths by cause have been precisely recorded. The Population Attributable Fraction (PAF) of deaths and Years of Life Lost (YLLs) due to CVDs attributable to exposures of interest were calculated. Overall, 223 deaths due to ischemic heart disease (IHD), 207 deaths due to cerebrovascular accidents (CVA), and 460 deaths due to all CVDs could be averted if the SBP of all subjects in the study were optimal. Similarly, 5,560 YLLs due to IHD, 4,771 YLLs due to CVA, and 11,135 YLLs due to CVDs could be prevented if SBP were optimal. In all age groups, the avertable deaths and YLLs were higher due to IHD compared with CVA. Deaths and YLLs attributable to non-optimal SBP in women were less than men. A very large proportion of CVD deaths can be averted if blood pressure is controlled in Iran. Effective interventions in primary and secondary health care setting are mandatory to be implemented as early as possible.

  19. Efficacy of a classical antiobesity Unani pharmacopial formulation (Safoof-e-Muhazzil in systolic and diastolic blood pressure: A randomized, open-labeled, controlled clinical study

    Directory of Open Access Journals (Sweden)

    Asim Ali Khan

    2013-01-01

    Full Text Available The aim of this study is to evaluate the efficacy of a Unani formulation in hypertension. A total of 90 patients with total cholesterol level of more than 220 mg/dl with associated conditions were included in this study. A total of 30 patients having a mean systolic blood pressure (BP of 133.86 mmHg comprising Group A received Unani formulation Safoof-e-Muhazzil (SM in its classical powder form in the dose of 5 g twice a day orally. Group B comprising of 30 patients with a mean systolic BP of 133.13 mmHg received same drug, but in compressed tablet form in the same dosage, whereas, 30 patients comprising Group C with a mean systolic BP of 129.45 mmHg, received Atorvastatin 10 mg as a standard control. Patients were evaluated on each follow-up at 2 nd , 4 th and 6 th week. The mean systolic BP in Group A and B before treatment was 133.86 ± 3.028 mmHg and 133.13 ± 2.852 mmHg, which significantly decreased to 119.33 ± 1.922 mmHg (P < 0.001 and 119 ± 1.760 mmHg (P < 0.001 respectively. In the control Group C before treatment BP was 129.45 ± 2.499 mmHg and after treatment it significantly decreased to 124.34 ± 1.794 mmHg (P < 0.01. The percentage change after treatment was 10.85%, 10.61% and 3.94% respectively in each group. Mean diastolic BP in Group A and B before treatment was 85.06 ± 2.11 mmHg and 84.56 ± 1.5 mmHg, which significantly decreased to 79.06 ± 1.56 mmHg (P < 0.001 and 79.96 ± 1.15 mmHg (P < 0.001 respectively, BP before treatment in Group C was 83.23 ± 1.588 mmHg, which was decreased to 124.34 ± 1.794 mmHg (P < 0.01. The study results indicate that the test drug was quite effective in reducing both systolic as well as diastolic BP.

  20. Observation of the pulse oximeter trace to estimate systolic blood ...

    African Journals Online (AJOL)

    Southern African Journal of Anaesthesia and Analgesia is co-published by Medpharm .... a clinically relevant amount of time when compared with NIBP ... at the time of recruitment to the study. ... Inclusion criteria were age > 18 years, ASA Class 1 to 3 and .... measured systolic blood pressure values (mean [SD], mmHg) per.

  1. Prevalence of Eligibility Criteria for the Systolic Blood Pressure Intervention Trial in US Adults Among Excluded Groups: Age Diabetes Mellitus, or a History of Stroke.

    Science.gov (United States)

    Bress, Adam P; Tanner, Rikki M; Hess, Rachel; Gidding, Samuel S; Colantonio, Lisandro D; Shimbo, Daichi; Muntner, Paul

    2016-07-12

    Adults diabetes mellitus, or a history of stroke were not enrolled in the Systolic Blood Pressure Intervention Trial (SPRINT). Estimating the size and characteristics of these excluded groups who meet the other SPRINT eligibility criteria may provide information on the potential impact of providers extending the SPRINT findings to these populations. We analyzed the National Health and Nutrition Examination Survey 2003-2012 (n=25 076) to estimate the percentage and characteristics of US adults ≥20 years in 3 populations (age diabetes mellitus, or history of stroke) excluded from SPRINT who otherwise meet the trial eligibility criteria: age ≥50 years, systolic blood pressure (SBP) 130-180 mm Hg, high cardiovascular disease risk, and not having trial exclusion criteria. Overall, 1.0% (95% CI 0.8-1.3) of US adults age diabetes mellitus, and 19.0% (95% CI 16.0-22.4) with history of stroke met the other SPRINT eligibility criteria. Among US adults with SBP ≥130 mm Hg, other SPRINT eligibility criteria were met by 7.5% (95% CI 6.1-9.2) of those age diabetes mellitus, and 23.0% (95% CI 19.4-27.0) with history of stroke. Among US adults meeting the other SPRINT eligibility criteria, antihypertensive medication was being taken by 31.0% (95% CI 23.9-41.3) of those diabetes mellitus, and 68.9% (95% CI 59.4-77.1) with a history of stroke. A substantial percentage of US adults with diabetes mellitus or history of stroke and a small percentage <50 years old meet the other SPRINT eligibility criteria. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  2. Lower Protein-to-Carbohydrate Ratio in Maternal Diet is Associated with Higher Childhood Systolic Blood Pressure up to Age Four Years

    Directory of Open Access Journals (Sweden)

    Michelle L. Blumfield

    2015-04-01

    Full Text Available The prenatal environment can influence development of offspring blood pressure (BP, which tracks into adulthood. This prospective longitudinal study investigated whether maternal pregnancy dietary intake is associated with the development of child BP up to age four years. Data are from 129 mother-child dyads enrolled in the Women and Their Children’s Health study. Maternal diet was assessed using a validated 74-item food frequency questionnaire at 18 to 24 weeks and 36 to 40 weeks, with a reference period of the previous three months. Child systolic and diastolic BP were measured at 3, 6, 9, 12, 24, 36 and 48 months, using an automated BP monitor. Using mixed-model regression analyses adjusted for childhood growth indices, pregnancy intakes of percentage of energy (E% polyunsaturated fat (β coefficient 0.73; 95% CI 0.003, 1.45; p = 0.045, E% omega-6 fatty acids (β coefficient 0.89; 95% CI 0.09, 1.69; p = 0.03 and protein-to-carbohydrate (P:C ratio (β coefficient −14.14; 95% CI −27.68, −0.60; p = 0.04 were associated with child systolic BP trajectory up to 4 years. Child systolic BP was greatest at low proportions of dietary protein (<16% of energy and high carbohydrate (>40% of energy intakes. There may be an ideal maternal macronutrient ratio associated with optimal infant BP. Maternal diet, which is potentially modifiable, may play an important role in influencing offspring risk of future hypertension.

  3. Cytochrome P450 (CYP2D6) genotype is associated with elevated systolic blood pressure in preterm infants after discharge from the neonatal intensive care unit.

    Science.gov (United States)

    Dagle, John M; Fisher, Tyler J; Haynes, Susan E; Berends, Susan K; Brophy, Patrick D; Morriss, Frank H; Murray, Jeffrey C

    2011-07-01

    To determine genetic and clinical risk factors associated with elevated systolic blood pressure (ESBP) in preterm infants after discharge from the neonatal intensive care unit (NICU). A convenience cohort of infants born at 90th percentile for term infants). Genetic testing identified alleles associated with ESBP. Multivariate logistic regression analysis was performed for the outcome ESBP, with clinical characteristics and genotype as independent variables. Predictors of ESBP were cytochrome P450, family 2, subfamily D, polypeptide 6 (CYP2D6) (rs28360521) CC genotype (OR, 2.92; 95% CI, 1.48-5.79), adjusted for outpatient oxygen therapy (OR, 4.53; 95% CI, 2.23-8.81) and history of urinary tract infection (OR, 4.68; 95% CI, 1.47-14.86). Maximum SBP was modeled by multivariate linear regression analysis: maximum SBP=84.8 mm Hg + 6.8 mm Hg if cytochrome P450, family 2, subfamily D, polypeptide 6 (CYP2D6) CC genotype + 6.8 mm Hg if discharged on supplemental oxygen + 4.4 mm Hg if received inpatient glucocorticoids (P=.0002). ESBP is common in preterm infants with residual lung disease after discharge from the NICU. This study defines clinical factors associated with ESBP, identifies a candidate gene for further testing, and supports the recommendation to monitor blood pressure before age 3 years, as is suggested for term infants. Copyright © 2011 Mosby, Inc. All rights reserved.

  4. Inter-arm systolic blood pressure differences, relations with future vascular events and mortality in patients with and without manifest vascular disease.

    Science.gov (United States)

    Kranenburg, Guido; Spiering, Wilko; de Jong, Pim A; Kappelle, L Jaap; de Borst, Gert Jan; Cramer, Maarten J; Visseren, Frank L J; Aboyans, Victor; Westerink, Jan

    2017-10-01

    Inter-arm systolic blood pressure difference (SBPD) is an easily obtained patient characteristic which relates to vascular disease. We aimed to identify determinants of large inter-arm SBPD and to investigate the relation between inter-arm SBPD and vascular events in patients with and without manifest vascular disease. In a cohort of 7344 patients with manifest vascular disease or vascular risk factors alone enrolled in the Second Manifestations of ARTerial disease (SMART) study, single bilateral non-simultaneous blood pressure measurements were performed. Logistic and Cox regression was used to identify determinants of large inter-arm SBPD (≥15mmHg) and to investigate the relation between inter-arm SBPD and vascular events (composite of non-fatal myocardial infarction, stroke, and vascular mortality) and all-cause mortality. In all patients the median inter-arm SBPD was 7mmHg (IQR 3-11) and 1182 (16%) patients had inter-arm SBPD ≥15mmHg. Higher age, higher systolic blood pressure, diabetes mellitus, peripheral artery disease, carotid artery stenosis, higher carotid intima-media thickness, and lower ankle-brachial indices were related to large inter-arm SBPD (≥15mmHg). Each 5mmHg increase in inter-arm SBPD was related to a 12% higher risk of vascular events in patients without manifest vascular disease (HR 1.12; 95% CI 1.00-1.27), whereas no relation was apparent in patients with manifest vascular disease (HR 0.98; 95% CI 0.93-1.04, interaction p-value 0.036). Inter-arm SBPD was not related to all-cause mortality (HR 1.05; 95% CI 0.93-1.19). Inter-arm SBPD relates to a higher risk of vascular events in patients without manifest vascular disease, whereas this relation is not apparent in patients with manifest vascular disease. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Development and validation of optimal cut-off value in inter-arm systolic blood pressure difference for prediction of cardiovascular events.

    Science.gov (United States)

    Hirono, Akira; Kusunose, Kenya; Kageyama, Norihito; Sumitomo, Masayuki; Abe, Masahiro; Fujinaga, Hiroyuki; Sata, Masataka

    2018-01-01

    An inter-arm systolic blood pressure difference (IAD) is associated with cardiovascular disease. The aim of this study was to develop and validate the optimal cut-off value of IAD as a predictor of major adverse cardiac events in patients with arteriosclerosis risk factors. From 2009 to 2014, 1076 patients who had at least one cardiovascular risk factor were included in the analysis. We defined 700 randomly selected patients as a development cohort to confirm that IAD was the predictor of cardiovascular events and to determine optimal cut-off value of IAD. Next, we validated outcomes in the remaining 376 patients as a validation cohort. The blood pressure (BP) of both arms measurements were done simultaneously using the ankle-brachial blood pressure index (ABI) form of automatic device. The primary endpoint was the cardiovascular event and secondary endpoint was the all-cause mortality. During a median period of 2.8 years, 143 patients reached the primary endpoint in the development cohort. In the multivariate Cox proportional hazards analysis, IAD was the strong predictor of cardiovascular events (hazard ratio: 1.03, 95% confidence interval: 1.01-1.05, p=0.005). The receiver operating characteristic curve revealed that 5mmHg was the optimal cut-off point of IAD to predict cardiovascular events (p<0.001). In the validation cohort, the presence of a large IAD (IAD ≥5mmHg) was significantly associated with the primary endpoint (p=0.021). IAD is significantly associated with future cardiovascular events in patients with arteriosclerosis risk factors. The optimal cut-off value of IAD is 5mmHg. Copyright © 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  6. Cocoa extract intake for 4 weeks reduces postprandial systolic blood pressure response of obese subjects, even after following an energy-restricted diet

    Science.gov (United States)

    Ibero-Baraibar, Idoia; Suárez, Manuel; Arola-Arnal, Anna; Zulet, M. Angeles; Martinez, J. Alfredo

    2016-01-01

    Background Cardiometabolic profile is usually altered in obesity. Interestingly, the consumption of flavanol-rich foods might be protective against those metabolic alterations. Objective To evaluate the postprandial cardiometabolic effects after the acute consumption of cocoa extract before and after 4 weeks of its daily intake. Furthermore, the bioavailability of cocoa extract was investigated. Design Twenty-four overweight/obese middle-aged subjects participated in a 4-week intervention study. Half of the volunteers consumed a test meal enriched with 1.4 g of cocoa extract (415 mg flavanols), while the rest of the volunteers consumed the same meal without the cocoa extract (control group). Glucose and lipid profile, as well as blood pressure and cocoa metabolites in plasma, were assessed before and at 60, 120, and 180 min post-consumption, at the beginning of the study (Postprandial 1) and after following a 4-week 15% energy-restricted diet including meals containing or not containing the cocoa extract (Postprandial 2). Results In the Postprandial 1 test, the area under the curve (AUC) of systolic blood pressure (SBP) was significantly higher in the cocoa group compared with the control group (p=0.007), showing significant differences after 120 min of intake. However, no differences between groups were observed at Postprandial 2. Interestingly, the reduction of postprandial AUC of SBP (AUC_Postprandial 2-AUC_Postprandial 1) was higher in the cocoa group (p=0.016). Furthermore, cocoa-derived metabolites were detected in plasma of the cocoa group, while the absence or significantly lower amounts of metabolites were found in the control group. Conclusions The daily consumption of cocoa extract within an energy-restricted diet for 4 weeks resulted in a greater reduction of postprandial AUC of SBP compared with the effect of energy-restricted diet alone and independently of body weight loss. These results suggest the role of cocoa flavanols on postprandial blood

  7. Cocoa extract intake for 4 weeks reduces postprandial systolic blood pressure response of obese subjects, even after following an energy-restricted diet

    Directory of Open Access Journals (Sweden)

    Idoia Ibero-Baraibar

    2016-03-01

    Full Text Available Background: Cardiometabolic profile is usually altered in obesity. Interestingly, the consumption of flavanol-rich foods might be protective against those metabolic alterations. Objective: To evaluate the postprandial cardiometabolic effects after the acute consumption of cocoa extract before and after 4 weeks of its daily intake. Furthermore, the bioavailability of cocoa extract was investigated. Design: Twenty-four overweight/obese middle-aged subjects participated in a 4-week intervention study. Half of the volunteers consumed a test meal enriched with 1.4 g of cocoa extract (415 mg flavanols, while the rest of the volunteers consumed the same meal without the cocoa extract (control group. Glucose and lipid profile, as well as blood pressure and cocoa metabolites in plasma, were assessed before and at 60, 120, and 180 min post-consumption, at the beginning of the study (Postprandial 1 and after following a 4-week 15% energy-restricted diet including meals containing or not containing the cocoa extract (Postprandial 2. Results: In the Postprandial 1 test, the area under the curve (AUC of systolic blood pressure (SBP was significantly higher in the cocoa group compared with the control group (p=0.007, showing significant differences after 120 min of intake. However, no differences between groups were observed at Postprandial 2. Interestingly, the reduction of postprandial AUC of SBP (AUC_Postprandial 2-AUC_Postprandial 1 was higher in the cocoa group (p=0.016. Furthermore, cocoa-derived metabolites were detected in plasma of the cocoa group, while the absence or significantly lower amounts of metabolites were found in the control group. Conclusions: The daily consumption of cocoa extract within an energy-restricted diet for 4 weeks resulted in a greater reduction of postprandial AUC of SBP compared with the effect of energy-restricted diet alone and independently of body weight loss. These results suggest the role of cocoa flavanols on

  8. Cocoa extract intake for 4 weeks reduces postprandial systolic blood pressure response of obese subjects, even after following an energy-restricted diet.

    Science.gov (United States)

    Ibero-Baraibar, Idoia; Suárez, Manuel; Arola-Arnal, Anna; Zulet, M Angeles; Martinez, J Alfredo

    2016-01-01

    Cardiometabolic profile is usually altered in obesity. Interestingly, the consumption of flavanol-rich foods might be protective against those metabolic alterations. To evaluate the postprandial cardiometabolic effects after the acute consumption of cocoa extract before and after 4 weeks of its daily intake. Furthermore, the bioavailability of cocoa extract was investigated. Twenty-four overweight/obese middle-aged subjects participated in a 4-week intervention study. Half of the volunteers consumed a test meal enriched with 1.4 g of cocoa extract (415 mg flavanols), while the rest of the volunteers consumed the same meal without the cocoa extract (control group). Glucose and lipid profile, as well as blood pressure and cocoa metabolites in plasma, were assessed before and at 60, 120, and 180 min post-consumption, at the beginning of the study (Postprandial 1) and after following a 4-week 15% energy-restricted diet including meals containing or not containing the cocoa extract (Postprandial 2). In the Postprandial 1 test, the area under the curve (AUC) of systolic blood pressure (SBP) was significantly higher in the cocoa group compared with the control group (p=0.007), showing significant differences after 120 min of intake. However, no differences between groups were observed at Postprandial 2. Interestingly, the reduction of postprandial AUC of SBP (AUC_Postprandial 2-AUC_Postprandial 1) was higher in the cocoa group (p=0.016). Furthermore, cocoa-derived metabolites were detected in plasma of the cocoa group, while the absence or significantly lower amounts of metabolites were found in the control group. The daily consumption of cocoa extract within an energy-restricted diet for 4 weeks resulted in a greater reduction of postprandial AUC of SBP compared with the effect of energy-restricted diet alone and independently of body weight loss. These results suggest the role of cocoa flavanols on postprandial blood pressure homeostasis.

  9. Simultaneously measured inter-arm and inter-leg systolic blood pressure differences and cardiovascular risk stratification: a systemic review and meta-analysis.

    Science.gov (United States)

    Singh, Sukhchain; Sethi, Ankur; Singh, Mukesh; Khosla, Kavia; Grewal, Navsheen; Khosla, Sandeep

    2015-08-01

    Association of inter-arm systolic blood pressure difference (IASBPD) with cardiovascular (CV) morbidity and mortality remains controversial. We aimed to thoroughly examine all available evidence on inter-limb blood pressure (BP) difference and its association with CV risk and outcomes. We searched PubMed, EMBASE, CINAHL, Cochrane library, and Ovid for studies reporting bilateral simultaneous BP measurements in arms or legs and risk of peripheral arterial disease (PAD), coronary artery disease, cerebrovascular disease, subclavian stenosis, or mortality. Random-effect meta-analysis was performed to compare effect estimates. Twenty-seven studies met inclusion criteria, but only 17 studies (18 cohorts) were suitable for analysis. IASBPD of 10 mmHg or more was associated with PAD (risk ratios, 2.22; 1.41-3.5; P = .0006; sensitivity 16.6%; 6.7-35.4; specificity 91.9%; 83.1-96.3; 8 cohorts; 4774 subjects), left ventricular mass index (standardized mean difference 0.21; 0.03-0.39; P = .02; 2 cohort; 1604 subjects), and brachial-ankle pulse wave velocity (PWV) (one cohort). Association of PAD remained significant at cutoff of 15 mmHg (risk ratios, 1.91; 1.28-2.84; P = .001; 5 cohorts; 1914 subjects). We could not find statistically significant direct association of coronary artery disease, cerebrovascular disease, CV, and all-cause mortality in subjects with IASBPD of 10 mmHg or more, 15 mmHg or more, and inter-leg systolic BP difference of 15 mmHg or more. Inter-leg BP difference of 15 mmHg or more was strong predictor of PAD (P = .0001) and brachial-ankle PWV (P = .0001). Two invasive studies showed association of IASBPD and subclavian stenosis (estimates could not be combined). In conclusion, inter-arm and leg BP differences are strong predictors of PAD. IASBPD may be associated with subclavian stenosis, high left ventricular mass effect, and higher brachial-ankle PWVs. Inter-leg BP difference may also be associated with high left ventricular mass effect and higher

  10. Interarm Difference in Systolic Blood Pressure in Different Ethnic Groups and Relationship to the "White Coat Effect": A Cross-Sectional Study.

    Science.gov (United States)

    Schwartz, Claire Lorraine; Clark, Christopher; Koshiaris, Constantinos; Gill, Paramjit S; Greenfield, Shelia M; Haque, Sayeed M; Heer, Gurdip; Johal, Amanpreet; Kaur, Ramandeep; Mant, Jonathan; Martin, Una; Mohammed, Mohamed A; Wood, Sally; McManus, Richard J

    2017-09-01

    Interarm differences (IADs) ≥10 mm Hg in systolic blood pressure (BP) are associated with greater incidence of cardiovascular disease. The effect of ethnicity and the white coat effect (WCE) on significant systolic IADs (ssIADs) are not well understood. Differences in BP by ethnicity for different methods of BP measurement were examined in 770 people (300 White British, 241 South Asian, 229 African-Caribbean). Repeated clinic measurements were obtained simultaneously in the right and left arm using 2 BPTru monitors and comparisons made between the first reading, mean of second and third and mean of second to sixth readings for patients with, and without known hypertension. All patients had ambulatory BP monitoring (ABPM). WCE was defined as systolic clinic BP ≥10 mm Hg higher than daytime ABPM. No significant differences were seen in the prevalence of ssIAD between ethnicities whichever combinations of BP measurement were used and regardless of hypertensive status. ssIADs fell between the 1st measurement (161, 22%), 2nd/3rd (113, 16%), and 2nd-6th (78, 11%) (1st vs. 2nd/3rd and 2nd-6th, P < 0.001). Hypertensives with a WCE were more likely to have ssIADs on 1st, (odds ratio [OR] 1.73 (95% confidence interval 1.04-2.86); 2nd/3rd, (OR 3.05 (1.68-5.53); and 2nd-6th measurements, (OR 2.58 (1.22-5.44). Nonhypertensive participants with a WCE were more likely to have a ssIAD on their first measurement (OR 3.82 (1.77 to -8.25) only. ssIAD prevalence does not vary with ethnicity regardless of hypertensive status but is affected by the number of readings, suggesting the influence of WCE. Multiple readings should be used to confirm ssIADs. © The Author 2017. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd.

  11. A difference in systolic blood pressure between arms and between lower limbs is a novel risk marker for diabetic nephropathy in patients with type 2 diabetes.

    Science.gov (United States)

    Okada, Hiroshi; Fukui, Michiaki; Tanaka, Muhei; Matsumoto, Shinobu; Mineoka, Yusuke; Nakanishi, Naoko; Asano, Mai; Yamazaki, Masahiro; Hasegawa, Goji; Nakamura, Naoto

    2013-05-01

    Recent studies have demonstrated that a difference in systolic blood pressure (SBP) between arms is associated with both vascular disease and mortality. The aim of this study was to investigate the relationship between a difference in SBP between arms and between lower limbs and the degree of albuminuria, which is an established marker for cardiovascular disease and diabetic nephropathy in patients with Type 2 diabetes. We measured blood pressure in the arms and lower limbs of 314 consecutive patients with Type 2 diabetes, and we calculated a difference in SBP between arms and between lower limbs. We then evaluated the relationship of the difference in SBP between arms and between lower limbs to the degree of urinary albumin excretion (UAE). The average difference in SBP between arms and between lower limbs was 3.52±3.94 and 9.66±14.1 mm Hg, respectively. Multiple regression analyses demonstrated that a difference in SBP between arms (β=0.172, P=0.0239) and between lower limbs (β=0.238, P=0.0033) independently correlated with the logarithm of the UAE. Multiple logistic regression analyses showed that a difference in SBP of 10 mm Hg between arms (odds ratio 12.23 (95% CI 1.130-132.35), Pdifference in SBP of 15 mm Hg between lower limbs (odds ratio 4.291 (95% CI 1.403-13.123), Pdifference in SBP between arms and between lower limbs, therefore, could be a novel risk marker for diabetic nephropathy in patients with Type 2 diabetes.

  12. Impact of an Early Decrease in Systolic Blood Pressure on The Risk of Contrast-Induced Nephropathy after Percutaneous Coronary Intervention.

    Science.gov (United States)

    Li, Hualong; Huang, Shuijin; He, Yiting; Liu, Yong; Liu, Yuanhui; Chen, Jiyan; Zhou, Yingling; Tan, Ning; Duan, Chongyang; Chen, Pingyan

    2016-02-01

    The early postprocedural period was thought to be the rush hour of contrast media excretion, causing rapid and prolonged renal hypoperfusion, which was the critical time window for contrast-induced nephropathy (CIN). 349 consecutive patients were enrolled into the study. The relation between an early postprocedural decrease in systolic blood pressure (SBP) and the risk of CIN was assessed using multivariate logistic regression. A postprocedural decrease in SBP was observed in 63% of patients and CIN developed in 28 (8.0%) patients. The CIN group had a lower postprocedural SBP (114.5±13.5 vs. 123.7±15.6mmHg, P=0.003) and a greater postprocedural decrease in SBP (16.2±19.1 vs. 5.9±18.7mmHg, P=0.005) than the no-CIN group. ROC analysis revealed that the optimum cutoff value for the SBP decrease in detecting CIN was >10mmHg (sensitivity 60.7%, specificity 59.5%, AUC=0.66). Multivariate logistic regression analysis found that a postprocedural decrease in SBP >10mmHg was a significant independent predictor of CIN (OR 2.368, 95%CI: 1.043-5.379, P=0.039), after adjustment for other risk factors. An early moderate postprocedural decrease in SBP may increase the risk of CIN in patients undergoing PCI. Copyright © 2015. Published by Elsevier B.V.

  13. [Twenty-four hour time and frequency domain variability of systolic blood pressure and heart rate in an experimental model of arterial hypertension plus obesity].

    Science.gov (United States)

    Pelat, M; Verwaerde, P; Lazartiques, E; Cabrol, P; Galitzky, J; Berlan, M; Montastruc, J L; Senard, J M

    1998-08-01

    Modifications of heart rate (HR) and systolic blood pressure (SBP) variabilities (V) have been reported in the human syndrome arterial hypertension plus insulin-resistance. The aim of this study was to characterize the 24 h SBPV and HRV in both time and frequency domains during weight increase in dogs fed ad libitum with a high fat diet. Implantable transmitter units for measurement of blood pressure and heart rate were surgically implanted in five beagle male dogs. BP and HR were continuously recorded using telemetric measurements during 24 hours, before and after 6 and 9 weeks of hypercaloric diet in quiet animals submitted to a 12h light-dark cycle. To study nychtemeral cycle of SBP and HR, two periods were chosen: day (from 6.00 h to 19.00 h) and night (from 23.00 h to 6.00 h). Spontaneous baroreflex efficiency was measured using the sequence method. Spectral variability of HR and SBP was analyzed using a fast Fourier transformation on 512 consecutive values and normalized units of low (LF: 50-150 mHz, reflecting sympathetic activity) and high (HF: respiratory rate +/- 50 mHz, reflecting parasympathetic activity) frequency bands were calculated. The energy of total spectrum (from 0.004 to 1 Hz) was also studied. Body weight (12.4 +/- 0.9 vs 14.9 +/- 0.9 kg, p vs 147 +/- 1 mmHg, p vs night: 71 +/- 1 bpm) but not after 9 weeks (day: 91 +/- 4 bpm ; night: 86 +/- 2 bpm). Concomitantly, the efficiency of spontaneous baroreflex decreased at 6 weeks (36 +/- 1 vs 42 +/- 2 mmHg/ms, p energy of HRV was found after 6 but not after 9 weeks. LF energy of SBPV was increased at 6 but not at 9 weeks (table). [table: see text] In conclusion, this study shows that an hyperlipidic and hypercaloric diet induces transient variations in autonomic nervous system activity which could be the physiopathological link between obesity, insulin-resistance and arterial hypertension.

  14. Marinobufagenin is related to elevated central and 24-h systolic blood pressures in young black women: the African-PREDICT Study.

    Science.gov (United States)

    Strauss, Michél; Smith, Wayne; Wei, Wen; Fedorova, Olga V; Schutte, Aletta E

    2018-03-01

    Marinobufagenin (MBG) is an endogenous steroidal α1-Na + K + -ATPase inhibitor. Because of its role in sodium handling, MBG has been associated with both antihypertensive and prohypertensive effects in normal physiology and pathology. MBG is positively associated with blood pressure in Dahl salt-sensitive rats exhibiting a similar hypertensive phenotype to black populations, characterized by impaired urinary Na + excretion. However, clinical studies exploring blood pressure (BP)-related effects of MBG in black populations are scant. We determined whether the MBG/Na + ratio (assessing the effectiveness of Na + excretion resistance to MBG) is related to systolic BP (SBP) in young black men and women, compared to whites. We included 331 apparently healthy participants (20-30 years) (42.9% black, 43.8% men) on a habitual diet. We obtained 24-h and central SBP, and 24-h urinary Na + and MBG levels. We found no ethnic differences in MBG, Na + or MBG/Na + . MBG excretion correlated positively with Na + excretion in all groups and to SBP in white men and black women (p ≤ 0.011). In black women only SBP related positively to MBG/Na + in single and multi-variable adjusted regression models: central SBP (R 2  = 0.26; ß = 0.28; p = 0.039), 24-h SBP (R 2  = 0.46; ß = 0.30; p = 0.011), daytime (R 2  = 0.38; ß = 0.28; p = 0.023) and nighttime SBP (R 2  = 0.38; ß = 0.33; p = 0.009). In contrast, inverse associations of MBG/Na + with nighttime SBP were evident in white women (r = -0.20; p = 0.038) but lost significance after multiple adjustments (R 2  = 0.36; ß = -0.13; p = 0.12). We found independent positive associations of SBP with MBG/Na + in black women. This data supports the concept that reduced MBG-mediated Na + excretion can contribute to adverse hemodynamics.

  15. Impact of age on the importance of systolic and diastolic blood pressures for stroke risk: the MOnica, Risk, Genetics, Archiving, and Monograph (MORGAM) Project.

    Science.gov (United States)

    Vishram, Julie K K; Borglykke, Anders; Andreasen, Anne H; Jeppesen, Jørgen; Ibsen, Hans; Jørgensen, Torben; Broda, Grazyna; Palmieri, Luigi; Giampaoli, Simona; Donfrancesco, Chiara; Kee, Frank; Mancia, Giuseppe; Cesana, Giancarlo; Kuulasmaa, Kari; Sans, Susana; Olsen, Michael H

    2012-11-01

    This study investigates age-related shifts in the relative importance of systolic (SBP) and diastolic (DBP) blood pressures as predictors of stroke and whether these relations are influenced by other cardiovascular risk factors. Using 34 European cohorts from the MOnica, Risk, Genetics, Archiving, and Monograph (MORGAM) Project with baseline between 1982 and 1997, 68 551 subjects aged 19 to 78 years, without cardiovascular disease and not receiving antihypertensive treatment, were included. During a mean of 13.2 years of follow-up, stroke incidence was 2.8%. Stroke risk was analyzed using hazard ratios per 10-mm Hg/5-mm Hg increase in SBP/DBP by multivariate-adjusted Cox regressions, including SBP and DBP simultaneously. Because of nonlinearity, DBP was analyzed separately for DBP ≥ 71 mm Hg and DBP <71 mm Hg. Stroke risk was associated positively with SBP and DBP ≥ 71 mm Hg (SBP/DBP ≥ 71 mm Hg; hazard ratios: 1.15/1.06 [95% CI: 1.12-1.18/1.03-1.09]) and negatively with DBP <71 mm Hg (0.88[0.79-0.98]). The hazard ratio for DBP decreased with age (P<0.001) and was not influenced by other cardiovascular risk factors. Taking into account the age × DBP interaction, both SBP and DBP ≥ 71 mm Hg were significantly associated with stroke risk until age 62 years, but in subjects older than 46 years the superiority of SBP for stroke risk exceeded that of DBP ≥ 71 mm Hg and remained significant until age 78 years. DBP <71 mm Hg became significant at age 50 years with an inverse relation to stroke risk. In Europeans, stroke risk should be assessed by both SBP and DBP until age 62 years with increased focus on SBP from age 47 years. From age 62 years, emphasis should be on SBP without neglecting the potential harm of very low DBP.

  16. Systolic blood pressure decline in very old individuals is explained by deteriorating health: Longitudinal changes from Umeå85+/GERDA.

    Science.gov (United States)

    Weidung, Bodil; Toots, Annika; Nordström, Peter; Carlberg, Bo; Gustafson, Yngve

    2017-12-01

    Declining systolic blood pressure (SBP) is common in very old age and is associated with adverse events, such as dementia. Knowledge of factors associated with SBP changes could explain the etiology of this decline in SBP. This study investigated longitudinal changes in socioeconomic factors, medical conditions, drug prescriptions, and assessments and their associations with SBP changes among very old followed individuals.The study was based on data from the Umeå85+/Gerontological Regional Database (GERDA) cohort study, which provided cross-sectional and longitudinal data on participants aged 85, 90, and ≥95 years from 2000 to 2015. Follow-up assessments were conducted after 5 years. The main outcome was a change in SBP. Factors associated with SBP changes were assessed using multivariate linear regression models.In the Umeå85+/GERDA study, 454 surviving individuals underwent follow-up assessment after 5 years. Of these, 297 had SBP measured at baseline and follow-up. The mean change ± standard deviation in SBP was -12 ± 25 mm Hg. SBP decline was associated independently with later investigation year (P = .009), higher baseline SBP (P < .001), baseline antidepressant prescription (P = .011), incident acute myocardial infarction during follow-up (P = .003), new diuretic prescription during follow-up (P = .044), and a decline in the Barthel Activities of Daily Living index at follow-up (P < .001).In conclusion, SBP declines among very old individuals. This decline seems to be associated with initial SBP level, investigation year, and health-related factors. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  17. Long-term N-acetylcysteine and L-arginine administration reduces endothelial activation and systolic blood pressure in hypertensive patients with type 2 diabetes.

    Science.gov (United States)

    Martina, Valentino; Masha, Andi; Gigliardi, Valentina Ramella; Brocato, Loredana; Manzato, Enzo; Berchio, Arrigo; Massarenti, Paola; Settanni, Fabio; Della Casa, Lara; Bergamini, Stefania; Iannone, Anna

    2008-05-01

    Reactive oxygen and nitric oxide (NO) have recently been considered to be involved in the cardiovascular complications of patients with type 2 diabetes, as NO is thought to lose its beneficial physiological effects in the presence of oxygen radicals. For this reason, we tested the effects of l-arginine (ARG) and N-acetylcysteine (NAC) administration in increasing NO bioavailability by reducing free radical formation. A double-blind study was performed on 24 male patients with type 2 diabetes and hypertension divided into two groups of 12 patients that randomly received either an oral supplementation of placebo or NAC + ARG for 6 months. The NAC + ARG treatment caused a reduction of both systolic (P < 0.05) and diastolic (P < 0.05) mean arterial blood pressure, total cholesterol (P < 0.01), LDL cholesterol (P < 0.005), oxidized LDL (P < 0.05), high-sensitive C-reactive protein (P < 0.05), intracellular adhesion molecule (P < 0.05), vascular cell adhesion molecule (P < 0.01), nitrotyrosine (P < 0.01), fibrinogen (P < 0.01), and plasminogen activator inhibitor-1 (P < 0.05), and an improvement of the intima-media thickness during endothelial postischemic vasodilation (P < 0.02). HDL cholesterol increased (P < 0.05). No changes in other parameters studied were observed. NAC + ARG administration seems to be a potential well-tolerated antiatherogenic therapy because it improves endothelial function in hypertensive patients with type 2 diabetes by improving NO bioavailability via reduction of oxidative stress and increase of NO production. Our study's results give prominence to its potential use in primary and secondary cardiovascular prevention in these patients.

  18. Evidence to Maintain the Systolic Blood Pressure Treatment Threshold at 140 mm Hg for Stroke Prevention: The Northern Manhattan Study.

    Science.gov (United States)

    Dong, Chuanhui; Della-Morte, David; Rundek, Tatjana; Wright, Clinton B; Elkind, Mitchell S V; Sacco, Ralph L

    2016-03-01

    In 2014, the Eighth Joint National Committee revised the target maximum systolic blood pressure (SBP) from 140 to 150 mm Hg in patients aged ≥60 years without diabetes mellitus or chronic kidney disease. The evidence from cohort studies supporting this change was sparse, particularly among US minority populations. In the Northern Manhattan Study, 1750 participants aged ≥60 years and free of stroke, diabetes mellitus, and chronic kidney disease had SBP measured at baseline and were annually followed up for incident stroke. Mean age at baseline was 72±8 years, 63% were women, 48% Hispanic, 25% non-Hispanic white, and 25% non-Hispanic black. Among all participants, 40% were on antihypertensive medications; 43% had SBP Hg, 20% had 140 to 149 mm Hg, and 37% had ≥150 mm Hg. Over a median follow-up of 13 years, 182 participants developed stroke. The crude stroke incidence was greater among individuals with SBP≥150 mm Hg (10.8 per 1000 person-years) and SBP 140 to 149 (12.3) than among those with SBPHg had an increased risk of stroke (hazard ratio, 1.7; 95% confidence interval, 1.2-2.6) compared with those with SBP Hg. The increased stroke risk was most notable among Hispanics and non-Hispanic blacks. Raising the SBP threshold from 140 to 150 mm Hg as a new target for hypertension treatment in older individuals without diabetes mellitus or chronic kidney disease could have a detrimental effect on stroke risk reduction, especially among minority US populations. © 2016 American Heart Association, Inc.

  19. A difference in systolic blood pressure between arms is a novel predictor of the development and progression of diabetic nephropathy in patients with type 2 diabetes.

    Science.gov (United States)

    Okada, Hiroshi; Fukui, Michiaki; Tanaka, Muhei; Matsumoto, Shinobu; Iwase, Hiroya; Kobayashi, Kanae; Asano, Mai; Yamazaki, Masahiro; Hasegawa, Goji; Nakamura, Naoto

    2013-10-01

    Recent studies have suggested that a difference in systolic blood pressure (SBP) between arms is associated with both vascular disease and mortality. The aim of this study was to investigate the relationship between a difference in SBP between arms and change in urinary albumin excretion or development of albuminuria in patients with type 2 diabetes. We measured SBP in 408 consecutive patients with type 2 diabetes, and calculated a difference in SBP between arms. We performed follow-up study to assess change in urinary albumin excretion or development of albuminuria, mean interval of which was 4.6 ± 1.7 years. We then evaluated the relationship of a difference in SBP between arms to diabetic nephropathy using multiple regression analysis and multiple Cox regression model. Multiple regression analyses demonstrated that a difference in SBP between arms was independently associated with change in urinary albumin excretion (β = 0.1869, P = 0.0010). Adjusted Cox regression analyses demonstrated that a difference in SBP between arms was associated with an increased hazard of development of albuminuria; hazard ratio was 1.215 (95% confidence interval 1.077-1.376). Moreover, the risk of development of albuminuria was increased in patients with a difference in SBP of equal to or more than 10 mmHg between arms; hazard ratio was 4.168 (95% confidence interval 1.478-11.70). A difference in SBP between arms could be a novel predictor of the development and progression of diabetic nephropathy in patients with type 2 diabetes. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  20. A relative difference in systolic blood pressure between arms by synchronal measurement and conventional cardiovascular risk factors are associated with the severity of coronary atherosclerosis.

    Science.gov (United States)

    Yamamoto, Tomohiko; Miura, Shin-Ichiro; Suematsu, Yasunori; Kuwano, Takashi; Sugihara, Makoto; Ike, Amane; Iwata, Atsushi; Nishikawa, Hiroaki; Saku, Keijiro

    2016-06-01

    It is not known the relationships between a difference in systolic blood pressure (SBP) or diastolic BP (DBP) between arms by synchronal measurement and the presence of coronary artery disease (CAD), and between a difference in BP between arms and the severity of coronary atherosclerosis. We enrolled 425 consecutive patients (M/F = 286/139, 67 ± 13 year) who were admitted to our University Hospital and in whom we could measure the absolute (|rt. BP - lt. BP|) and relative (rt. BP - lt. BP) differences in SBP and DBP using a nico PS-501(®) (Parama-Tech). We divided all patients into those who did and did not have CAD. The relative differences in SBP between arms in patients with CAD were significantly lower than those in patients without CAD. However, the relative difference in SBP between arms was not a predictor of the presence of CAD. We also divided 267 patients who underwent coronary angiography into tertiles according to the Gensini score (low, middle, and high score groups). Interestingly, the middle + high score groups showed significantly lower relative differences in SBP between arms than the low score group. The mean Korotkoff sound graph in the middle + high Gensini score group was significantly higher than that in the low Gensini score group. Among conventional cardiovascular risk factors and nico parameters, the relative difference in SBP between arms in addition to the risk factors (age, gender, body mass index, hypertension, dyslipidemia, and diabetes mellitus) was associated with the score by a logistic regression analysis. In conclusion, the relative difference in SBP between arms as well as conventional risk factors may be associated with the severity of coronary arteriosclerosis.

  1. Effect of self-monitoring and medication self-titration on systolic blood pressure in hypertensive patients at high risk of cardiovascular disease: the TASMIN-SR randomized clinical trial.

    Science.gov (United States)

    McManus, Richard J; Mant, Jonathan; Haque, M Sayeed; Bray, Emma P; Bryan, Stirling; Greenfield, Sheila M; Jones, Miren I; Jowett, Sue; Little, Paul; Penaloza, Cristina; Schwartz, Claire; Shackleford, Helen; Shovelton, Claire; Varghese, Jinu; Williams, Bryan; Hobbs, F D Richard; Gooding, Trevor; Morrey, Ian; Fisher, Crispin; Buckley, David

    2014-08-27

    Self-monitoring of blood pressure with self-titration of antihypertensives (self-management) results in lower blood pressure in patients with hypertension, but there are no data about patients in high-risk groups. To determine the effect of self-monitoring with self-titration of antihypertensive medication compared with usual care on systolic blood pressure among patients with cardiovascular disease, diabetes, or chronic kidney disease. A primary care, unblinded, randomized clinical trial involving 552 patients who were aged at least 35 years with a history of stroke, coronary heart disease, diabetes, or chronic kidney disease and with baseline blood pressure of at least 130/80 mm Hg being treated at 59 UK primary care practices was conducted between March 2011 and January 2013. Self-monitoring of blood pressure combined with an individualized self-titration algorithm. During the study period, the office visit blood pressure measurement target was 130/80 mm Hg and the home measurement target was 120/75 mm Hg. Control patients received usual care consisting of seeing their health care clinician for routine blood pressure measurement and adjustment of medication if necessary. The primary outcome was the difference in systolic blood pressure between intervention and control groups at the 12-month office visit. Primary outcome data were available from 450 patients (81%). The mean baseline blood pressure was 143.1/80.5 mm Hg in the intervention group and 143.6/79.5 mm Hg in the control group. After 12 months, the mean blood pressure had decreased to 128.2/73.8 mm Hg in the intervention group and to 137.8/76.3 mm Hg in the control group, a difference of 9.2 mm Hg (95% CI, 5.7-12.7) in systolic and 3.4 mm Hg (95% CI, 1.8-5.0) in diastolic blood pressure following correction for baseline blood pressure. Multiple imputation for missing values gave similar results: the mean baseline was 143.5/80.2 mm Hg in the intervention group vs 144.2/79.9 mm Hg in the control group, and

  2. Association of an inter-arm systolic blood pressure difference with all-cause and cardiovascular mortality: An updated meta-analysis of cohort studies.

    Science.gov (United States)

    Cao, Kaiwu; Xu, Jingsong; Shangguan, Qing; Hu, Weitong; Li, Ping; Cheng, Xiaoshu; Su, Hai

    2015-01-01

    To evaluate whether an association exists between an inter-arm systolic blood pressure difference (sIAD) and all-cause and cardiovascular mortality. We searched for cohort studies that evaluated the association of a sIAD and all-cause or cardiovascular mortality in the electronic databases Medline/PubMed and Embase (August 2014). Random effects models were used to calculate pooled hazard ratios (HRs) and 95% confidence intervals (CIs). Nine cohort studies (4 prospective and 5 retrospective) enrolling 15,617 participants were included. The pooled HR of all-cause mortality for a sIAD of ≥ 10 mm Hg was 1.53 (95% CI 1.14-2.06), and that for a sIAD of ≥ 15 mm Hg was 1.46 (1.13-1.88). Pooled HRs of cardiovascular mortality were 2.21 (95% CI 1.52-3.21) for a sIAD of ≥ 10mm Hg, and 1.89 (1.32-2.69) for a sIAD of ≥ 15 mm Hg. In the patient-based cohorts including hospital- and diabetes-based cohorts, both sIADs of ≥ 10 and ≥ 15 mm Hg were associated with increased all-cause (pooled HR 1.95, 95% CI 1.01-3.78 and 1.59, 1.06-2.38, respectively) and cardiovascular mortality (pooled HR 2.98, 95% CI 1.88-4.72 and 2.10, 1.07-4.13, respectively). In the community-based cohorts, however, only a sIAD of ≥ 15 mm Hg was associated with increased cardiovascular mortality (pooled HR 1.94, 95 % CI 1.12-3.35). In the patient populations, a sIAD of ≥ 10 or of ≥ 15 mm Hg could be a useful indictor for increased all-cause and cardiovascular mortality, and a sIAD of ≥ 15 mm Hg might help to predict increased cardiovascular mortality in the community populations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Association of a difference in systolic blood pressure between arms with vascular disease and mortality: a systematic review and meta-analysis.

    Science.gov (United States)

    Clark, Christopher E; Taylor, Rod S; Shore, Angela C; Ukoumunne, Obioha C; Campbell, John L

    2012-03-10

    Differences in systolic blood pressure (SBP) of 10 mm Hg or more or 15 mm Hg or more between arms have been associated with peripheral vascular disease and attributed to subclavian stenosis. We investigated whether an association exists between this difference and central or peripheral vascular disease, and mortality. We searched Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane, and Medline In Process databases for studies published before July, 2011, showing differences in SBP between arms, with data for subclavian stenosis, peripheral vascular disease, cerebrovascular disease, cardiovascular disease, or survival. We used random effects meta-analysis to combine estimates of the association between differences in SBP between arms and each outcome. We identified 28 eligible studies for review, 20 of which were included in our meta-analyses. In five invasive studies using angiography, mean difference in SBP between arms was 36·9 mm Hg (95% CI 35·4-38·4) for proven subclavian stenosis (>50% occlusion), and a difference of 10 mm Hg or more was strongly associated with subclavian stenosis (risk ratio [RR] 8·8, 95% CI 3·6-21·2). In non-invasive studies, pooled findings showed that a difference of 15 mm Hg or more was associated with peripheral vascular disease (nine cohorts; RR 2·5, 95% CI 1·6-3·8; sensitivity 15%, 9-23; specificity 96%, 94-98); pre-existing cerebrovascular disease (five cohorts; RR 1·6, 1·1-2·4; sensitivity 8%, 2-26; specificity 93%, 86-97); and increased cardiovascular mortality (four cohorts; hazard ratio [HR] 1·7, 95% CI 1·1-2·5) and all-cause mortality (HR 1·6, 1·1-2·3). A difference of 10 mm Hg or higher was associated with peripheral vascular disease (five studies; RR 2·4, 1·5-3·9; sensitivity 32%, 23-41; specificity 91%, 86-94). A difference in SBP of 10 mm Hg or more, or of 15 mm Hg or more, between arms might help to identify patients who need further vascular assessment. A difference of

  4. Low Systolic Blood Pressure and Mortality From All Causes and Vascular Diseases Among Older Middle-aged Men: Korean Veterans Health Study

    Directory of Open Access Journals (Sweden)

    Sang-Wook Yi

    2015-03-01

    Full Text Available Objectives: Recently, low systolic blood pressure (SBP was found to be associated with an increased risk of death from vascular diseases in a rural elderly population in Korea. However, evidence on the association between low SBP and vascular diseases is scarce. The aim of this study was to prospectively examine the association between low SBP and mortality from all causes and vascular diseases in older middle-aged Korean men. Methods: From 2004 to 2010, 94 085 Korean Vietnam War veterans were followed-up for deaths. The adjusted hazard ratios (aHR were calculated using the Cox proportional hazard model. A stratified analysis was conducted by age at enrollment. SBP was self-reported by a postal survey in 2004. Results: Among the participants aged 60 and older, the lowest SBP (<90 mmHg category had an elevated aHR for mortality from all causes (aHR, 1.9; 95% confidence interval [CI], 1.2 to 3.1 and vascular diseases (International Classification of Disease, 10th revision, I00-I99; aHR, 3.2; 95% CI, 1.2 to 8.4 compared to those with an SBP of 100 to 119 mmHg. Those with an SBP below 80 mmHg (aHR, 4.5; 95% CI, 1.1 to 18.8 and those with an SBP of 80 to 89 mmHg (aHR, 3.1; 95% CI, 0.9 to 10.2 also had an increased risk of vascular mortality, compared to those with an SBP of 90 to 119 mmHg. This association was sustained when excluding the first two years of follow-up or preexisting vascular diseases. In men younger than 60 years, the association of low SBP was weaker than that in those aged 60 years or older. Conclusions: Our findings suggest that low SBP (<90 mmHg may increase vascular mortality in Korean men aged 60 years or older.

  5. Peak systolic pressure-volume relationships in man

    International Nuclear Information System (INIS)

    Adachi, Haruhiko; Sugihara, Hiroki; Nakagawa, Hiroaki; Katsume, Hiroshi; Ochiai, Masakazu; Ijichi, Hamao

    1985-01-01

    We determined the relationship between left ventricular (LV) peak systolic pressure (PSP) and end-systolic volume, non-invasively using cuff sphygmomanometry and radionuclide angiocardiography (RNA). Systolic blood pressure (SBP) measured in the arm was substituted for PSP. LV enddiastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (EF) were determined by a non-geometric method of gated RNA and recorded in three different hemodynamic states: at rest (basal state), during increased SBP after angiotensin administration (initial dose, 1-2 μg/min) and during decreased SBP after nitrate (sublingual nitroglycerin, 0.3-0.6 mg, or intravenous isosorbide dinitrate, 0.5-1.0 mg/min). The reproducibility of this method, tested in six subjects, proved to be good. Fifty-five subjects were divided into four groups based on EF at rest. The EDV and ESV were increased by angiotensin, and decreased by nitrate in all groups. EF was decreased by angiotensin and increased by nitrate. In contrast, the changes in PSP/ESVI due to these drugs remained in a narrow range in all groups. The regression lines of the PSP/ESVI relationship were almost linear and were steeper in the group with higher EF. Esub(max), the slope of the lines, was 5.75 +- 3.48 mmHg/ml/m 2 in group 1 (EF>50%), 3.16 +- 1.83 mmHg/ml/m 2 in group 2 (EF 49-40%), 2.27 +- 0.86 mmHg/ml/m 2 in group 3 (EF 39-30%) and 0.59 +- 0.50 mmHg/ml/m 2 in group 4 (EF<29%). The theoretical volume at zero pressure (VoI) did not meet in a definite value and was not related to EF at rest. Thus, the left ventricular peak systolic pressure-end-systolic volume relationship can be assessed non-invasively from radionuclide angiocardiography, which can be widely used for the evaluation of ventricular contractility, even in patients with asynergic ventricular contraction for whom echocardiography is unsuitable in measuring ventricular volume. (author)

  6. The evolution of systolic blood pressure as a strong predictor of cardiovascular risk and the effectiveness of fixed-dose ARB/CCB combinations in lowering levels of this preferential target

    Directory of Open Access Journals (Sweden)

    Jean-Jacques Mourad

    2008-12-01

    Full Text Available Jean-Jacques MouradHypertension Unit, Avicenne Hospital – AP-HP and Paris XIII University Bobigny, FranceAbstract: Elevated blood pressure is an important cardiovascular risk factor. Although targets for both diastolic blood pressure (DBP and systolic blood pressure (SBP are defined by current guidelines, DBP has historically taken precedence in hypertension management. However, there is strong evidence that SBP is superior to DBP as a predictor of cardiovascular events. Moreover, achieving control of SBP is assuming greater importance amongst an aging population. In spite of the growing recognition of the importance of SBP in reducing cardiovascular risk and the emphasis by current guidelines on SBP control, a substantial proportion of patients still fail to achieve SBP targets, and SBP control is achieved much less frequently than DBP control. Thus, new approaches to the management of hypertension are required in order to control SBP and minimize cardiovascular risk. Fixed-dose combination (FDC therapy is an approach that offers the advantages of multiple drug administration and a reduction in regimen complexity that favors compliance. We have reviewed the latest evidence demonstrating the efficacy in targeting SBP of the most recent FDC products; combinations of the calcium channel blocker (CCB, amlodipine, with angiotensin receptor blockers (ARBs, valsartan or olmesartan. In addition, results from studies with new classes of agent are outlined.Keywords: hypertension, systolic blood pressure, angiotensin receptor blocker, calcium channel blocker, combination therapy

  7. Ratio of systolic blood pressure to left ventricular end-diastolic pressure at the time of primary percutaneous coronary intervention predicts in-hospital mortality in patients with ST-elevation myocardial infarction.

    Science.gov (United States)

    Sola, Michael; Venkatesh, Kiran; Caughey, Melissa; Rayson, Robert; Dai, Xuming; Stouffer, George A; Yeung, Michael

    2017-09-01

    To determine the ability of simple hemodynamic parameters obtained at the time of cardiac catheterization to predict in-hospital mortality following ST-elevation myocardial infarction (STEMI). Hemodynamic parameters measured at the time of primary percutaneous coronary intervention (PPCI) could potentially identify high-risk patients who would benefit from aggressive hemodynamic support in the Cardiac Catheterization laboratory. This is a retrospective single-center study of 219 consecutive patients with STEMI. Left ventricular end-diastolic pressure (LVEDP), systolic blood pressure (SBP), and aortic diastolic blood pressure were obtained after successful revascularization. The prognostic ability of LVEDP, pulse pressure, and SBP/LVEDP ratio were compared to major mortality risk scores. Patients had a mean age of 60 ±14 years, were predominantly white (73%), male (64%), with anterior wall infarcts in 39%. Comorbidities included diabetes mellitus (27%), heart failure (9%), and chronic kidney disease (7%). In-hospital mortality was 9%. Patients with SBP/LVEDP ≤ 4 had increased risk of in-hospital death (32% vs. 5.3%, P  4. The area under curve (AUC) for SBP/LVEDP ratio for in-hospital mortality (0.69) was more predictive than LVEDP (0.61, P = 0.04) or pulse pressure (0.55, P = 0.02) but similar to Shock Index (ratio of heart rate to SBP) and Modified Shock Index (ratio of HR to mean arterial pressure). An SBP/LVEDP ratio ≤ 4 identified a group of STEMI patients at high risk of in-hospital death. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  8. Isolated Systolic Hypertension: A Health Concern?

    Science.gov (United States)

    Isolated systolic hypertension: A health concern? Is having a high top number (systolic) blood pressure, but a normal bottom number (diastolic) ... mm Hg, you have a common type of high blood pressure called isolated systolic hypertension. Isolated systolic hypertension can ...

  9. An adaptive technique for multiscale approximate entropy (MAEbin) threshold (r) selection: application to heart rate variability (HRV) and systolic blood pressure variability (SBPV) under postural stress.

    Science.gov (United States)

    Singh, Amritpal; Saini, Barjinder Singh; Singh, Dilbag

    2016-06-01

    Multiscale approximate entropy (MAE) is used to quantify the complexity of a time series as a function of time scale τ. Approximate entropy (ApEn) tolerance threshold selection 'r' is based on either: (1) arbitrary selection in the recommended range (0.1-0.25) times standard deviation of time series (2) or finding maximum ApEn (ApEnmax) i.e., the point where self-matches start to prevail over other matches and choosing the corresponding 'r' (rmax) as threshold (3) or computing rchon by empirically finding the relation between rmax, SD1/SD2 ratio and N using curve fitting, where, SD1 and SD2 are short-term and long-term variability of a time series respectively. None of these methods is gold standard for selection of 'r'. In our previous study [1], an adaptive procedure for selection of 'r' is proposed for approximate entropy (ApEn). In this paper, this is extended to multiple time scales using MAEbin and multiscale cross-MAEbin (XMAEbin). We applied this to simulations i.e. 50 realizations (n = 50) of random number series, fractional Brownian motion (fBm) and MIX (P) [1] series of data length of N = 300 and short term recordings of HRV and SBPV performed under postural stress from supine to standing. MAEbin and XMAEbin analysis was performed on laboratory recorded data of 50 healthy young subjects experiencing postural stress from supine to upright. The study showed that (i) ApEnbin of HRV is more than SBPV in supine position but is lower than SBPV in upright position (ii) ApEnbin of HRV decreases from supine i.e. 1.7324 ± 0.112 (mean ± SD) to upright 1.4916 ± 0.108 due to vagal inhibition (iii) ApEnbin of SBPV increases from supine i.e. 1.5535 ± 0.098 to upright i.e. 1.6241 ± 0.101 due sympathetic activation (iv) individual and cross complexities of RRi and systolic blood pressure (SBP) series depend on time scale under consideration (v) XMAEbin calculated using ApEnmax is correlated with cross-MAE calculated using ApEn (0.1-0.26) in steps of 0

  10. Effects of Acidic Polysaccharides from Gastrodia Rhizome on Systolic Blood Pressure and Serum Lipid Concentrations in Spontaneously Hypertensive Rats Fed a High-Fat Diet

    Science.gov (United States)

    Lee, Ok-Hwan; Kim, Kyung-Im; Han, Chan-Kyu; Kim, Young-Chan; Hong, Hee-Do

    2012-01-01

    The effects of acidic polysaccharides purified from Gastrodia rhizome on blood pressure and serum lipid levels in spontaneously hypertensive rats (SHR) fed a high-fat diet were investigated. Acidic polysaccharides were purified from crude polysaccharides by DEAE-Sepharose CL-6B. Thirty-six male SHR were randomly divided into three groups: Gastrodia rhizome crude polysaccharide (A), acidic polysaccharide (B) groups, and a control group (C). A 5-week oral administration of all treatment groups was performed daily in 3- to 8-week-old SHRs with a dose of 6 mg/kg of body weight/day. After 5 weeks of treatment, total cholesterol in the acidic polysaccharide group, at 69.7 ± 10.6 mg/dL, was lower than in the crude polysaccharide group (75.0 ± 6.0 mg/dL) and the control group (89.2 ± 7.4 mg/dL). In addition, triglyceride and low-density lipoprotein cholesterol levels in the acidic polysaccharide group were lower than in the crude polysaccharide and control groups. The atherogenic index of the acidic polysaccharide group was 46.3% lower than in the control group. Initial blood pressure after the initial three weeks on the high-fat diet averaged 195.9 ± 3.3 mmHg among all rats. Compared with the initial blood pressure, the final blood pressure in the control group was increased by 22.8 mmHg, whereas it decreased in the acidic polysaccharide group by 14.9 mmHg. These results indicate that acidic polysaccharides from Gastrodia rhizome reduce hypertension and improve serum lipid levels. PMID:22312280

  11. Effects of Acidic Polysaccharides from Gastrodia Rhizome on Systolic Blood Pressure and Serum Lipid Concentrations in Spontaneously Hypertensive Rats Fed a High-Fat Diet

    Directory of Open Access Journals (Sweden)

    Hee-Do Hong

    2012-01-01

    Full Text Available The effects of acidic polysaccharides purified from Gastrodia rhizome on blood pressure and serum lipid levels in spontaneously hypertensive rats (SHR fed a high-fat diet were investigated. Acidic polysaccharides were purified from crude polysaccharides by DEAE-Sepharose CL-6B. Thirty-six male SHR were randomly divided into three groups: Gastrodia rhizome crude polysaccharide (A, acidic polysaccharide (B groups, and a control group (C. A 5-week oral administration of all treatment groups was performed daily in 3- to 8-week-old SHRs with a dose of 6 mg/kg of body weight/day. After 5 weeks of treatment, total cholesterol in the acidic polysaccharide group, at 69.7 ± 10.6 mg/dL, was lower than in the crude polysaccharide group (75.0 ± 6.0 mg/dL and the control group (89.2 ± 7.4 mg/dL. In addition, triglyceride and low-density lipoprotein cholesterol levels in the acidic polysaccharide group were lower than in the crude polysaccharide and control groups. The atherogenic index of the acidic polysaccharide group was 46.3% lower than in the control group. Initial blood pressure after the initial three weeks on the high-fat diet averaged 195.9 ± 3.3 mmHg among all rats. Compared with the initial blood pressure, the final blood pressure in the control group was increased by 22.8 mmHg, whereas it decreased in the acidic polysaccharide group by 14.9 mmHg. These results indicate that acidic polysaccharides from Gastrodia rhizome reduce hypertension and improve serum lipid levels.

  12. A PILOT STUDY ON THE EFFECTS OF MAGNESIUM SUPPLEMENTATION WITH HIGH AND LOW HABITUAL DIETARY MAGNESIUM INTAKE ON RESTING AND RECOVERY FROM AEROBIC AND RESISTANCE EXERCISE AND SYSTOLIC BLOOD PRESSURE

    Directory of Open Access Journals (Sweden)

    Lindsy S. Kass

    2013-03-01

    Full Text Available The effects of magnesium supplementation on blood pressure (BP have been studied for over 25 years and results have been inconsistent. Blood pressure reductions in randomized studies have varied from 12 mmHg reductions to no reduction. The objective of this pilot intervention was to investigate the effect of magnesium supplementation on systolic blood pressure whilst resting and during recovery from aerobic and resistance exercise and on performance. A further objective was to see whether the effect of a high vs low habitual dietary magnesium intake affected these results. Sixteen male volunteers were randomly assigned to either a 300 mg·d-1 magnesium oxide supplementation (MO or a control group (CG for 14 days. Resting blood pressure (BP and heart rate (HR were measured before subjects performed a maximal 30 minute cycle, immediately followed by three x 5 second isometric bench press, both at baseline and after the intervention. Blood pressure and heart rate were recorded immediately post exercise and after five minutes recovery. A 3 day food diary was recorded for all subjects to measure dietary magnesium intake. At the end of the intervention, the supplemented group, had a reduction in mean resting systolic BP by 8.9 mmHg (115.125 ± 9.46 mmHg, p = 0.01 and post exercise by 13 mmHg (122.625 ± 9. 88 mmHg, p = 0.01. Recovery BP was 11.9 mmHg lower in the intervention group compared to control (p = 0.006 and HR decreased by 7 beats per minute in the experimental group (69.0 ± 11.6 bpm, p = 0. 02. Performance indicators did not change within and between the groups. Habitual dietary magnesium intake affected both resting and post exercise systolic BP and the subsequent effect of the magnesium supplementation. These results have an implication in a health setting and for health and exercise but not performance.

  13. ORANGE JUICE AND BLOOD PRESSURE

    Directory of Open Access Journals (Sweden)

    M. F. VALIM

    2009-01-01

    Full Text Available

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

  14. Significance of white-coat hypertension in older persons with isolated systolic hypertension: a meta-analysis using the International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes population.

    Science.gov (United States)

    Franklin, Stanley S; Thijs, Lutgarde; Hansen, Tine W; Li, Yan; Boggia, José; Kikuya, Masahiro; Björklund-Bodegård, Kristina; Ohkubo, Takayoshi; Jeppesen, Jørgen; Torp-Pedersen, Christian; Dolan, Eamon; Kuznetsova, Tatiana; Stolarz-Skrzypek, Katarzyna; Tikhonoff, Valérie; Malyutina, Sofia; Casiglia, Edoardo; Nikitin, Yuri; Lind, Lars; Sandoya, Edgardo; Kawecka-Jaszcz, Kalina; Imai, Yutaka; Wang, Jiguang; Ibsen, Hans; O'Brien, Eoin; Staessen, Jan A

    2012-03-01

    The significance of white-coat hypertension in older persons with isolated systolic hypertension remains poorly understood. We analyzed subjects from the population-based 11-country International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes database who had daytime ambulatory blood pressure (BP; ABP) and conventional BP (CBP) measurements. After excluding persons with diastolic hypertension by CBP (≥90 mm Hg) or by daytime ABP (≥85 mm Hg), a history of cardiovascular disease, and persons <18 years of age, the present analysis totaled 7295 persons, of whom 1593 had isolated systolic hypertension. During a median follow-up of 10.6 years, there was a total of 655 fatal and nonfatal cardiovascular events. The analyses were stratified by treatment status. In untreated subjects, those with white-coat hypertension (CBP ≥140/<90 mm Hg and ABP <135/<85 mm Hg) and subjects with normal BP (CBP <140/<90 mm Hg and ABP <135/<85 mm Hg) were at similar risk (adjusted hazard rate: 1.17 [95% CI: 0.87-1.57]; P=0.29). Furthermore, in treated subjects with isolated systolic hypertension, the cardiovascular risk was similar in elevated conventional and normal daytime systolic BP as compared with those with normal conventional and normal daytime BPs (adjusted hazard rate: 1.10 [95% CI: 0.79-1.53]; P=0.57). However, both treated isolated systolic hypertension subjects with white-coat hypertension (adjusted hazard rate: 2.00; [95% CI: 1.43-2.79]; P<0.0001) and treated subjects with normal BP (adjusted hazard rate: 1.98 [95% CI: 1.49-2.62]; P<0.0001) were at higher risk as compared with untreated normotensive subjects. In conclusion, subjects with sustained hypertension who have their ABP normalized on antihypertensive therapy but with residual white-coat effect by CBP measurement have an entity that we have termed, "treated normalized hypertension." Therefore, one should be cautious in applying the term "white-coat hypertension" to persons

  15. Urinary protein as a marker for systolic blood pressure reduction in patients with type 2 diabetes mellitus participating in an in-hospital diabetes education program.

    Science.gov (United States)

    Okada, Kenta; Miyamoto, Michiaki; Kotani, Kazuhiko; Yagyu, Hiroaki; Osuga, Junichi; Nagasaka, Shoichiro; Ishibashi, Shun

    2011-10-01

    Increased blood pressure (BP) and urinary protein (UP)/microalbuminuria are risk factors for cardiovascular disease in patients with diabetes. Although the management of BP in patients with diabetes should involve a multidisciplinary therapy, there are no reports in which modulators have been identified in an in-hospital diabetes education program. The aim of the present study was to investigate the change in BP levels in patients with type 2 diabetes mellitus (T2DM) during a short-term (2-week) in-hospital education program on lifestyle modifications. A total of 167 patients with T2DM (101 men, 66 women; mean age, 61.1 years; glycated hemoglobin, 9.2%) were divided into 2 groups on the basis of their urinary albumin levels: 1 group without UP (urinary albumin level patients with T2DM.

  16. Impact of age on pulmonary artery systolic pressures at rest and with exercise

    Directory of Open Access Journals (Sweden)

    Garvan C Kane

    2016-06-01

    Full Text Available Aim: It is not well known if advancing age influences normal rest or exercise pulmonary artery pressures. The purpose of the study was to evaluate the association of increasing age with measurements of pulmonary artery systolic pressure at rest and with exercise. Subjects and methods: A total of 467 adults without cardiopulmonary disease and normal exercise capacity (age range: 18–85 years underwent symptom-limited treadmill exercise testing with Doppler measurement of rest and exercise pulmonary artery systolic pressure. Results: There was a progressive increase in rest and exercise pulmonary artery pressures with increasing age. Pulmonary artery systolic pressures at rest and with exercise were 25 ± 5 mmHg and 33 ± 9 mmHg, respectively, in those <40 years, and 30 ± 5 mmHg and 41 ± 12 mmHg, respectively, in those ≥70 years. While elevated left-sided cardiac filling pressures were excluded by protocol design, markers of arterial stiffness associated with the age-dependent effects on pulmonary pressures. Conclusion: These data demonstrate that in echocardiographically normal adults, pulmonary artery systolic pressure increases with advancing age. This increase is seen at rest and with exercise. These increases in pulmonary pressure occur in association with decreasing transpulmonary flow and increases in systemic pulse pressure, suggesting that age-associated blood vessel stiffening may contribute to these differences in pulmonary artery systolic pressure.

  17. Effect of atrial systole on canine and porcine coronary blood flow.

    Science.gov (United States)

    Bellamy, R F

    1981-09-01

    A feature of phasic coronary flow patterns recorded in conscious chronically instrumented dogs is the atrial cove--a transient depression of arterial flow that occurs during atrial systole. The association between the hemodynamic effects of atrial systole and the atrial cove was studied in anesthetized dogs and pigs with complete heart block. Many atrial coves are available for study in these preparations because atrial activity continues unabated during the diastolic ventricular arrest that follows cessation of electrical pacing. The effect of atrial systole is to translate the pressure-flow relation found during diastole to a higher intercept pressure without change in slope. The increase in the intercept pressure equals the increase in intramyocardial pressure measured with microtransducers embedded in the left ventricular wall. The decrement in flow during the atrial cove is a direct function of the change in intramyocardial pressure and an inverse function of coronary vascular resistance. Each atrial systole is associated with a forward flow transient in the coronary veins, the peak of which occurs at the same instant as does the nadir of atrial flow. These data suggest that the coronary vessels are acting as collapsible tubes and that the waterfall model of the coronary circulation is applicable. The following sequence is proposed to account for the atrial cove. Atrial systole ejects a bolus of blood into the left ventricle increasing both ventricular cavity and intramyocardial pressures. The increase in intramyocardial pressure raises the back pressure opposing coronary flow, reducing the arterial perfusion pressure gradient and causing flow to fall.

  18. Blood Pressure Test

    Science.gov (United States)

    ... pressure monitors may have some limitations. Tracking your blood pressure readings It can be helpful in diagnosing or ... more Stage 2 high blood pressure (hypertension) Elevated blood pressure and stages 1 and 2 high blood pressure ( ...

  19. Diagnosis of childhood hypertension: is blood pressure height ratio ...

    African Journals Online (AJOL)

    Blood pressure was also recorded according to the standard method. Systolic and diastolic blood pressure to height ratio were then calculated. Receiver operating curves was used to assess the ability of systolic blood and diastolic blood pressure height ratio to discriminate childhood prehypertension and hypertension.

  20. Maximum home systolic blood pressure is a useful indicator of arterial stiffness in patients with type 2 diabetes mellitus: post hoc analysis of a cross-sectional multicenter study.

    Science.gov (United States)

    Ushigome, Emi; Fukui, Michiaki; Hamaguchi, Masahide; Tanaka, Toru; Atsuta, Haruhiko; Mogami, Shin-ichi; Tsunoda, Sei; Yamazaki, Masahiro; Hasegawa, Goji; Nakamura, Naoto

    2014-09-01

    Maximum (max) home systolic blood pressure (HSBP) as well as mean HSBP or HSBP variability was reported to increase the predictive value of target organ damage. Yet, the association between max HSBP and target organ damage in patients with type 2 diabetes has never been reported. The aim of this study was to investigate the association between max HSBP and pulse wave velocity (PWV), a marker of arterial stiffness which in turn is a marker of target organ damage, in patients with type 2 diabetes. We assessed the relationship of mean HSBP or max HSBP to PWV, and compared area under the receiver-operating characteristic curve (AUC) of mean HSBP or max HSBP for arterial stiffness in 758 patients with type 2 diabetes. In the univariate analyses, age, duration of diabetes mellitus, body mass index, mean clinic systolic blood pressure (SBP), mean HSBP and max HSBP were associated with PWV. Multivariate linear regression analyses indicated that mean morning SBP (β=0.156, P=0.001) or max morning SBP (β=0.146, P=0.001) were significantly associated with PWV. AUC (95% CI) for arterial stiffness, defined as PWV equal to or more than 1800 cm per second, in mean morning SBP and max morning SBP were 0.622 (0.582-0.662; P<0.001) and 0.631 (0.591-0.670; P<0.001), respectively. Our findings implicate that max HSBP as well as mean HSBP was significantly associated with arterial stiffness in patients with type 2 diabetes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. The significance of abnormal systolic blood pressure response during supine ergometer exercise and postexercise in ischemic heart disease, studied by exercise radionuclide ventriculography

    International Nuclear Information System (INIS)

    Ajisaka, Ryuichi; Watanabe, Shigeyuki; Masuoka, Takeshi

    1989-01-01

    Abnormal response to blood pressure (BP) during exercise and postexercise was examined in 169 patients with ischemic heart disease. The patients underwent supine ergometer exercise gated equilibrium radionuclide ventriculography and coronary arteriography. When BP during exercise did not increase by at least 11 mmHg or initially increased but later decreased by more than 10 mmHg, the BP response was defined as abnormal during exercise. A postexercise BP increase of more than 10 mmHg above the peak exercise BP was defined as abnormal during postexercise. Fifteen-one patients (30%) were classified as abnormal (group 1) and the other 118 as normal (group 2). Abnormal BP response fell into three types: (1a) exercise hypotension (n=11), (1b) postexercise hypertension (n=30), and (1c) exercise hypotension with postexercise hypertension (n=10). Both average exercise duration and peak heart rate were significantly lower in groups 1a, 1b, and 1c than group 2. Exercise ST-segment depression was more noticeable in groups 1b and 1c than group 2. However, there was no significant difference in the severitiy of exercise ST-segment depression between groups 1a and 2. A decline in ejection fraction occurred more frequently in groups 1b and 1c than group 2. Patients in groups 1a, 1b, and 1c had more extensive coronary artery disease than did patients in group 2. Medically managed patients having an abnormal BP response had a poorer prognosis than those with a normal BP response. An abnormal BP response during both supine exercise and postexercise was infrequent. The abnormal BP during exercise may be usually associated with impaired exercise tolerance and severe coronary artery disease; and that during postexercise may be closely associated with myocardial ischemia and global left ventricular dysfunction. Postexercise hypertension may be of the same value as exercise hypotension in predicting poor prognosis. (Namekawa, K)

  2. The inter-arm difference in systolic blood pressure is a novel risk marker for subclinical atherosclerosis in patients with type 2 diabetes.

    Science.gov (United States)

    Tanaka, Yoshimitsu; Fukui, Michiaki; Tanaka, Muhei; Fukuda, Yukiko; Mitsuhashi, Kazuteru; Okada, Hiroshi; Yamazaki, Masahiro; Hasegawa, Goji; Yoshioka, Keiji; Nakamura, Naoto

    2014-06-01

    Recent studies have suggested that the inter-arm blood pressure difference (IAD) is associated with cardiovascular events and mortality. The aim of this study was to assess whether the IAD could be a marker for subclinical atherosclerosis in patients with type 2 diabetes who are at high risk of cardiovascular disease (CVD). In a cross-sectional retrospective study of 206 Japanese patients with type 2 diabetes aged 49-76 years, we examined the correlation of the IAD with the carotid intima-media thickness (IMT), ankle-brachial index (ABI) or cardio ankle vascular index (CAVI). The IAD was positively correlated with the maximum IMT (r=0.266, P<0.0001), mean IMT (r=0.209, P=0.00726) or CAVI (r=0.240, P=0.0005). The IAD was higher in patients with CVD than in those without (P=0.0020). A multiple linear regression analysis demonstrated that the IAD was an independent determinant of maximum IMT (β=0.169, P=0.0167), mean IMT (β=0.178, P=0.0153), ABI (β=-0.222, P=0.0033) or CAVI (β=0.213, P=0.0011) after adjusting for known risk factors. The area under the receiver operating characteristic curve (AUC) of the IAD as a predictor of subclinical atherosclerosis was similar to the AUC of the Framingham 10-year coronary heart disease risk score. In conclusion, the IAD could be a novel risk marker for subclinical atherosclerosis in patients with type 2 diabetes.

  3. Low Blood Pressure

    Science.gov (United States)

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

  4. Low Blood Pressure (Hypotension)

    Science.gov (United States)

    ... lowest at night and rises sharply on waking. Blood pressure: How low can you go? What's considered low ... low blood pressure. Medications that can cause low blood pressure Some medications can cause low blood pressure, including: ...

  5. Systolic blood pressure, cardiovascular outcomes and efficacy and safety of sacubitril/valsartan (LCZ696) in patients with chronic heart failure and reduced ejection fraction: results from PARADIGM-HF.

    Science.gov (United States)

    Böhm, Michael; Young, Robin; Jhund, Pardeep S; Solomon, Scott D; Gong, Jianjian; Lefkowitz, Martin P; Rizkala, Adel R; Rouleau, Jean L; Shi, Victor C; Swedberg, Karl; Zile, Michael R; Packer, Milton; McMurray, John J V

    2017-04-14

    Compared to heart failure patients with higher systolic blood pressure (SBP), those with lower SBP have a worse prognosis. To make matters worse, the latter patients often do not receive treatment with life-saving therapies that might lower blood pressure further. We examined the association between SBP and outcomes in the Prospective Comparison of angiotensin receptor-neprilysin inhibitor (ARNI) with an angiotensin-converting enzyme (ACE) inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure trial (PARADIGM-HF), as well as the effect of sacubitril/valsartan, compared with enalapril, according to baseline SBP. We analysed the effect of treatment on SBP and on the primary composite outcome (cardiovascular death or heart failure hospitalization), its components and all-cause death. We examined baseline SBP as a categorical (sacubitril/valsartan over enalapril was consistent across all baseline SBP categories for all outcomes. For example, the sacubitril/valsartan versus enalapril hazard ratio for the primary endpoint was 0.88 (95%CI 0.74-1.06) in patients with a baseline SBP sacubitril/valsartan and had the same relative benefit over enalapril as patients with higher baseline SBP. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For Permissions, please email: journals.permissions@oup.com.

  6. Smart blood pressure holter.

    Science.gov (United States)

    İlhan, İlhan

    2018-03-01

    In this study, a wireless blood pressure holter that can be used with smart mobile devices was developed. The developed blood pressure holter consists of two parts, which are a smart mobile device and a cuff. The smart mobile device is used as a recording, control and display device through a developed interface, while the cuff was designed to take measurements from the arm. Resistor-Capacitor (RC) and digital filters were used on the cuff that communicates with the smart mobile device via Bluetooth. The blood pressure was estimated using the Simple Hill Climbing Algorithm (HCA). It is possible to measure instantaneous or programmable blood pressure and heart rate values at certain intervals using this holter. The test was conducted with 30 individuals at different ages with the guidance of a specialist health personnel. The results showed that an accuracy at 93.89% and 91.95% rates could be obtained for systolic and diastolic pressure values, respectively, when compared with those obtained using a traditional sphygmomanometer. The accuracy level for the heart rate was measured as 97.66%. Furthermore, this device was tested day and night in the holter mode in terms of working time, the continuity of the Bluetooth connection and the reliability of the measurement results. The test results were evaluated separately in terms of measurement accuracy, working time, the continuity of the Bluetooth connection and the reliability of the measurement results. The measurement accuracy for systolic, diastolic blood pressure and heart rate values was obtained as 93.89%, 91.95% and 97.66%, respectively. The maximum number of measurements which can be conducted with four 1000 mA alkaline batteries at 20 min intervals was found approximately 79 (little more than 24 h). In addition, it was determined that the continuity of the Bluetooth connection and the reliability of the measurement results were automatically achieved through the features in the interface developed for the

  7. Worldwide trends in blood pressure from 1975 to 2015

    NARCIS (Netherlands)

    Ezzati, Majid; Geleijnse, J.M.

    2017-01-01

    Background

    Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic

  8. Visit-to-visit blood pressure variation is associated with outcomes in a U-shaped fashion in patients with myocardial infarction complicated with systolic dysfunction and/or heart failure: findings from the EPHESUS and OPTIMAAL trials.

    Science.gov (United States)

    Ferreira, João Pedro; Duarte, Kévin; Pitt, Bertram; Dickstein, Kenneth; McMurray, John J V; Zannad, Faiez; Rossignol, Patrick

    2018-04-21

    Visit-to-visit office blood pressure variation (BPV) has prognostic implications independent from mean BP across several populations in the cardiovascular field. The association of BPV with outcomes in patients with myocardial infarction (MI) with systolic dysfunction and/or heart failure is yet to be determined. Two independent cohorts were assessed: the EPHESUS and the OPTIMAAL trials with a total of more than 12 000 patients. The primary outcome was all-cause death. BPV was calculated as a coefficient of variation, that is, the ratio of the SD to the mean BP along the postbaseline follow-up. Cox regression models were used to determine the associations between BPV and events. Compared with the middle and lower BPV tertiles, patients in the upper BPV tertile were older, more often women, hypertensive, diabetic, with peripheral artery disease, and had more frequent use of loop diuretics and ACEi/ARBs. They also had lower LVEF, hemoglobin, and eGFR (all P < 0.001). BPV was independently associated with worse prognosis in a U-shaped manner. In the EPHESUS trial, both low and high BPV were associated with higher rates of death (and also cardiovascular death and the composite of cardiovascular death/ cardiovascular hospitalization): adjusted hazard ratio (95% CI) for the outcome of death is 1.99 (1.68-2.36) for high BPV and is 1.60 (1.35-1.90) for low BPV. Similar results were observed in the OPTIMAAL trial population. In two independent cohorts of MI patients with systolic dysfunction and/or heart failure, BPV was associated with worse prognosis in a U-shaped manner independently of the mean BP.

  9. High Blood Pressure

    Science.gov (United States)

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

  10. High Blood Pressure Facts

    Science.gov (United States)

    ... Stroke Heart Disease Cholesterol Salt Million Hearts® WISEWOMAN High Blood Pressure Facts Recommend on Facebook Tweet Share Compartir On ... Top of Page CDC Fact Sheets Related to High Blood Pressure High Blood Pressure Pulmonary Hypertension Heart Disease Signs ...

  11. High Blood Pressure (Hypertension)

    Science.gov (United States)

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

  12. Predictive ability of visit-to-visit variability in HbA1c and systolic blood pressure for the development of microalbuminuria and retinopathy in people with type 2 diabetes.

    Science.gov (United States)

    Takao, Toshiko; Suka, Machi; Yanagisawa, Hiroyuki; Matsuyama, Yutaka; Iwamoto, Yasuhiko

    2017-06-01

    We explored whether visit-to-visit variability in both glycated hemoglobin (HbA1c) and systolic blood pressure (SBP) simultaneously predicted the development of microalbuminuria and retinopathy, and whether the predictive ability of these measurements changed according to mean HbA1c and SBP levels in people with type 2 diabetes. A retrospective observational cohort study was conducted on 243 type 2 diabetes patients with normoalbuminuria and 486 without retinopathy at the first visit and within 1year thereafter. The two cohorts were followed up from 1995 until 2012. Multivariate and stratified analyses were performed using Cox proportional hazard models. Microalbuminuria developed in 84 patients and retinopathy in 108. Hazard ratios (HRs) for the development of microalbuminuria associated with the coefficient of variation (CV) and variation independent of mean (VIM) of both HbA1c and SBP significantly increased. In participants with a mean SBP HbA1c were abruptly elevated and significant compared with those with a mean SBP ≥130mmHg. Visit-to-visit variability in both HbA1c and SBP simultaneously predict the development of microalbuminuria. HbA1c variability may predict the development of retinopathy when the mean SBP is normal (<130mmHg). Copyright © 2017 Elsevier B.V. All rights reserved.

  13. THE INFLUENCE OF BIOFEEDBACK SESSIONS IN CLOSED LOOP OF HEART RATE VARIABILITY AND PACED BREATHING ON SYSTOLIC BLOOD PRESSURE CONTROL DURING STANDARD DRUG THERAPY IN PATIENTS WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    S. A. S. Belal

    2015-06-01

    Full Text Available Changes of systolic blood pressure (SBP in biofeedback (BFB sessions with closed loop of paced breathing (PB and heart rate variability (HRV during standard drug therapy of arterial hypertension (AH was studied. 275 patients with 1-3 degree of AH (143 men and 132 women, mean age 58,55 ± 7,99 years was divided into two comparable groups: 1 - BFB (139 patients in investigated PB loop, 2 - control group (136 patients with BFB without PB. In both groups was performed 10 sessions of BFB. Changes of SBP depending on the stage and degree of AH, gender and age was assessed. BP was measured by the method of Korotkov’s with monometer Microlife BP AG1-20 in same conditions. Data were processed by parametric and nonparametric statistics. It is proved that the use of biofeedback in the loop of PB and HRV significantly (p < 0.01 exceeds in efficiency an isolated drug therapy in control of SBP at any stage and degree of AH in patients of both sexes in all age groups. Extent of the effect increases with the stage and degree of the disease and not related to the sex and age of the patient. Findings allow to recommend this technique in clinical practice.

  14. Influence of the Lactotripeptides Isoleucine-Proline-Proline and Valine-Proline-Proline on Systolic Blood Pressure in Japanese Subjects: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Directory of Open Access Journals (Sweden)

    Aurelie Chanson-Rolle

    Full Text Available The lactotripeptides isoleucine-proline-proline (IPP and valine-proline-proline (VPP have been shown to decrease systolic blood pressure (SBP in several populations, but the size of the effect varies among studies. We performed a meta-analysis including all published studies to evaluate the SBP-lowering effect of IPP/VPP in Japanese subjects more comprehensively.Eligible randomized controlled trials were searched for within four bibliographic databases, including two Japanese ones. Eighteen studies (including a total of 1194 subjects were included in the meta-analysis. A random effect model using the restricted maximum likelihood (REML estimator was used for the analysis. The analysis showed that consumption of IPP/VPP induced a significant reduction in SBP as compared with placebo in Japanese subjects, with an estimated effect of -5.63 mm Hg (95% CI, -6.87 to -4.39, P<0.0001 and no evidence of publication bias. A significant heterogeneity between series was evident, which could be explained by a significant influence of the baseline blood pressure status of the subjects, the effect of IPP/VPP on SBP being stronger in hypertensive subjects (-8.35 mm Hg, P<0.0001 than in non-hypertensive subjects (-3.42mm Hg, P<0.0001. Furthermore, the effect of IPP/VPP on SBP remained significant when limiting the analysis to series that tested the usual doses of IPP/VPP consumed daily (below 5 mg/d, with estimated effects of -6.01 mm Hg in the overall population and -3.32 mm Hg in non-hypertensive subjects.Results from this meta-analysis show that IPP/VPP lactotripeptides can significantly reduce office SBP in Japanese subjects with or without overt hypertension, and for doses that can potentially be consumed as an everyday supplement. This suggests that these peptides could play a role in controlling blood pressure in Japanese subjects. The systematic review protocol was published on the PROSPERO register (CRD42014014322.

  15. Analysis of end-systolic pressure-volume relation by gated radionuclide angiocardiography

    International Nuclear Information System (INIS)

    Adachi, Haruhiko; Sugihara, Horoki; Katsume, Hiroshi; Ijichi, Hamao; Miyanaga, Hajime

    1982-01-01

    Left ventricular end-systolic pressure-volume relation has been proved experimentally to b e an useful index of left ventricular contractility relatively independent of preload or afterload. But less clinical application has been reported because of its invasive nature, and we evaluated this relationship non-invasively using gated radionuclide angiocardiography as volume determination and cuff sphyngomanometer in the arm as pressure measurement. Gated equilibrium blood pool scintigrams were obtained at rest and during intravenous infusion of angiotensin or nitrate. Ventricular volumes were derived from ventricular activity and peripheral blood volume and activity. The peak systolic pressure (PSP) by cuff method to end-systolic volume index (ESVI) relations showed good linearity (r gt .930 in 84% of consecutive 50 cases) and were gentler in the groups with more impaired left ventricular function. Emax was related exponentially to ejection fraction (EF) and hyperbolically to end-diastolic volume index. The dead volume (VoI) was unfixed and fell into positive or negative value, and was not related to EF under control condition. PSP/ESVI in each loading condition was less variable with the alteration of blood pressure than EF. The linear relation was found between PSP/ESVI under control condition and Emax (PSP/ESVI = 0.651.Emax + 0.958, r = 0.841, p lt .001). Thus in measuring ventricular volume, gated radionuclide angiocardiography is a non-invasive method less affected by the geometry of the left ventricle. Non-invasive determination of end-systolic pressure-volume relation using the volume by radionuclide and the blood pressure by cuff method is clinically useful in the assessment of left ventricular contractility. (author)

  16. Hypertension (High Blood Pressure)

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Hypertension (High Blood Pressure) KidsHealth / For Teens / Hypertension (High Blood Pressure) What's ... rest temperature diet emotions posture medicines Why Is High Blood Pressure Bad? High blood pressure means a person's heart ...

  17. Systolic blood pressure of dogs at hospital and domestic environment Pressão arterial sistólica de cães nos ambientes hospitalar e doméstico

    Directory of Open Access Journals (Sweden)

    Frederico Aécio Carvalho Soares

    2012-07-01

    Full Text Available The measurement of blood pressure (BP is an important assessment of the cardiovascular system, being influenced by physical and pathological conditions. Certain situations of stress and anxiety during BP measurement can lead to elevated values in small animals, known in medicine as "white coat effect". The aim of this research was to compare systolic blood pressure (SBP measurement using Doppler ultrasonography in 45 adult healthy dogs in two environments, at a veterinary hospital and at home. Comparison of heart rate, serum concentrations of cortisol and glucose intended to help the evaluation of the stress level of the animals. The mean of SBP at the veterinary hospital was 154.7mmHg and it was significantly (PA medida da pressão arterial constitui uma importante avaliação do sistema cardiovascular, sendo influenciada por condições físicas e patológicas. Situações de estresse e ansiedade no momento da aferição podem causar valores de pressão sanguínea elevados, o que é conhecido na medicina humana como "efeito jaleco branco". O objetivo deste trabalho foi comparar os valores da pressão arterial sistólica (PAS pelo método Doppler em 45 cães em dois ambientes, o doméstico e o hospitalar. Além disso, foram comparadas as frequências cardíacas e concentrações séricas de glicose e cortisol nos dois ambientes, com o objetivo de auxiliar a avaliação o nível de estresse dos animais. A média de PAS observada no hospital foi de 154,7mmHg e foi significativamente superior que a observada em casa (136,3mmHg. Também foi observado que os valores de FC (média=122,7bpm e concentrações séricas de cortisol (mediana=4,5µg dL-1 e glicose (média=95,9mg dL-1 foram superiores (P<0,01 no ambiente hospitalar, quando comparados com os valores obtidos no lar dos animais (109,6bpm; 1,5µg dL-1 e 85,5mg dL-1, respectivamente. Assim, condições ambientais podem influenciar a PAS em cães, devido a fatores relacionados ao estresse.

  18. Influence of short-term blood pressure variability on blood pressure determinations

    NARCIS (Netherlands)

    Bos, W. J.; van Goudoever, J.; van Montfrans, G. A.; Wesseling, K. H.

    1992-01-01

    To evaluate the effect of blood pressure variability on Riva Rocci Korotkoff blood pressure determinations, we studied the intra-arterial pressure during Riva Rocci Korotkoff determinations in 25 patients. In 50 measurements with a cuff deflation rate of 2.5 mm Hg/sec, the systolic intra-arterial

  19. Worldwide trends in blood pressure from 1975 to 2015

    DEFF Research Database (Denmark)

    Linneberg, Allan René; Sørensen, Thorkild I.A.

    2017-01-01

    BACKGROUND: Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood...... pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher. METHODS: For this analysis, we pooled national, subnational, or community population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends...... from 1975 to 2015 in mean systolic and mean diastolic blood pressure, and the prevalence of raised blood pressure for 200 countries. We calculated the contributions of changes in prevalence versus population growth and ageing to the increase in the number of adults with raised blood pressure. FINDINGS...

  20. National, regional, and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 5·4 million participants

    NARCIS (Netherlands)

    Danaei, Goodarz; Finucane, Mariel M.; Lin, John K.; Singh, Gitanjali M.; Paciorek, Christopher J.; Cowan, Melanie J.; Farzadfar, Farshad; Stevens, Gretchen A.; Lim, Stephen S.; Riley, Leanne M.; Ezzati, Majid; Abdeen, Ziad; Agyemang, Charles; Al Nsour, Mohannad; Ali, Mohamed M.; Ambady, Ramachandran; Babu, Bontha V.; Barbagallo, Carlo M.; Barceló, Alberto; Barreto, Sandhi; Barros, Henrique; Bautista, Leonelo E.; Bjerregaard, Peter; Björkelund, Cecilia; Bo, Simona; Bobak, Martin; Bonora, Enzo; Botana, Manuel A.; Bovet, Pascal; Breckenkamp, Juergen; Breteler, Monique M.; Broda, Grazyna; Brown, Ian J.; Bursztyn, Michael; de León, Antonio Cabrera; Casiglia, Edoardo; Castetbon, Katia; Chatterji, Somnath; Chen, Zhengming; Chen, Chien-Jen; Chua, Lily; Cífková, Renata; Cobiac, Linda J.; Cooper, Richard S.; Dankner, Rachel S.; Dong, Guang-Hui; Elliott, Paul; Erem, Cihangir; Esteghamati, Alireza; Fan, Jian-Gao

    2011-01-01

    Data for trends in blood pressure are needed to understand the effects of its dietary, lifestyle, and pharmacological determinants; set intervention priorities; and evaluate national programmes. However, few worldwide analyses of trends in blood pressure have been done. We estimated worldwide trends

  1. Diurnal blood pressure changes.

    Science.gov (United States)

    Asayama, Kei; Satoh, Michihiro; Kikuya, Masahiro

    2018-05-23

    The definition of diurnal blood pressure changes varies widely, which can be confusing. Short-term blood pressure variability during a 24-h period and the dipping status of diurnal blood pressure can be captured by ambulatory blood pressure monitoring, and these metrics are reported to have prognostic significance for cardiovascular complications. Morning blood pressure surge also indicates this risk, but its effect may be limited to populations with specific conditions. Meanwhile, the combined use of conventional office blood pressure and out-of-office blood pressure allows us to identify people with white-coat and masked hypertension. Current home devices can measure nocturnal blood pressure during sleep more conveniently than ambulatory monitoring; however, we should pay attention to blood pressure measurement conditions regardless of whether they are in a home, ambulatory, or office setting. The relatively poor reproducibility of diurnal blood pressure changes, including the nocturnal fall of blood pressure, is another underestimated issue to be addressed. Although information on diurnal blood pressure changes is expected to be used more effectively in the future, we should also keep in mind that blood pressure levels have remained central to the primary and secondary prevention of blood pressure-related cardiovascular diseases in clinical practice.

  2. Interarm difference in blood pressure

    DEFF Research Database (Denmark)

    Mehlsen, Jesper; Wiinberg, Niels

    2014-01-01

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

  3. [Central blood pressure and vascular damage].

    Science.gov (United States)

    Pérez-Lahiguera, Francisco; Rodilla, Enrique; Costa, José Antonio; Pascual, José María

    2015-07-20

    The aim of this study was to assess the relationship between central blood pressure and vascular damage. This cross-sectional study involved 393 never treated hypertensive patients (166 women). Clinical blood pressure (BP), 24h blood pressure (BP24h) and central blood pressure (CBP) were measured. Vascular organ damage (VOD) was assessed by calculating the albumin/creatinine ratio (ACR), wave pulse pressure velocity and echocardiographic left ventricular mass index (LVMI). Patients with VOD had higher values of BP, BP24h, and CBP than patients without ACR. When comparing several systolic BP, systolic BP24h had a higher linear correlation with CBP (Z Steiger test: 2.26; P=.02) and LVMI (Z Steiger test: 3.23; P=.01) than PAC. In a multiple regression analysis corrected by age, sex and metabolic syndrome, all pressures were related with VOD but systolic BP24h showed the highest correlation. In a logistic regression analysis, having the highest tercile of systolic BP24h was the stronger predictor of VOD (multivariate odds ratio: 3.4; CI 95%: 2.5-5.5, P=.001). CBP does not have more correlation with VOD than other measurements of peripheral BP. Systolic BP24h is the BP measurement that best predicts VOD. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  4. Blood Pressure Medicines

    Science.gov (United States)

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

  5. High blood pressure - children

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007696.htm High blood pressure - children To use the sharing features on this page, please enable JavaScript. High blood pressure (hypertension) is an increase in the force of ...

  6. Preventing High Blood Pressure

    Science.gov (United States)

    ... Heart Disease Cholesterol Salt Million Hearts® WISEWOMAN Preventing High Blood Pressure: Healthy Living Habits Recommend on Facebook Tweet Share ... meal and snack options can help you avoid high blood pressure and its complications. Be sure to eat plenty ...

  7. High blood pressure - infants

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007329.htm High blood pressure - infants To use the sharing features on this page, please enable JavaScript. High blood pressure (hypertension) is an increase in the force of ...

  8. High blood pressure medications

    Science.gov (United States)

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

  9. Impact of systolic blood pressure on the safety and tolerability of initiating and up-titrating sacubitril/valsartan in patients with heart failure and reduced ejection fraction: insights from the TITRATION study.

    Science.gov (United States)

    Senni, Michele; McMurray, John J V; Wachter, Rolf; McIntyre, Hugh F; Anand, Inder S; Duino, Vincenzo; Sarkar, Arnab; Shi, Victor; Charney, Alan

    2018-03-01

    The TITRATION trial investigated two strategies to initiate and up-titrate sacubitril/valsartan (LCZ696) to the same target dose, over a condensed (3-week) or conservative (6-week) period, in patients with heart failure with reduced ejection fraction (HFrEF) and systolic blood pressure (SBP) of ≥100 mmHg. This post hoc analysis examined the relationship between baseline SBP at screening and achievement of the target dose of sacubitril/valsartan of 97 mg/103 mg (also termed 'LCZ696 200 mg') twice per day during the study. Patients (n = 498) were categorized in four groups based on SBP at screening: 100-110 mmHg (n = 70); 111-120 mmHg (n = 93); 121-139 mmHg (n = 168) and ≥140 mmHg (n = 167). Overall, 72.7%, 76.1%, 85.6% and 82.9%, respectively, of patients in these SBP categories achieved and maintained the target dose of sacubitril/valsartan without down-titration/dose interruption over 12 weeks ('treatment success'). Compared with patients with SBP of 100-110 mmHg, rates of treatment success among patients in the higher SBP groups [111-120 mmHg (P = 0.96); 121-139 mmHg (P = 0.06) and ≥140 mmHg (P = 0.25)] did not differ significantly. A higher percentage of patients with lower SBP (100-110 mmHg) achieved treatment success with gradual up-titration (6 weeks) (∼80%) than with rapid up-titration (∼69%). Similar findings were observed with regard to 'tolerability success' (maintenance of the target dose for at least the final 2 weeks prior to study completion). Hypotension occurred more frequently in patients with lower SBP. The majority of patients (>80%) with SBP of ≥100 mmHg achieved and maintained the target dose of sacubitril/valsartan if the treatment was titrated gradually. These findings suggest that low SBP should not prevent clinicians from considering the initiation of sacubitril/valsartan. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of

  10. Correlates of blood pressure in Yanomami Indians of northwestern Brazil.

    Science.gov (United States)

    Crews, D E; Mancilha-Carvalho, J J

    1993-01-01

    We determined associations of measures of body habitus with blood pressure for 100 adult Yanomami Indians (61 men, 39 women) examined during February and March 1990. Measurements included body weight and height, four skinfolds (triceps, subscapular, suprailiac, abdomen), four circumferences (wrist, upper arm, abdomen, hip), systolic and diastolic blood pressures, pulse rate, and estimated age. Various indices of fat distribution were determined from the measurements of skinfolds, circumferences, weight, and height. Estimated age averaged 35.0 years in men and 33.4 years in women (range: 15 to 63 years). Mean systolic and diastolic blood pressures were low in both men (104.8/70.4 mm Hg) and women (94.8/63.5 mm Hg), as was body mass index (men: 20.7; women: 21.4 kg/m2). In Yanomami women, all four skinfolds, wrist circumference, and the indices of hip and abdominal fat were significant correlates of systolic blood pressure, while the abdominal skinfold and wrist and hip circumferences correlated significantly with diastolic blood pressure. Among men, there was a negative correlation between estimated age and systolic blood pressure and a positive correlation between BMI and upper arm and hip circumferences and systolic blood pressure. There was a significant positive correlation between wrist, upper arm, and hip circumferences and diastolic blood pressure among Yanomami men. We used stepwise regression to generate sex-specific predictive equations for blood pressure. For men, estimated age and hip circumference, and for women, abdominal skinfold measurement and age were included in the model for systolic blood pressure. Among men, wrist circumference and height, and among women, wrist circumference alone entered the model for diastolic blood pressure. On the basis of these results, we suggest that even in a low-blood pressure, low-body fat, no-salt setting, systolic blood pressure is associated with the amount and placement of adipose tissue. However, diastolic blood

  11. A comparative research on obesity hypertension by the comparisons and associations between waist circumference, body mass index with systolic and diastolic blood pressure, and the clinical laboratory data between four special Chinese adult groups.

    Science.gov (United States)

    Wu, Ou; Leng, Jian-Hang; Yang, Fen-Fang; Yang, Hai-Ming; Zhang, Hu; Li, Zeng-Fang; Zhang, Xing-Yu; Yuan, Cheng-Da; Li, Jia-Jia; Pan, Qi; Liu, Wei; Ren, Yan-Jun; Liu, Bing; Liu, Qing-Min; Cao, Cheng-Jian

    2018-01-01

    The obesity-hypertension pathogenesis is complex. From the phenotype to molecular mechanism, there is a long way to clarify the mechanism. To explore the association between obesity and hypertension, we correlate the phenotypes such as the waist circumference (WC), body mass index (BMI), systolic blood pressure (SB), and diastolic blood pressure (DB) with the clinical laboratory data between four specific Chinese adult physical examination groups (newly diagnosed untreated just-obesity group, newly diagnosed untreated obesity-hypertension group, newly diagnosed untreated just-hypertension group, and normal healthy group), and the results may show something. To explore the mechanisms from obesity to hypertension by analyzing the correlations and differences between WC, BMI, SB, DB, and other clinical laboratory data indices in four specific Chinese adult physical examination groups. This cross-sectional study was conducted from September 2012 to July 2014, and 153 adult subjects, 34 women and 119 men, from 21 to 69 years, were taken from four characteristic Chinese adult physical examination groups (newly diagnosed untreated just-obesity group, newly diagnosed untreated obesity-hypertension group, newly diagnosed untreated just-hypertension group, and normal healthy group). The study was approved by the ethics committee of Hangzhou Center for Disease Control and Prevention. WC, BMI, SB, DB, and other clinical laboratory data were collected and analyzed by SPSS. Serum levels of albumin (ALB),alanine aminotransferase (ALT), low density lipoprotein cholesterol (LDLC), triglyceride (TG), high density lipoprotein cholesterol (HDLC), alkaline phosphatase (ALP), uric acid (Ua), and TC/HDLC (odds ratio) were statistically significantly different between the four groups. WC statistically significantly positively correlated with BMI, ALT, Ua, and serum levels of glucose (GLU), and TC/HDLC, and negatively with ALB, HDLC, and serum levels of conjugated bilirubin (CB). BMI

  12. Automatic algorithm for monitoring systolic pressure variation and difference in pulse pressure.

    Science.gov (United States)

    Pestel, Gunther; Fukui, Kimiko; Hartwich, Volker; Schumacher, Peter M; Vogt, Andreas; Hiltebrand, Luzius B; Kurz, Andrea; Fujita, Yoshihisa; Inderbitzin, Daniel; Leibundgut, Daniel

    2009-06-01

    Difference in pulse pressure (dPP) reliably predicts fluid responsiveness in patients. We have developed a respiratory variation (RV) monitoring device (RV monitor), which continuously records both airway pressure and arterial blood pressure (ABP). We compared the RV monitor measurements with manual dPP measurements. ABP and airway pressure (PAW) from 24 patients were recorded. Data were fed to the RV monitor to calculate dPP and systolic pressure variation in two different ways: (a) considering both ABP and PAW (RV algorithm) and (b) ABP only (RV(slim) algorithm). Additionally, ABP and PAW were recorded intraoperatively in 10-min intervals for later calculation of dPP by manual assessment. Interobserver variability was determined. Manual dPP assessments were used for comparison with automated measurements. To estimate the importance of the PAW signal, RV(slim) measurements were compared with RV measurements. For the 24 patients, 174 measurements (6-10 per patient) were recorded. Six observers assessed dPP manually in the first 8 patients (10-min interval, 53 measurements); no interobserver variability occurred using a computer-assisted method. Bland-Altman analysis showed acceptable bias and limits of agreement of the 2 automated methods compared with the manual method (RV: -0.33% +/- 8.72% and RV(slim): -1.74% +/- 7.97%). The difference between RV measurements and RV(slim) measurements is small (bias -1.05%, limits of agreement 5.67%). Measurements of the automated device are comparable with measurements obtained by human observers, who use a computer-assisted method. The importance of the PAW signal is questionable.

  13. Studies Comparing Ambulatory Blood Pressure and Home Blood Pressure on Cardiovascular Disease and Mortality Outcomes: A Systematic Review

    Science.gov (United States)

    Shimbo, Daichi; Abdalla, Marwah; Falzon, Louise; Townsend, Raymond R.; Muntner, Paul

    2015-01-01

    Ambulatory blood pressure monitoring (ABPM) is more commonly recommended for assessing out-of-clinic blood pressure than home blood pressure monitoring (HBPM). We conducted a systematic review to examine whether ABPM or HBPM is more strongly associated with cardiovascular disease events and/or mortality. Of 1,007 abstracts published through July 20, 2015, nine articles, reporting results from seven cohorts, were identified. After adjustment for blood pressure on HBPM, blood pressure on ABPM was associated with an increased risk of outcomes in two of four cohorts for systolic blood pressure and two of three cohorts for diastolic blood pressure. After adjustment for blood pressure on ABPM, systolic blood pressure on HBPM was associated with outcomes in zero of three cohorts; an association was present in one of two cohorts for diastolic blood pressure on HBPM. There is a lack of strong empiric evidence supporting ABPM or HBPM over the other approach for predicting cardiovascular events or mortality. PMID:26822864

  14. Assessing pharmacy students' ability to accurately measure blood pressure using a blood pressure simulator arm.

    Science.gov (United States)

    Bottenberg, Michelle M; Bryant, Ginelle A; Haack, Sally L; North, Andrew M

    2013-06-12

    To compare student accuracy in measuring normal and high blood pressures using a simulator arm. In this prospective, single-blind, study involving third-year pharmacy students, simulator arms were programmed with prespecified normal and high blood pressures. Students measured preset normal and high diastolic and systolic blood pressure using a crossover design. One hundred sixteen students completed both blood pressure measurements. There was a significant difference between the accuracy of high systolic blood pressure (HSBP) measurement and normal systolic blood pressure (NSBP) measurement (mean HSBP difference 8.4 ± 10.9 mmHg vs NSBP 3.6 ± 6.4 mmHg; pdifference between the accuracy of high diastolic blood pressure (HDBP) measurement and normal diastolic blood pressure (NDBP) measurement (mean HDBP difference 6.8 ± 9.6 mmHg vs. mean NDBP difference 4.6 ± 4.5 mmHg; p=0.089). Pharmacy students may need additional instruction and experience with taking high blood pressure measurements to ensure they are able to accurately assess this important vital sign.

  15. Assessing Pharmacy Students’ Ability to Accurately Measure Blood Pressure Using a Blood Pressure Simulator Arm

    Science.gov (United States)

    Bryant, Ginelle A.; Haack, Sally L.; North, Andrew M.

    2013-01-01

    Objective. To compare student accuracy in measuring normal and high blood pressures using a simulator arm. Methods. In this prospective, single-blind, study involving third-year pharmacy students, simulator arms were programmed with prespecified normal and high blood pressures. Students measured preset normal and high diastolic and systolic blood pressure using a crossover design. Results. One hundred sixteen students completed both blood pressure measurements. There was a significant difference between the accuracy of high systolic blood pressure (HSBP) measurement and normal systolic blood pressure (NSBP) measurement (mean HSBP difference 8.4 ± 10.9 mmHg vs NSBP 3.6 ± 6.4 mmHg; pdifference between the accuracy of high diastolic blood pressure (HDBP) measurement and normal diastolic blood pressure (NDBP) measurement (mean HDBP difference 6.8 ± 9.6 mmHg vs. mean NDBP difference 4.6 ± 4.5 mmHg; p=0.089). Conclusions. Pharmacy students may need additional instruction and experience with taking high blood pressure measurements to ensure they are able to accurately assess this important vital sign. PMID:23788809

  16. Letter to editor: Blood pressure, hypertension and lead exposure.

    Science.gov (United States)

    Yang, Wen-Yi; Staessen, Jan A

    2018-02-19

    A significant association of office diastolic blood pressure with low-level blood lead exposure was reported in a Brazilian adult population. However, caution should be taken to interpret these results. The multivariable-adjusted association with blood pressure was positive for diastolic blood pressure, but inverse for systolic blood pressure. The association sizes were infinitesimal without clinical relevance. The outcome measures, i.e. blood pressure and the prevalence of hypertension were analysed across categories of the blood lead distribution - not in relation to blood lead as continuous variable. Blood pressure was the average of two oscillometric office readings, whereas ambulatory monitoring is the state-of-the-art.

  17. Oscillometric blood pressure measurements: differences between measured and calculated mean arterial pressure.

    NARCIS (Netherlands)

    Kiers, H.D.; Hofstra, J.M.; Wetzels, J.F.M.

    2008-01-01

    Mean arterial pressure (MAP) is often used as an index of overall blood pressure. In recent years, the use of automated oscillometric blood pressure measurement devices is increasing. These devices directly measure and display MAP; however, MAP is often calculated from systolic blood pressure (SBP)

  18. Understanding Blood Pressure Readings

    Science.gov (United States)

    ... Venous Thromboembolism Aortic Aneurysm More Understanding Blood Pressure Readings Updated:Jun 1,2018 What do your blood ... and Live Our Interactive Cardiovascular Library has detailed animations and illustrations to help you learn about conditions, ...

  19. High blood pressure - adults

    Science.gov (United States)

    ... pressure is found. This is called essential hypertension. High blood pressure that is caused by another medical condition or medicine you are taking is called secondary hypertension. Secondary hypertension may be due to: Chronic ...

  20. Intrathoracic Pressure Regulator for Blood Loss

    Science.gov (United States)

    2016-05-24

    hepatitis A antibody, and human immunodeficiency virus antibody), urine tests (drug screen I-abuse, marijuana, and a pregnancy test), and a 12-lead... sodium chloride; 250 mL over 2.5 minutes) were administered if systolic BP < 85 mmHg. Blood pressure, other hemodynamics, UO, and total amount of

  1. High Blood Pressure (Hypertension)

    Science.gov (United States)

    ... other risk factors, like diabetes, you may need treatment. How does high blood pressure affect pregnant women? A few women will get ... HIV, Birth Control Heart Health for Women Pregnancy Menopause More Women's Health ... High Blood Pressure--Medicines to Help You Women and Diabetes Heart ...

  2. Ambulatory blood pressure profiles in familial dysautonomia.

    Science.gov (United States)

    Goldberg, Lior; Bar-Aluma, Bat-El; Krauthammer, Alex; Efrati, Ori; Sharabi, Yehonatan

    2018-02-12

    Familial dysautonomia (FD) is a rare genetic disease that involves extreme blood pressure fluctuations secondary to afferent baroreflex failure. The diurnal blood pressure profile, including the average, variability, and day-night difference, may have implications for long-term end organ damage. The purpose of this study was to describe the circadian pattern of blood pressure in the FD population and relationships with renal and pulmonary function, use of medications, and overall disability. We analyzed 24-h ambulatory blood pressure monitoring recordings in 22 patients with FD. Information about medications, disease severity, renal function (estimated glomerular filtration, eGFR), pulmonary function (forced expiratory volume in 1 s, FEV1) and an index of blood pressure variability (standard deviation of systolic pressure) were analyzed. The mean (± SEM) 24-h blood pressure was 115 ± 5.6/72 ± 2.0 mmHg. The diurnal blood pressure variability was high (daytime systolic pressure standard deviation 22.4 ± 1.5 mmHg, nighttime 17.2 ± 1.6), with a high frequency of a non-dipping pattern (16 patients, 73%). eGFR, use of medications, FEV1, and disability scores were unrelated to the degree of blood pressure variability or to dipping status. This FD cohort had normal average 24-h blood pressure, fluctuating blood pressure, and a high frequency of non-dippers. Although there was evidence of renal dysfunction based on eGFR and proteinuria, the ABPM profile was unrelated to the measures of end organ dysfunction or to reported disability.

  3. Reference values of fetal peak systolic blood flow Velocity in the ...

    African Journals Online (AJOL)

    Objectives: The objectives of this prospective cross sectional study are (i) to establish new reference values of peak systolic blood flow velocity measurement in the fetal middle cerebral artery (MCA-PSV) following validated methodological guidelines (ii) to correlate peak systolic velocity with gestational age and (iii) to ...

  4. Blood pressure changes in dogs with babesiosis

    Directory of Open Access Journals (Sweden)

    L.S. Jacobson

    2000-07-01

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

  5. Blood pressure variations in Subjects with different Haemoglobin ...

    African Journals Online (AJOL)

    Dr Olaleye Samuel

    compared with the normal controls. The systolic blood pressures in control (HB AA) and SCD patients were .... especially in older patients and may predispose them to stroke and other ... autonomic responses to change in posture or vitamin C.

  6. Blood pressure documentation in the emergency department

    Science.gov (United States)

    Daniel, Ana Carolina Queiroz Godoy; Machado, Juliana Pereira; Veiga, Eugenia Velludo

    2017-01-01

    ABSTRACT Objective To analyze the frequency of blood pressure documentation performed by nursing professionals in an emergency department. Methods This is a cross-sectional, observational, descriptive, and analytical study, which included medical records of adult patients admitted to the observation ward of an emergency department, between March and May 2014. Data were obtained through a collection instrument divided into three parts: patient identification, triage data, and blood pressure documentation. For statistical analysis, Pearson’s correlation coefficient was used, with a significance level of α<0.05. Results One hundred fifty-seven records and 430 blood pressure measurements were analyzed with an average of three measurements per patient. Of these measures, 46.5% were abnormal. The mean time from admission to documentation of the first blood pressure measurement was 2.5 minutes, with 42 minutes between subsequent measures. There is no correlation between the systolic blood pressure values and the mean time interval between blood pressure documentations: 0.173 (p=0.031). Conclusion The present study found no correlation between frequency of blood pressure documentation and blood pressure values. The frequency of blood pressure documentation increased according to the severity of the patient and decreased during the length of stay in the emergency department. PMID:28444085

  7. High Blood Pressure

    Science.gov (United States)

    ... kidney disease, diabetes, or metabolic syndrome Read less Unhealthy lifestyle habits Unhealthy lifestyle habits can increase the risk of high blood pressure. These habits include: Unhealthy eating patterns, such as eating too much sodium ...

  8. High Blood Pressure

    Science.gov (United States)

    ... factors Diabetes High blood pressure Family history Obesity Race/ethnicity Full list of causes and risk factors ... give Give monthly Memorials and tributes Donate a car Donate gently used items Stock donation Workplace giving ...

  9. Blood Pressure Control among Treated Hypertensives in a Tertiary ...

    African Journals Online (AJOL)

    Background: Goal blood pressure (BP) was defined by the JNC VI and the World Health Organization- International Society of Hypertension (WHO/ISH) as <140 mm Hg systolic and <90 mm Hg diastolic for the general and <130 mm Hg systolic and <85 mm Hg diastolic for special high-risk populations. It is well established ...

  10. Segmental blood pressure after total hip replacement

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Soelberg, M; Henriksen, Jens Henrik Sahl

    1992-01-01

    Twenty-nine patients due to have a total hip replacement had their systemic systolic and segmental blood pressures measured prior to operation and 1 and 6 weeks postoperatively. No patients had signs of ischemia. The segmental blood pressure was measured at the ankle and at the toes. A significant...... drop was found in all pressures 1 week postoperatively. The decrease followed the systemic pressure and was restored to normal after 6 weeks. In a group of six patients with preoperatively decreased ankle pressure, a significant transient further decrease in the ankle-toe gradient pressure was found...... on the operated side. None of the patients had symptoms from the lowered pressure. We conclude that in patients without signs of ischemia, the postoperative segmental pressure decrease is reversible and therefore not dangerous....

  11. Inter-arm blood pressure differences in pregnant women.

    Science.gov (United States)

    Poon, L C Y; Kametas, N; Strobl, I; Pachoumi, C; Nicolaides, K H

    2008-08-01

    To determine the prevalence of blood pressure inter-arm difference (IAD) in early pregnancy and to investigate its possible association with maternal characteristics. A cross-sectional observational study. Routine antenatal visit in a university hospital. A total of 5435 pregnant women at 11-14 weeks of gestation. Blood pressure was taken from both arms simultaneously with a validated automated device. The presence of inter-arm blood pressure difference of 10 mmHg or more. The IAD in systolic and diastolic blood pressure was 10 mmHg or more in 8.3 and 2.3% of the women, respectively. Systolic IAD was found to be significantly related to systolic blood pressure and pulse pressure, and diastolic IAD was found to be significantly related to maternal age, diastolic blood pressure and pulse pressure. The systolic and diastolic IAD were higher in the hypertensive group compared with the normotensive group and absolute IAD increased with increasing blood pressure. About 31.0 and 23.9% of cases of hypertension would have been underreported if the left arm and the right arm were used, respectively, in measuring the blood pressure. There is a blood pressure IAD in a significant proportion of the pregnant population, and its prevalence increases with increasing blood pressure. By measuring blood pressure only on one arm, there is a one in three chance of underreporting hypertension. Therefore, it would be prudent that during the booking visit blood pressure should be taken in both arms and thus provide guidance for subsequent blood pressure measurements during the course of pregnancy.

  12. Healing of ulcers on the feet correlated with distal blood pressure measurements in occlusive arterial disease

    DEFF Research Database (Denmark)

    Holstein, P; Lassen, N A

    1980-01-01

    The frequency of healing in subchronic ulcers in 66 feet in 62 patients with arterial occlusive disease was correlated with the systolic digital blood pressure (SDBP) and the systolic ankle blood pressure (SABP), both measured with a strain gauge, and with the skin perfusion pressure on the heel...

  13. Prenatal air pollution exposure and newborn blood pressure

    NARCIS (Netherlands)

    van Rossem, Lenie; Rifas-Shiman, Sheryl L.; Melly, Steven J.; Kloog, Itai; Luttmann-Gibson, Heike; Zanobetti, Antonella; Coull, Brent A.; Schwartz, Joel D.; Mittleman, Murray A.; Oken, Emily; Gillman, Matthew W.; Koutrakis, Petros; Gold, Diane R.

    2015-01-01

    Background: Air pollution exposure has been associated with increased blood pressure in adults. oBjective: We examined associations of antenatal exposure to ambient air pollution with newborn systolic blood pressure (SBP). Methods: We studied 1,131 mother–infant pairs in a Boston, Massachusetts,

  14. Hypertension. Age-specificity of blood-pressure-associated complications

    OpenAIRE

    Staessen, Jan A

    2014-01-01

    In an analysis of electronic health records, 1.25 million patients aged ≥30 years without diagnosed cardiovascular disease experienced 83,098 cardiovascular events during follow-up (median 5.2 years). Associations between incident cardiovascular disease and blood pressure differed for systolic and diastolic blood pressures and between the 12 cardiovascular end points examined.

  15. Differential Systolic and Diastolic Regulation of the Cerebral Pressure-Flow Relationship During Squat-Stand Manoeuvres.

    Science.gov (United States)

    Smirl, Jonathan D; Wright, Alexander D; Ainslie, Philip N; Tzeng, Yu-Chieh; van Donkelaar, Paul

    2018-01-01

    Cerebral pressure-flow dynamics are typically reported between mean arterial pressure and mean cerebral blood velocity. However, by reporting only mean responses, potential differential regulatory properties associated with systole and diastole may have been overlooked. Twenty young adults (16 male, age: 26.7 ± 6.6 years, BMI: 24.9 ± 3.0 kg/m 2 ) were recruited for this study. Middle cerebral artery velocity was indexed via transcranial Doppler. Cerebral pressure-flow dynamics were assessed using transfer function analysis at both 0.05 and 0.10 Hz using squat-stand manoeuvres. This method provides robust and reliable measures for coherence (correlation index), phase (timing buffer) and gain (amplitude buffer) metrics. There were main effects for both cardiac cycle and frequency for phase and gain metrics (p flow relationship. The oscillations associated with systole are extensively buffered within the cerebrovasculature, whereas diastolic oscillations are relatively unaltered. This indicates that the brain is adapted to protect itself against large increases in systolic blood pressure, likely as a mechanism to prevent cerebral haemorrhages.

  16. [Ambulatory blood pressure monitoring (ABPM) in elderly].

    Science.gov (United States)

    Palade, D; Iliescu, D; Cotârleţ, Laura; Pandele, G I

    2010-01-01

    Comparison of blood pressure values measured by two methods. 94 hypertensive patients (66 women and 28 men in relation to 2.36/1) were assessed classically and also by ABPM. For statistic evaluation we have used t - Student test, chi2 test, Pearson correlation coefficient and variation coefficient (cv%). It shows significant differences between mean values of systolic and diastolic blood pressure obtained by the 2 methods. ABPM measured values are more accurate compared to clinic, bringing also information on pattern hypertensive therapy.

  17. [Comparison of invasive blood pressure measurement in the aorta with indirect oscillometric blood pressure measurement at the wrist and forearm].

    Science.gov (United States)

    Saul, F; Aristidou, Y; Klaus, D; Wiemeyer, A; Lösse, B

    1995-09-01

    Indirectly measured blood pressure at the wrist or upper arm was compared with directly measured values in the aortic arch during routinely performed diagnostic cardiac catheterization in 100 patients (31-80 years, mean 59.3 years, 60% males). The noninvasive measurements were carried out by oscillometric devices, NAiS Blood Pressure Watch for measurements at the wrist, and Hestia OZ80 at the upper arm. Systolic blood pressure measured at the wrist was 4.3 +/- 14.1 mm Hg, and the diastolic value 6.0 +/- 8.9 mm Hg higher than when measured at the aortic arch; the difference was significant in both cases. Correlation coefficients were 0.85 for systolic and 0.71 for diastolic blood pressure. In 16% of the patients the systolic blood pressure at the wrist differed more than +/- 20 mm Hg. The diastolic blood pressure at the wrist measured more than +/- 20 mm Hg higher than in the aorta in 5% of the patients. At the upper arm mean systolic values were not different to the aorta. The diastolic pressure was 9.3 +/- 9.8 mm Hg higher in the aorta than at the upper arm. To verify the accuracy of values measured with the NAiS Blood Pressure Watch compared with the standard technique at the upper arm, sequential measurements were made at wrist and ipsilateral upper arm in the same group of 100 patients. The systolic blood pressure at the left wrist was 3.4 +/- 13.3 mm Hg higher and the diastolic pressure 3.8 +/- 9.5 mm Hg lower than at the upper arm. Only 53% of systolic values lay within a range of +/- 10 mm Hg. The correspondence between wrist and upper arm values was better for diastolic blood pressure, the values differing by less than +/- 10 mm Hg in two-thirds of patients. Self-measurement of arterial blood pressure with an oscillometric device at the wrist can be recommended only in individual cases with a difference of simultaneously measured values at the upper arm of less than +/- 10 mm Hg for systolic and diastolic blood pressures. The standard method for indirectly

  18. Clinical study on influences of enteric coated aspirin on blood pressure and blood pressure variability.

    Science.gov (United States)

    Ji, A-L; Chen, W-W; Huang, W-J

    2016-12-01

    We investigated the effects of oral administration of enteric coated aspirin (ASA) on blood pressure and blood pressure variability of hypertension patients before sleep. We observed 150 hypertension cases, classified as Grade 1-2, from September 2006 to March 2008. They are divided into a control group with 30 cases, ASA I group with 60 cases and ASA II group with 60 cases randomly. Subjects in the control group had proper diets, were losing weight, exercising and maintaining a healthy mentality and were taking 30 mg Adalat orally once a day. Based on the treatment of control group, patients in ASA I group were administered 0.1 g Bayaspirin (produced by Bayer Company) at drought in the morning. Also, based on the treatment of control group, patients in ASA II group were administered 0.1 g Bayaspirin at draught before sleep. The course of treatment is 3 months and then after the treatment, decreasing blood pressure and blood pressure variability conditions in three groups will be compared. Through the comparison of ASA II group with the control group, they have differences in terms of systolic blood pressure (SBP), diastolic blood pressure (DBP), decreasing range of blood pressure and blood pressure variability (p sleep has synergistic effects on decreasing blood pressure of hypertension patients and improving blood pressure variability.

  19. Blood pressure normalization post-jugular venous balloon angioplasty.

    Science.gov (United States)

    Sternberg, Zohara; Grewal, Prabhjot; Cen, Steven; DeBarge-Igoe, Frances; Yu, Jinhee; Arata, Michael

    2015-05-01

    This study is the first in a series investigating the relationship between autonomic nervous system dysfunction and chronic cerebrospinal venous insufficiency in multiple sclerosis patients. We screened patients for the combined presence of the narrowing of the internal jugular veins and symptoms of autonomic nervous system dysfunction (fatigue, cognitive dysfunction, sleeping disorders, headache, thermal intolerance, bowel/bladder dysfunction) and determined systolic and diastolic blood pressure responses to balloon angioplasty. The criteria for eligibility for balloon angioplasty intervention included ≥ 50% narrowing in one or both internal jugular veins, as determined by the magnetic resonance venography, and ≥ 3 clinical symptoms of autonomic nervous system dysfunction. Blood pressure was measured at baseline and post-balloon angioplasty. Among patients who were screened, 91% were identified as having internal jugular veins narrowing (with obstructing lesions) combined with the presence of three or more symptoms of autonomic nervous system dysfunction. Balloon angioplasty reduced the average systolic and diastolic blood pressure. However, blood pressure categorization showed a biphasic response to balloon angioplasty. The procedure increased blood pressure in multiple sclerosis patients who presented with baseline blood pressure within lower limits of normal ranges (systolic ≤ 105 mmHg, diastolic ≤ 70 mmHg) but decreased blood pressure in patients with baseline blood pressure above normal ranges (systolic ≥ 130 mmHg, diastolic ≥ 80 mmHg). In addition, gender differences in baseline blood pressure subcategories were observed. The coexistence of internal jugular veins narrowing and symptoms of autonomic nervous system dysfunction suggests that the two phenomena may be related. Balloon angioplasty corrects blood pressure deviation in multiple sclerosis patients undergoing internal jugular vein dilation. Further studies should investigate the

  20. Genetic variants in novel pathways influence blood pressure and cardiovascular disease risk

    NARCIS (Netherlands)

    G.B. Ehret (Georg); P. Munroe (Patricia); K.M. Rice (Kenneth); M. Bochud (Murielle); A.D. Johnson (Andrew); D.I. Chasman (Daniel); A.V. Smith (Albert Vernon); M.D. Tobin (Martin); G.C. Verwoert (Germaine); S.J. Hwang; V. Pihur (Vasyl); P. Vollenweider (Peter); P.F. O'Reilly (Paul); N. Amin (Najaf); J.L. Bragg-Gresham (Jennifer L.); A. Teumer (Alexander); N.L. Glazer (Nicole); L.J. Launer (Lenore); J.H. Zhao (Jing Hua); Y.S. Aulchenko (Yurii); S.C. Heath (Simon); S. Sõber (Siim); A. Parsa (Afshin); J. Luan; P. Arora (Pankaj); A. Dehghan (Abbas); F. Zhang (Feng); G. Lucas (Gavin); A.A. Hicks (Andrew); A.U. Jackson (Anne); J. Peden (John); T. Tanaka (Toshiko); S.H. Wild (Sarah); I. Rudan (Igor); W. Igl (Wilmar); Y. Milaneschi (Yuri); A.N. Parker (Alex); C. Fava (Cristiano); J.C. Chambers (John); E.R. Fox (Ervin); M. Kumari (Meena); M. Jin Go (Min); P. van der Harst (Pim); W. Hong Linda Kao (Wen); M. Sjögren (Marketa); D.G. Vinay; M. Alexander (Myriam); Y. Tabara (Yasuharu); S. Shaw-Hawkins (Sue); P.H. Whincup (Peter); Y. Liu (YongMei); G. Shi (Gang); J. Kuusisto (Johanna); B. Tayo (Bamidele); M. Seielstad (Mark); X. Sim (Xueling); K.-D. Hoang Nguyen; T. Lehtimäki (Terho); G. Matullo (Giuseppe); Y. Wu (Ying); T.R. Gaunt (Tom); N. Charlotte Onland-Moret; M.N. Cooper (Matthew); C. Platou (Carl); E. Org (Elin); R. Hardy (Rebecca); S. Dahgam (Santosh); J. Palmen (Jutta); V. Vitart (Veronique); P.S. Braund (Peter); T. Kuznetsova (Tatiana); C.S.P.M. Uiterwaal (Cuno); A. Adeyemo (Adebowale); W. Palmas (Walter); H. Campbell (Harry); B. Ludwig (Barbara); M. Tomaszewski; I. Tzoulaki; N.D. Palmer (Nicholette); T. Aspelund (Thor); M. Garcia (Melissa); Y.-P.C. Chang (Yen-Pei); J.R. O´Connell; N.I. Steinle (Nanette); D.E. Grobbee (Diederick); D.E. Arking (Dan); S.L. Kardia (Sharon); A.C. Morrison (Alanna); D.G. Hernandez (Dena); S.S. Najjar (Samer); W.L. McArdle (Wendy); D. Hadley (David); M.J. Brown (Morris); J. Connell (John); A. Hingorani (Aroon); I.N.M. Day (Ian); D.A. Lawlor (Debbie); J.P. Beilby (John); R.W. Lawrence (Robert); R. Clarke; J. Hopewell; H. Ongen (Halit); A.W. Dreisbach (Albert); Y. Li (Yali); J. Hunter Young; J.C. Bis (Joshua); M. Kähönen (Mika); J. Viikari (Jorma); N.R. Lee (Nanette); M-H. Chen (Ming-Huei); M. Olden (Matthias); C. Pattaro (Cristian); J.A. Hoffman Bolton (Judith); A. Köttgen (Anna); S.M. Bergmann (Sven); V. Mooser (Vincent); N. Chaturvedi (Nish); T.M. Frayling (Timothy); M. Islam (Muhammad); T.H. Jafar (Tazeen); S.R. Kulkarni (Smita); S.R. Bornstein (Stefan); J. Gräßler (Jürgen); L. Groop (Leif); B.F. Voight (Benjamin); J. Kettunen (Johannes); P. Howard (Philip); A. Taylor (Andrew); S. Guarrera (Simonetta); F. Ricceri (Fulvio); V. Emilsson (Valur); A.S. Plump (Andrew); K-T. Khaw (Kay-Tee); A.B. Weder (Alan); S.C. Hunt (Steven); Y.V. Sun (Yan); R.N. Bergman (Richard); F.S. Collins (Francis); L.L. Bonnycastle (Lori); L.J. Scott (Laura); H.M. Stringham (Heather); L. Peltonen (Leena Johanna); M. Perola (Markus); E. Vartiainen (Erkki); S.-M. Brand; J.A. Staessen (Jan); Y.A. Wang (Ying); P.R. Burton (Paul); M. Soler Artigas (Maria); Y. Dong (Yanbin); H. Snieder (Harold); H. Zhu (Haidong); K. Lohman (Kurt); M.E. Rudock (Megan); S.R. Heckbert (Susan); K.L. Wiggins (Kerri); A. Doumatey (Ayo); D. Shriner (Daniel); G. Veldre (Gudrun); M. Viigimaa (Margus); S. Kinra (Sanjay); D. Prabhakaran (Dorairaj); V. Tripathy (Vikal); C.D. Langefeld (Carl); A. Rosengren (Annika); D.S. Thelle (Dag); A. Maria Corsi (Anna); A. Singleton (Andrew); T. Forrester (Terrence); G. Hilton (Gina); C.A. McKenzie (Colin); T. Salako (Tunde); N. Iwai (Naoharu); Y. Kita (Yoshikuni); T. Ogihara (Toshio); T. Ohkubo (Takayoshi); T. Okamura (Tomonori); H. Ueshima (Hirotsugu); S. Umemura (Satoshi); S. Eyheramendy (Susana); T. Meitinger (Thomas); H.E. Wichmann (Heinz Erich); Y. Shin Cho (Yoon); H.-L. Kim; J.S. Sehmi (Joban); B. Hedblad (Bo); P. Nilsson (Peter); G. Davey-Smith (George); A. Wong (Andrew); N. Narisu (Narisu); A. Stancáková (Alena); L.J. Raffel (Leslie); J. Yao (Jie); S. Kathiresan (Sekar); C.J. O'Donnell (Christopher); S.M. Schwartz (Stephen); M.A. Ikram (Arfan); W.T. Longstreth Jr; T.H. Mosley (Thomas); S. Seshadri (Sudha); N.R.G. Shrine (Nick); L.V. Wain (Louise); M.A. Morken (Mario); A.J. Swift (Amy); J. Laitinen (Jaana); I. Prokopenko (Inga); P. Zitting (Paavo); S.E. Humphries (Steve); J. Danesh (John); A. Rasheed (Asif); A. Goel (Anuj); A. Hamsten (Anders); H. Watkins (Hugh); W.H. van Gilst (Wiek); C.S. Janipalli (Charles); K. Radha Mani; C. Yajnik (Chittaranjan); A. Hofman (Albert); F.U.S. Mattace Raso (Francesco); B.A. Oostra (Ben); A. Demirkan (Ayşe); A.J. Isaacs (Aaron); F. Rivadeneira Ramirez (Fernando); E. Lakatta (Edward); M. Orrù (Marco); A. Scuteri (Angelo); M. Ala-Korpela (Mika); A.J. Kangas (Antti); L.-P. Lyytikäinen (Leo-Pekka); P. Soininen (Pasi); T. Tukiainen (Taru); P. Würtz (Peter); R. Twee-Hee Ong (Rick); M. Dörr (Marcus); H.K. Kroemer (Heyo); U. Völker (Uwe); H. Völzke (Henry); P. Galan (Pilar); S. Hercberg (Serge); G.M. Lathrop (Mark); D. Zelenika (Diana); P. Deloukas (Panagiotis); M. Mangino (Massimo); T.D. Spector (Timothy); G. Zhai (Guangju); J.F. Meschia (James F.); M.A. Nalls (Michael); P. Sharma (Pankaj); J. Terzic (Janos); M.V. Kranthi Kumar; M. Denniff (Matthew); E. Zukowska-Szczechowska (Ewa); L.E. Wagenknecht (Lynne); F. Gerald R. Fowkes; F.J. Charchar (Fadi); P.E.H. Schwarz (Peter); C. Hayward (Caroline); X. Guo (Xiuqing); C. Rotimi (Charles); M.L. Bots (Michiel); N.J. Samani (Nilesh); O. Polasek (Ozren); P.J. Talmud (Philippa); F. Nyberg (Fredrik); D. Kuh (Diana); M. Laan (Maris); K. Hveem (Kristian); Y.T. van der Schouw (Yvonne); J.P. Casas (Juan); K.L. Mohlke (Karen); P. Vineis (Paolo); O. Raitakari (Olli); S.K. Ganesh (Santhi); E. Shyong Tai; M. Laakso (Markku); D.C. Rao (Dabeeru C.); T.B. Harris (Tamara); R.W. Morris (Richard); A. Dominiczak (Anna); M. Kivimaki (Mika); M. Marmot (Michael); T. Miki (Tetsuro); D. Saleheen; G.R. Chandak (Giriraj); J. Coresh (Josef); G. Navis (Gerjan); V. Salomaa (Veikko); B.-G. Han; J.S. Kooner (Jaspal); O. Melander (Olle); P.M. Ridker (Paul); S. Bandinelli (Stefania); U. Gyllensten (Ulf); A.F. Wright (Alan); J.F. Wilson (James); L. Ferrucci (Luigi); M. Farrall (Martin); J. Tuomilehto (Jaakko); P.P. Pramstaller (Peter Paul); R. Elosua (Roberto); N. Soranzo (Nicole); E.J.G. Sijbrands (Eric); D. Altshuler (David); R.J.F. Loos (Ruth); A.R. Shuldiner (Alan); C. Gieger (Christian); P. Meneton (Pierre); A.G. Uitterlinden (André); N.J. Wareham (Nick); V. Gudnason (Vilmundur); J.I. Rotter (Jerome); R. Rettig (Rainer); M. Uda (Manuela); D.P. Strachan (David); J.C.M. Witteman (Jacqueline); A.L. Hartikainen; J.S. Beckmann (Jacques); E.A. Boerwinkle (Eric); J. Erdmann (Jeanette); R.S. Vasan (Ramachandran Srini); M. Boehnke (Michael); M.G. Larson (Martin); M.R. Järvelin; B.M. Psaty (Bruce); P. Tikka-Kleemola (Päivi); C. Newton-Cheh (Christopher); P. Elliott (Paul); D. Levy (Daniel); M. Caulfield (Mark); G.R. Abecasis (Gonçalo); L.S. Adair (Linda); S.J.L. Bakker (Stephan); I.E. Barroso (Inês)

    2011-01-01

    textabstractBlood pressure is a heritable trait influenced by several biological pathways and responsive to environmental stimuli. Over one billion people worldwide have hypertension (≥140mmg Hg systolic blood pressure ≥90mmg Hg diastolic blood pressure). Even small increments in blood pressure are

  1. Genetic variants in novel pathways influence blood pressure and cardiovascular disease risk

    NARCIS (Netherlands)

    Ehret, Georg B.; Munroe, Patricia B.; Rice, Kenneth M.; Bochud, Murielle; Johnson, Andrew D.; Chasman, Daniel I.; Smith, Albert V.; Tobin, Martin D.; Verwoert, Germaine C.; Hwang, Shih-Jen; Pihur, Vasyl; Vollenweider, Peter; O'Reilly, Paul F.; Amin, Najaf; Bragg-Gresham, Jennifer L.; Teumer, Alexander; Glazer, Nicole L.; Launer, Lenore; Zhao, Jing Hua; Aulchenko, Yurii; Heath, Simon; Sõber, Siim; Parsa, Afshin; Luan, Jian'an; Arora, Pankaj; Dehghan, Abbas; Zhang, Feng; Lucas, Gavin; Hicks, Andrew A.; Jackson, Anne U.; Peden, John F.; Tanaka, Toshiko; Wild, Sarah H.; Rudan, Igor; Igl, Wilmar; Milaneschi, Yuri; Parker, Alex N.; Fava, Cristiano; Chambers, John C.; Fox, Ervin R.; Kumari, Meena; Go, Min Jin; van der Harst, Pim; Kao, Wen Hong Linda; Sjögren, Marketa; Vinay, D. G.; Alexander, Myriam; Tabara, Yasuharu; Shaw-Hawkins, Sue; Whincup, Peter H.; Liu, Yongmei; Shi, Gang; Kuusisto, Johanna; Tayo, Bamidele; Seielstad, Mark; Sim, Xueling; Nguyen, Khanh-Dung Hoang; Lehtimäki, Terho; Matullo, Giuseppe; Wu, Ying; Gaunt, Tom R.; Onland-Moret, N. Charlotte; Cooper, Matthew N.; Platou, Carl G. P.; Org, Elin; Hardy, Rebecca; Dahgam, Santosh; Palmen, Jutta; Vitart, Veronique; Braund, Peter S.; Kuznetsova, Tatiana; Uiterwaal, Cuno S. P. M.; Adeyemo, Adebowale; Palmas, Walter; Campbell, Harry; Ludwig, Barbara; Tomaszewski, Maciej; Tzoulaki, Ioanna; Palmer, Nicholette D.; Aspelund, Thor; Garcia, Melissa; Chang, Yen-Pei C.; O'Connell, Jeffrey R.; Steinle, Nanette I.; Grobbee, Diederick E.; Arking, Dan E.; Kardia, Sharon L.; Morrison, Alanna C.; Hernandez, Dena; Najjar, Samer; McArdle, Wendy L.; Hadley, David; Brown, Morris J.; Connell, John M.; Hingorani, Aroon D.; Day, Ian N. M.; Lawlor, Debbie A.; Beilby, John P.; Lawrence, Robert W.; Clarke, Robert; Hopewell, Jemma C.; Ongen, Halit; Dreisbach, Albert W.; Li, Yali; Young, J. Hunter; Bis, Joshua C.; Kähönen, Mika; Viikari, Jorma; Adair, Linda S.; Lee, Nanette R.; Chen, Ming-Huei; Olden, Matthias; Pattaro, Cristian; Bolton, Judith A. Hoffman; Köttgen, Anna; Bergmann, Sven; Mooser, Vincent; Chaturvedi, Nish; Frayling, Timothy M.; Islam, Muhammad; Jafar, Tazeen H.; Erdmann, Jeanette; Kulkarni, Smita R.; Bornstein, Stefan R.; Grässler, Jürgen; Groop, Leif; Voight, Benjamin F.; Kettunen, Johannes; Howard, Philip; Taylor, Andrew; Guarrera, Simonetta; Ricceri, Fulvio; Emilsson, Valur; Plump, Andrew; Barroso, Inês; Khaw, Kay-Tee; Weder, Alan B.; Hunt, Steven C.; Sun, Yan V.; Bergman, Richard N.; Collins, Francis S.; Bonnycastle, Lori L.; Scott, Laura J.; Stringham, Heather M.; Peltonen, Leena; Perola, Markus; Vartiainen, Erkki; Brand, Stefan-Martin; Staessen, Jan A.; Wang, Thomas J.; Burton, Paul R.; Artigas, Maria Soler; Dong, Yanbin; Snieder, Harold; Wang, Xiaoling; Zhu, Haidong; Lohman, Kurt K.; Rudock, Megan E.; Heckbert, Susan R.; Smith, Nicholas L.; Wiggins, Kerri L.; Doumatey, Ayo; Shriner, Daniel; Veldre, Gudrun; Viigimaa, Margus; Kinra, Sanjay; Prabhakaran, Dorairaj; Tripathy, Vikal; Langefeld, Carl D.; Rosengren, Annika; Thelle, Dag S.; Corsi, Anna Maria; Singleton, Andrew; Forrester, Terrence; Hilton, Gina; McKenzie, Colin A.; Salako, Tunde; Iwai, Naoharu; Kita, Yoshikuni; Ogihara, Toshio; Ohkubo, Takayoshi; Okamura, Tomonori; Ueshima, Hirotsugu; Umemura, Satoshi; Eyheramendy, Susana; Meitinger, Thomas; Wichmann, H.-Erich; Cho, Yoon Shin; Kim, Hyung-Lae; Lee, Jong-Young; Scott, James; Sehmi, Joban S.; Zhang, Weihua; Hedblad, Bo; Nilsson, Peter; Smith, George Davey; Wong, Andrew; Narisu, Narisu; Stančáková, Alena; Raffel, Leslie J.; Yao, Jie; Kathiresan, Sekar; O'Donnell, Christopher J.; Schwartz, Stephen M.; Ikram, M. Arfan; Longstreth, W. T.; Mosley, Thomas H.; Seshadri, Sudha; Shrine, Nick R. G.; Wain, Louise V.; Morken, Mario A.; Swift, Amy J.; Laitinen, Jaana; Prokopenko, Inga; Zitting, Paavo; Cooper, Jackie A.; Humphries, Steve E.; Danesh, John; Rasheed, Asif; Goel, Anuj; Hamsten, Anders; Watkins, Hugh; Bakker, Stephan J. L.; van Gilst, Wiek H.; Janipalli, Charles S.; Mani, K. Radha; Yajnik, Chittaranjan S.; Hofman, Albert; Mattace-Raso, Francesco U. S.; Oostra, Ben A.; Demirkan, Ayse; Isaacs, Aaron; Rivadeneira, Fernando; Lakatta, Edward G.; Orru, Marco; Scuteri, Angelo; Ala-Korpela, Mika; Kangas, Antti J.; Lyytikäinen, Leo-Pekka; Soininen, Pasi; Tukiainen, Taru; Würtz, Peter; Ong, Rick Twee-Hee; Dörr, Marcus; Kroemer, Heyo K.; Völker, Uwe; Völzke, Henry; Galan, Pilar; Hercberg, Serge; Lathrop, Mark; Zelenika, Diana; Deloukas, Panos; Mangino, Massimo; Spector, Tim D.; Zhai, Guangju; Meschia, James F.; Nalls, Michael A.; Sharma, Pankaj; Terzic, Janos; Kumar, M. V. Kranthi; Denniff, Matthew; Zukowska-Szczechowska, Ewa; Wagenknecht, Lynne E.; Fowkes, F. Gerald R.; Charchar, Fadi J.; Schwarz, Peter E. H.; Hayward, Caroline; Guo, Xiuqing; Rotimi, Charles; Bots, Michiel L.; Brand, Eva; Samani, Nilesh J.; Polasek, Ozren; Talmud, Philippa J.; Nyberg, Fredrik; Kuh, Diana; Laan, Maris; Hveem, Kristian; Palmer, Lyle J.; van der Schouw, Yvonne T.; Casas, Juan P.; Mohlke, Karen L.; Vineis, Paolo; Raitakari, Olli; Ganesh, Santhi K.; Wong, Tien Y.; Tai, E. Shyong; Cooper, Richard S.; Laakso, Markku; Rao, Dabeeru C.; Harris, Tamara B.; Morris, Richard W.; Dominiczak, Anna F.; Kivimaki, Mika; Marmot, Michael G.; Miki, Tetsuro; Saleheen, Danish; Chandak, Giriraj R.; Coresh, Josef; Navis, Gerjan; Salomaa, Veikko; Han, Bok-Ghee; Zhu, Xiaofeng; Kooner, Jaspal S.; Melander, Olle; Ridker, Paul M.; Bandinelli, Stefania; Gyllensten, Ulf B.; Wright, Alan F.; Wilson, James F.; Ferrucci, Luigi; Farrall, Martin; Tuomilehto, Jaakko; Pramstaller, Peter P.; Elosua, Roberto; Soranzo, Nicole; Sijbrands, Eric J. G.; Altshuler, David; Loos, Ruth J. F.; Shuldiner, Alan R.; Gieger, Christian; Meneton, Pierre; Uitterlinden, Andre G.; Wareham, Nicholas J.; Gudnason, Vilmundur; Rotter, Jerome I.; Rettig, Rainer; Uda, Manuela; Strachan, David P.; Witteman, Jacqueline C. M.; Hartikainen, Anna-Liisa; Beckmann, Jacques S.; Boerwinkle, Eric; Vasan, Ramachandran S.; Boehnke, Michael; Larson, Martin G.; Järvelin, Marjo-Riitta; Psaty, Bruce M.; Abecasis, Gonçalo R.; Chakravarti, Aravinda; Elliott, Paul; van Duijn, Cornelia M.; Newton-Cheh, Christopher; Levy, Daniel; Caulfield, Mark J.; Johnson, Toby; Tang, Hua; Knowles, Joshua; Hlatky, Mark; Fortmann, Stephen; Assimes, Themistocles L.; Quertermous, Thomas; Go, Alan; Iribarren, Carlos; Absher, Devin; Risch, Neil; Myers, Richard; Sidney, Steven; Ziegler, Andreas; Schillert, Arne; Bickel, Christoph; Sinning, Christoph; Rupprecht, Hans J.; Lackner, Karl; Wild, Philipp; Schnabel, Renate; Blankenberg, Stefan; Zeller, Tanja; Münzel, Thomas; Perret, Claire; Cambien, Francois; Tiret, Laurence; Nicaud, Viviane; Proust, Carole; Uitterlinden, Andre; van Duijn, Cornelia; Whitteman, Jaqueline; Cupples, L. Adrienne; Demissie-Banjaw, Serkalem; Ramachandran, Vasan; Smith, Albert; Folsom, Aaron; Morrison, Alanna; Chen, Ida Yii-Der; Bis, Joshua; Volcik, Kelly; Rice, Kenneth; Taylor, Kent D.; Marciante, Kristin; Smith, Nicholas; Glazer, Nicole; Heckbert, Susan; Harris, Tamara; Lumley, Thomas; Kong, Augustine; Thorleifsson, Gudmar; Thorgeirsson, Gudmundur; Holm, Hilma; Gulcher, Jeffrey R.; Stefansson, Kari; Andersen, Karl; Gretarsdottir, Solveig; Thorsteinsdottir, Unnur; Preuss, Michael; Schreiber, Stefan; König, Inke R.; Lieb, Wolfgang; Hengstenberg, Christian; Schunkert, Heribert; Fischer, Marcus; Grosshennig, Anika; Medack, Anja; Stark, Klaus; Linsel-Nitschke, Patrick; Bruse, Petra; Aherrahrou, Zouhair; Peters, Annette; Loley, Christina; Willenborg, Christina; Nahrstedt, Janja; Freyer, Jennifer; Gulde, Stephanie; Doering, Angela; Meisinger, Christina; Klopp, Norman; Illig, Thomas; Meinitzer, Andreas; Tomaschitz, Andreas; Halperin, Eran; Dobnig, Harald; Scharnagl, Hubert; Kleber, Marcus; Laaksonen, Reijo; Pilz, Stefan; Grammer, Tanja B.; Stojakovic, Tatjana; Renner, Wilfried; März, Winfried; Böhm, Bernhard O.; Winkelmann, Bernhard R.; Winkler, Karl; Hoffmann, Michael M.; Siscovick, David S.; Musunuru, Kiran; Barbalic, Maja; Guiducci, Candace; Burtt, Noel; Gabriel, Stacey B.; Stewart, Alexandre F. R.; Wells, George A.; Chen, Li; Jarinova, Olga; Roberts, Robert; McPherson, Ruth; Dandona, Sonny; Pichard, Augusto D.; Rader, Daniel J.; Devaney, Joe; Lindsay, Joseph M.; Kent, Kenneth M.; Qu, Liming; Satler, Lowell; Burnett, Mary Susan; Li, Mingyao; Reilly, Muredach P.; Wilensky, Robert; Waksman, Ron; Epstein, Stephen; Matthai, William; Knouff, Christopher W.; Waterworth, Dawn M.; Hakonarson, Hakon H.; Walker, Max C.; Hall, Alistair S.; Balmforth, Anthony J.; Wright, Benjamin J.; Nelson, Chris; Thompson, John R.; Ball, Stephen G.; Felix, Janine F.; Demissie, Serkalem; Loehr, Laura R.; Rosamond, Wayne D.; Folsom, Aaron R.; Benjamin, Emelia; Aulchenko, Yurii S.; Haritunians, Talin; Couper, David; Murabito, Joanne; Wang, Ying A.; Stricker, Bruno H.; Gottdiener, John S.; Chang, Patricia P.; Willerson, James T.; Köttgen, A.; Pattaro, C.; Böger, C. A.; Fuchsberger, C.; Olden, M.; Glazer, N. L.; Parsa, A.; Gao, X.; Yang, Q.; Smith, A. V.; O'Connell, J. R.; Li, M.; Schmidt, H.; Tanaka, T.; Isaacs, A.; Ketkar, S.; Hwang, S. J.; Johnson, A. D.; Dehghan, A.; Teumer, A.; Paré, G.; Atkinson, E. J.; Zeller, T.; Lohman, K.; Cornelis, M. C.; Probst-Hensch, N. M.; Kronenberg, F.; Tönjes, A.; Hayward, C.; Aspelund, T.; Eiriksdottir, G.; Launer, L. J.; Harris, T. B.; Rampersaud, E.; Mitchell, B. D.; Arking, D. E.; Boerwinkle, E.; Struchalin, M.; Cavalieri, M.; Singleton, A.; Giallauria, F.; Metter, J.; de Boer, J.; Haritunians, T.; Lumley, T.; Siscovick, D.; Psaty, B. M.; Zillikens, M. C.; Oostra, B. A.; Feitosa, M.; Province, M.; de Andrade, M.; Turner, S. T.; Schillert, A.; Ziegler, A.; Wild, P. S.; Schnabel, R. B.; Wilde, S.; Munzel, T. F.; Leak, T. S.; Illig, T.; Klopp, N.; Meisinger, C.; Wichmann, H. E.; Koenig, W.; Zgaga, L.; Zemunik, T.; Kolcic, I.; Minelli, C.; Hu, F. B.; Johansson, A.; Igl, W.; Zaboli, G.; Wild, S. H.; Wright, A. F.; Campbell, H.; Ellinghaus, D.; Schreiber, S.; Aulchenko, Y. S.; Felix, J. F.; Rivadeneira, F.; Uitterlinden, A. G.; Hofman, A.; Imboden, M.; Nitsch, D.; Brandstätter, A.; Kollerits, B.; Kedenko, L.; Mägi, R.; Stumvoll, M.; Kovacs, P.; Boban, M.; Campbell, S.; Endlich, K.; Völzke, H.; Kroemer, H. K.; Nauck, M.; Völker, U.; Polasek, O.; Vitart, V.; Badola, S.; Parker, A. N.; Ridker, P. M.; Kardia, S. L.; Blankenberg, S.; Liu, Y.; Curhan, G. C.; Franke, A.; Rochat, T.; Paulweber, B.; Prokopenko, I.; Wang, W.; Gudnason, V.; Shuldiner, A. R.; Coresh, J.; Schmidt, R.; Ferrucci, L.; Shlipak, M. G.; van Duijn, C. M.; Borecki, I.; Krämer, B. K.; Rudan, I.; Gyllensten, U.; Wilson, J. F.; Witteman, J. C.; Pramstaller, P. P.; Rettig, R.; Hastie, N.; Chasman, D. I.; Kao, W. H.; Heid, I. M.; Fox, C. S.; Vasan, R. S.; Lieb, W.; Felix, S. B.; Watzinger, N.; Larson, M. G.; Smith, N. L.; Grosshennig, A.; Kathiresan, S.; König, I. R.; Homuth, G.; Aragam, J.; Bis, J. C.; Erdmann, J.; Dörr, M.; Zweiker, R.; Lind, L.; Rodeheffer, R. J.; Greiser, K. H.; Levy, D.; Deckers, J. W.; Stritzke, J.; Lackner, K. J.; Ingelsson, E.; Kullo, I.; Haerting, J.; O'Donnell, C. J.; Heckbert, S. R.; Stricker, B. H.; Reffelmann, T.; Redfield, M. M.; Werdan, K.; Mitchell, G. F.; Rice, K.; Arnett, D. K.; Gottdiener, J. S.; Meitinger, T.; Blettner, M.; Friedrich, N.; Wang, T. J.; Benjamin, E. J.; Rotter, J. I.; Schunkert, H.; Chambers, J. C.; Zhang, W.; Lord, G. M.; van der Harst, P.; Lawlor, D. A.; Sehmi, J. S.; Gale, D. P.; Wass, M. N.; Ahmadi, K. R.; Bakker, S. J.; Beckmann, J.; Bilo, H. J.; Bochud, M.; Brown, M. J.; Caulfield, M. J.; Connell, J. M.; Cook, H. T.; Cotlarciuc, I.; Davey Smith, G.; de Silva, R.; Deng, G.; Devuyst, O.; Dikkeschei, L. D.; Dimkovic, N.; Dockrell, M.; Dominiczak, A.; Ebrahim, S.; Eggermann, T.; Farrall, M.; Floege, J.; Forouhi, N. G.; Gansevoort, R. T.; Han, X.; Hedblad, B.; Homan van der Heide, J. J.; Hepkema, B. G.; Hernandez-Fuentes, M.; Hypponen, E.; Johnson, T.; de Jong, P. E.; Kleefstra, N.; Lagou, V.; Lapsley, M.; Li, Y.; Loos, R. J.; Luan, J.; Luttropp, K.; Maréchal, C.; Melander, O.; Munroe, P. B.; Nordfors, L.; Peltonen, L.; Penninx, B. W.; Perucha, E.; Pouta, A.; Roderick, P. J.; Ruokonen, A.; Samani, N. J.; Sanna, S.; Schalling, M.; Schlessinger, D.; Schlieper, G.; Seelen, M. A.; Sjögren, M.; Smit, J. H.; Snieder, H.; Soranzo, N.; Spector, T. D.; Stenvinkel, P.; Sternberg, M. J.; Swaminathan, R.; Ubink-Veltmaat, L. J.; Uda, M.; Vollenweider, P.; Wallace, C.; Waterworth, D.; Zerres, K.; Waeber, G.; Wareham, N. J.; Maxwell, P. H.; McCarthy, M. I.; Jarvelin, M. R.; Mooser, V.; Abecasis, G. R.; Lightstone, L.; Scott, J.; Navis, G.; Elliott, P.; Kooner, J. S.

    2011-01-01

    Blood pressure is a heritable trait influenced by several biological pathways and responsive to environmental stimuli. Over one billion people worldwide have hypertension (≥140 mm Hg systolic blood pressure or  ≥90 mm Hg diastolic blood pressure). Even small increments in blood pressure are

  2. Pulse pressure as a haemodynamic variable in systolic heart failure

    NARCIS (Netherlands)

    Petrie, Colin James

    2016-01-01

    In patients with heart failure, the heart is unable to pump enough blood to satisfy the requirements of the body. Explanations for this include heart muscle damage after a heart attack. This could be very recently, or in the past, sometimes dating back many years. In other cases the explanation for

  3. Genome-wide association analysis identifies novel blood pressure loci and offers biological insights into cardiovascular risk

    NARCIS (Netherlands)

    Warren, Helen R.; Evangelou, Evangelos; Cabrera, Claudia P.; Gao, He; Ren, Meixia; Mifsud, Borbala; Ntalla, Ioanna; Surendran, Praveen; Liu, Chunyu; Cook, James P.; Kraja, Aldi T.; Drenos, Fotios; Loh, Marie; Verweij, Niek; Marten, Jonathan; Karaman, Ibrahim; Lepe, Marcelo P. Segura; O'Reilly, Paul F.; Knight, Joanne; Snieder, Harold; Kato, Norihiro; He, Jiang; Tai, E. Shyong; Said, M. Abdullah; Porteous, David; Alver, Maris; Poulter, Neil; Farrall, Martin; Gansevoort, Ron T.; Padmanabhan, Sandosh; Magi, Reedik; Stanton, Alice; Connell, John; Bakker, Stephan J. L.; Metspalu, Andres; Shields, Denis C.; Thom, Simon; Brown, Morris; Sever, Peter; Esko, Tonu; Hayward, Caroline; van der Harst, Pim; Saleheen, Danish; Chowdhury, Rajiv; Chambers, John C.; Chasman, Daniel I.; Chakravarti, Aravinda; Newton-Cheh, Christopher; Lindgren, Cecilia M.; Levy, Daniel; Kooner, Jaspal S.; Keavney, Bernard; Tomaszewski, Maciej; Samani, Nilesh J.; Howson, Joanna M. M.; Tobin, Martin D.; Munroe, Patricia B.; Ehret, Georg B.; Wain, Louise V.; Barnes, Michael R.; Tzoulaki, Joanna; Caulfield, Mark J.; Elliott, Paul; Vaez, Ahmad; Jansen, Rick; Joehanes, Roby; van der Most, Peter J.; Erzurumluoglu, A. Mesut; O'Reilly, Paul; Rose, Lynda M.; Verwoert, Germaine C.; Hottenga, Jouke-Jan; Strawbridge, Rona J.; Arking, Dan E.; Hwang, Shih-Jen; Guo, Xiuqing; Kutalik, Zoltan; Trompet, Stella; Shrine, Nick; Teumer, Alexander; Ried, Janina S.; Bis, Joshua C.; Smith, Albert V.; Amin, Najaf; Nolte, Ilja M.; Lyytikainen, Leo-Pekka; Mahajan, Anubha; Wareham, Nicholas J.; Hofer, Edith; Joshi, Peter K.; Kristiansson, Kati; Traglia, Michela; Havulinna, Aki S.; Goel, Anuj; Nalls, Mike A.; Sober, Siim; Vuckovic, Dragana; Luan, Jian'an; del Greco, Fabiola M.; Ayers, Kristin L.; Marrugat, Jaume; Ruggiero, Daniela; Lopez, Lorna M.; Niiranen, Teemu; Enroth, Stefan; Jackson, Anne U.; Nelson, Christopher P.; Huffman, Jennifer E.; Zhang, Weihua; Gandin, Ilaria; Harris, Sarah E.; Zemonik, Tatijana; Lu, Yingchang; Shah, Nabi; de Borst, Martin H.; Mangino, Massimo; Prins, Bram P.; Campbell, Archie; Li-Gao, Ruifang; Chauhan, Ganesh; Oldmeadow, Christopher; Abecasis, Goncalo; Abedi, Maryam; Barbieri, Caterina M.; Batini, Chiara; Blake, Tineka; Boehnke, Michael; Bottinger, Erwin P.; Braund, Peter S.; Brumat, Marco; Campbell, Harry; Cocca, Massimiliano; Collins, Francis; Cordell, Heather J.; Damman, Jeffrey J.; Davies, Gail; de Geus, Eco J.; de Mutsert, Renee; Deelen, Joris; Demirkale, Yusuf; Doney, Alex S. F.; Dorr, Marcus; Ferreira, Teresa; Franberg, Mattias; Giedraitis, Vilmantas; Gieger, Christian; Giulianini, Franco; Gow, Alan J.; Hamsten, Anders; Harris, Tamara B.; Hofman, Albert; Holliday, Elizabeth G.; Jarvelin, Marjo-Riitta; Johansson, Asa; Johnson, Andrew D.; Jousilahti, Pekka; Jula, Antti; Kahonen, Mika; Kathiresan, Sekar; Khaw, Kay-Tee; Kolcic, Ivana; Koskinen, Seppo; Langenberg, Claudia; Larson, Marty; Launer, Lenore J.; Lehne, Benjamin; Liewald, David C. M.; Lin, Li; Lind, Lars; Mach, Francois; Mamasoula, Chrysovalanto; Menni, Cristina; Milaneschi, Yuri; Morgan, Anna; Morris, Andrew D.; Morrison, Alanna C.; Munson, Peter J.; Nandakumar, Priyanka; Nguyen, Quang Tri; Nutile, Teresa; Oldehinkel, Albertine J.; Oostra, Ben A.; Org, Elin; Palotie, Aarno; Pare, Guillaume; Pattie, Alison; Penninx, Brenda W. J. H.; Pramstaller, Peter P.; Raitakari, Olli T.; Rice, Kenneth; Ridker, Paul M.; Riese, Harriette; Ripatti, Samuli; Robino, Antonietta; Rotter, Jerome I.; Rudan, Igor; Saba, Yasaman; Saint Pierre, Aude; Sala, Cinzia F.; Sarin, Antti-Pekka; Schmidt, Reinhold; Scott, Rodney; Seelen, Marc A.; Siscovick, David; Sorice, Rossella; Stott, David J.; Sundstrom, Johan; Swertz, Morris; Taylor, Kent D.; Tzoulaki, Ioanna; Tzourio, Christophe; Uitterlinden, Andre G.; Volker, Uwe; Vollenweider, Peter; Wild, Sarah; Willemsen, Gonneke; Wright, Alan F.; Yao, Jie; Theriault, Sebastien; Conen, David; John, Attia; Debette, Stephanie; Mook-Kanamori, Dennis O.; Zeggini, Eleftheria; Spector, Tim D.; Palmer, Colin N. A.; Vergnaud, Anne-Claire; Loos, Ruth J. F.; Polasek, Ozren; Starr, John M.; Girotto, Giorgia; Lindgren, Cecila M.; Vitart, Veronique; Tuomilehto, Jaakko; Gyllensten, Ulf; Knekt, Paul; Deary, Ian J.; Ciullo, Marina; Elosua, Roberto; Keavney, Bernard D.; Hicks, Andrew A.; Scott, Robert A.; Gasparini, Paolo; Laan, Maris; Liu, Yongmei; Watkins, Hugh; Hartman, Catharina A.; Salomaa, Veikko; Toniolo, Daniela; Perola, Markus; Wilson, James F.; Schmidt, Helena; Zhao, Jing Hua; Lehtimaki, Terho; van Duijn, Cornelia M.; Gudnason, Vilmundur; Psaty, Bruce M.; Peters, Annette; Rettig, Rainer; James, Alan; Jukema, J. Wouter; Strachan, David P.; Palmas, Walter; Ingelsson, Erik; Boomsma, Dorret I.; Franco, Oscar H.; Bochud, Murielle; Morris, Andrew P.

    2017-01-01

    Elevated blood pressure is the leading heritable risk factor for cardiovascular disease worldwide. We report genetic association of blood pressure (systolic, diastolic, pulse pressure) among UK Biobank participants of European ancestry with independent replication in other cohorts, and robust

  4. Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure

    DEFF Research Database (Denmark)

    Overvad, Kim

    2018-01-01

    interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million......, where relevant. We used a linear mixed effect model to quantify the association between (probit-transformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence...... participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights...

  5. Wearing an abdominal belt increases diastolic blood pressure.

    Science.gov (United States)

    Rafacz, W; McGill, S M

    1996-09-01

    The purpose of this study was to determine the effect of wearing an abdominal belt on blood pressure (systolic and diastolic) and heart rate during a variety of tasks. The belt was typical of the elastic type with suspenders and Velcro tabs for cinching the belt snug. The tasks performed included sitting at rest, sitting with the torso inclined forward at 45 degrees, standing with the torso inclined forward at 45 degrees (with and without holding an 11-kg weight), a trunk axial rotation task, and squat lifting. Blood pressure was monitored noninvasively with a FINAPRES blood pressure monitor. Twenty healthy men performed each task with and without the abdominal belt. Although no significant increases in mean systolic blood pressure or heart rate were found, there was a significant increase in diastolic blood pressure in all conditions. All people considering wearing an abdominal belt should also consider the risks and liability associated with the additional cardiovascular load, particularly heart attack and stroke.

  6. Cost-effectiveness of Intensive Blood Pressure Management

    DEFF Research Database (Denmark)

    Richman, Ilana B; Fairley, Michael; Jørgensen, Mads Emil

    2016-01-01

    Importance: Among high-risk patients with hypertension, targeting a systolic blood pressure of 120 mm Hg reduces cardiovascular morbidity and mortality compared with a higher target. However, intensive blood pressure management incurs additional costs from treatment and from adverse events......-effectiveness of intensive blood pressure management among 68-year-old high-risk adults with hypertension but not diabetes. We used the Systolic Blood Pressure Intervention Trial (SPRINT) to estimate treatment effects and adverse event rates. We used Centers for Disease Control and Prevention Life Tables to project age...... and accrued $155 261 in lifetime costs, while intensive management yielded 10.5 QALYs and accrued $176 584 in costs. Intensive blood pressure management cost $23 777 per QALY gained. In a sensitivity analysis, serious adverse events would need to occur at 3 times the rate observed in SPRINT and be 3 times...

  7. Cocoa, blood pressure, and cardiovascular health.

    Science.gov (United States)

    Ferri, Claudio; Desideri, Giovambattista; Ferri, Livia; Proietti, Ilenia; Di Agostino, Stefania; Martella, Letizia; Mai, Francesca; Di Giosia, Paolo; Grassi, Davide

    2015-11-18

    High blood pressure is an important risk factor for cardiovascular disease and cardiovascular events worldwide. Clinical and epidemiological studies suggest that cocoa-rich products reduce the risk of cardiovascular disease. According to this, cocoa has a high content in polyphenols, especially flavanols. Flavanols have been described to exert favorable effects on endothelium-derived vasodilation via the stimulation of nitric oxide-synthase, the increased availability of l-arginine, and the decreased degradation of NO. Cocoa may also have a beneficial effect by protecting against oxidative stress alterations and via decreased platelet aggregation, decreased lipid oxidation, and insulin resistance. These effects are associated with a decrease of blood pressure and a favorable trend toward a reduction in cardiovascular events and strokes. Previous meta-analyses have shown that cocoa-rich foods may reduce blood pressure. Long-term trials investigating the effect of cocoa products are needed to determine whether or not blood pressure is reduced on a chronic basis by daily ingestion of cocoa. Furthermore, long-term trials investigating the effect of cocoa on clinical outcomes are also needed to assess whether cocoa has an effect on cardiovascular events. A 3 mmHg systolic blood pressure reduction has been estimated to decrease the risk of cardiovascular and all-cause mortality. This paper summarizes new findings concerning cocoa effects on blood pressure and cardiovascular health, focusing on putative mechanisms of action and "nutraceutical " viewpoints.

  8. Alanine increases blood pressure during hypotension

    Science.gov (United States)

    Conlay, L. A.; Maher, T. J.; Wurtman, R. J.

    1990-01-01

    The effect of L-alanine administration on blood pressure (BP) during haemorrhagic shock was investigated using anesthetized rats whose left carotid arteries were cannulated for BP measurement, blood removal, and drug administration. It was found that L-alanine, in doses of 10, 25, 50, 100, and 200 mg/kg, increased the systolic BP of hypotensive rats by 38 to 80 percent (while 100 mg/kg pyruvate increased BP by only 9.4 mmhg, not significantly different from saline). The results suggest that L-alanine might influence cardiovascular function.

  9. Effect of antecedent hypertension and follow-up blood pressure on outcomes after high-risk myocardial infarction

    DEFF Research Database (Denmark)

    Thune, J.J.; Signorovitch, J.; Velazquez, E.J.

    2007-01-01

    myocardial infarction in the Valsartan in Myocardial Infarction Trial. We assessed the relationship between antecedent hypertension and outcomes and the association between elevated (systolic: >140 mm Hg) or low blood pressure (systolic:

  10. Blood pressure monitors for home

    Science.gov (United States)

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

  11. Common High Blood Pressure Myths

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Common High Blood Pressure Myths Updated:May 4,2018 Knowing the facts ... This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  12. Blood Pressure vs. Heart Rate

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Blood Pressure vs. Heart Rate (Pulse) Updated:Nov 13,2017 ... This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  13. High Blood Pressure in Pregnancy

    Science.gov (United States)

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

  14. Medications for High Blood Pressure

    Science.gov (United States)

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

  15. High blood pressure and diet

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007483.htm High blood pressure and diet To use the sharing features on ... diet is a proven way to help control high blood pressure . These changes can also help you lose weight ...

  16. The changes of state-trait anxiety and blood plasma cortisol as well systolic pressure of armymen turned to sea training%部队转场海训后军人状态-特质焦虑与其收缩压和血皮质醇的变化

    Institute of Scientific and Technical Information of China (English)

    朱媛; 吴志颖; 付晓丽; 王丽杰

    2014-01-01

    Through investigating the state-trait anxiety of mental characteristics change of armymen in military activity,to provide the basis for early warning prevention. Methods Transition to sea training for the 15th day,state-trait anxiety based on a questionnaire of 420 people,and blood pressure,pulse rate and blood cortisol (08:00am-09:00am) were investigated and detected whose results were compared to the norm or the normal value. Results State anxiety was 2 values in 185 persons higher than the standard deviation of the norm, accounting for 44% of the total person-number. Trait anxiety values was 2 votes in 113 higher than the standard deviation of the norm (high trait anxiety), accounting for 26.9% of the total person-number, value of trait-anxiety was less than the standard deviation of the norm 2 votes(low trait anxiety) in 85 persons, accounting for 20.2% of the total number. Systolic blood pressure and cortisol changed significantly (P<0.01). State anxiety and serum cortisol and systolic blood pressure changed at the same time significantly in total person-number of 30.2%,but changes in diastolic blood pressure was not evident. Higher trait anxiety anxiety , blood cortisol and elevated systolic blood pressure in high trait anxiety persons were of 61.9%(70/113);state anxiety,elevated blood cortisol and systolic blood pressure were in 23.7% of the total number of non-higher trait anxiety persons (79/334),low trait anxiety of trait-anxiety were of 15% of total person-number(13/85). Conclusion Sea training is a stress event, trait anxiety refers to the relative stability,as personality trait anxiety tendency has individual differences. So coping anxiety active has military significance to physical and mental health and enhancing fighting capacity.%目的:通过调查状态-特质焦虑心理特质在军事活动中的变化,为预警预防提供依据。方法转场海训的第15天时,对420人进行状态-特质焦虑问卷、血

  17. Types of Blood Pressure Medications

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More Types of Blood Pressure Medications Updated:Nov 6,2017 Prescription blood pressure ... This content was last reviewed October 2017. High Blood Pressure • Home • Get the Facts About HBP • Know Your ...

  18. Controlling your high blood pressure

    Science.gov (United States)

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

  19. The Role of Central Blood Pressure Monitoring in the Management of Hypertension.

    Science.gov (United States)

    Ochoa, Adrian; Patarroyo-Aponte, Gabriel; Rahman, Mahboob

    2018-04-19

    Central blood pressure is a novel predictor of cardiovascular risk that can be measured in the clinical setting using currently available technology. This paper will review current available methods of central blood pressure monitoring as well as its impact in cardiac and renal disease. Both aortic and carotid systolic blood pressure are independently associated with cardiovascular mortality and serious cardiac events. Furthermore, studies show that systolic aortic blood pressure has been shown to be superior predictor of cardiovascular as compared to brachial blood pressure. Inhibitors of the renin angiotensin axis may have a beneficial effect on central blood pressure; however, long term studies evaluating the impact of lowering central blood pressure on clinical outcomes are lacking. Central blood pressure is a good predictor of cardiovascular risk. As more studies emerge demonstrating the value of central blood pressure as a therapeutic target, it is possible that targeting central blood pressure may become an important part of the armamentarium to lower cardiovascular risk.

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

    Directory of Open Access Journals (Sweden)

    Maryam Alinezhad-Namaghi

    2016-03-01

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

  1. Ambulatory blood pressure monitoring in patients with hyperthyroidism before the introduction of therapy and on therapy

    Directory of Open Access Journals (Sweden)

    Stojanović Miloš

    2017-01-01

    Full Text Available The increased secretion of thyroid gland hormones affects the cardiovascular system by increasing heart rate and often by increasing systolic and diastolic blood pressure. We examined the influence of elevated thyroid hormone on blood pressure. Blood pressure monitoring was performed prior to the introduction of therapy in people with increased FT4 and on therapy when FT4 was in the normal range. We analyzed 32 people, of which 26 women had normal blood pressure values measured by blood pressure monitoring. Average age 45 and body mass index 27 kg/m2. Blood pressure was measured by monitoring blood pressure for 24 hours. On average, before the introduction of the therapy, it was 133/83 mmHg P 96 / min. The blood pressure on average on therapy with tireosuppressive was 128/82 mmHg P 74 / min. The Wilcoxon-Mann-Whitney paired test shows a significant P <0.05 higher systolic blood pressure and pulse rate during the day and night before the treatment, when FT4 was higher, than the time when medication was taking, when the FT4 was in the normal range. No significant difference was found for diastolic blood pressure before the introduction of therapy and during therapy with tireosuppressives. When values of FT4 are increased, monitoring of blood pressure shows significantly higher values of systolic blood pressure and pulse during day and night compared to systolic blood pressure and pulse values when FT4 is in the normal range.

  2. Serial blood pressure measurements

    Directory of Open Access Journals (Sweden)

    N.R. Koehler

    2002-05-01

    Full Text Available The objective of the present investigation was to study the effects of a 60-s interval of venous congestion between two noninvasive measurements of arterial blood pressure (ABP on the fluctuation of ABP, assessed by the standard deviation of the differences between two readings. ABP was measured in 345 successive patients, at rest, four times each. For 269 participants, one pair of readings was obtained with a 60-s interval and the other pair without an interval. For 76 patients, the first pair was read at the same interval, and the second pair had venous congestion interposed and there was no waiting interval. There was no increased ABP oscillation, either when there was no interval between ABP readings, or when venous congestion was interposed compared to pairs of ABP measurements performed with a 60-s interval. There was no increase in ABP oscillations when successive ABP readings were taken without an interval or even with venous congestion interposed. Contrary to the present belief, there seems to be no loss of reliability when blood pressure recordings are taken immediately one after another, in the clinical setting.

  3. Blood pressure and sexual maturity in adolescents: the Heartfelt Study.

    Science.gov (United States)

    Cho, S D; Mueller, W H; Meininger, J C; Liehr, P; Chan, W

    2001-01-01

    This study investigates sexual maturity as a predictor of resting blood pressures independent of other known predictors, in 179 boys and 204 girls 11-16 years of age from the Heartfelt Study. The sample included youth of African (n = 140), Mexican (n = 117), and European and "other" (n = 126) backgrounds. Sexual maturity was assessed during clinical examination of three standard indicators for each sex. Systolic and diastolic blood pressures were higher in children of maturity stages IV and V, compared to stages I-III, in each gender/ethnic group (P maturity for their age group, had significantly higher systolic blood pressures (but not diastolic) than the less advanced in linear models that included height, body mass index (BMI), ethnicity, and age as co-predictors. Diastolic blood pressures were predicted by height in boys and by age and the BMI in girls. This analysis, using a very conservative approach, suggests that sexual maturity provides important and independent information on systolic blood pressure in adolescents. Further investigation of its role in 24-hr blood pressures and in blood pressures taken during physical and emotional stress, is recommended.

  4. High blood pressure in acute ischemic stroke and clinical outcome.

    Science.gov (United States)

    Manabe, Yasuhiro; Kono, Syoichiro; Tanaka, Tomotaka; Narai, Hisashi; Omori, Nobuhiko

    2009-11-16

    This study aimed to evaluate the prognostic value of acute phase blood pressure in patients with acute ischemic stroke by determining whether or not it contributes to clinical outcome. We studied 515 consecutive patients admitted within the first 48 hours after the onset of ischemic strokes, employing systolic and diastolic blood pressure measurements recorded within 36 hours after admission. High blood pressure was defined when the mean of at least 2 blood pressure measurements was ≥200 mmHg systolic and/or ≥110 mmHg diastolic at 6 to 24 hours after admission or ≥180 mmHg systolic and/or ≥105 mmHg diastolic at 24 to 36 hours after admission. The high blood pressure group was found to include 16% of the patients. Age, sex, diabetes mellitus, hypercholesterolemia, atrial fibrillation, ischemic heart disease, stroke history, carotid artery stenosis, leukoaraiosis, NIH Stroke Scale (NIHSS) on admission and mortality were not significantly correlated with either the high blood pressure or non-high blood pressure group. High blood pressure on admission was significantly associated with a past history of hypertension, kidney disease, the modified Rankin Scale (mRS) on discharge and the length of stay. On logistic regression analysis, with no previous history of hypertension, diabetes mellitus, atrial fibrillation, and kidney disease were independent risk factors associated with the presence of high blood pressure [odds ratio (OR), 1.85 (95% confidence interval (CI): 1.06-3.22), 1.89 (95% CI: 1.11-3.22), and 3.31 (95% CI: 1.36-8.04), respectively]. Multi-organ injury may be presented in acute stroke patients with high blood pressure. Patients with high blood pressure had a poor functional outcome after acute ischemic stroke.

  5. The relationship between blood viscosity and blood pressure in a random sample of the population aged 55 to 74 years.

    Science.gov (United States)

    Fowkes, F G; Lowe, G D; Rumley, A; Lennie, S E; Smith, F B; Donnan, P T

    1993-05-01

    Blood viscosity is elevated in hypertensive subjects, but the association of viscosity with arterial blood pressure in the general population, and the influence of social, lifestyle and disease characteristics on this association, are not established. In the Edinburgh Artery Study, 1592 men and women aged 55-74 years selected randomly from the general population attended a university clinic. A fasting blood sample was taken for the measurement of blood viscosity and its major determinants (haematocrit, plasma viscosity and fibrinogen). Systolic pressure was related univariately to blood viscosity (P viscosity (P index. Diastolic pressure was related univariately to blood viscosity (P viscosity (P viscosity and systolic pressure was confined to males. Blood viscosity was associated equally with systolic and diastolic pressures in males, and remained independently related on multivariate analysis adjusting for age, sex, body mass index, social class, smoking, alcohol intake, exercise, angina, HDL and non-HDL cholesterol, diabetes mellitus, plasma viscosity, fibrinogen, and haematocrit.

  6. The usefulness of contrast during exercise echocardiography for the assessment of systolic pulmonary pressure

    Directory of Open Access Journals (Sweden)

    Cordeiro Ana

    2008-10-01

    Full Text Available Abstract Background The systolic pulmonary artery pressure (PAPs can be accurately estimated, non-invasively, using continuous-wave Doppler (CWD ultrasound measurement of the peak velocity of a tricuspid regurgitant (TR jet. However, it is often difficult to obtain adequate tricuspid regurgitation signals for measurement of PAPs, what could lead to its underestimation. Therefore, utilization of air-blood-saline contrast has been implemented for the improvement of Doppler signal in several clinical contexts. It is now recommended in the evaluation of patients with pulmonary hypertension. Physical activity is severely restricted in patients with PAH, being exertional dypnea the most typical symptom. Exercise stress echo-Doppler imaging allows assessment of the response to exercise. It is an excellent screening test for patients with suspected PAH. Our purpose was to evaluate the value and accuracy of agitated saline with blood contrast echocardiography, in the improvement of the Doppler signal, to quantify PAPs during treadmill exercise-echocardiography. Purpose To evaluate the value of contrast echocardiography, using agitated saline with blood, in the improvement of the Doppler signal used to quantify the pulmonary artery systolic pressure during exercise. Methods From a total of 41 patients (pts, we studied 38 pts (93%, 35 women, aged 54 ± 12 years-old. 27 with the diagnosis of systemic sclerosis, 10 with history of pulmonary embolism and one patient with a suspected idiopathic PAH, who were referred to the Unity of Heart Failure and Pulmonary Hypertension for screening of PAH. According to the Unity protocol, a transthoracic echocardiogram was made, in left decubitus (LD, with evaluation of right ventricle-right atria gradient (RV/RAg. A peripheral venous access was obtained, with a 3-way stopcock and the patients were placed in orthostatism (O, with a new evaluation of RV/RAg. Exercise echocardiography (EE was begun, with evaluation of RV

  7. Association of betaine with blood pressure in dialysis patients.

    Science.gov (United States)

    Wang, Lulu; Zhao, Mingming; Liu, Wenjin; Li, Xiurong; Chu, Hong; Bai, Youwei; Sun, Zhuxing; Gao, Chaoqing; Zheng, Lemin; Yang, Junwei

    2018-02-01

    Mechanisms underlying elevated blood pressure in dialysis patients are complex as a variety of non-traditional factors are involved. We sought to explore the association of circulating betaine, a compound widely distributed in food, with blood pressure in dialysis patients. We used baseline data of an ongoing cohort study involving patients on hemodialysis. Plasma betaine was measured by high performance liquid chromatography in 327 subjects. Blood pressure level was determined by intradialytic ambulatory blood pressure monitoring. The mean age of the patients was 52.6 ± 11.9 years, and 58.4% were male. Average interdialytic ambulatory systolic and diastolic blood pressure were 138.4 ± 22.7 mm Hg and 84.4 ± 12.5 mm Hg, respectively. Mean plasma betaine level was 37.6 μmol/L. Multiple linear regression analysis revealed significant associations of betaine with both systolic blood pressure (β = -3.66, P = .003) and diastolic blood pressure (β = -2.00, P = .004). The associations persisted even after extensive adjustment for cardiovascular covariates. Subgroup analysis revealed that the association between betaine and blood pressure was mainly limited to female patients. Our data suggest that alteration of circulating betaine possibly contributes to blood pressure regulation in these patients. ©2018 Wiley Periodicals, Inc.

  8. Effects of endurance training on blood pressure, blood pressure-regulating mechanisms, and cardiovascular risk factors.

    Science.gov (United States)

    Cornelissen, Véronique A; Fagard, Robert H

    2005-10-01

    Previous meta-analyses of randomized controlled trials on the effects of chronic dynamic aerobic endurance training on blood pressure reported on resting blood pressure only. Our aim was to perform a comprehensive meta-analysis including resting and ambulatory blood pressure, blood pressure-regulating mechanisms, and concomitant cardiovascular risk factors. Inclusion criteria of studies were: random allocation to intervention and control; endurance training as the sole intervention; inclusion of healthy sedentary normotensive or hypertensive adults; intervention duration of > or =4 weeks; availability of systolic or diastolic blood pressure; and publication in a peer-reviewed journal up to December 2003. The meta-analysis involved 72 trials, 105 study groups, and 3936 participants. After weighting for the number of trained participants and using a random-effects model, training induced significant net reductions of resting and daytime ambulatory blood pressure of, respectively, 3.0/2.4 mm Hg (Phypertensive study groups (-6.9/-4.9) than in the others (-1.9/-1.6; Pendurance training decreases blood pressure through a reduction of vascular resistance, in which the sympathetic nervous system and the renin-angiotensin system appear to be involved, and favorably affects concomitant cardiovascular risk factors.

  9. The influence of blood pressure management on neurological outcome in endovascular therapy for acute ischaemic stroke.

    Science.gov (United States)

    Rasmussen, M; Espelund, U S; Juul, N; Yoo, A J; Sørensen, L H; Sørensen, K E; Johnsen, S P; Andersen, G; Simonsen, C Z

    2018-06-01

    Observational studies have suggested that low blood pressure and blood pressure variability may partially explain adverse neurological outcome after endovascular therapy with general anaesthesia (GA) for acute ischaemic stroke. The aim of this study was to further examine whether blood pressure related parameters during endovascular therapy are associated with neurological outcome. The GOLIATH trial randomised 128 patients to either GA or conscious sedation for endovascular therapy in acute ischaemic stroke. The primary outcome was 90 day modified Rankin Score. The haemodynamic protocol aimed at keeping the systolic blood pressure >140 mm Hg and mean blood pressure >70 mm Hg during the procedure. Blood pressure related parameters of interest included 20% reduction in mean blood pressure; mean blood pressure blood pressure blood pressure; mean blood pressure at the time of groin puncture; postreperfusion mean blood pressure; blood pressure variability; and use of vasopressors. Sensitivity analyses were performed in the subgroup of reperfused patients. Procedural average mean and systolic blood pressures were higher in the conscious sedation group (Pblood pressure blood pressure blood pressure variability, and use of vasopressors were all higher in the GA group (Pblood pressure related parameters and the modified Rankin Score in the overall patient population, and in the subgroup of patients with full reperfusion. We found no statistically significant association between blood pressure related parameters during endovascular therapy and neurological outcome. NCT 02317237. Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

  10. Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19.1 million participants

    NARCIS (Netherlands)

    Zhou, Bin; Bentham, James; Di Cesare, Mariachiara; Bixby, Honor; Danaei, Goodarz; Cowan, Melanie J.; Paciorek, Christopher J.; Singh, Gitanjali; Hajifathalian, Kaveh; Bennett, James E.; Taddei, Cristina; Bilano, Ver; Carrillo-Larco, Rodrigo M.; Djalalinia, Shirin; Khatibzadeh, Shahab; Lugero, Charles; Peykari, Niloofar; Zhang, Wan Zhu; Lu, Yuan; Stevens, Gretchen A.; Riley, Leanne M.; Bovet, Pascal; Elliott, Paul; Gu, Dongfeng; Ikeda, Nayu; Jackson, Rod T.; Joffres, Michel; Kengne, Andre Pascal; Laatikainen, Tiina; Lam, Tai Hing; Laxmaiah, Avula; Liu, Jing; Miranda, J. Jaime; Mondo, Charles K.; Neuhauser, Hannelore K.; Sundstrom, Johan; Smeeth, Liam; Soric, Maroje; Woodward, Mark; Ezzati, Majid; Abarca-Gomez, Leandra; Abdeen, Ziad A.; Rahim, Hanan Abdul; Abu-Rmeileh, Niveen M.; Acosta-Cazares, Benjamin; Adams, Robert; Aekplakorn, Wichai; Afsana, Kaosar; Aguilar-Salinas, Carlos A.; Agyemang, Charles; Ahmadvand, Alireza; Ahrens, Wolfgang; Al Raddadi, Rajaa; Al Woyatan, Rihab; Ali, Mohamed M.; Alkerwi, Ala'a; Aly, Eman; Amouyel, Philippe; Amuzu, Antoinette; Andersen, Lars Bo; Anderssen, Sigmund A.; Angquist, Lars; Anjana, Ranjit Mohan; Ansong, Daniel; Aounallah-Skhiri, Hajer; Araujo, Joana; Ariansen, Inger; Aris, Tahir; Arlappa, Nimmathota; Aryal, Krishna; Arveiler, Dominique; Assah, Felix K.; Assuncao, Maria Cecilia F.; Avdicova, Maria; Azevedo, Ana; Azizi, Fereidoun; Babu, Bontha V.; Bahijri, Suhad; Balakrishna, Nagalla; Bandosz, Piotr; Banegas, Jose R.; Barbagallo, Carlo M.; Barcelo, Alberto; Barkat, Amina; Barros, Aluisio J. D.; Barros, Mauro V.; Bata, Iqbal; Batieha, Anwar M.; Baur, Louise A.; Beaglehole, Robert; Ben Romdhane, Habiba; Benet, Mikhail; Benson, Lowell S.; Bernabe-Ortiz, Antonio; Bernotiene, Gailute; Bettiol, Heloisa; Bhagyalaxmi, Aroor; Bharadwaj, Sumit; Bhargava, Santosh K.; Bi, Yufang; Bikbov, Mukharram; Bjerregaard, Peter; Bjertness, Espen; Bjokelund, Cecilia; Blokstra, Anneke; Bo, Simona; Bobak, Martin; Boeing, Heiner; Boggia, Jose G.; Boissonnet, Carlos P.; Bongard, Vanina; Braeckman, Lutgart; Brajkovich, Imperia; Branca, Francesco; Breckenkamp, Juergen; Brenner, Hermann; Brewster, Lizzy M.; Bruno, Graziella; Bueno-de-Mesquita, H. B. (as); Bugge, Anna; Burns, Con; Bursztyn, Michael; de Leon, Antonio Cabrera; Cameron, Christine; Can, Gunay; Candido, Ana Paula C.; Capuano, Vincenzo; Cardoso, Viviane C.; Carlsson, Axel C.; Carvalho, Maria J.; Casanueva, Felipe F.; Casas, Juan-Pablo; Caserta, Carmelo A.; Chamukuttan, Snehalatha; Chan, Angelique W.; Chan, Queenie; Chaturvedi, Himanshu K.; Chaturvedi, Nishi; Chen, Chien-Jen; Chen, Fangfang; Chen, Huashuai; Chen, Shuohua; Chen, Zhengming; Cheng, Ching-Yu; Dekkaki, Imane Cherkaoui; Chetrit, Angela; Chiolero, Arnaud; Chiou, Shu-Ti; Chirita-Emandi, Adela; Cho, Belong; Cho, Yumi; Chudek, Jerzy; Cifkova, Renata; Claessens, Frank; Clays, Els; Concin, Hans; Cooper, Cyrus; Cooper, Rachel; Coppinger, Tara C.; Costanzo, Simona; Cottel, Dominique; Cowell, Chris; Craig, Cora L.; Crujeiras, Ana B.; Cruz, Juan J.; D'Arrigo, Graziella; d'Orsi, Eleonora; Dallongeville, Jean; Damasceno, Albertino; Dankner, Rachel; Dantoft, Thomas M.; Dauchet, Luc; de Backer, Guy; de Gaetano, Giovanni; de Henauw, Stefaan; de Smedt, Delphine; Deepa, Mohan; Dehghan, Abbas; Delisle, Helene; Deschamps, Valerie; Dhana, Klodian; Di Castelnuovo, Augusto F.; Dias-da-Costa, Juvenal Soares; Diaz, Alejandro; Dickerson, Ty T.; Do, Ha T. P.; Dobson, Annette J.; Donfrancesco, Chiara; Donoso, Silvana P.; Doering, Angela; Doua, Kouamelan; Drygas, Wojciech; Dulskiene, Virginija; Dzakula, Aleksandar; Dzerve, Vilnis; Dziankowska-Zaborszczyk, Elzbieta; Eggertsen, Robert; Ekelund, Ulf; El Ati, Jalila; Ellert, Ute; Elosua, Roberto; Erasmus, Rajiv T.; Erem, Cihangir; Eriksen, Louise; Escobedo-de la Pena, Jorge; Evans, Alun; Faeh, David; Fall, Caroline H.; Farzadfar, Farshad; Felix-Redondo, Francisco J.; Ferguson, Trevor S.; Fernandez-Berges, Daniel; Ferrante, Daniel; Ferrari, Marika; Ferreccio, Catterina; Ferrieres, Jean; Finn, Joseph D.; Fischer, Krista; Foeger, Bernhard; Foo, Leng Huat; Forslund, Ann-Sofie; Forsner, Maria; Fortmann, Stephen P.; Fouad, Heba M.; Francis, Damian K.; Franco, Maria do Carmo; Franco, Oscar H.; Frontera, Guillermo; Fuchs, Flavio D.; Fuchs, Sandra C.; Fujita, Yuki; Furusawa, Takuro; Gaciong, Zbigniew; Gareta, Dickman; Garnett, Sarah P.; Gaspoz, Jean-Michel; Gasull, Magda; Gates, Louise; Gavrila, Diana; Geleijnse, Johanna M.; Ghasemian, Anoosheh; Ghimire, Anup; Giampaoli, Simona; Gianfagna, Francesco; Giovannelli, Jonathan; Goldsmith, Rebecca A.; Goncalves, Helen; Gonzalez Gross, Marcela; Gonzalez Rivas, Juan P.; Gottrand, Frederic; Graff-Iversen, Sidsel; Grafnetter, Dusan; Grajda, Aneta; Gregor, Ronald D.; Grodzicki, Tomasz; Grontved, Anders; Gruden, Grabriella; Grujic, Vera; Guan, Ong Peng; Gudnason, Vilmundur; Guerrero, Ramiro; Guessous, Idris; Guimaraes, Andre L.; Gulliford, Martin C.; Gunnlaugsdottir, Johanna; Gunter, Marc; Gupta, Prakash C.; Gureje, Oye; Gurzkowska, Beata; Gutierrez, Laura; Gutzwiller, Felix; Hadaegh, Farzad; Halkjaer, Jytte; Hambleton, Ian R.; Hardy, Rebecca; Harikumar, Rachakulla; Hata, Jun; Hayes, Alison J.; He, Jiang; Hendriks, Marleen Elisabeth; Henriques, Ana; Hernandez Cadena, Leticia; Herqutanto, N. N.; Herrala, Sauli; Heshmat, Ramin; Hihtaniemi, Ilpo Tapani; Ho, Sai Yin; Ho, Suzanne C.; Hobbs, Michael; Hofman, Albert; Dinc, Gonul Horasan; Hormiga, Claudia M.; Horta, Bernardo L.; Houti, Leila; Howitt, Christina; Htay, Thein Thein; Htet, Aung Soe; Hu, Yonghua; Maria Huerta, Jose; Husseini, Abdullatif S.; Huybrechts, Inge; Hwalla, Nahla; Iacoviello, Licia; Iannone, Anna G.; Ibrahim, M. Mohsen; Ikram, M. Arfan; Irazola, Vilma E.; Islam, Muhammad; Ivkovic, Vanja; Iwasaki, Masanori; Jacobs, Jeremy M.; Jafar, Tazeen; Jamrozik, Konrad; Janszky, Imre; Jasienska, Grazyna; Jelakovic, Bojan; Jiang, Chao Qiang; Johansson, Mattias; Jonas, Jost B.; Jorgensen, Torben; Joshi, Pradeep; Juolevi, Anne; Jurak, Gregor; Juresa, Vesna; Kaaks, Rudolf; Kafatos, Anthony; Kalter-Leibovici, Ofra; Kamaruddin, Nor Azmi; Kasaeian, Amir; Katz, Joanne; Kauhanen, Jussi; Kaur, Prabhdeep; Kavousi, Maryam; Kazakbaeva, Gyulli; Keil, Ulrich; Boker, Lital Keinan; Keinanen-Kiukaanniemi, Sirkka; Kelishadi, Roya; Kemper, Han C. G.; Kersting, Mathilde; Key, Timothy; Khader, Yousef Saleh; Khalili, Davood; Khang, Young-Ho; Khaw, Kay-Tee; Kiechl, Stefan; Killewo, Japhet; Kim, Jeongseon; Klumbiene, Jurate; Kolle, Elin; Kolsteren, Patrick; Korrovits, Paul; Koskinen, Seppo; Kouda, Katsuyasu; Koziel, Slawomir; Kristensen, Peter Lund; Krokstad, Steinar; Kromhout, Daan; Kruger, Herculina S.; Kubinova, Ruzena; Kuciene, Renata; Kuh, Diana; Kujala, Urho M.; Kula, Krzysztof; Kulaga, Zbigniew; Kumar, R. Krishna; Kurjata, Pawel; Kusuma, Yadlapalli S.; Kuulasmaa, Kari; Kyobutungi, Catherine; Lachat, Carl; Landrove, Orlando; Lanska, Vera; Lappas, Georg; Larijani, Bagher; Laugsand, Lars E.; Le, Nguyen Bao Khanh; Le, Tuyen D.; Leclercq, Catherine; Lee, Jeannette; Lee, Jeonghee; Lehtimaki, Terho; Lekhraj, Rampal; Leon-Munoz, Luz M.; Levitt, Naomi S.; Li, Yanping; Lilly, Christa L.; Lim, Wei-Yen; Fernanda Lima-Costa, M.; Lin, Hsien-Ho; Lin, Xu; Linneberg, Allan; Lissner, Lauren; Litwin, Mieczyslaw; Lorbeer, Roberto; Lotufo, Paulo A.; Eugenio Lozano, Jose; Luksiene, Dalia; Lundqvist, Annamari; Lunet, Nuno; Lytsy, Per; Ma, Guansheng; Ma, Jun; Machado-Coelho, George L. L.; Machi, Suka; Maggi, Stefania; Magliano, Dianna J.; Majer, Marjeta; Makdisse, Marcia; Malekzadeh, Reza; Malhotra, Rahul; Rao, Kodavanti Mallikharjuna; Malyutina, Sofia; Manios, Yannis; Mann, Jim I.; Manzato, Enzo; Margozzini, Paula; Marques-Vidal, Pedro; Marrugat, Jaume; Martorell, Reynaldo; Mathiesen, Ellisiv B.; Matijasevich, Alicia; Matsha, Tandi E.; Mbanya, Jean Claude N.; Posso, Anselmo J. Mc Donald; McFarlane, Shelly R.; McGarvey, Stephen T.; McLachlan, Stela; McLean, Rachael M.; McNulty, Breige A.; Khir, Amir Sharifuddin Md; Mediene-Benchekor, Sounnia; Medzioniene, Jurate; Meirhaeghe, Aline; Meisinger, Christa; Menezes, Ana Maria B.; Menon, Geetha R.; Meshram, Indrapal I.; Metspalu, Andres; Mi, Jie; Mikkel, Kairit; Miller, Jody C.; Francisco Miquel, Juan; Jaime Miranda, J.; Misigoj-Durakovic, Marjeta; Mohamed, Mostafa K.; Mohammad, Kazem; Mohammadifard, Noushin; Mohan, Viswanathan; Yusoff, Muhammad Fadhli Mohd; Moller, Niels C.; Molnar, Denes; Momenan, Amirabbas; Monyeki, Kotsedi Daniel K.; Moreira, Leila B.; Morejon, Alain; Moreno, Luis A.; Morgan, Karen; Moschonis, George; Mossakowska, Malgorzata; Mostafa, Aya; Mota, Jorge; Motlagh, Mohammad Esmaeel; Motta, Jorge; Muiesan, Maria L.; Mueller-Nurasyid, Martina; Murphy, Neil; Mursu, Jaakko; Musil, Vera; Nagel, Gabriele; Naidu, Balkish M.; Nakamura, Harunobu; Namsna, Jana; Nang, Ei Ei K.; Nangia, Vinay B.; Narake, Sameer; Maria Navarrete-Munoz, Eva; Ndiaye, Ndeye Coumba; Neal, William A.; Nenko, Ilona; Nervi, Flavio; Nguyen, Nguyen D.; Nguyen, Quang Ngoc; Nieto-Martinez, Ramfis E.; Niiranen, Teemu J.; Ning, Guang; Ninomiya, Toshiharu; Nishtar, Sania; Noale, Marianna; Noboa, Oscar A.; Noorbala, Ahmad Ali; Norat, Teresa; Noto, Davide; Al Nsour, Mohannad; O'Reilly, Dermot; Oh, Kyungwon; Olinto, Maria Teresa A.; Oliveira, Isabel O.; Omar, Mohd Azahadi; Onat, Altan; Ordunez, Pedro; Osmond, Clive; Ostojic, Sergej M.; Otero, Johanna A.; Overvad, Kim; Owusu-Dabo, Ellis; Paccaud, Fred Michel; Padez, Cristina; Pahomova, Elena; Pajak, Andrzej; Palli, Domenico; Palmieri, Luigi; Panda-Jonas, Songhomitra; Panza, Francesco; Papandreou, Dimitrios; Parnell, Winsome R.; Parsaeian, Mahboubeh; Pecin, Ivan; Pednekar, Mangesh S.; Peer, Nasheeta; Peeters, Petra H.; Peixoto, Sergio Viana; Pelletier, Catherine; Peltonen, Markku; Pereira, Alexandre C.; Marina Perez, Rosa; Peters, Annette; Petkeviciene, Janina; Pham, Son Thai; Pigeot, Iris; Pikhart, Hynek; Pilav, Aida; Pilotto, Lorenza; Pitakaka, Freda; Plans-Rubio, Pedro; Polakowska, Maria; Polasek, Ozren; Porta, Miquel; Portegies, Marileen L. P.; Pourshams, Akram; Pradeepa, Rajendra; Prashant, Mathur; Price, Jacqueline F.; Puiu, Maria; Punab, Margus; Qasrawi, Radwan F.; Qorbani, Mostafa; Radic, Ivana; Radisauskas, Ricardas; Rahman, Mahfuzar; Raitakari, Olli; Raj, Manu; Rao, Sudha Ramachandra; Ramos, Elisabete; Rampal, Sanjay; Rangel Reina, Daniel A.; Rasmussen, Finn; Redon, Josep; Reganit, Paul Ferdinand M.; Ribeiro, Robespierre; Riboli, Elio; Rigo, Fernando; de Wit, Tobias F. Rinke; Ritti-Dias, Raphael M.; Robinson, Sian M.; Robitaille, Cynthia; Rodriguez-Artalejo, Fernando; Rodriguez-Villamizar, Laura A.; Rojas-Martinez, Rosalba; Rosengren, Annika; Rubinstein, Adolfo; Rui, Ornelas; Sandra Ruiz-Betancourt, Blanca; Russo Horimoto, Andrea R. V.; Rutkowski, Marcin; Sabanayagam, Charumathi; Sachdev, Harshpal S.; Saidi, Olfa; Sakarya, Sibel; Salanave, Benoit; Salazar Martinez, Eduardo; Salmeron, Diego; Salomaa, Veikko; Salonen, Jukka T.; Salvetti, Massimo; Sanchez-Abanto, Jose; Sans, Susana; Santos, Diana; Santos, Ina S.; dos Santos, Renata Nunes; Santos, Rute; Saramies, Jouko L.; Sardinha, Luis B.; Margolis, Giselle Sarganas; Sarrafzadegan, Nizal; Saum, Kai-Uwe; Savva, Savvas C.; Scazufca, Marcia; Schargrodsky, Herman; Schneider, Ione J.; Schultsz, Constance; Schutte, Aletta E.; Sen, Abhijit; Senbanjo, Idowu O.; Sepanlou, Sadaf G.; Sharma, Sanjib K.; Shaw, Jonathan E.; Shibuya, Kenji; Shin, Dong Wook; Shin, Youchan; Siantar, Rosalynn; Sibai, Abla M.; Santos Silva, Diego Augusto; Simon, Mary; Simons, Judith; Simons, Leon A.; Sjotrom, Michael; Skovbjerg, Sine; Slowikowska-Hilczer, Jolanta; Slusarczyk, Przemyslaw; Smith, Margaret C.; Snijder, Marieke B.; So, Hung-Kwan; Sobngwi, Eugene; Soderberg, Stefan; Solfrizzi, Vincenzo; Sonestedt, Emily; Song, Yi; Sorensen, Thorkild I. A.; Jerome, Charles Sossa; Soumare, Aicha; Staessen, Jan A.; Starc, Gregor; Stathopoulou, Maria G.; Stavreski, Bill; Steene-Johannessen, Jostein; Stehle, Peter; Stein, Aryeh D.; Stergiou, George S.; Stessman, Jochanan; Stieber, Jutta; Stoeckl, Doris; Stocks, Tanja; Stokwiszewski, Jakub; Stronks, Karien; Strufaldi, Maria Wany; Sun, Chien-An; Sung, Yn-Tz; Suriyawongpaisal, Paibul; Sy, Rody G.; Tai, E. Shyong; Tammesoo, Mari-Liis; Tamosiunas, Abdonas; Tang, Line; Tang, Xun; Tanser, Frank; Tao, Yong; Tarawneh, Mohammed Rasoul; Tarqui-Mamani, Carolina B.; Taylor, Anne; Theobald, Holger; Thijs, Lutgarde; Thuesen, Betina H.; Tjonneland, Anne; Tolonen, Hanna K.; Topbas, Murat; Topor-Madry, Roman; Jose Tormo, Maria; Torrent, Maties; Traissac, Pierre; Trichopoulos, Dimitrios; Trichopoulou, Antonia; Trinh, Oanh T. H.; Trivedi, Atul; Tshepo, Lechaba; Tulloch-Reid, Marshall K.; Tuomainen, Tomi-Pekka; Turley, Maria L.; Tynelius, Per; Tzourio, Christophe; Ueda, Peter; Ugel, Eunice; Ulmer, Hanno; Uusitalo, Hannu M. T.; Valdivia, Gonzalo; Valvi, Damaskini; van der Schouw, Yvonne T.; van Herck, Koen; van Rossem, Lenie; van Valkengoed, Irene G. M.; Vanderschueren, Dirk; Vanuzzo, Diego; Vatten, Lars; Vega, Tomas; Velasquez-Melendez, Gustavo; Veronesi, Giovanni; Verschuren, W. M. Monique; Verstraeten, Roosmarijn; Victora, Cesar G.; Viet, Lucie; Viikari-Juntura, Eira; Vineis, Paolo; Vioque, Jesus; Virtanen, Jyrki K.; Visvikis-Siest, Sophie; Viswanathan, Bharathi; Vollenweider, Peter; Vrdoljak, Ana; Vrijheid, Martine; Wade, Alisha N.; Wagner, Aline; Walton, Janette; Mohamud, Wan Nazaimoon Wan; Wang, Ming-Dong; Wang, Qian; Wang, Ya Xing; Wannamethee, S. Goya; Wareham, Nicholas; Wederkopp, Niels; Weerasekera, Deepa; Whincup, Peter H.; Widhalm, Kurt; Widyahening, Indah S.; Wiecek, Andrzej; Wijga, Alet H.; Wilks, Rainford J.; Willeit, Peter; Williams, Emmanuel A.; Wilsgaard, Tom; Wojtyniak, Bogdan; Wong, Tien Yin; Wong-McClure, Roy A.; Woo, Jean; Wu, Aleksander Giwercman; Wu, Frederick C.; Wu, Shou Ling; Xu, Haiquan; Yan, Weili; Yang, Xiaoguang; Ye, Xingwang; Yiallouros, Panayiotis K.; Yoshihara, Akihiro; Younger-Coleman, Novie O.; Yusoff, Ahmad F.; Zambon, Sabina; Zdrojewski, Tomasz; Zeng, Yi; Zhao, Dong; Zhao, Wenhua; Zheng, Yingffeng; Zhu, Dan; Zimmermann, Esther; Zuniga Cisneros, Julio

    2017-01-01

    Background Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood

  11. Worldwide trends in blood pressure from 1975 to 2015 : a pooled analysis of 1479 population-based measurement studies with 19·1 million participants

    NARCIS (Netherlands)

    Zhou, B.; Bentham, James; Di Cesare, Mariachiara; Bixby, Honor; Danaei, Goodarz; Cowan, Melanie J.; Paciorek, Christopher J.; Singh, Gitanjali; Hajifathalian, Kaveh; Bennett, James E.; Taddei, Cristina; Bilano, Ver; Carrillo-Larco, Rodrigo M.; Djalalinia, Shirin; Khatibzadeh, Shahab; Lugero, Charles; Peykari, Niloofar; Zhang, Wan Zhu; Lu, Yuan; Stevens, Gretchen A.; Riley, Leanne M.; Bovet, Pascal; Elliott, Paul; Gu, Dongfeng; Ikeda, Nayu; Jackson, Rod T.; Joffres, Michel; Kengne, Andre Pascal; Laatikainen, Tiina; Lam, Tai Hing; Laxmaiah, Avula; Liu, Jing; Miranda, J. Jaime; Mondo, Charles K.; Neuhauser, Hannelore K.; Sundström, Johan; Smeeth, Liam; Sorić, Maroje; Woodward, Mark; Ezzati, Majid; Abarca-Gómez, Leandra; Abdeen, Ziad A.; Rahim, Hanan Abdul; Abu-Rmeileh, Niveen M.; Acosta-Cazares, Benjamin; Adams, Robert; Aekplakorn, Wichai; Afsana, Kaosar; Aguilar-Salinas, Carlos A.; Agyemang, Charles; Ahmadvand, Alireza; Ahrens, Wolfgang; Al Raddadi, Rajaa; Al Woyatan, Rihab; Ali, Mohamed M.; Alkerwi, Ala'a; Aly, Eman; Amouyel, Philippe; Amuzu, Antoinette; Andersen, Lars Bo; Anderssen, Sigmund A.; Ängquist, Lars; Anjana, Ranjit Mohan; Ansong, Daniel; Aounallah-Skhiri, Hajer; Araújo, Joana; Ariansen, Inger; Aris, Tahir; Arlappa, Nimmathota; Aryal, Krishna; Arveiler, Dominique; Assah, Felix K.; Assunção, Maria Cecília F.; Avdicová, Mária; Azevedo, Ana; Azizi, Fereidoun; Babu, Bontha V.; Bahijri, Suhad; Balakrishna, Nagalla; Bandosz, Piotr; Banegas, José R.; Barbagallo, Carlo M.; Barceló, Alberto; Barkat, Amina; Barros, Aluisio J.D.; Barros, Mauro V.; Bata, Iqbal; Batieha, Anwar M.; Baur, Louise A.; Beaglehole, Robert; Romdhane, Habiba Ben; Benet, Mikhail; Benson, Lowell S.; Bernabe-Ortiz, Antonio; Bernotiene, Gailute; Bettiol, Heloisa; Bhagyalaxmi, Aroor; Bharadwaj, Sumit; Bhargava, Santosh K.; Bi, Yufang; Bikbov, Mukharram; Bjerregaard, Peter; Bjertness, Espen; Björkelund, Cecilia; Blokstra, Anneke; Bo, Simona; Bobak, Martin; Boeing, Heiner; Boggia, Jose G.; Boissonnet, Carlos P.; Bongard, Vanina; Braeckman, Lutgart; Brajkovich, Imperia; Branca, Francesco; Breckenkamp, Juergen; Brenner, Hermann; Brewster, Lizzy M.; Bruno, Graziella; Bueno-de-Mesquita, H B As; Bugge, Anna; Burns, Con; Bursztyn, Michael; de León, Antonio Cabrera; Cacciottolo, Joseph; Cameron, Christine; Can, Günay; Cândido, Ana Paula C.; Capuano, Vincenzo; Cardoso, Viviane C.; Carlsson, Axel C.; Carvalho, Maria J.; Casanueva, Felipe F.; Casas, Juan-Pablo; Caserta, Carmelo A.; Chamukuttan, Snehalatha; Chan, Angelique W.; Chan, Queenie; Chaturvedi, Himanshu K.; Chaturvedi, Nishi; Chen, Chien-Jen; Chen, Fangfang; Chen, Huashuai; Chen, Shuohua; Chen, Zhengming; Cheng, Yu Ching; Dekkaki, Imane Cherkaoui; Chetrit, Angela; Chiolero, Arnaud; Chiou, Shu Ti; Chirita-Emandi, Adela; Cho, Belong; Cho, Yumi; Chudek, Jerzy; Cifkova, Renata; Claessens, Frank; Clays, Els; Concin, Hans; Cooper, Cyrus; Cooper, Rachel; Coppinger, Tara C.; Costanzo, Simona; Cottel, Dominique; Cowell, Chris; Craig, Cora L.; Crujeiras, Ana B.; Cruz, Juan J.; D'Arrigo, Graziella; d'Orsi, Eleonora; Dallongeville, Jean; Damasceno, Albertino; Danaei, Goodarz; Dankner, Rachel; Dantoft, Thomas M.; Dauchet, Luc; De Backer, Guy; De Bacquer, Dirk; de Gaetano, Giovanni; De Henauw, Stefaan; De Smedt, Delphine; Deepa, Mohan; Dehghan, Abbas; Delisle, Hélène; Deschamps, Valérie; Dhana, Klodian; Di Castelnuovo, Augusto F.; Dias-da-Costa, Juvenal Soares; Diaz, Alejandro; Dickerson, Ty T.; Do, Ha T.P.; Dobson, Annette J.; Donfrancesco, Chiara; Donoso, Silvana P.; Döring, Angela; Doua, Kouamelan; Drygas, Wojciech; Dulskiene, Virginija; Džakula, Aleksandar; Dzerve, Vilnis; Dziankowska-Zaborszczyk, Elzbieta; Eggertsen, Robert; Ekelund, Ulf; El Ati, Jalila; Ellert, Ute; Elliott, Paul; Elosua, Roberto; Erasmus, Rajiv T.; Erem, Cihangir; Eriksen, Louise; Escobedo-de la Peña, Jorge; Evans, Alun; Faeh, David; Fall, Caroline H.; Farzadfar, Farshad; Felix-Redondo, Francisco J.; Ferguson, Trevor S.; Fernández-Bergés, Daniel; Ferrante, Daniel; Ferrari, Marika; Ferreccio, Catterina; Ferrieres, Jean; Finn, Joseph D.; Fischer, Krista; Föger, Bernhard; Foo, Leng Huat; Forslund, Ann Sofie; Forsner, Maria; Fortmann, Stephen P.; Fouad, Heba M.; Francis, Damian K.; do Carmo Franco, Maria; Franco, Oscar H.; Frontera, Guillermo; Fuchs, Flavio D.; Fuchs, Sandra C.; Fujita, Yuki; Furusawa, Takuro; Gaciong, Zbigniew; Gareta, Dickman; Garnett, Sarah P.; Gaspoz, Jean-Michel; Gasull, Magda; Gates, Louise; Gavrila, Diana; Geleijnse, Johanna M.; Ghasemian, Anoosheh; Ghimire, Anup; Giampaoli, Simona; Gianfagna, Francesco; Giovannelli, Jonathan; Goldsmith, Rebecca A.; Gonçalves, Helen; Gross, Marcela Gonzalez; González Rivas, Juan P.; Gottrand, Frederic; Graff-Iversen, Sidsel; Grafnetter, Dušan; Grajda, Aneta; Gregor, Ronald D.; Grodzicki, Tomasz; Grøntved, Anders; Gruden, Grabriella; Grujic, Vera; Gu, Dongfeng; Guan, Ong Peng; Gudnason, Vilmundur; Guerrero, Ramiro; Guessous, Idris; Guimaraes, Andre L.; Gulliford, Martin C.; Gunnlaugsdottir, Johanna; Gunter, Marc J.; Gupta, Prakash C.; Gureje, Oye; Gurzkowska, Beata; Gutierrez, Laura; Gutzwiller, Felix; Hadaegh, Farzad; Halkjær, Jytte; Hambleton, Ian R.; Hardy, Rebecca; Harikumar, Rachakulla; Hata, Jun; Hayes, Alison J.; He, Jiang; Hendriks, Marleen Elisabeth; Henriques, Ana; Cadena, Leticia Hernandez; Herrala, Sauli; Heshmat, Ramin; Hihtaniemi, Ilpo Tapani; Ho, Sai Yin; Ho, Suzanne C.; Hobbs, Michael; Hofman, Albert; Dinc, Gonul Horasan; Hormiga, Claudia M.; Horta, Bernardo Lessa; Houti, Leila; Howitt, Christina; Htay, Thein Thein; Htet, Aung Soe; Hu, Yonghua; Huerta, José María; Husseini, Abdullatif S.; Huybrechts, Inge; Hwalla, Nahla; Iacoviello, Licia; Iannone, Anna G.; Ibrahim, M. Mohsen; Ikram, M. Arfan; Irazola, Vilma E.; Islam, Muhammad; Ivkovic, Vanja; Iwasaki, Masanori; Jackson, Rod T.; Jacobs, Jeremy M.; Jafar, Tazeen; Jamrozik, Konrad; Janszky, Imre; Jasienska, Grazyna; Jelakovic, Bojan; Jiang, Chao Qiang; Joffres, Michel; Johansson, Mattias; Jonas, Jost B; Jørgensen, Torben; Joshi, Pradeep; Juolevi, Anne; Jurak, Gregor; Jureša, Vesna; Kaaks, Rudolf; Kafatos, Anthony; Kalter-Leibovici, Ofra; Kamaruddin, Nor Azmi; Kasaeian, Amir; Katz, Joanne; Kauhanen, Jussi; Kaur, Prabhdeep; Kavousi, Maryam; Kazakbaeva, Gyulli; Keil, Ulrich; Boker, Lital Keinan; Keinänen-Kiukaanniemi, Sirkka; Kelishadi, Roya; Kemper, Han C.G.; Kengne, Andre Pascal; Kersting, Mathilde; Key, Timothy J.; Khader, Yousef Saleh; Khalili, Davood; Khang, Young Ho; Khaw, Kay Tee; Kiechl, Stefan; Killewo, Japhet; Kim, Jeongseon; Klumbiene, Jurate; Kolle, Elin; Kolsteren, Patrick; Korrovits, Paul; Koskinen, Seppo; Kouda, Katsuyasu; Koziel, Slawomir; Kristensen, Peter Lund; Krokstad, Steinar; Kromhout, Daan; Kruger, Herculina S.; Kubinova, Ruzena; Kuciene, Renata; Kuh, Diana; Kujala, Urho M.; Kula, Krzysztof; Kulaga, Zbigniew; Krishna Kumar, R.; Kurjata, Pawel; Kusuma, Yadlapalli S.; Kuulasmaa, Kari; Kyobutungi, Catherine; Laatikainen, Tiina; Lachat, Carl; Lam, Tai Hing; Landrove, Orlando; Lanska, Vera; Lappas, Georg; Larijani, Bagher; Laugsand, Lars E.; Laxmaiah, Avula; Le Nguyen Bao, Khanh; Le, Tuyen D.; Leclercq, Catherine; Lee, Jeannette; Lee, Jeonghee; Lehtimäki, Terho; Lekhraj, Rampal; León-Muñoz, Luz M.; Levitt, Naomi S.; Li, Yanping; Lilly, Christa L.; Lim, Wei-Yen; Lima-Costa, M. Fernanda; Lin, Hsien Ho; Lin, Xu; Linneberg, Allan; Lissner, Lauren; Litwin, Mieczyslaw; Lorbeer, Roberto; Lotufo, Paulo A.; Lozano, José Eugenio; Luksiene, Dalia; Lundqvist, Annamari; Lunet, Nuno; Lytsy, Per; Ma, Guansheng; Ma, Jun; Machado-Coelho, George L.L.; Machi, Suka; Maggi, Stefania; Magliano, Dianna J.; Majer, Marjeta; Makdisse, Marcia; Malekzadeh, Reza; Malhotra, Rahul; Rao, Kodavanti Mallikharjuna; Malyutina, Sofia; Manios, Yannis; Mann, Jim I.; Manzato, Enzo; Margozzini, Paula; Marques-Vidal, Pedro; Marrugat, Jaume; Martorell, Reynaldo; Mathiesen, Ellisiv B.; Matijasevich, Alicia; Matsha, Tandi E.; Mbanya, Jean Claude N.; McDonald Posso, Anselmo J.; McFarlane, Shelly R.; McGarvey, Stephen T.; McLachlan, Stela; McLean, Rachael M.; McNulty, Breige A.; MdKhir, Amir Sharifuddin; Mediene-Benchekor, Sounnia; Medzioniene, Jurate; Meirhaeghe, Aline; Meisinger, Christa; Menezes, Ana Maria B.; Menon, Geetha R.; Meshram, Indrapal I.; Metspalu, Andres; Mi, Jie; Mikkel, Kairit; Miller, Jody C.; Miquel, Juan-Francisco; Mišigoj-Durakovic, Marjeta; Mohamed, Mostafa K.; Mohammad, Kazem; Mohammadifard, Noushin; Mohan, Viswanathan; Mohd Yusoff, Muhammad Fadhli; Møller, Niels C.; Molnár, Dénes; Momenan, Amirabbas; Mondo, Charles K.; Monyeki, Kotsedi Daniel K.; Moreira, Leila B.; Morejon, Alain; Moreno, Luis A.; Morgan, Karen; Moschonis, George; Mossakowska, Malgorzata; Mota, Jorge; Mostafa, Aya; Motlagh, Mohammad Esmaeel; Motta, Jorge; Muiesan, Maria L.; Müller-Nurasyid, Martina; Murphy, Neil; Mursu, Jaakko; Musil, Vera; Nagel, Gabriele; Naidu, Balkish M.; Nakamura, Harunobu; Námešná, Jana; Nang, Ei Ei K.; Nangia, Vinay B.; Narake, Sameer; Navarrete-Muñoz, Eva Maria; Ndiaye, Ndeye Coumba; Neal, William A.; Nenko, Ilona; Nervi, Flavio; Nguyen, Nguyen D.; Nguyen, Quang Ngoc; Nieto-Martínez, Ramfis E.; Niiranen, Teemu J.; Ning, Guang; Ninomiya, Toshiharu; Nishtar, Sania; Noale, Marianna; Noboa, Oscar A.; Noorbala, Ahmad Ali; Norat, Teresa; Noto, Davide; Al Nsour, Mohannad; O'Reilly, Dermot; Oh, Kyungwon; Olinto, Maria Teresa A.; Oliveira, Isabel O.; Omar, Mohd Azahadi; Onat, Altan; Ordunez, Pedro; Osmond, Clive; Ostojic, Sergej M.; Otero, Johanna A.; Overvad, Kim; Owusu-Dabo, Ellis; Paccaud, Fred Michel; Padez, Cristina; Pahomova, Elena; Pajak, Andrzej; Palli, Domenico; Palmieri, Luigi; Panda-Jonas, Songhomitra; Panza, Francesco; Papandreou, Dimitrios; Parnell, Winsome R.; Parsaeian, Mahboubeh; Pecin, Ivan; Pednekar, Mangesh S.; Peer, Nasheeta; Peeters, Petra H.; Peixoto, Sergio Viana; Pelletier, Catherine; Peltonen, Markku; Pereira, Alexandre C.; Pérez, Rosa Marina; Peters, Annette; Petkeviciene, Janina; Pham, Son Thai; Pigeot, Iris; Pikhart, Hynek; Pilav, Aida; Pilotto, Lorenza; Pitakaka, Freda; Plans-Rubió, Pedro; Polakowska, Maria; Polašek, Ozren; Porta, Miquel; Portegies, Marileen L.P.; Pourshams, Akram; Pradeepa, Rajendra; Prashant, Mathur; Price, Jacqueline F.; Puiu, Maria; Punab, Margus; Qasrawi, Radwan F.; Qorbani, Mostafa; Radic, Ivana; Radisauskas, Ricardas; Rahman, Mahfuzar; Raitakari, Olli T.; Raj, Manu; Rao, Sudha Ramachandra; Ramachandran, Ambady; Ramos, Elisabete; Rampal, Sanjay; Rangel Reina, Daniel A.; Rasmussen, Finn; Redon, Josep; Reganit, Paul Ferdinand M.; Ribeiro, Robespierre; Riboli, Elio; Rigo, Fernando; Rinke de Wit, Tobias F.; Ritti-Dias, Raphael M.; Robinson, Sian M.; Robitaille, Cynthia; Rodríguez-Artalejo, Fernando; del Cristo Rodriguez-Perez, María; Rodríguez-Villamizar, Laura A.; Rojas-Martinez, Rosalba; Rosengren, Annika; Rubinstein, Adolfo; Rui, Ornelas; Ruiz-Betancourt, Blanca Sandra; Russo Horimoto, Andrea R.V.; Rutkowski, Marcin; Sabanayagam, Charumathi; Sachdev, Harshpal S.; Saidi, Olfa; Sakarya, Sibel; Salanave, Benoit; Martinez, Eduardo Salazar; Salmerón, Diego; Salomaa, Veikko; Salonen, Jukka T.; Salvetti, Massimo; Sánchez-Abanto, Jose; Sans, Susana; Santos, Diana; Santos, Ina S.; dos Santos, Renata Nunes; Santos, Rute; Saramies, Jouko L.; Sardinha, Luis B.; Margolis, Giselle Sarganas; Sarrafzadegan, Nizal; Saum, Kai Uwe; Savva, Savvas C.; Scazufca, Marcia; Schargrodsky, Herman; Schneider, Ione J.; Schultsz, Constance; Schutte, Aletta E.; Schutte, Aletta E.; Sen, Abhijit; Senbanjo, Idowu O.; Sepanlou, Sadaf G.; Sharma, Sanjib K.; Shaw, Jonathan E.; Shibuya, Kenji; Shin, Dong Wook; Shin, Youchan; Siantar, Rosalynn; Sibai, Abla M.; Santos Silva, Diego Augusto; Simon, Mary; Simons, Judith; Simons, Leon A; Sjöström, Michael; Skovbjerg, Sine; Slowikowska-Hilczer, Jolanta; Slusarczyk, Przemyslaw; Smith, Margaret C.; Snijder, Marieke B.; So, Hung Kwan; Sobngwi, Eugène; Söderberg, Stefan; Solfrizzi, Vincenzo; Sonestedt, Emily; Song, Yi; Sørensen, Thorkild I A; Soric, Maroje; Jérome, Charles Sossa; Soumare, Aicha; Staessen, Jan A.; Starc, Gregor; Stathopoulou, Maria G.; Stavreski, Bill; Steene-Johannessen, Jostein; Stehle, Peter; Stein, Aryeh D.; Stergiou, George S.; Stessman, Jochanan; Stieber, Jutta; Stöckl, Doris; Stocks, Tanja; Stokwiszewski, Jakub; Stronks, Karien; Strufaldi, Maria Wany; Sun, Chien An; Sung, Yn Tz; Suriyawongpaisal, Paibul; Sy, Rody G.; Tai, E. Shyong; Tammesoo, Mari Liis; Tamosiunas, Abdonas; Tang, Line; Tang, Xun; Tao, Yong; Tanser, Frank; Tarawneh, Mohammed Rasoul; Tarqui-Mamani, Carolina B.; Taylor, Anne; Theobald, Holger; Thijs, Lutgarde; Thuesen, Betina Heinsbek; Tjonneland, Anne; Tolonen, Hanna K.; Tolstrup, Janne S.; Topbas, Murat; Topór-Madry, Roman; Tormo, María José; Torrent, Maties; Traissac, Pierre; Trichopoulos, Dimitrios; Trichopoulou, Antonia; Trinh, Oanh T.H.; Trivedi, Atul; Tshepo, Lechaba; Tulloch-Reid, Marshall K.; Tuomainen, Tomi-Pekka; Tuomilehto, Jaakko; Turley, Maria L.; Tynelius, Per; Tzourio, Christophe; Ueda, Peter; Ugel, Eunice; Ulmer, Hanno; Uusitalo, Hannu M.T.; Valdivia, Gonzalo; Valvi, Damaskini; van der Schouw, Yvonne T.; Van Herck, Koen; van Rossem, Lenie; Van Valkengoed, Irene G M; Vanderschueren, Dirk; Vanuzzo, Diego; Vatten, Lars; Vega, Tomas; Velasquez-Melendez, Gustavo; Veronesi, Giovanni; Verschuren, W. M.Monique; Verstraeten, Roosmarijn; Victora, Cesar G.; Viet, Lucie; Viikari-Juntura, Eira; Vineis, Paolo; Vioque, Jesus; Virtanen, Jyrki K.; Visvikis-Siest, Sophie; Viswanathan, Bharathi; Vollenweider, Peter; Voutilainen, Sari; Vrdoljak, Ana; Vrijheid, Martine; Wade, Alisha N.; Wagner, Aline; Walton, Janette; Wan Mohamud, Wan Nazaimoon; Wang, Ming Dong; Wang, Qian; Wang, Ya Xing; Wannamethee, S. Goya; Wareham, Nicholas J.; Wederkopp, Niels; Weerasekera, Deepa; Whincup, Peter H.; Widhalm, Kurt; Widyahening, Indah S.; Wijga, Alet H; Wiecek, Andrzej; Wilks, Rainford J.; Willeit, Johann; Willeit, Peter; Williams, Emmanuel A.; Wilsgaard, Tom; Wojtyniak, Bogdan; Wong, Tien-Yin; Wong-McClure, Roy A.; Woo, Jean; Woodward, Mark; Woodward, Mark; Wu, Aleksander Giwercman; Wu, Frederick C.; Wu, Shou Ling; Xu, Haiquan; Yan, Weili; Yang, Xiaoguang; Ye, Xingwang; Yiallouros, Panayiotis K.; Yoshihara, Akihiro; Younger-Coleman, Novie O.; Yusoff, Ahmad F.; Yusoff, Muhammad Fadhli M.; Zambon, Sabina; Zdrojewski, Tomasz; Zeng, Yi-Xin; Zeng, Yi-Xin; Zhao, Dong; Zhao, Wenhua; Zheng, Yingffeng; Zimmermann, Esther; Cisneros, Julio Zuñiga; Zhu, Dan

    2017-01-01

    Background Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood

  12. Worldwide trends in blood pressure from 1975 to 2015 : a pooled analysis of 1479 population-based measurement studies with 19.1 million participants

    NARCIS (Netherlands)

    Zhou, Bin; Bentham, James; Di Cesare, Mariachiara; Bixby, Honor; Danaei, Goodarz; Cowan, Melanie J.; Paciorek, Christopher J.; Singh, Gitanjali M; Hajifathalian, Kaveh; Bennett, James E.; Taddei, Cristina; Bilano, Ver; Carrillo-Larco, Rodrigo M.; Djalalinia, Shirin; Khatibzadeh, Shahab; Lugero, Charles; Peykari, Niloofar; Zhang, Wan Zhu; Lu, Yuan; Stevens, Gretchen A.; Riley, Leanne M.; Bovet, Pascal; Elliott, Paul; Gu, Dongfeng; Ikeda, Nayu; Jackson, Rod T.; Joffres, Michel; Kengne, Andre-Pascal; Laatikainen, Tiina; Lam, Tai Hing; Laxmaiah, Avula; Liu, Jing; Miranda, J. Jaime; Mondo, Charles K.; Neuhauser, Hannelore K.; Sundstrom, Johan; Smeeth, Liam; Soric, Maroje; Woodward, Mark; Ezzati, Majid; Abarca-Gomez, Leandra; Abdeen, Ziad A.; Rahim, Hanan Abdul; Abu-Rmeileh, Niveen Me; Acosta-Cazares, Benjamin; Adams, Robert; Aekplakorn, Wichai; Afsana, Kaosar; Aguilar-Salinas, Carlos A; Kromhout, Daan

    2017-01-01

    Background Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood

  13. Relationship of central and peripheral blood pressure to left ventricular mass in hypertensive patients.

    Science.gov (United States)

    Pérez-Lahiguera, Francisco J; Rodilla, Enrique; Costa, Jose A; Gonzalez, Carmen; Martín, Joaquin; Pascual, Jose M

    2012-12-01

    The purpose of the present study was to assess the relationship of central and peripheral blood pressure to left ventricular mass. Cross-sectional study that included 392 never treated hypertensive individuals. Measurement of office, 24-h ambulatory, and central blood pressure (obtained using applanation tonometry) and determination of left ventricular mass by echocardiography were performed in all patients. In a multiple regression analysis, with adjustment for age, gender and metabolic syndrome, 24-h blood pressure was more closely related to ventricular mass than the respective office and central blood pressures. Systolic blood pressures always exhibited a higher correlation than diastolic blood pressures in all 3 determinations. The correlation between left ventricular mass index and 24-h systolic blood pressure was higher than that of office (P<.002) or central systolic blood pressures (P<.002). Changes in 24-h systolic blood pressure caused the greatest variations in left ventricular mass index (P<.001). In our population of untreated middle-aged hypertensive patients, left ventricular mass index is more closely related to 24-h ambulatory blood pressure than to office or central blood pressure. Central blood pressure does not enable us to better identify patients with left ventricular hypertrophy. Copyright © 2012 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  14. Home readings of blood pressure in assessment of hypertensive subjects

    DEFF Research Database (Denmark)

    Nielsen, P.E.; Myschetzky, P; Andersen, A R

    1986-01-01

    Out-patient clinic blood pressure (OPC-BP) was compared to home blood pressure (Home-BP) measured three times daily during a two week period in 122 consecutively referred hypertensive subjects. A semi-automatic device (TM-101) including a microphone for detection of Korotkoff-sounds, self......-deflation of cuff pressure and digital display of blood pressure was used. Mean difference between OPC-BP and Home-BP was systolic +13 mm Hg (range -21 - +100 mg Hg) and diastolic +5 mm Hg (range -27 - +36 mm Hg). Although a significant correlation could be demonstrated between Home-BP and OPC-BP, the inter...

  15. Blood pressure in Afghan male immigrants to Denmark

    DEFF Research Database (Denmark)

    Asmar, Ali; Bülow, Jens; Simonsen, Lene

    2013-01-01

    PURPOSE: Immigration from a Third-World society to a Western society can be associated with higher blood pressure and salt sensitivity. We therefore tested whether immigrants from Afghanistan to Denmark compared with non-immigrant Danes exhibit a (i) higher 24-h ambulatory blood pressure (24-h ABP...... immigrants to Denmark exhibit a lower 24-h ABP than Danes. In young Afghans, PRA is less sensitive to changes in salt intake, while PNA is higher and may reflect their lower systolic blood pressure and/or arterial pulse pressure. Whether these hormonal differences can explain the lower 24-h ABP in Afghans...

  16. Effect of cocoa on blood pressure.

    Science.gov (United States)

    Ried, Karin; Fakler, Peter; Stocks, Nigel P

    2017-04-25

    High blood pressure is an important risk factor for cardiovascular disease, contributing to about 50% of cardiovascular events worldwide and 37% of cardiovascular-related deaths in Western populations. Epidemiological studies suggest that cocoa-rich products reduce the risk of cardiovascular disease. Flavanols found in cocoa have been shown to increase the formation of endothelial nitric oxide which promotes vasodilation and therefore blood pressure reduction. Here we update previous meta-analyses on the effect of cocoa on blood pressure. To assess the effects on blood pressure of chocolate or cocoa products versus low-flavanol products or placebo in adults with or without hypertension when consumed for two weeks or longer. This is an updated version of the review initially published in 2012. In this updated version, we searched the following electronic databases from inception to November 2016: Cochrane Hypertension Group Specialised Register, CENTRAL, MEDLINE and Embase. We also searched international trial registries, and the reference lists of review articles and included trials. Randomised controlled trials (RCTs) investigating the effects of chocolate or cocoa products on systolic and diastolic blood pressure in adults for a minimum of two weeks duration. Two review authors independently extracted data and assessed the risks of bias in each trial. We conducted random-effects meta-analyses on the included studies using Review Manager 5. We explored heterogeneity with subgroup analyses by baseline blood pressure, flavanol content of control group, blinding, age and duration. Sensitivity analyses explored the influence of unusual study design. Thirty-five trials (including 40 treatment comparisons) met the inclusion criteria. Of these, we added 17 trials (20 treatment comparisons) to the 18 trials (20 treatment comparisons) in the previous version of this updated review.Trials provided participants with 30 to 1218 mg of flavanols (mean = 670 mg) in 1.4 to 105

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

    DEFF Research Database (Denmark)

    Tønnesen, K H; Noer, Ivan; Paaske, William

    1980-01-01

    Systolic blood pressures at toe and ankle were measured in 459 consecutive patients with occlusive arterial disease. Fifty-eight per cent had intermittent claudication with arterial disease of all degrees of severity. Seventeen per cent complained of rest pain having toe systolic pressures below 30...

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

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Hypertension (High Blood Pressure) KidsHealth / For Parents / Hypertension (High Blood Pressure) What's ... High Blood Pressure) Treated? Print What Is Hypertension (High Blood Pressure)? Blood pressure is the pressure of blood against ...

  19. Contribution of the Arterial System and the Heart to Blood Pressure during Normal Aging - A Simulation Study

    NARCIS (Netherlands)

    Maksuti, Elira; Westerhof, Nico; Westerhof, Berend E.; Broomé, Michael; Stergiopulos, Nikos

    2016-01-01

    During aging, systolic blood pressure continuously increases over time, whereas diastolic pressure first increases and then slightly decreases after middle age. These pressure changes are usually explained by changes of the arterial system alone (increase in arterial stiffness and vascular

  20. Diurnal changes of blood pressure values (24 h blood pressures in women with polycystic ovary syndrome

    Directory of Open Access Journals (Sweden)

    Barbara Grzechocińska

    2011-06-01

    Full Text Available Background: More attention is being paid lately to polycystic ovary syndrome (PCOS not only in the aspect of fertility but also according to long-term metabolic and cardiovascular abnormalities. Observations of women with PCOS show that the occurrence of blood hypertension is more frequent after the menopause. There are few articles concerning the predictable symptoms of blood hypertension. It seems that twenty-four hour blood pressure monitoring and assessment of changes of diurnal rhythm could be useful in this group of patients.Aim of the study: The purpose of this study was to assess diurnal changes of blood pressure in women with polycystic ovary syndrome.Material and methods: 26 women with PCOS diagnosed according to Rotterdam consensus criteria and Androgen Excess Society (AES criteria were included in our study. The mean age of the examined women was 29.5 years and the mean BMI (body mass index was 24.7 kg/m2. The control group consisted of 12 age-matched women, without PCOS. Twenty-four hour Holter monitoring of ambulatory blood pressure was performed during normal daily activity in all patients. Halberg’s cosinor method was used to analyse daily biorhythm.Results: Results show the diurnal changes of systolic blood pressure in the preclinical phase in 30% and diastolic in 15% of PCOS women. In this group no physiological decrease of blood pressure at night time was observed.

  1. Blood pressure and control of cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Judith A Whitworth

    2005-10-01

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

  2. Association between ambient temperature and blood pressure and blood pressure regulators: 1831 hypertensive patients followed up for three years.

    Directory of Open Access Journals (Sweden)

    Qing Chen

    Full Text Available Several studies have suggested an association between ambient air temperature and blood pressure. However, this has not been reliably confirmed by longitudinal studies. Also, whether the reaction to temperature stimulation is modified by other factors such as antihypertensive medication is rarely investigated. The present study explores the relationship between ambient temperature and blood pressure, without and with antihypertensive medication, in a study of 1,831 hypertensive patients followed up for three years, in two or four weekly check ups, accumulating 62,452 follow-up records. Both baseline and follow-up blood pressure showed an inverse association with ambient temperature, which explained 32.4% and 65.6% of variation of systolic blood pressure and diastolic blood pressure (P<0.05 respectively. The amplitude of individual blood pressure fluctuation with temperature throughout a year (a 29 degrees centigrade range was 9.4/7.3 mmHg. Medication with angiotensin converting enzyme inhibitor benazepril attenuated the blood pressure fluctuation by 2.4/1.3 mmHg each year, though the inverse association of temperature and blood pressure remained. Gender, drinking behavior and body mass index were also found to modify the association between temperature and diastolic blood pressure. The results indicate that ambient temperature may negatively regulate blood pressure. Hypertensive patients should monitor and treat blood pressure more carefully in cold days, and it could be especially important for the males, thinner people and drinkers.

  3. Estimating the burden of disease attributable to high blood pressure ...

    African Journals Online (AJOL)

    Objectives. To estimate the burden of disease attributable to high blood pressure (BP) in adults aged 30 years and older in South Africa in 2000. Design. World Health Organization comparative risk assessment (CRA) methodology was followed. Mean systolic BP (SBP) estimates by age and sex were obtained from the 1998 ...

  4. Remote Blood Pressure Waveform Sensing Method and Apparatus

    Science.gov (United States)

    2008-06-02

    test the effects of drugs, exercise, or other stimuli, whereby an increase or decrease in the ratio may indicate an improvement or worsening of systolic...even though high blood pressure in animals can be symptomatic of a variety of diseases including chronic renal failure, hyperthyroidism , Cushing’s

  5. Dairy consumption, systolic blood pressure, and risk of hypertension

    DEFF Research Database (Denmark)

    Ding, Ming; Huang, Tao; Bergholdt, Helle K

    2017-01-01

    .Setting CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium.Participants Data from 22 studies with 171 213 participants, and an additional 10 published prospective studies with 26 119 participants included in the observational analysis.Main outcome measures The instrumental variable...

  6. The effect of fish oil supplements on blood pressure.

    Science.gov (United States)

    Lofgren, R P; Wilt, T J; Nichol, K L; Crespin, L; Pluhar, R; Eckfeldt, J

    1993-01-01

    We conducted a double-blind, placebo-controlled crossover study to determine the effects of fish oil supplementation on blood pressure in middle-aged men. Subjects were randomly assigned to consume either 20 g of fish oil or safflower oil for 12 weeks and then consume the other oil for an additional 12 weeks after a 4-week washout period. We found no significant changes from the pretreatment value in systolic or diastolic blood pressure with the use of fish oil supplements. In addition, there were no significant differences in the posttreatment blood pressures comparing the fish and safflower oil phases of the study. PMID:8427339

  7. Serotonin and Blood Pressure Regulation

    Science.gov (United States)

    Morrison, Shaun F.; Davis, Robert Patrick; Barman, Susan M.

    2012-01-01

    5-Hydroxytryptamine (5-HT; serotonin) was discovered more than 60 years ago as a substance isolated from blood. The neural effects of 5-HT have been well investigated and understood, thanks in part to the pharmacological tools available to dissect the serotonergic system and the development of the frequently prescribed selective serotonin-reuptake inhibitors. By contrast, our understanding of the role of 5-HT in the control and modification of blood pressure pales in comparison. Here we focus on the role of 5-HT in systemic blood pressure control. This review provides an in-depth study of the function and pharmacology of 5-HT in those tissues that can modify blood pressure (blood, vasculature, heart, adrenal gland, kidney, brain), with a focus on the autonomic nervous system that includes mechanisms of action and pharmacology of 5-HT within each system. We compare the change in blood pressure produced in different species by short- and long-term administration of 5-HT or selective serotonin receptor agonists. To further our understanding of the mechanisms through which 5-HT modifies blood pressure, we also describe the blood pressure effects of commonly used drugs that modify the actions of 5-HT. The pharmacology and physiological actions of 5-HT in modifying blood pressure are important, given its involvement in circulatory shock, orthostatic hypotension, serotonin syndrome and hypertension. PMID:22407614

  8. Relationship between blood lead, blood pressure, stroke, and heart attacks in middle-aged British men

    International Nuclear Information System (INIS)

    Pocock, S.J.; Shaper, A.G.; Ashby, D.; Delves, H.T.; Clayton, B.E.

    1988-01-01

    The relationship between blood lead concentration and blood pressure is examined in a survey of 7371 men aged 40 to 59 from 24 British towns. After allowance for relevant confounding variables, including town of residence and alcohol consumption, there exists a very weak but statistically significant positive association between blood lead and both systolic and diastolic blood pressure. After 6 years of follow-up, 316 of these men had major ischemic heart disease, and 66 had a stroke. After allowance for the confounding effects of cigarette smoking and town of residence there is no evidence that blood lead is a risk factor for these cardiovascular events. However, as the blood lead-blood pressure association is so weak, it is unlikely that any consequent association between lead and cardiovascular disease could be demonstrated from prospective epidemiological studies. An overview of data from this and other large epidemiological surveys provides reasonable consistent evidence on lead and blood pressure. While NHANES II data on 2254 US men indicate a slightly stronger association between blood lead and systolic blood pressure, data from two Welsh studies on over 2000 men did not show a statistically significant association. Nevertheless, such statistical association cannot be taken as establishing a causal effect of low-level lead exposure on blood pressure

  9. Diabetes and blood pressure (image)

    Science.gov (United States)

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

  10. Blood Pressure Drugs and AMD

    Science.gov (United States)

    ... Patient Stories Español Eye Health / News Research News: Blood Pressure Drugs and AMD Leer en Español: Noticias de ... also found an association between AMD and high blood pressure, but this has been inconsistent. To help clarify ...

  11. High Blood Pressure - Multiple Languages

    Science.gov (United States)

    ... Being 8 - High Blood Pressure - Amarɨñña / አማርኛ (Amharic) MP3 Siloam Family Health Center Arabic (العربية) Expand Section ... Being 8 - High Blood Pressure - myanma bhasa (Burmese) MP3 Siloam Family Health Center Chinese, Simplified (Mandarin dialect) ( ...

  12. What Is High Blood Pressure?

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More What is High Blood Pressure? Updated:Feb 27,2018 First, let’s define high ... resources . This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  13. Is the area under blood pressure curve the best parameter to evaluate 24-h ambulatory blood pressure monitoring data?

    Science.gov (United States)

    Nobre, Fernando; Mion, Décio

    2005-10-01

    Ambulatory blood pressure monitoring (ABPM) provides relevant data about blood pressure over a 24-h period. The analysis of parameters to determine the blood pressure profile from these data is of great importance. To calculate areas under systolic and diastolic blood pressure curves (SBP-AUC/DBP-AUC) and compare with systolic and diastolic blood pressure load (SBPL/DBPL) and 24-h systolic and diastolic blood pressure (24-h SBP/24-h DBP) in order to determine which provides the best correlation with left ventricular mass index (LVMI). ABPM measurements (1143 individuals) were analyzed to obtain 24-h SBP/24-h DBP, SBPL/DBPL, and SBP-AUC/ DBP-AUC, using Spacelabs (90207) and CardioSistemas devices. Left ventricular mass was determined using an echocardiograph HP Sonos 5500 and LVMI was calculated. The correlations between all possible pairs within the group 24-h SBP/SBPL/SBP-AUC and 24-h DBP/DBPL/DBP-AUC were high and statistically significant. The correlations between 24-h SBP/24-h DBP and SBP-AUC/DBP-AUC with SBPL/DBPL close to 100%, were lower than those mentioned above. The correlations of the parameters obtained by ABPM with LVMI were also high and statistically significant, except for blood pressure load between 90 and 100%, and for 24-h SBP of 135 mmHg or less and SBPL higher than 50%. SBPL/DBPL and SBP-AUC/DBP-AUC can be used for the evaluation of ABPM data owing to the strong correlation with 24-h SBP/24-h DBP and with LVMI, except when SBPL is close to 100% or 24-h SBP is below 135 mmHg but SBPL is above 50%. SBP-AUC/DBP-AUC, however, are a better alternative because they do not have the limitations of blood pressure load or even of 24-h blood pressure present.

  14. [Intervention of systolic pressure and left ventricular hypertrophy in rats under cold stress].

    Science.gov (United States)

    Sun, C F; Wang, S G; Peng, Y G; Shi, Y; Du, Y P; Shi, G X; Wen, T; Wang, Y K; Su, H

    2016-06-20

    To investigate the effects of different drugs on systolic blood pressure (SBP) and left ventricular hypertrophy (LVH) in spontaneously hypertensive rats under cold stress. A total of 40 male spontaneously hypertensive rats aged 10 weeks (160~200 g) were given adaptive feeding for 7 days at a temperature of 20±1°C and then randomly divided into control group, cold stress group, metoprolol group, amlodipine group, and benazepril group, with 8 rats in each group. SBP, body weight, and heart rate were measured once a week. After the rats were sacrificed by exsanguination, left ventricular weight (LVW) was measured, and left ventricular weight index (LVWI; mg/g) was calculated. Radioimmunoassay was used to measure the concentrations of endothelin-1 (ET-1) and angiotensin-II (Ang-II) in plasma and myocardium, and the chemical method was used to measure the concentrations of nitric oxide (NO) in plasma and myocardium. RT-PCR was used to measure the mRNA expression of endothelin-A receptor. Compared with the cold stress group, all medication groups showed significant reductions in SBP since week 5 (Pcold stress group showed a significant increase in LVWI compared with the control group (3.38±0.27 mg/g vs 2.89±0.19 mg/g, Pcold stress group (2.98±0.28 mg/g vs 3.38±0.27 mg/g, Pcold stress group showed a significant reduction in plasma NO concentration compared with the control group (104.9±19.5 μmol/L vs 129.3±17.8 μmol/L, Pcold stress group, all the medication groups showed significant increases in blood NO concentration (Pcold stress group showed a significant increase in myocardial ET-1 concentration compared with the control group (6.3±1.5 pg/100 mg vs 4.5±1.9 pg/100 mg, Pcold stress group, the amlodipine group showed a significant reduction in myocardial ET-1 concentration (4.4±1.0 pg/100 mg vs 6.3±1.5 pg/100 mg, Pcold stress group had significantly higher mRNA expression of endothelin-A receptor than the control group (0.86±0.23 vs 0.45±0.16, Pcold

  15. Dysglycemia induces abnormal circadian blood pressure variability

    Directory of Open Access Journals (Sweden)

    Kumarasamy Sivarajan

    2011-11-01

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

  16. Exploring the relationship of peripheral total bilirubin, red blood cell, and hemoglobin with blood pressure during childhood and adolescence.

    Science.gov (United States)

    Chen, Xiao-Tian; Yang, Song; Yang, Ya-Ming; Zhao, Hai-Long; Chen, Yan-Chun; Zhao, Xiang-Hai; Wen, Jin-Bo; Tian, Yuan-Rui; Yan, Wei-Li; Shen, Chong

    2017-11-04

    Total bilirubin is beneficial for protecting cardiovascular diseases in adults. The authors aimed to investigate the association of total bilirubin, red blood cell, and hemoglobin levels with the prevalence of high blood pressure in children and adolescents. A total of 3776 students (aged from 6 to 16 years old) were examined using cluster sampling. Pre-high blood pressure and high blood pressure were respectively defined as the point of 90th and 95th percentiles based on the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Both systolic and diastolic blood pressure were standardized into z-scores. Peripheral total bilirubin, red blood cell and hemoglobin levels were significantly correlated with age, and also varied with gender. Peripheral total bilirubin was negatively correlated with systolic blood pressure in 6- and 9-year-old boys, whilst positively correlated with diastolic blood pressure in the 12-year-old boys and 13- to 15-year-old girls (p0.05). Total bilirubin could be weakly correlated with both systolic and diastolic blood pressure, as correlations varied with age and gender in children and adolescents; in turn, the increased levels of red blood cell and hemoglobin are proposed to be positively associated with the prevalence of high blood pressure. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  17. Ambulatory blood pressure monitoring-derived short-term blood pressure variability in primary hyperparathyroidism.

    Science.gov (United States)

    Concistrè, A; Grillo, A; La Torre, G; Carretta, R; Fabris, B; Petramala, L; Marinelli, C; Rebellato, A; Fallo, F; Letizia, C

    2018-04-01

    Primary hyperparathyroidism is associated with a cluster of cardiovascular manifestations, including hypertension, leading to increased cardiovascular risk. The aim of our study was to investigate the ambulatory blood pressure monitoring-derived short-term blood pressure variability in patients with primary hyperparathyroidism, in comparison with patients with essential hypertension and normotensive controls. Twenty-five patients with primary hyperparathyroidism (7 normotensive,18 hypertensive) underwent ambulatory blood pressure monitoring at diagnosis, and fifteen out of them were re-evaluated after parathyroidectomy. Short-term-blood pressure variability was derived from ambulatory blood pressure monitoring and calculated as the following: 1) Standard Deviation of 24-h, day-time and night-time-BP; 2) the average of day-time and night-time-Standard Deviation, weighted for the duration of the day and night periods (24-h "weighted" Standard Deviation of BP); 3) average real variability, i.e., the average of the absolute differences between all consecutive BP measurements. Baseline data of normotensive and essential hypertension patients were matched for age, sex, BMI and 24-h ambulatory blood pressure monitoring values with normotensive and hypertensive-primary hyperparathyroidism patients, respectively. Normotensive-primary hyperparathyroidism patients showed a 24-h weighted Standard Deviation (P blood pressure higher than that of 12 normotensive controls. 24-h average real variability of systolic BP, as well as serum calcium and parathyroid hormone levels, were reduced in operated patients (P blood pressure variability is increased in normotensive patients with primary hyperparathyroidism and is reduced by parathyroidectomy, and may potentially represent an additional cardiovascular risk factor in this disease.

  18. Evaluation of the impact of atmospheric pressure in different seasons on blood pressure in patients with arterial hypertension.

    Science.gov (United States)

    Kamiński, Marek; Cieślik-Guerra, Urszula I; Kotas, Rafał; Mazur, Piotr; Marańda, Witold; Piotrowicz, Maciej; Sakowicz, Bartosz; Napieralski, Andrzej; Trzos, Ewa; Uznańska-Loch, Barbara; Rechciński, Tomasz; Kurpesa, Małgorzata

    2016-01-01

    Atmospheric pressure is the most objective weather factor because regardless of if outdoors or indoors it affects all objects in the same way. The majority of previous studies have used the average daily values of atmospheric pressure in a bioclimatic analysis and have found no correlation with blood pressure changes. The main objective of our research was to assess the relationship between atmospheric pressure recorded with a frequency of 1 measurement per minute and the results of 24-h blood pressure monitoring in patients with treated hypertension in different seasons in the moderate climate of the City of Łódź (Poland). The study group consisted of 1662 patients, divided into 2 equal groups (due to a lower and higher average value of atmospheric pressure). Comparisons between blood pressure values in the 2 groups were performed using the Mann-Whitney U test. We observed a significant difference in blood pressure recorded during the lower and higher range of atmospheric pressure: on the days of the spring months systolic (p = 0.043) and diastolic (p = 0.005) blood pressure, and at nights of the winter months systolic blood pressure (p = 0.013). A significant inverse relationship between atmospheric pressure and blood pressure during the spring days and, only for systolic blood pressure, during winter nights was observed. Int J Occup Med Environ Health 2016;29(5):783-792. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  19. [Effects of acupuncture on circadian rhythm of blood pressure in patients with essential hypertension].

    Science.gov (United States)

    Lei, Yun; Jin, Jiu; Ban, Haipeng; Du, Yuzheng

    2017-11-12

    To observe the effects of acupuncture combined with medication on circadian rhythm of blood pressure in patients with essential hypertension. Sixty-four patients of essential hypertension were randomly divided into an observation group and a control group, 32 cases in each group. All the patients maintained original treatment (taking antihypertensive medication); the patients in the observation group were treated with acupuncture method of " Huoxue Sanfeng , Shugan Jianpi ", once a day, five times per week, for totally 6 weeks (30 times). The circadian rhythm of blood pressure and related dynamic parameters were observed before and after treatment in the two groups. (1) The differences of daytime average systolic blood pressure (dASBP), daytime average diastolic blood pressure (dADBP), nighttime average systolic blood pressure (nASBP) and circadian rhythm of systolic blood pressure before and after treatment were significant in the observation group (all P circadian rhythm of blood pressure and related dynamic parameters before and after treatment were insignificant in the control group (all P >0.05). The nASBP and circadian rhythm of systolic blood pressure in the observation group were significantly different from those in the control group (all P circadian rhythm of blood pressure in the observation group was higher than that in the control group ( P circadian rhythm of blood pressure and related dynamic parameters in patients with essential hypertension.

  20. Associations of ambulatory blood pressure with urinary caffeine and caffeine metabolite excretions.

    Science.gov (United States)

    Guessous, Idris; Pruijm, Menno; Ponte, Belén; Ackermann, Daniel; Ehret, Georg; Ansermot, Nicolas; Vuistiner, Philippe; Staessen, Jan; Gu, Yumei; Paccaud, Fred; Mohaupt, Markus; Vogt, Bruno; Pechère-Bertschi, Antoinette; Pechère-Berstchi, Antoinette; Martin, Pierre-Yves; Burnier, Michel; Eap, Chin B; Bochud, Murielle

    2015-03-01

    Intake of caffeinated beverages might be associated with reduced cardiovascular mortality possibly via the lowering of blood pressure. We estimated the association of ambulatory blood pressure with urinary caffeine and caffeine metabolites in a population-based sample. Families were randomly selected from the general population of Swiss cities. Ambulatory blood pressure monitoring was conducted using validated devices. Urinary caffeine, paraxanthine, theophylline, and theobromine excretions were measured in 24 hours urine using ultrahigh performance liquid chromatography tandem mass spectrometry. We used mixed models to explore the associations of urinary excretions with blood pressure although adjusting for major confounders. The 836 participants (48.9% men) included in this analysis had mean age of 47.8 and mean 24-hour systolic and diastolic blood pressure of 120.1 and 78.0 mm Hg. For each doubling of caffeine excretion, 24-hour and night-time systolic blood pressure decreased by 0.642 and 1.107 mm Hg (both P values theobromine excretion was not associated with blood pressure. Anti-hypertensive therapy, diabetes mellitus, and alcohol consumption modify the association of caffeine urinary excretion with systolic blood pressure. Ambulatory systolic blood pressure was inversely associated with urinary excretions of caffeine and other caffeine metabolites. Our results are compatible with a potential protective effect of caffeine on blood pressure. © 2014 American Heart Association, Inc.

  1. 24-hour central aortic systolic pressure and 24-hour central pulse pressure are related to diabetic complications in type 1 diabetes - a cross-sectional study

    DEFF Research Database (Denmark)

    Theilade, Simone; Lajer, Maria Stenkil; Hansen, Tine Willum

    2013-01-01

    BACKGROUND: Non-invasive measurements of 24 hour ambulatory central aortic systolic pressure (24 h-CASP) and central pulse pressure (24 h-CPP) are now feasible. We evaluate the relationship between 24 h central blood pressure and diabetes-related complications in patients with type 1 diabetes.......68) and 3.72 (1.85-7.47) and autonomic dysfunction: 3.25 (1.65-6.41), 1.64 (1.12-2.39) and 2.89 (1.54-5.42). CONCLUSIONS: 24 h-CASP and 24 h-CPP was higher in patients vs. controls and increased with diabetic complications independently of covariates. Furthermore, 24 h-CASP was stronger associated....... METHODS: The study was cross-sectional, including 715 subjects: 86 controls (C), 69 patients with short diabetes duration (diabetes (≥ 10 years) and normoalbuminuria (LN), 163...

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

    DEFF Research Database (Denmark)

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

    1995-01-01

    Cirrhotic patients have disturbed systemic hemodynamics with reduced arterial blood pressure, but this has not been investigated during daily activity and sleep. Systolic (SBP), diastolic (DBP), and mean arterial blood pressure (MAP), and heart rate (HR) were measured by an automatic ambulant...... device for monitoring blood pressure in 35 patients with cirrhosis and 35 healthy matched controls. During the daytime, SBP, DBP, and MAP were significantly lower in the patients than in the controls (median 118 vs. 127; 70 vs. 78; 86 vs. 94 mm Hg, P blood pressures...... were almost similar in the two groups (108 vs. 110; 65 vs. 67; 78 vs. 82 mm Hg, NS). Conversely, HR was significantly higher in the patients both in the daytime (86 vs. 72/min, P blood pressure and HR from daytime...

  3. Validation of the SCIAN LD-735 wrist blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    Science.gov (United States)

    Kang, Yuan-Yuan; Chen, Qi; Li, Yan; Wang, Ji-Guang

    2016-08-01

    This study aimed to evaluate the accuracy of the automated oscillometric wrist blood pressure monitor SCIAN LD-735 for home blood pressure monitoring according to the International Protocol of the European Society of Hypertension revision 2010. Systolic and diastolic blood pressures were measured sequentially in 33 adult Chinese participants (10 women, mean age 44.8 years) using a mercury sphygmomanometer (two observers) and the SCIAN LD-735 device (one supervisor). A total of 99 pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. The SCIAN LD-735 device achieved the targets in part 1 of the validation study. The number of absolute differences between device and observers within 5, 10, and 15 mmHg was 86/99, 97/99, and 98/99, respectively, for systolic blood pressure and 85/99, 98/99, and 99/99, respectively, for diastolic blood pressure. The device also fulfilled the criteria in part 2 of the validation study. In total, 30 and 33 participants for systolic and diastolic blood pressure, respectively, had at least two of the three device-observer differences within 5 mmHg (required ≥24). No participant had all of the three device-observer comparisons greater than 5 mmHg for systolic or diastolic blood pressure. The SCIAN wrist blood pressure monitor LD-735 has passed the requirements of the International Protocol revision 2010, and hence can be recommended for home use in adults.

  4. Validation of the AVITA BPM17 wrist blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    Science.gov (United States)

    Kang, Yuan-Yuan; Chen, Qi; Liu, Chang-Yuan; Li, Yan; Wang, Ji-Guang

    2017-08-01

    The aim of the present study was to evaluate the accuracy of the automated oscillometric wrist blood pressure monitor AVITA BPM17 for home blood pressure monitoring according to the International Protocol of the European Society of Hypertension revision 2010. Systolic and diastolic blood pressures were sequentially measured in 33 adult Chinese (19 men, 45.7 years of mean age) using a mercury sphygmomanometer (two observers) and the AVITA BPM17 device (one supervisor). Ninety-nine pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. The AVITA BPM17 device achieved the targets in part 1 of the validation study. The number of absolute differences between device and observers within 5, 10, and 15 mmHg was 94/99, 98/99, and 98/99, respectively, for systolic blood pressure and 92/99, 99/99, and 99/99, respectively, for diastolic blood pressure. The device also fulfilled the criteria in part 2 of the validation study. Overall, 32 participants for both systolic and diastolic blood pressure, respectively, had at least two of the three device-observerss differences within 5 mmHg (required ≥24). None had all the three device-observers comparisons greater than 5 mmHg for systolic and diastolic blood pressure. The AVITA wrist blood pressure monitor BPM17 has passed the requirements of the International Protocol revision 2010, and hence can be recommended for home use in adults.

  5. Validation of the AVITA BPM15S wrist blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    Science.gov (United States)

    Kang, Yuan-Yuan; Zeng, Wei-Fang; Zhang, Lu; Li, Yan; Wang, Ji-Guang

    2014-06-01

    The present study aimed to evaluate the accuracy of the automated oscillometric wrist blood pressure monitor AVITA BPM15S for home blood pressure monitoring according to the International Protocol revision 2010 of the European Society of Hypertension. Systolic and diastolic blood pressures were sequentially measured in 33 Chinese adults (15 women, mean age 51 years) using a mercury sphygmomanometer (two observers) and the AVITA BPM15S device (one supervisor). Ninety-nine pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. The AVITA BPM15S device achieved the targets in part 1 of the validation study. The number of absolute differences between the device and observers within 5, 10, and 15 mmHg were 85/99, 94/99, and 98/99, respectively, for systolic blood pressure, and 82/99, 96/99, and 98/99, respectively, for diastolic blood pressure. The device also achieved the criteria in part 2 of the validation study. Thirty-two and 28 participants for systolic and diastolic blood pressure, respectively, had at least two of the three device-observer differences within 5 mmHg (required ≥ 24). No participant had all of the three device-observer comparisons greater than 5 mmHg for systolic or diastolic blood pressure. The AVITA wrist blood pressure monitor BPM15S fulfilled the requirements of the International Protocol revision 2010 and hence can be recommended for home use in an adult population.

  6. Diet, blood pressure, and multicollinearity.

    Science.gov (United States)

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

    1985-01-01

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

  7. Influence of Baseline Diastolic Blood Pressure on Effects of Intensive Compared With Standard Blood Pressure Control.

    Science.gov (United States)

    Beddhu, Srinivasan; Chertow, Glenn M; Cheung, Alfred K; Cushman, William C; Rahman, Mahboob; Greene, Tom; Wei, Guo; Campbell, Ruth C; Conroy, Margaret; Freedman, Barry I; Haley, William; Horwitz, Edward; Kitzman, Dalane; Lash, James; Papademetriou, Vasilios; Pisoni, Roberto; Riessen, Erik; Rosendorff, Clive; Watnick, Suzanne G; Whittle, Jeffrey; Whelton, Paul K

    2018-01-09

    In individuals with a low diastolic blood pressure (DBP), the potential benefits or risks of intensive systolic blood pressure (SBP) lowering are unclear. SPRINT (Systolic Blood Pressure Intervention Trial) was a randomized controlled trial that compared the effects of intensive (target baseline DBP. Mean baseline SBP and DBP were 139.7±15.6 and 78.1±11.9 mm Hg, respectively. Regardless of the randomized treatment, baseline DBP had a U-shaped association with the hazard of the primary cardiovascular disease outcome. However, the effects of the intensive SBP intervention on the primary outcome were not influenced by baseline DBP level ( P for interaction=0.83). The primary outcome hazard ratio for intensive versus standard treatment was 0.78 (95% confidence interval, 0.57-1.07) in the lowest DBP quintile (mean baseline DBP, 61±5 mm Hg) and 0.74 (95% confidence interval, 0.61-0.90) in the upper 4 DBP quintiles (mean baseline DBP, 82±9 mm Hg), with an interaction P value of 0.78. Results were similar for all-cause death and kidney events. Low baseline DBP was associated with increased risk of cardiovascular disease events, but there was no evidence that the benefit of the intensive SBP lowering differed by baseline DBP. URL: https://www.clinicaltrials.gov. Unique identifier: NCT01206062. © 2017 American Heart Association, Inc.

  8. Systolic hypertension: an increasing clinical challenge in Asia

    Science.gov (United States)

    Park, Jeong Bae; Kario, Kazuomi; Wang, Ji-Guang

    2015-01-01

    Systolic hypertension, the predominant form of hypertension in patients aged over 50–60 years, is a growing health issue as the Asian population ages. Elevated systolic blood pressure is mainly caused by arterial stiffening, resulting from age-related vascular changes. Elevated systolic pressure increases the risk of cardiovascular disease, mortality and renal function decline, and this risk may increase at lower systolic pressure levels in Asian than Western subjects. Hence, effective systolic pressure lowering is particularly important in Asians yet blood pressure control remains inadequate despite the availability of numerous antihypertensive medications. Reasons for poor blood pressure control include low awareness of hypertension among health-care professionals and patients, under-treatment, and tolerability problems with antihypertensive drugs. Current antihypertensive treatments also lack effects on the underlying vascular pathology of systolic hypertension, so novel drugs that address the pathophysiology of arterial stiffening are needed for optimal management of systolic hypertension and its cardiovascular complications. PMID:25503845

  9. Ischemic preconditioning of the lower extremity attenuates the normal hypoxic increase in pulmonary artery systolic pressure.

    Science.gov (United States)

    Foster, Gary P; Westerdahl, Daniel E; Foster, Laura A; Hsu, Jeffrey V; Anholm, James D

    2011-12-15

    Ischemic pre-condition of an extremity (IPC) induces effects on local and remote tissues that are protective against ischemic injury. To test the effects of IPC on the normal hypoxic increase in pulmonary pressures and exercise performance, 8 amateur cyclists were evaluated under normoxia and hypoxia (13% F(I)O(2)) in a randomized cross-over trial. IPC was induced using an arterial occlusive cuff to one thigh for 5 min followed by deflation for 5 min for 4 cycles. In the control condition, the resting pulmonary artery systolic pressure (PASP) increased from a normoxic value of 25.6±2.3 mmHg to 41.8±7.2 mmHg following 90 min of hypoxia. In the IPC condition, the PASP increased to only 32.4±3.1 mmHg following hypoxia, representing a 72.8% attenuation (p=0.003). No significant difference was detected in cycle ergometer time trial duration between control and IPC conditions with either normoxia or hypoxia. IPC administered prior to hypoxic exposure was associated with profound attenuation of the normal hypoxic increase of pulmonary artery systolic pressure. Published by Elsevier B.V.

  10. Peripheral vascular effects on auscultatory blood pressure measurement.

    Science.gov (United States)

    Rabbany, S Y; Drzewiecki, G M; Noordergraaf, A

    1993-01-01

    Experiments were conducted to examine the accuracy of the conventional auscultatory method of blood pressure measurement. The influence of the physiologic state of the vascular system in the forearm distal to the site of Korotkoff sound recording and its impact on the precision of the measured blood pressure is discussed. The peripheral resistance in the arm distal to the cuff was changed noninvasively by heating and cooling effects and by induction of reactive hyperemia. All interventions were preceded by an investigation of their effect on central blood pressure to distinguish local effects from changes in central blood pressure. These interventions were sufficiently moderate to make their effect on central blood pressure, recorded in the other arm, statistically insignificant (i.e., changes in systolic [p cooling experiments was statistically significant (p < 0.001). Moreover, both measured systolic (p < 0.004) and diastolic (p < 0.001) pressure decreases during the reactive hyperemia experiments were statistically significant. The findings demonstrate that alteration in vascular state generates perplexing changes in blood pressure, hence confirming experimental observations by earlier investigators as well as predictions by our model studies.

  11. Blood pressure load does not add to ambulatory blood pressure level for cardiovascular risk stratification

    DEFF Research Database (Denmark)

    Li, Yan; Thijs, Lutgarde; Boggia, José

    2014-01-01

    Experts proposed blood pressure (BP) load derived from 24-hour ambulatory BP recordings as a more accurate predictor of outcome than level, in particular in normotensive people. We analyzed 8711 subjects (mean age, 54.8 years; 47.0% women) randomly recruited from 10 populations. We expressed BP...... load as percentage (%) of systolic/diastolic readings ≥135/≥85 mm Hg and ≥120/≥70 mm Hg during day and night, respectively, or as the area under the BP curve (mm Hg×h) using the same ceiling values. During a period of 10.7 years (median), 1284 participants died and 1109 experienced a fatal or nonfatal...... cardiovascular end point. In multivariable-adjusted models, the risk of cardiovascular complications gradually increased across deciles of BP level and load (Pbased on 24-hour systolic or diastolic BP level (generalized R(2) statistic ≤0.294%; net...

  12. Signal quality measures for unsupervised blood pressure measurement

    International Nuclear Information System (INIS)

    Abdul Sukor, J; Redmond, S J; Lovell, N H; Chan, G S H

    2012-01-01

    Accurate systolic and diastolic pressure estimation, using automated blood pressure measurement, is difficult to achieve when the transduced signals are contaminated with noise or interference, such as movement artifact. This study presents an algorithm for automated signal quality assessment in blood pressure measurement by determining the feasibility of accurately detecting systolic and diastolic pressures when corrupted with various levels of movement artifact. The performance of the proposed algorithm is compared to a manually annotated reference scoring (RS). Based on visual representations and audible playback of Korotkoff sounds, the creation of the RS involved two experts identifying sections of the recorded sounds and annotating sections of noise contamination. The experts determined the systolic and diastolic pressure in 100 recorded Korotkoff sound recordings, using a simultaneous electrocardiograph as a reference signal. The recorded Korotkoff sounds were acquired from 25 healthy subjects (16 men and 9 women) with a total of four measurements per subject. Two of these measurements contained purposely induced noise artifact caused by subject movement. Morphological changes in the cuff pressure signal and the width of the Korotkoff pulse were extracted features which were believed to be correlated with the noise presence in the recorded Korotkoff sounds. Verification of reliable Korotkoff pulses was also performed using extracted features from the oscillometric waveform as recorded from the inflatable cuff. The time between an identified noise section and a verified Korotkoff pulse was the key feature used to determine the validity of possible systolic and diastolic pressures in noise contaminated Korotkoff sounds. The performance of the algorithm was assessed based on the ability to: verify if a signal was contaminated with any noise; the accuracy, sensitivity and specificity of this noise classification, and the systolic and diastolic pressure

  13. Evaluating combined effect of noise and heat on blood pressure changes among males in climatic chamber

    OpenAIRE

    Dehghan, Habibollah; Bastami, Mohamad Taghi; Mahaki, Behzad

    2017-01-01

    INTRODUCTION: Exposure to noise and heat causes individuals to experience some changes in the function of cardiovascular system in workplaces. This study aimed to find the combined effect of heat and noise on systolic and diastolic types of blood pressure in experimentally controlled conditions. METHODS: This quasi-experimental study was performed with 12 male students in a climatic chamber in 2014. Blood pressure including systolic and diastolic was measured in the following conditions: 15 m...

  14. Blood Pressure Control: Stroke and Stroke Prevention

    Directory of Open Access Journals (Sweden)

    Hans-Christoph Diener

    2005-03-01

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

  15. Severity assessment criteria recommended by the British Thoracic Society (BTS) for community-acquired pneumonia (CAP) and older patients. Should SOAR (systolic blood pressure, oxygenation, age and respiratory rate) criteria be used in older people? A compilation study of two prospective cohorts.

    Science.gov (United States)

    Myint, Phyo K; Kamath, Ajay V; Vowler, Sarah L; Maisey, David N; Harrison, Brian D W

    2006-05-01

    To assess the usefulness of the British Thoracic Society guidelines for severity assessment of community-acquired pneumonia (CAP) in predicting mortality and to explore alternative criteria which could be more useful in older patients. Compilation study of two prospective observational cohorts. A University hospital in Norfolk, UK with a catchment population of 568,000. Subjects were 195 patients (median age = 77 years) who were included in two prospective studies of CAP. All-cause mortality occurring within the 6 week follow-up. sensitivity, specificity, positive and negative predictive values for study outcome using CURB and CURB-65 were assessed in 189 patients, and CRB-65 in 192 patients out of a total of 195 patients. Our results were comparable with the original study by Lim et al. Although CURB-65 and CRB-65 included age criteria, in effect they did not materially improve the specificity in predicting high-risk patients in both studies. We found that oxygenation measured by ventilation perfusion mismatch (PaO2:FiO2) was the best predictor of outcome in this slightly older cohort [odds ratio (OR) = 0.99 (0.98-0.99), P = 0.0001]. We derived a new set of criteria; SOAR (systolic blood pressure, oxygenation, age and respiratory rate) based on our findings. Their sensitivity, specificity, positive and negative predictive values were 81.0% (58.1-94.6), 59.3% (49.6-68.4), 27.0% (16.6-39.7) and 94.4% (86.2-98.4), respectively, confirming their comparability with existing criteria. Our Study confirms the usefulness of currently recommended severity rules for CAP in this older cohort. SOAR criteria may be useful as alternative criteria for a better identification of severe CAP in advanced age where both raised urea level above 7 mmol/l and confusion are common.

  16. Ambulatory blood pressure and urinary albumin excretion in clinically healthy subjects

    DEFF Research Database (Denmark)

    Clausen, Peter Vilhelm; Jensen, J S; Borch-Johnsen, K

    1998-01-01

    UAER. Because 24-hour ambulatory blood pressure is a superior predictor of hypertensive target organ involvement, we aimed to investigate blood pressure profile in clinically healthy subjects with elevated UAER. Ambulatory blood pressure monitoring was performed with a portable recorder in 27 subjects...... loss of albumin could not be solely related to the higher blood pressure. In conclusion, apparently healthy subjects with elevated UAER had slightly but significantly higher 24-hour systolic and diastolic blood pressure levels in addition to increased blood pressure loads but normal circadian variation...

  17. High Blood Pressure and Women

    Science.gov (United States)

    ... is known as gestational hypertension, a form of secondary hypertension caused by the pregnancy that usually disappears after delivery. If the mother is not treated, high blood pressure can be dangerous to both the mother ...

  18. Validation of the Andon KD-5965 upper-arm blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    Science.gov (United States)

    Huang, Jinhua; Li, Zhijie; Li, Guimei; Liu, Zhaoying

    2015-10-01

    This study aimed to evaluate the accuracy of the Andon KD-5965 upper-arm blood pressure monitor according to the European Society of Hypertension International Protocol revision 2010. Systolic and diastolic blood pressures were sequentially measured in 33 adults, with 20 women using a mercury sphygmomanometer (two observers) and the Andon KD-5965 device (one supervisor). A total of 99 pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. The device achieved the targets in part 1 of the validation study. The number of absolute differences between the device and observers within 5, 10, and 15 mmHg was 70/99, 91/99, and 98/99, respectively, for systolic blood pressure and 81/99, 99/99, and 99/99, respectively, for diastolic blood pressure. The device also fulfilled the criteria in part 2 of the validation study. Twenty-five and 29 participants, for systolic and diastolic blood pressure, respectively, had at least two of the three device-observers differences within 5 mmHg (required≥24). Two and one participants for systolic and diastolic blood pressure, respectively, had all three device-observers comparisons greater than 5 mmHg. According to the validation results, with better performance for diastolic blood pressure than that for systolic blood pressure, the Andon automated oscillometric upper-arm blood pressure monitor KD-5965 fulfilled the requirements of the European Society of Hypertension International Protocol revision 2010, and hence can be recommended for blood pressure measurement in adults.

  19. Family Adaptability and Cohesion and High Blood Pressure among Urban African American women

    Science.gov (United States)

    Brittain, Kelly; Taylor, Jacquelyn Y.; Wu, Chun Yi

    2010-01-01

    African American women are at greater risk for complications related to high blood pressure. This study examined relationships between high blood pressure, pulse pressure, body mass index, family adaptability, family cohesion and social support among 146 Urban African American women. Significant relationships were found between family adaptability and systolic blood pressure (p = .03) and between adaptability and pulse pressure (p ≤ .01). Based on study results, practitioners should routinely assess family functioning, specifically family adaptability, in African American women who are at risk for high blood pressure or diagnosed with high blood pressure to minimize complications associated with hypertension. PMID:21076625

  20. Cell Phone Information Seeking Explains Blood Pressure in African American Women.

    Science.gov (United States)

    Jones, Lenette M; Veinot, Tiffany C; Pressler, Susan J

    2018-05-01

    Although cell phone use and Internet access via cell phone is not marked by racial disparities, little is known about how cell phone use relates to blood pressure and health information seeking behaviors. The purposes of this study were to (a) describe Internet activities, cell phone use, and information seeking; (b) determine differences in blood pressure and information seeking between cell phone information seekers and nonseekers; and (c) examine cell phone information seeking as a predictor of blood pressure in African American women. Participants ( N = 147) completed a survey and had their blood pressure measured. Independent-sample t tests showed a significant difference in systolic blood pressure in cell phone information seekers and nonseekers. Linear regression revealed cell phone information seeking as an independent predictor of systolic blood pressure, despite confounders. It is possible that cell phone information seekers were using health information to make decisions about self-management of blood pressure.

  1. Psoriasis and high blood pressure.

    Science.gov (United States)

    Salihbegovic, Eldina Malkic; Hadzigrahic, Nermina; Suljagic, Edin; Kurtalic, Nermina; Sadic, Sena; Zejcirovic, Alema; Mujacic, Almina

    2015-02-01

    Psoriasis is a chronic skin ailment which can be connected with an increased occurrence of other illnesses, including high blood pressure. A prospective study has been conducted which included 70 patients affected by psoriasis, both genders, older than 18 years. Average age being 47,14 (SD= ±15,41) years, from that there were 36 men or 51,43 and 34 women or 48,57%. Average duration of psoriasis was 15,52 (SD=±12,54) years. Frequency of high blood pressure in those affected by psoriasis was 54,28%. Average age of the patients with psoriasis and high blood pressure was 53,79 year (SD=±14,15) and average duration of psoriasis was 17,19 years (SD=±13,51). Average values of PASI score were 16,65. Increase in values of PASI score and high blood pressure were statistically highly related (r=0,36, p=0,0001). Psoriasis was related to high blood pressure and there was a correlation between the severity of psoriasis and high blood pressure.

  2. Self-monitoring of blood pressure during pregnancy

    DEFF Research Database (Denmark)

    Lihme, Frederikke F; Madsen, Mette E; Lykke, Jacob A

    2017-01-01

    arterial blood pressure (MAP) and were compared using the paired sample t-test. Mean values and differences of systolic and diastolic pressure were plotted in Bland-Altman plots to test the agreement of the measurements. Finally, a mean evaluation score was calculated. RESULTS: One hundred pregnant women...... and instructed each participant in correct measurement and then took three measurements on both arms. The participant then repeated the measurements and filled an evaluation questionnaire. We used a validated semiautomatic device for all measurements. Mean values were calculated for systolic, diastolic and mean...... were included in the study. Mean values of systolic, diastolic and MAP were 110.6, 69.7 and 83.3 mmHg, respectively, as assessed by the hospital staff. The corresponding self-measurements were 111.4, 70.2 and 83.9 mmHg, respectively. Mean differences between hospital and self-measurements were 0.79 mm...

  3. [The association between blood pressure variability and sleep stability in essential hypertensive patients with sleep disorder].

    Science.gov (United States)

    Zhu, Y Q; Long, Q; Xiao, Q F; Zhang, M; Wei, Y L; Jiang, H; Tang, B

    2018-03-13

    Objective: To investigate the association of blood pressure variability and sleep stability in essential hypertensive patients with sleep disorder by cardiopulmonary coupling. Methods: Performed according to strict inclusion and exclusion criteria, 88 new cases of essential hypertension who came from the international department and the cardiology department of china-japan friendship hospital were enrolled. Sleep stability and 24 h ambulatory blood pressure data were collected by the portable sleep monitor based on cardiopulmonary coupling technique and 24 h ambulatory blood pressure monitor. Analysis the correlation of blood pressure variability and sleep stability. Results: In the nighttime, systolic blood pressure standard deviation, systolic blood pressure variation coefficient, the ratio of the systolic blood pressure minimum to the maximum, diastolic blood pressure standard deviation, diastolic blood pressure variation coefficient were positively correlated with unstable sleep duration ( r =0.185, 0.24, 0.237, 0.43, 0.276, P Blood pressure variability is associated with sleep stability, especially at night, the longer the unstable sleep duration, the greater the variability in night blood pressure.

  4. Alcohol: Does It Affect Blood Pressure?

    Science.gov (United States)

    Alcohol: Does it affect blood pressure? Does drinking alcohol affect your blood pressure? Answers from Sheldon G. Sheps, M.D. Drinking too much alcohol can raise blood pressure to unhealthy levels. Having ...

  5. Polynomial analysis of ambulatory blood pressure measurements

    NARCIS (Netherlands)

    Zwinderman, A. H.; Cleophas, T. A.; Cleophas, T. J.; van der Wall, E. E.

    2001-01-01

    In normotensive subjects blood pressures follow a circadian rhythm. A circadian rhythm in hypertensive patients is less well established, and may be clinically important, particularly with rigorous treatments of daytime blood pressures. Polynomial analysis of ambulatory blood pressure monitoring

  6. Anxiety: A Cause of High Blood Pressure?

    Science.gov (United States)

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

  7. African Americans and High Blood Pressure

    Science.gov (United States)

    ANSWERS by heart Lifestyle + Risk Reduction High Blood Pressure What About African Americans and High Blood Pressure? African Americans in the U.S. have a higher prevalence of high blood pressure (HBP) than ...

  8. High Blood Pressure: Medicines to Help You

    Science.gov (United States)

    ... For Consumers Consumer Information by Audience For Women High Blood Pressure--Medicines to Help You Share Tweet Linkedin Pin ... Click here for the Color Version (PDF 533KB) High blood pressure is a serious illness. High blood pressure is ...

  9. The distal blood pressure predicts healing of amputations on the feet

    DEFF Research Database (Denmark)

    Holstein, P

    1984-01-01

    The healing of digital and transmetatarsal forefoot amputations was compared with the systolic digital and ankle blood pressure, both measured with a strain-gauge, and with the skin perfusion pressure on the forefoot measured with the isotope washout technique. In 85 out of 134 legs (63 per cent......) the amputation healed. The frequency of healing correlated statistically significantly with all three measures of distal blood pressures, the closest correlation being with the systolic digital blood pressure (SDBP). As measured in 110 cases the healing rates were: SDBP less than 20 mm Hg: four out of 23; SDBP...

  10. Acute effect on ambulatory blood pressure from aerobic exercise

    DEFF Research Database (Denmark)

    Lund Rasmussen, Charlotte; Nielsen, Line; Linander Henriksen, Marie

    2018-01-01

    session among female cleaners. METHODS: Twenty-two female cleaners were randomised to a cross-over study with a reference and an aerobic exercise session. Differences in 24-h, work hours, leisure time, and sleep ambulatory blood pressure (ABP) were evaluated using repeated measure 2 × 2 mixed...... of 1.5 mmHg (p = 0.03) were found after the aerobic exercise session. During leisure time, the systolic ABP was lowered by 1.7 mmHg (p = 0.04) and the diastolic ABP was unaltered. During sleep, the systolic and diastolic ABP was unaltered. CONCLUSION: A single aerobic exercise session lowered 24-h...

  11. Improvement of Diurnal Blood Pressure Variation by Azilsartan.

    Science.gov (United States)

    Okamura, Keisuke; Shirai, Kazuyuki; Okuda, Tetsu; Urata, Hidenori

    2018-01-01

    Azilsartan is an angiotensin II receptor blocker with a potent antihypertensive effect. In a multicenter, prospective, open-label study, 265 patients with poor blood pressure control despite treatment with other angiotensin II receptor blockers were switched to 20 mg/day of azilsartan (patients on standard dosages) or 40 mg/day of azilsartan (patients on high dosages). Blood pressure was 149/83 mm Hg before switching and was significantly reduced from 1 month after switching until final assessment (132/76 mm Hg, P < 0.001). The pulse rate was 72/min before switching and increased significantly from 3 months after switching until final assessment (74/min, P < 0.005). A significant decrease of home morning systolic and diastolic pressure was observed from 1 and 3 months, respectively. Home morning blood pressure was 143/82 mm Hg before switching and 130/76 mm Hg at final assessment (P < 0.01). The morning-evening difference of systolic blood pressure decreased from 14.6 to 6.6 mm Hg after switching (P = 0.09). The estimated glomerular filtration rate was significantly decreased at 3, 6, and 12 months after switching, and serum uric acid was significantly increased at 12 months. No serious adverse events occurred. Azilsartan significantly reduced the blood pressure and decreased diurnal variation in patients responding poorly to other angiotensin II receptor blockers.

  12. [Blood pressure in 6 Yanomami villages].

    Science.gov (United States)

    Mancilha-Carvalho, J J; Sousa e Silva, N A; Carvalho, J V; Lima, J A

    1991-06-01

    To investigate in Yanomami Indians that not add salt to food, the relationship between blood pressure (BP), biological variables (age, body weight, height and pulse) and urinary electrolytes (Na+, K+, Ca++ and Mg++). We studied 125 males and 129 females from six villages on Surucuru plateau and on Catrimani and Ajarani rivers region in the state of Roraima, north Brazil. Two BP measurements were made and the mean of them were used in data analysis. None hypertensive was found. Systolic BP decreased with age and correlated with body weight, pulse and urinary Na+. Diastolic BP only correlated with body weight. Height, urinary K+, Ca++ and Mg++ did not correlate with BP. There was no hypertension nor increase of BP with increasing age in these isolated Yanomami.

  13. Cardiorespiratory Fitness and Blood Pressure: A Longitudinal Analysis.

    Science.gov (United States)

    Agostinis-Sobrinho, César; Ruiz, Jonatan R; Moreira, Carla; Abreu, Sandra; Lopes, Luís; Oliveira-Santos, José; Mota, Jorge; Santos, Rute

    2018-01-01

    To examine the association between cardiorespiratory fitness and cardiovascular indices 2 years later, and to determine whether changes in cardiorespiratory fitness are associated with cardiovascular indices at a 2-year follow-up in adolescents. The sample comprised 734 adolescents (349 girls) aged 12-18 years followed for 3 years from the LabMed Physical Activity Study. Cardiorespiratory fitness was assessed by the 20-meter shuttle run test. Height, weight, waist circumference, and resting blood pressure (BP) were measured according to standard procedures. Regression analyses showed a significant inverse association between cardiorespiratory fitness at baseline and systolic BP (B = -0.126; P = .047) and rate pressure product (B = -29.94; P = .016), at follow-up after adjustments for age, sex, height, pubertal stage, socioeconomic status, and waist circumference. Significant differences were found between cardiorespiratory fitness groups (fit vs unfit) at baseline and systolic BP and rate pressure product at follow-up (P fitness changes and systolic BP (P = .024) and rate pressure product (P = .014), after adjustment for age, sex, height, pubertal status, socioeconomic status, and waist circumference. Changes in cardiorespiratory fitness during adolescence were associated with cardiovascular indices over a 2-year period. Adolescents with persistently low levels of cardiorespiratory fitness exhibited the highest levels of systolic BP and rate pressure product. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Acute Effects of Positive Airway Pressure on Functional Mitral Regurgitation in Patients with Systolic Heart Failure

    Directory of Open Access Journals (Sweden)

    Takao Kato

    2017-11-01

    Full Text Available Background: Acute effects of positive airway pressure (PAP [including continuous PAP (CPAP and adaptive servo-ventilation, an advanced form of bi-level PAP] on functional mitral regurgitation (fMR in patients with heart failure (HF with left ventricular (LV systolic dysfunction remain unclear. Thus, whether PAP therapy reduces fMR in such patients with HF was investigated.Methods and Results: Twenty patients with HF and LV systolic dysfunction defined as LV ejection fraction (LVEF <50% (14 men; mean LVEF, 35.0 ± 11.5% with fMR underwent echocardiography during 10-min CPAP (4 and 8 cm H2O and adaptive servo-ventilation. For fMR assessment, MR jet area fraction, defined as the ratio of MR jet on color Doppler to the left atrial area, was measured. The forward stroke volume (SV index (fSVI was calculated from the time-velocity integral, cross-sectional area of the aortic annulus, and body surface area. fMR significantly reduced on CPAP at 8 cm H2O (0.30 ± 0.12 and adaptive servo-ventilation (0.29 ± 0.12, compared with the baseline phase (0.37 ± 0.12 and CPAP at 4 cm H2O (0.34 ± 0.12 (P < 0.001. The fSVI did not change in any of the PAP sessions (P = 0.888. However, significant differences in fSVI responses to PAP were found between sexes (P for interaction, 0.006, with a significant reduction in fSVI in women (P = 0.041 and between patients with baseline fSVI ≥ and < the median value (27.8 ml/m2, P for interaction, 0.018, with a significant fSVI reduction in patients with high baseline fSVI (P = 0.028. In addition, significant differences were found in fSVI responses to PAP between patients with LV end-systolic volume (LVESV index ≥ and < the median value (62.0 ml/m2, P for interaction, 0.034, with a significant fSVI increase in patients with a high LVESV index (P = 0.023.Conclusion: In patients with HF, LV systolic dysfunction, and fMR, PAP can alleviate fMR without any overall changes in forward SV. However, MR alleviation due to PAP

  15. Effects of curative treatment emphasizing endurance training on the performance and blood pressure of hypertensive and normotensives

    Science.gov (United States)

    Worms, F.

    1981-01-01

    The problem of normal values of blood pressure after exercise taking into account the blood pressure at the end of the exercise test is discussed. Hypertensives showed a lower working capacity than normotensives. In normotensives, however, systolic blood pressure at the end of an exercise correlated well with the working capacity. After the endurance cure submaximal blood pressure was markedly lower in hypertensives with a striking dependence on the level of initial values. Systolic blood pressure at the end of an exercise test was not changed significantly. Most probably it is not possible to overcome this malregulation in hypertensives by endurance training alone.

  16. Measurement of digital blood pressure after local cooling

    DEFF Research Database (Denmark)

    Nielsen, S L; Lassen, N A

    1977-01-01

    A double-inlet plastic cuff was designed for local cooling and systolic blood pressure measurement on the middle phalanx of the fingers. With a tourniquet on the proximal phalanx of one finger, cooling for 5 min made the digital artery temperature equal the skin temperature. The difference between...... the systolic pressure in a control finger and in the cooled finger give the reopening pressure in the digital arteries. At 30, 25, 20, 15, and 10 degrees C, respectively the percent decrease of the finger pressure was 0.2 (0.2), 1.5 (2.5), 8.5 (3.7), 11.4 (3.4), and 15.3 (3.1) in normal young women...

  17. Sleep deprivation increases blood pressure in healthy normotensive elderly and attenuates the blood pressure response to orthostatic challenge.

    Science.gov (United States)

    Robillard, Rébecca; Lanfranchi, Paola A; Prince, François; Filipini, Daniel; Carrier, Julie

    2011-03-01

    To determine how aging affects the impact of sleep deprivation on blood pressure at rest and under orthostatic challenge. Subjects underwent a night of sleep and 24.5 h of sleep deprivation in a crossover counterbalanced design. Sleep laboratory. Sixteen healthy normotensive men and women: 8 young adults (mean 24 years [SD 3.1], range 20-28 years) and 8 elderly adults (mean 64.1 years [SD 3.4], range 60-69 years). Sleep deprivation. Brachial cuff arterial blood pressure and heart rate were measured in semi-recumbent and upright positions. These measurements were compared across homeostatic sleep pressure conditions and age groups. Sleep deprivation induced a significant increase in systolic and diastolic blood pressure in elderly but not young adults. Moreover, sleep deprivation attenuated the systolic blood pressure orthostatic response in both age groups. Our results suggest that sleep deprivation alters the regulatory mechanisms of blood pressure and might increase the risk of hypertension in healthy normotensive elderly.

  18. Exercise blood pressure and the risk for future hypertension among normotensive middle-aged adults.

    Science.gov (United States)

    Berger, Assaf; Grossman, Ehud; Katz, Moshe; Kivity, Shaye; Klempfner, Robert; Segev, Shlomo; Goldenberg, Ilan; Sidi, Yehezkel; Maor, Elad

    2015-04-22

    The aim of the present study was to examine whether exercise blood pressure can be used to predict the development of hypertension in normotensive middle-aged adults. We investigated 7082 normotensive subjects who were annually screened in a tertiary medical center and completed maximal treadmill exercise tests at each visit. After the initial 3 years, subjects were divided into approximate quartiles according to their average exercise systolic and diastolic blood pressure responses (≤158; 158 to 170; 170 to 183; ≥183 mm Hg for systolic blood pressure and ≤73; 73 to 77; 77 to 82; ≥82 mm Hg for diastolic blood pressure). Mean age of the study population was 48 ± 9 years and 73% were men. Average baseline resting blood pressure was 120/77 ± 12/7 mm Hg. During a follow-up of 5 ± 3 years, 1036 (14.6%) subjects developed hypertension. The cumulative probability of new-onset hypertension at 5 years was significantly increased with increasing quartiles of exercise systolic blood pressure (5%, 9%, 17%, and 35%, respectively; Pexercise either systolic or diastolic blood pressures were independently associated with respective 11% (Phypertension. In normotensive middle-aged individuals, blood pressure response to exercise is associated with future development of hypertension. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  19. Exercise Blood Pressure and the Risk for Future Hypertension Among Normotensive Middle‐Aged Adults

    Science.gov (United States)

    Berger, Assaf; Grossman, Ehud; Katz, Moshe; Kivity, Shaye; Klempfner, Robert; Segev, Shlomo; Goldenberg, Ilan; Sidi, Yehezkel; Maor, Elad

    2015-01-01

    Background The aim of the present study was to examine whether exercise blood pressure can be used to predict the development of hypertension in normotensive middle‐aged adults. Methods and Results We investigated 7082 normotensive subjects who were annually screened in a tertiary medical center and completed maximal treadmill exercise tests at each visit. After the initial 3 years, subjects were divided into approximate quartiles according to their average exercise systolic and diastolic blood pressure responses (≤158; 158 to 170; 170 to 183; ≥183 mm Hg for systolic blood pressure and ≤73; 73 to 77; 77 to 82; ≥82 mm Hg for diastolic blood pressure). Mean age of the study population was 48±9 years and 73% were men. Average baseline resting blood pressure was 120/77±12/7 mm Hg. During a follow‐up of 5±3 years, 1036 (14.6%) subjects developed hypertension. The cumulative probability of new‐onset hypertension at 5 years was significantly increased with increasing quartiles of exercise systolic blood pressure (5%, 9%, 17%, and 35%, respectively; Pexercise either systolic or diastolic blood pressures were independently associated with respective 11% (Phypertension. Conclusions In normotensive middle‐aged individuals, blood pressure response to exercise is associated with future development of hypertension. PMID:25904593

  20. Mechanisms of blood pressure changes following renal irradiation of intact, adrenalectomized and adrenal regenerating rats

    International Nuclear Information System (INIS)

    Rosenblum, M.

    1976-01-01

    Results are reported from studies on the differences in changes in systolic arterial blood pressure following renal x-irradiation (1100 R) in adrenal-intact, adrenalectomized, and adrenal-regenerating rats and the roles of the kidneys and of the adrenal glands in the blood pressure changes

  1. Noise exposure at school and blood pressure in adolescents

    Directory of Open Access Journals (Sweden)

    Fadhilah Ihsani

    2017-01-01

    Full Text Available Background The increasing prevalence of primary hypertension has motivated researchers to identify influencing factors, one of which is noise. There have been few studies on a relationships between noise exposure and blood pressure in children, and none have dealt exclusively with adolescents. Objective To assess for an association between noise exposure at school and blood pressure in adolescents.   Methods To identify noisy and quiet schools, the mean noise levels of 192 senior high schools in Medan were measured using sound level meters. One noisy school and one quiet school were randomly selected for inclusion (mean noise levels of  68.2 and  53.8 dB, respectively. Students from both schools underwent blood pressure measurements by mercury sphygmomanometer. Their Body weights and heights were obtained for body mass index calculations. Subjects filled questionnaires and their parents were interviewed regarding history of illnesses. Results Of the 271 adolescents recruited, 136 (50.2% were from the noisy school. Adolescents from the noisy school had higher mean systolic and diastolic blood pressures [121.6 (SD 13.87 mmHg and 71.1 (SD 8.15 mmHg, respectively], than those from the quiet school [111.8 (SD 12.61 mmHg and 63.8 (SD 8.05 mmHg, respectively]. After adjusting for other factors, noise had a significant, moderate, positive association with systolic and diastolic blood pressures [β = 0.452; B = 6.21 (95% CI 3.86-8.55 mmHg; and β = 0.473; B = 4.18 (95% CI 2.41 to 5.94 mmHg, respectively]. Conclusion Adolescents from a noisy school have a greater risk of higher systolic and diastolic blood pressures than those from a quiet school.

  2. The correlation between psychological intervention and heart rate,systolic pressure in patients of cervical cancer treated with interventional chemoembolization

    International Nuclear Information System (INIS)

    Qiao Cuiyun; Lan Guiyun; Liu Shuang; Chen Bao'e; Liu Yali; Wang Zhujun

    2010-01-01

    Objective: To discuss the effect of psychological intervention on the heart rate, systolic pressure of the patients with cervical cancer who are treated with interventional chemoembolization. Methods: Eighty patients with cervical cancer were randomly and equally divided into two groups. Transcatheter arterial chemoembolization (TACE) was performed in all cases. Patients in study group (n=10) received systemic psychological intervention 30 minutes before TACE. The heart rate and systolic pressure of the patients were measured when TACE started. The results were compared with that obtained at the time of admission. Patients in control group (n=10) did not receive systemic psychological intervention before TACE and their heart rate and systolic pressure were measured in the same way as in study group. Results: At the time TACE started the heart rate and systolic pressure of the patients in study group were significantly lower than that in control group (P < 0.05). Conclusion: Preoperative psychological intervention is very helpful for reducing psychological stress and mental tension,in stabilizing heart rate and systolic pressure of the patients with cervical cancer who are treated with TACE. (authors)

  3. Echocardiographic assessment of systolic pulmonary arterial pressure in HIV-positive patients.

    Directory of Open Access Journals (Sweden)

    Mehrnaz Rasoulinejad

    2014-11-01

    Full Text Available Pulmonary hypertension is rare but is one of the complications that occur due to HIV infection. Symptoms of HIV-associated pulmonary arterial hypertension are often non-specific but the main symptom of the disease is dyspnea. In this cross-sectional study, we measured systolic pulmonary arterial pressure (SPAP by echocardiographic methods among HIV-positive patients who received ART. This research is a descriptive, cross-sectional study of 170 HIV-positive patients that was conducted in Imam-Khomeini hospital, Tehran, Iran during 2011-2013. All patients regularly received antiretroviral therapy at least for recent 2 years. There were not any cardiopulmonary symptoms (cough, dyspnea, exertional fatigue and chest discomfort in these patients. All participants underwent echocardiography to estimate SPAP. The participants comprised 108 males (63.5% and 62 females (46.5%. The mean age of patients was 41 years old, and the mean duration of HIV infection was 5.5 years. The mean CD4 cell count was 401 cell/µl. The principal regimen of antiretroviral therapy included two nucleoside reverse transcriptase inhibitor (NRTI and one non-nucleoside reverse transcriptase inhibitor (NNRTI in the hospital. The mean of systolic pulmonary arterial pressure was 25 mmHg in the participants; 156 (93.4% of them had SPAP ≤ 30 mmHg (normal, six (3.6% had SPAP: 31-35 mmHg (borderline and five (3% had SPAP > 35 mmHg (pulmonary hypertension. Our results indicated a significant increase of pulmonary hypertension in asymptomatic HIV-positive patients that had no association with any other risk factor. Also, antiretroviral therapy was not a risk factor for pulmonary hypertension in this study.

  4. Validation of the AVITA BPM63S upper arm blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    Science.gov (United States)

    Kang, Yuan-Yuan; Zeng, Wei-Fang; Liu, Ming; Li, Yan; Wang, Ji-Guang

    2014-02-01

    The present study aimed to evaluate the accuracy of the AVITA BPM63S upper arm blood pressure monitor for home blood pressure monitoring according to the International Protocol of the European Society of Hypertension revision 2010. Systolic and diastolic blood pressures were sequentially measured in 33 adult Chinese (14 women, mean age of 47 years) using a mercury sphygmomanometer (two observers) and the AVITA BPM63S device (one supervisor). Ninety-nine pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. All the blood pressure requirements were fulfilled. The AVITA BPM63S device achieved the targets in part 1 of the validation study. The number of absolute differences between device and observers within 5, 10, and 15 mmHg was 68/99, 89/99, and 96/99, respectively, for systolic blood pressure, and 75/99, 95/99, and 97/99, respectively, for diastolic blood pressure. The device also achieved the criteria in part 2 of the validation study. Twenty-four and 25 participants for systolic and diastolic blood pressure, respectively, had at least two of the three device-observers differences within 5 mmHg (required ≥24). One and two participants for systolic and diastolic blood pressure, respectively, had all three device-observers differences greater than 5 mmHg. The AVITA BPM63S automated oscillometric upper arm blood pressure monitor has passed the requirements of the International Protocol revision 2010, and hence can be recommended for blood pressure measurement at home in adults.

  5. Associations between cadmium levels in blood and urine, blood pressure and hypertension among Canadian adults

    Energy Technology Data Exchange (ETDEWEB)

    Garner, Rochelle E., E-mail: rochelle.garner@canada.ca [Health Analysis Division, Statistics Canada, Ottawa, Ontario (Canada); Levallois, Patrick [Direction de la santé environnementale et de la toxicologie, Institut National de Santé Publique du Québec, Québec City, Québec (Canada); Axe santé des populations et pratiques optimales en santé, Centre de Recherche du CHU de Québec-Université Laval, Québec City, Québec (Canada)

    2017-05-15

    Background: Cadmium has been inconsistently related to blood pressure and hypertension. The present study seeks to clarify the relationship between cadmium levels found in blood and urine, blood pressure and hypertension in a large sample of adults. Methods: The study sample included participants ages 20 through 79 from multiple cycles of the Canadian Health Measures Survey (2007 through 2013) with measured blood cadmium (n=10,099) and urinary cadmium (n=6988). Linear regression models examined the association between natural logarithm transformed cadmium levels and blood pressure (separate models for systolic and diastolic blood pressure) after controlling for known covariates. Logistic regression models were used to examine the association between cadmium and hypertension. Models were run separately by sex, smoking status, and body mass index category. Results: Men had higher mean systolic (114.8 vs. 110.8 mmHg, p<0.01) and diastolic (74.0 vs. 69.6 mmHg, p<0.01) blood pressure compared to women. Although, geometric mean blood (0.46 vs. 0.38 µg/L, p<0.01) and creatinine-adjusted standardized urinary cadmium levels (0.48 vs. 0.38 µg/L, p<0.01) were higher among those with hypertension, these differences were no longer significant after adjustment for age, sex and smoking status. In overall regression models, increases in blood cadmium were associated with increased systolic (0.70 mmHg, 95% confidence interval [CI]=0.25–1.16, p<0.01) and diastolic blood pressure (0.74 mmHg, 95% CI=0.30–1.19, p<0.01). The associations between urinary cadmium, blood pressure and hypertension were not significant in overall models. Model stratification revealed significant and negative associations between urinary cadmium and hypertension among current smokers (OR=0.61, 95% CI=0.44–0.85, p<0.01), particularly female current smokers (OR=0.52, 95% CI=0.32–0.85, p=0.01). Conclusion: This study provides evidence of a significant association between cadmium levels, blood pressure

  6. Associations between cadmium levels in blood and urine, blood pressure and hypertension among Canadian adults

    International Nuclear Information System (INIS)

    Garner, Rochelle E.; Levallois, Patrick

    2017-01-01

    Background: Cadmium has been inconsistently related to blood pressure and hypertension. The present study seeks to clarify the relationship between cadmium levels found in blood and urine, blood pressure and hypertension in a large sample of adults. Methods: The study sample included participants ages 20 through 79 from multiple cycles of the Canadian Health Measures Survey (2007 through 2013) with measured blood cadmium (n=10,099) and urinary cadmium (n=6988). Linear regression models examined the association between natural logarithm transformed cadmium levels and blood pressure (separate models for systolic and diastolic blood pressure) after controlling for known covariates. Logistic regression models were used to examine the association between cadmium and hypertension. Models were run separately by sex, smoking status, and body mass index category. Results: Men had higher mean systolic (114.8 vs. 110.8 mmHg, p<0.01) and diastolic (74.0 vs. 69.6 mmHg, p<0.01) blood pressure compared to women. Although, geometric mean blood (0.46 vs. 0.38 µg/L, p<0.01) and creatinine-adjusted standardized urinary cadmium levels (0.48 vs. 0.38 µg/L, p<0.01) were higher among those with hypertension, these differences were no longer significant after adjustment for age, sex and smoking status. In overall regression models, increases in blood cadmium were associated with increased systolic (0.70 mmHg, 95% confidence interval [CI]=0.25–1.16, p<0.01) and diastolic blood pressure (0.74 mmHg, 95% CI=0.30–1.19, p<0.01). The associations between urinary cadmium, blood pressure and hypertension were not significant in overall models. Model stratification revealed significant and negative associations between urinary cadmium and hypertension among current smokers (OR=0.61, 95% CI=0.44–0.85, p<0.01), particularly female current smokers (OR=0.52, 95% CI=0.32–0.85, p=0.01). Conclusion: This study provides evidence of a significant association between cadmium levels, blood pressure

  7. Blood pressure and cardiovascular risk: what about cocoa and chocolate?

    Science.gov (United States)

    Grassi, Davide; Desideri, Giovambattista; Ferri, Claudio

    2010-09-01

    Cocoa flavonoids are able to reduce cardiovascular risk by improving endothelial function and decreasing blood pressure (BP). Interest in the biological activities of cocoa is daily increasing. A recent meta-analysis shows flavanol-rich cocoa administration decreases mean systolic (-4.5mm Hg; pcocoa effects on cardiovascular health focusing on putative mechanisms of action and nutritional and "pharmacological" viewpoints. Cocoa consumption could play a pivotal role in human health. 2010 Elsevier Inc. All rights reserved.

  8. Systolic hypertension in adult nigerians with hypertension

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  9. DASH diet to lower high blood pressure

    Science.gov (United States)

    ... patientinstructions/000770.htm DASH diet to lower high blood pressure To use the sharing features on this page, ... Hypertension. The DASH diet can help lower high blood pressure and cholesterol and other fats in your blood. ...

  10. High blood pressure and eye disease

    Science.gov (United States)

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

  11. Traffic congestion and blood pressure elevation: A comparative cross-sectional study in Lebanon.

    Science.gov (United States)

    Bou Samra, Patrick; El Tomb, Paul; Hosni, Mohammad; Kassem, Ahmad; Rizk, Robin; Shayya, Sami; Assaad, Sarah

    2017-12-01

    This comparative cross-sectional study examines the association between traffic congestion and elevation of systolic and/or diastolic blood pressure levels among a convenience sample of 310 drivers. Data collection took place during a gas station pause at a fixed time of day. Higher average systolic (142 vs 123 mm Hg) and diastolic (87 vs 78 mm Hg) blood pressures were detected among drivers exposed to traffic congestion compared with those who were not exposed (P<.001), while controlling for body mass index, age, sex, pack-year smoking, driving hours per week, and occupational driving. Moreover, among persons exposed to traffic congestion, longer exposure time was associated with higher systolic and diastolic blood pressures. Further studies are needed to better understand the mechanisms of the significant association between elevated blood pressure and traffic congestion. ©2017 Wiley Periodicals, Inc.

  12. Vital Signs - High Blood Pressure

    Centers for Disease Control (CDC) Podcasts

    2012-10-02

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

  13. High Blood Pressure: Unique to Older Adults

    Science.gov (United States)

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

  14. Blood pressure patterns in women with gestational hypertension or mild preeclampsia at term.

    Science.gov (United States)

    van der Tuuk, K; Tajik, P; Koopmans, C M; van den Berg, P P; Mol, B W J; van Pampus, M G; Groen, H

    2017-03-01

    Gestational hypertension (GH) and mild preeclampsia (PE) represent the most common medical complications of pregnancy, with the majority of cases developing at or near term. There is little knowledge of the course of blood pressure over time in these women. We explored the pattern of systolic and diastolic blood pressure over time in women with GH or mild PE at term participating in the HYPITAT trial, and we attempted to identify clinical factors influencing these blood pressure patterns and the impact of severe hypertension on clinical management. We used data from the HYPITAT trial, that included women with a singleton pregnancy with a fetus in cephalic position between 36 and 41 weeks of gestation with the diagnosis of GH or mild PE. Blood pressure measurements were performed from randomization or admission until delivery or discharge from the hospital. We included the highest blood pressure of each day. We evaluated systolic and diastolic blood pressure change over time, as well as the influence of clinical characteristics and laboratory findings on the course of blood pressure. We used univariate and multivariate regression analysis with a backward stepwise algorithm for the selection of variables. The model with the best fit (lowest AIC) was selected as the final model. We also compared mode of delivery for women with and without severe hypertension. We studied 1076 women who had 4188 blood pressure measurements done. The systolic blood pressure showed a significant non-linear increase over time and for the diastolic blood pressure the pattern was also non-linear. In the multivariable model of systolic blood pressure change over time, nulliparity, ethnicity, systolic blood pressure (at baseline), BMI and LDH at randomization influenced the course of blood pressure. In the diastolic blood pressure model ALT and the baseline diastolic blood pressure had a significant influence. When we explored the association between blood pressure and mode of delivery, it

  15. Associations between bacterial infections and blood pressure in pregnancy.

    Science.gov (United States)

    Petry, Clive J; Ong, Ken K; Hughes, Ieuan A; Acerini, Carlo L; Dunger, David B

    2017-10-01

    To test the hypothesis that bacterial infections in pregnancy are related to maternal blood pressure. Bacterial infection was assessed using antibiotic usage as a surrogate and its association with blood pressure in pregnancy tested in the Cambridge Baby Growth Study. Antibiotic usage in pregnancy was self-reported in questionnaires. Blood pressure measurements at four time points in pregnancy were collected from the hospital notes of 622 women. Using all the available blood pressure readings (adjusted for weeks gestation) antibiotic usage was associated with a higher mean arterial blood pressure across pregnancy: antibiotics used 85(84, 87)mmHg vs. no antibiotics used 83 (83, 84) mmHg (β=2.3 (0.6, 4.0) mmHg, p=9.6×10 -3 , from 621 individuals). Further analysis revealed that antibiotic usage was associated with diastolic (β=2.3 (0.6, 4.0) mmHg; p=7.0×10 -3 ) more than systolic blood pressure (β=1.4(-0.9, 3.7)mmHg; p=0.2). The effect size associated with antibiotic usage appeared to rise slightly after the first trimester. Bacterial infection in pregnancy, as assessed by self-reported antibiotic usage, is associated with small rises in blood pressure. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  16. Dark chocolate and blood pressure: a novel study from Jordan.

    Science.gov (United States)

    Al-Safi, Saafan A; Ayoub, Nehad M; Al-Doghim, Imad; Aboul-Enein, Faisal H

    2011-11-01

    The goal of this study was to assess the effect of dark chocolate intake on cardiovascular parameters like blood pressure and heart rate values in a normotensive population. This is a randomized cross-sectional study involving a total of 14,310 adults that were selected from various regions of Jordan. Well-trained pharmacy students interviewed participants in the outpatient settings. Participants reported their weekly intake of dark chocolate that has been further classified into mild (1-2 bars/week), moderate (3-4 bars/week), and high intake ( > 4 bars/week). For each participant, the systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate were measured three times with (10-15) minute intervals in the sitting position and the resting state. The arterial blood pressure (ABP) was calculated from the measured SBP and DBP values. All measured blood pressure values were significantly decreased for participants who reported higher dark chocolate consumption. Our results showed that heart rate values were not affected by variable intake of dark chocolate. In addition, increasing dark chocolate intake was associated with a significant decrease of blood pressure values in participants irrespective of the family history of hypertension or the age of the individual. However, heart rate values were unaffected. Higher intake of dark chocolate can be associated with lower values of blood pressure, while its effect on heart rate values was not consistent.

  17. Direct measured systolic pressure gradients across the aorto-iliac segment in multiple-level-obstruction arteriosclerosis

    DEFF Research Database (Denmark)

    Noer, Ivan; Praestholm, J; Tønnesen, K H

    1981-01-01

    Patients with severe ischemia due to multi-level obstructions in the leg arteries both above and below the region were assessed preoperatively by intraarterial brachial and femoral artery pressure measurements. The systolic pressure drop along aorto-iliac obstructions was compared to the angiogra....... Due to large variations, however, the angiographic information was found to be useless in the individual patient. No difference in the pressure drop was found between cases in which rich and poor collateral networks were visualized....

  18. Secular trends of blood pressure in A-bomb survivors

    International Nuclear Information System (INIS)

    Sasaki, Hideo; Kodama, Kazunori; Kitano, Koei

    1986-01-01

    There has been controversy about whether or not radiation exposure plays a major role in advancing age. To preliminarily study this relationship, a statistical analysis was made on blood pressure measurements in a cohort of A-bomb survivors for Adult Health Study carried out during a 22-year period from 1958 through 1980. Systolic blood pressure increased with advancing age in both men and women between 30 and 80 years. During the years 1974 through 1980, it tended to increase in both men and women aged in their thirties and fourties. Diastolic blood pressure for men increased between the ages of 30 and 60 years, and decreased between the ages of 60 and 80 years. It tended to increase from year to year for men. For women, it decreased prior to the 1970's, and thereafter, tended to increase. The parameters, including systolic and diastolic blood pressures and pulse pressure, were independent of exposure doses in the subgroups according to age or sex. (Namekawa, K.)

  19. Does chocolate reduce blood pressure? A meta-analysis

    Directory of Open Access Journals (Sweden)

    Ried Karin

    2010-06-01

    Full Text Available Abstract Background Dark chocolate and flavanol-rich cocoa products have attracted interest as an alternative treatment option for hypertension, a known risk factor for cardiovascular disease. Previous meta-analyses concluded that cocoa-rich foods may reduce blood pressure. Recently, several additional trials have been conducted with conflicting results. Our study summarises current evidence on the effect of flavanol-rich cocoa products on blood pressure in hypertensive and normotensive individuals. Methods We searched Medline, Cochrane and international trial registries between 1955 and 2009 for randomised controlled trials investigating the effect of cocoa as food or drink compared with placebo on systolic and diastolic blood pressure (SBP/DBP for a minimum duration of 2 weeks. We conducted random effects meta-analysis of all studies fitting the inclusion criteria, as well as subgroup analysis by baseline blood pressure (hypertensive/normotensive. Meta-regression analysis explored the association between type of treatment, dosage, duration or baseline blood pressure and blood pressure outcome. Statistical significance was set at P Results Fifteen trial arms of 13 assessed studies met the inclusion criteria. Pooled meta-analysis of all trials revealed a significant blood pressure-reducing effect of cocoa-chocolate compared with control (mean BP change ± SE: SBP: -3.2 ± 1.9 mmHg, P = 0.001; DBP: -2.0 ± 1.3 mmHg, P = 0.003. However, subgroup meta-analysis was significant only for the hypertensive or prehypertensive subgroups (SBP: -5.0 ± 3.0 mmHg; P = 0.0009; DBP: -2.7 ± 2.2 mm Hg, P = 0.01, while BP was not significantly reduced in the normotensive subgroups (SBP: -1.6 ± 2.3 mmHg, P = 0.17; DBP: -1.3 ± 1.6 mmHg, P = 0.12. Nine trials used chocolate containing 50% to 70% cocoa compared with white chocolate or other cocoa-free controls, while six trials compared high- with low-flavanol cocoa products. Daily flavanol dosages ranged from 30

  20. Pulse pressure and diurnal blood pressure variation

    DEFF Research Database (Denmark)

    Knudsen, Søren Tang; Poulsen, Per Løgstrup; Hansen, Klavs Würgler

    2002-01-01

    retinopathy, nephropathy, macrovascular disease, PP, and diurnal BP variation in a group of type 2 diabetic patients. METHODS: In 80 type 2 diabetic patients we performed 24-h ambulatory BP (AMBP) and fundus photographs. Urinary albumin excretion was evaluated by urinary albumin/creatinine ratio. Presence...... or absence of macrovascular disease was assessed by an independent physician. RESULTS: Forty-nine patients had no detectable retinal changes (grade 1), 13 had grade 2 retinopathy, and 18 had more advanced retinopathy (grades 3-6). Compared to patients without retinopathy (grade 1), patients with grades 2......BACKGROUND: In nondiabetic subjects pulse pressure (PP) is an independent predictor of cardiovascular disease and microalbuminuria. Reduced circadian blood pressure (BP) variation is a potential risk factor for the development of diabetic complications. We investigated the association between...

  1. Automatic Blood Pressure Measurements During Exercise

    Science.gov (United States)

    Weaver, Charles S.

    1985-01-01

    Microprocessor circuits and a computer algorithm for automatically measuring blood pressure during ambulatory monitoring and exercise stress testing have been under development at SRI International. A system that records ECG, Korotkov sound, and arm cuff pressure for off-line calculation of blood pressure has been delivered to NASA, and an LSLE physiological monitoring system that performs the algorithm calculations in real-time is being constructed. The algorithm measures the time between the R-wave peaks and the corresponding Korotkov sound on-set (RK-interval). Since the curve of RK-interval versus cuff pressure during deflation is predictable and slowly varying, windows can be set around the curve to eliminate false Korotkov sound detections that result from noise. The slope of this curve, which will generally decrease during exercise, is the inverse of the systolic slope of the brachial artery pulse. In measurements taken during treadmill stress testing, the changes in slopes of subjects with coronary artery disease were markedly different from the changes in slopes of healthy subjects. Measurements of slope and O2 consumption were also made before and after ten days of bed rest during NASA/Ames Research Center bed rest studies. Typically, the maximum rate of O2 consumption during the post-bed rest test is less than the maximum rate during the pre-bed rest test. The post-bed rest slope changes differ from the pre-bed rest slope changes, and the differences are highly correlated with the drop in the maximum rate of O2 consumption. We speculate that the differences between pre- and post-bed rest slopes are due to a drop in heart contractility.

  2. Blood pressure measurement in obese patients: comparison between upper arm and forearm measurements.

    Science.gov (United States)

    Pierin, Angela M G; Alavarce, Débora C; Gusmão, Josiane L; Halpern, Alfredo; Mion, Décio

    2004-06-01

    It is well known that blood pressure measurement with a standard 12-13 cm wide cuff is erroneous for large arms. To compare arm blood pressure measurements with an appropriate cuff and forearm blood pressure measurements (BPM) with a standard cuff, and both measurements by the Photopletismography (Finapres) method. One hundred and twenty-nine obese patients were studied (body mass index=40+/-7 kg/m2). The patients had three arm BPM taken by an automatic oscillometric device using an appropriate cuff and three forearm BPM with a standard cuff in the sitting position after a five-minute rest. Data were analysed by the analysis of variance. The correction values were obtained by the linear regression test. Systolic and diastolic arm BPM with an appropriate cuff were significantly lower (pforearm BPM with a standard cuff. The measurements obtained by Finapres were significantly lower (pforearm systolic and diastolic blood pressures and upper arm diastolic blood pressure. The equation to correct BPM in forearm in obese patients with arm circumference between 32-44 cm was: systolic BPM=33.2+/-0.68 x systolic forearm BPM, and diastolic BPM=25.2+0.59 x forearm diastolic BPM. This study showed that forearm blood pressure measurement overestimates the values of arm blood pressure measurement. In addition, it is possible to correct forearm BPM with an equation.

  3. Intensive versus conventional blood pressure monitoring in a general practice population. The Blood Pressure Reduction in Danish General Practice trial: a randomized controlled parallel group trial.

    Science.gov (United States)

    Klarskov, Pia; Bang, Lia E; Schultz-Larsen, Peter; Gregers Petersen, Hans; Benee Olsen, David; Berg, Ronan M G; Abrahamsen, Henrik; Wiinberg, Niels

    2018-01-17

    To compare the effect of a conventional to an intensive blood pressure monitoring regimen on blood pressure in hypertensive patients in the general practice setting. Randomized controlled parallel group trial with 12-month follow-up. One hundred and ten general practices in all regions of Denmark. One thousand forty-eight patients with essential hypertension. Conventional blood pressure monitoring ('usual group') continued usual ad hoc blood pressure monitoring by office blood pressure measurements, while intensive blood pressure monitoring ('intensive group') supplemented this with frequent home blood pressure monitoring and 24-hour ambulatory blood pressure monitoring. Mean day- and night-time systolic and diastolic 24-hour ambulatory blood pressure. Change in systolic and diastolic office blood pressure and change in cardiovascular risk profile. Of the patients, 515 (49%) were allocated to the usual group, and 533 (51%) to the intensive group. The reductions in day- and night-time 24-hour ambulatory blood pressure were similar (usual group: 4.6 ± 13.5/2.8 ± 82 mmHg; intensive group: 5.6 ± 13.0/3.5 ± 8.2 mmHg; P = 0.27/P = 0.20). Cardiovascular risk scores were reduced in both groups at follow-up, but more so in the intensive than in the usual group (P = 0.02). An intensive blood pressure monitoring strategy led to a similar blood pressure reduction to conventional monitoring. However, the intensive strategy appeared to improve patients' cardiovascular risk profile through other effects than a reduction of blood pressure. Clinical Trials NCT00244660. © The Author 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Does a colour-coded blood pressure diary improve blood pressure control for patients in general practice: The CoCo trial

    Directory of Open Access Journals (Sweden)

    Senn Oliver

    2010-04-01

    Full Text Available Abstract Background Insufficient blood pressure control is a frequent problem despite the existence of effective treatment. Insufficient adherence to self-monitoring as well as to therapy is a common reason. Blood pressure self-measurement at home (Home Blood Pressure Measurement, HBPM has positive effects on treatment adherence and is helpful in achieving the target blood pressure. Only a few studies have investigated whether adherence to HBPM can be improved through simple measures resulting also in better blood pressure control. Objective Improvement of self-monitoring and improved blood pressure control by using a new colour-coded blood pressure diary. Outcome Primary outcome: Change in systolic and/or diastolic blood pressure 6 months after using the new colour-coded blood pressure diary. Secondary outcome: Adherence to blood pressure self-measurement (number of measurements/entries. Methods/Design Randomised controlled study. Population: 138 adult patients in primary care with uncontrolled hypertension despite therapy. The control group uses a conventional blood pressure diary; the intervention group uses the new colour-coded blood pressure diary (green, yellow, red according a traffic light system. Expected results/conclusion The visual separation and entries in three colour-coded areas reflecting risk (green: blood pressure in the target range ≤ 140/≤ 90 mmHg, yellow: blood pressure >140/>90 mmHg, red: blood pressure in danger zone > 180 mmHg/>110 mmHg lead to better self-monitoring compared with the conventional (non-colour-coded blood pressure booklet. The colour-coded, visualised information supports improved perception (awareness and interpretation of blood pressure and triggers correct behaviour, in the means of improved adherence to the recommended treatment as well as better communication between patients and doctors resulting in improved blood pressure control. Trial registration ClinicalTrials.gov ID NCT01013467

  5. Validation of the HONSUN LD-578 blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol.

    Science.gov (United States)

    Zhang, Yi; Wang, Jie; Huang, Qi-Fang; Sheng, Chang-Sheng; Li, Yan; Wang, Ji-Guang

    2009-06-01

    This study aimed to evaluate the accuracy of the automated oscillometric upper arm blood pressure monitor LD-578 (HONSUN Group, Shanghai, China) for home blood pressure monitoring according to the International Protocol. Systolic and diastolic blood pressures were sequentially measured in 33 adult Chinese using a mercury sphygmomanometer (two observers) and the LD-578 device (one supervisor). Ninety-nine pairs of comparisons were obtained from 15 participants in phase 1 and a further 18 participants in phase 2 of the validation study. Data analysis was performed using the ESHIP Analyzer. The LD-578 device successfully passed phase 1 of the validation study with a number of absolute differences between device and observers within 5, 10, and 15 mmHg for at least 32 of 45, 41 of 45, and 45 of 45 measurements (required 25, 35, and 40), respectively. The device also achieved the targets for phase 2.1, with 67 of 99, 90 of 99, and 98 of 99 differences within 5, 10, and 15 mmHg, respectively, for systolic blood pressure, and with 69 of 99, 95 of 99, and 98 of 99 within 5, 10, and 15 mmHg, respectively, for diastolic blood pressure. In phase 2.2, 24 participants had at least two of the three device-observers differences within 5 mmHg (required >or=22) for systolic and diastolic blood pressure. The HONSUN upper arm blood pressure monitor LD-578 can be recommended for home use in adults.

  6. Risk Stratification by Ambulatory Blood Pressure Monitoring Across JNC Classes of Conventional Blood Pressure

    DEFF Research Database (Denmark)

    Brguljan-Hitij, Jana; Thijs, Lutgarde; Li, Yan

    2014-01-01

    BACKGROUND: Guidelines propose classification of conventional blood pressure (CBP) into normotension (<120/<80 mm Hg), prehypertension (120-139/80-89 mm Hg), and hypertension (≥140/≥90 mm Hg). METHODS: To assess the potential differential contribution of ambulatory blood pressure (ABP) in predict......BACKGROUND: Guidelines propose classification of conventional blood pressure (CBP) into normotension (ABP......%) and of cardiovascular (-34%), cardiac (-33%), or cerebrovascular (-47%) events. Multivariable-adjusted hazard ratios (HRs) for stroke associated with 24-hour and daytime diastolic ABP (+5 mm Hg) were higher (P ≤ 0.045) in normotension than in prehypertension and hypertension (1.98 vs.1.19 vs.1.28 and 1.73 vs.1.09 vs. 1.......24, respectively) with similar trends (0.03 ≤ P ≤ 0.11) for systolic ABP (+10 mm Hg). However, HRs for fatal endpoints and cardiac events associated with ABP did not differ significantly (P ≥ 0.13) across CBP categories. Of normotensive and prehypertensive participants, 7.5% and 29.3% had masked hypertension...

  7. Prevalence of inter-arm blood pressure difference among clinical out-patients.

    Science.gov (United States)

    Sharma, Balkishan; Ramawat, Pramila

    2016-04-01

    An increased inter-arm blood pressure difference is an easily determined physical finding, may use as an indicator of cardio vascular event and other sever diseases. Authors evaluated 477 patients to determine the prevalence and significance of inter-arm blood pressure difference. 477 routine outdoor patients selected to observe the inter-arm blood pressure difference. Age, height, weight, body mass index, history of disease and blood pressure recorded. The prevalence of ≥10 mmHg systolic inter-arm blood pressure difference was 5.0% was more as compared to 3.8% had diastolic inter-arm blood pressure difference. The prevalence of systolic and diastolic inter-arm difference between 6 to 10 mmHg was 31.4% and 27.9% respectively. Mean systolic inter-arm blood pressure difference was significantly higher among those patients had a multisystem disorder (10.57±0.98 mmHg) and followed by patients with cardiovascular disease (10.22±0.67 mmHg) as compared to healthy patients (2.71±0.96 mmHg). Various diseases highly influenced the increase in blood pressure irrespective of systolic or diastolic was confirmed strongly significant (pdifferent inter arm blood pressure difference levels. This study supports the view of inter-arm blood pressure difference as an alarming stage of increased disease risk that incorporated to investigate potential problems at an early diagnostic stage. A significant mean difference between left and right arm blood pressure recorded for many diseases.

  8. Accurate blood pressure recording: is it difficult?

    Science.gov (United States)

    Bhalla, A; Singh, R; D'cruz, S; Lehl, S S; Sachdev, A

    2005-11-01

    Blood pressure (BP) measurement is a routine procedure but errors are frequently committed during BP recording. AIMS AND SETTINGS: The aim of the study was to look at the prevalent practices in the institute regarding BP recording. The study was conducted in the Medicine Department at Government Medical College, Chandigarh, a teaching institute for MBBS students. A prospective, observational study was performed amongst the 80 doctors in a tertiary care hospital. All of them were observed by a single observer during the act of BP recording. The observer was well versed with the guidelines issued by British Hypertension Society (BHS) and the deviations from the standard set of guidelines issued by BHS were noted. The errors were defined as deviations from these guidelines. The results were recorded as percentage of doctors committing these errors. In our study, 90% used mercury type sphygmomanometer. Zero error of the apparatus, hand dominance was not noted by any one. Every one used the standard BP cuff for recording BP. 70% of them did not let the patient rest before recording BP. 80% did not remove the clothing from the arm. None of them recorded BP in both arms. In out patient setting, 80% recorded blood pressure in sitting position and 14% in supine position. In all the patients where BP was recorded in sitting position BP apparatus was below the level of heart and 20% did not have their arm supported. 60% did not use palpatory method for noticing systolic BP and 70% did not raise pressure 30-40 mm Hg above the systolic level before checking the BP by auscultation. 80% lowered the BP at a rate of more than 2 mm/s and 60% rounded off the BP to nearest 5-10 mm Hg. 70% recorded BP only once and 90% of the rest re inflated the cuff without completely deflating and allowing rest before a second reading was obtained. The practice of recording BP in our hospital varies from the standard guidelines issued by the BHS.

  9. Agreement between direct and indirect blood pressure measurements obtained from anesthetized Hispaniolan Amazon parrots.

    Science.gov (United States)

    Acierno, Mark J; da Cunha, Anderson; Smith, Julie; Tully, Thomas N; Guzman, David Sanchez-Migallon; Serra, Verna; Mitchell, Mark A

    2008-11-15

    To determine the level of agreement between direct and indirect blood pressure measurements obtained from healthy Hispaniolan Amazon parrots (Amazona ventralis) anesthetized with isoflurane. Validation study. 16 healthy adult Hispaniolan Amazon parrots. Parrots were anesthetized, and a 26-gauge, 19-mm catheter was placed percutaneously in the superficial ulnar artery for direct measurement of systolic, mean, and diastolic arterial pressures. Indirect blood pressure measurements were obtained with a Doppler ultrasonic flow detector and an oscillometric unit. The Bland-Altman method was used to compare direct and indirect blood pressure values. There was substantial disagreement between direct systolic arterial blood pressure and indirect blood pressure measurements obtained with the Doppler detector from the wing (bias, 24 mm Hg; limits of agreement, -37 to 85 mm Hg) and from the leg (bias, 14 mm Hg; limits of agreement, -14 to 42 mm Hg). Attempts to obtain indirect blood pressure measurements with the oscillometric unit were unsuccessful. Results suggested that there was substantial disagreement between indirect blood pressure measurements obtained with a Doppler ultrasonic flow detector in anesthetized Hispaniolan Amazon parrots and directly measured systolic arterial blood pressure.

  10. Riboflavin intake and 5-year blood pressure change in Chinese adults: interaction with hypertensive medication.

    Science.gov (United States)

    Shi, Zumin; Yuan, Baojun; Taylor, Anne W; Zhen, Shiqi; Zuo, Hui; Dai, Yue; Wittert, Gary A

    2014-03-01

    One previous large cross-sectional study across four countries suggests that riboflavin intake may be inversely associated with blood pressure. The aim of this analysis was to investigate a possible association between riboflavin intake and change in blood pressure over 5 years. The study population comprised Chinese men and women who participated in the Jiangsu Nutrition Study. Quantitative data relating to riboflavin intake at baseline in 2002 and measurements of blood pressure at baseline and follow-up in 2007 were available for 1,227 individuals. Overall, 97.2% of the participants had inadequate riboflavin intake (below the Estimated Average Requirement). In multivariable analysis adjusted for sociodemographic and lifestyle factors and dietary patterns, a higher riboflavin intake was inversely associated with change in systolic blood pressure (p = .036). In participants taking antihypertensive medication at baseline, the relationship between riboflavin intake and systolic blood pressure persisted; whereas, in those not taking antihypertensive medication, the diastolic blood pressure was less likely to increase with the increasing intake of riboflavin (p = .031). There was a three-way interaction between antihypertensive medications, body mass index, and riboflavin intake. Among those who were obese and taking antihypertensive medication, a higher riboflavin intake was associated with a smaller increment in systolic blood pressure and pulse pressure. There are complex interactions between riboflavin intake and blood pressure change that depend on prior antihypertensive use and the presence or absence of obesity.

  11. A Comparison and Calibration of a Wrist-Worn Blood Pressure Monitor for Patient Management: Assessing the Reliability of Innovative Blood Pressure Devices

    Science.gov (United States)

    Melville, Sarah; Teskey, Robert; Philip, Shona; Simpson, Jeremy A; Lutchmedial, Sohrab

    2018-01-01

    Background Clinical guidelines recommend monitoring of blood pressure at home using an automatic blood pressure device for the management of hypertension. Devices are not often calibrated against direct blood pressure measures, leaving health care providers and patients with less reliable information than is possible with current technology. Rigorous assessments of medical devices are necessary for establishing clinical utility. Objective The purpose of our study was 2-fold: (1) to assess the validity and perform iterative calibration of indirect blood pressure measurements by a noninvasive wrist cuff blood pressure device in direct comparison with simultaneously recorded peripheral and central intra-arterial blood pressure measurements and (2) to assess the validity of the measurements thereafter of the noninvasive wrist cuff blood pressure device in comparison with measurements by a noninvasive upper arm blood pressure device to the Canadian hypertension guidelines. Methods The cloud-based blood pressure algorithms for an oscillometric wrist cuff device were iteratively calibrated to direct pressure measures in 20 consented patient participants. We then assessed measurement validity of the device, using Bland-Altman analysis during routine cardiovascular catheterization. Results The precalibrated absolute mean difference between direct intra-arterial to wrist cuff pressure measurements were 10.8 (SD 9.7) for systolic and 16.1 (SD 6.3) for diastolic. The postcalibrated absolute mean difference was 7.2 (SD 5.1) for systolic and 4.3 (SD 3.3) for diastolic pressures. This is an improvement in accuracy of 33% systolic and 73% diastolic with a 48% reduction in the variability for both measures. Furthermore, the wrist cuff device demonstrated similar sensitivity in measuring high blood pressure compared with the direct intra-arterial method. The device, when calibrated to direct aortic pressures, demonstrated the potential to reduce a treatment gap in high blood

  12. Relationship between BMI and blood pressure in girls and boys.

    Science.gov (United States)

    Gundogdu, Zuhal

    2008-10-01

    To investigate the relationship between BMI and blood pressure as this is of crucial interest in evaluating both public health and the clinical impact of the so-called obesity epidemic. Data were gathered from 1899 children aged between 6 and 14 years, analysing and evaluating a possible relationship between BMI and systolic and diastolic blood pressure values for both girls and boys. Each child was classified on the basis of age- and sex-specific BMI percentile as normal weight (<85th percentile), overweight (95th percentile). In comparisons among age BMI percentile groups, systolic and diastolic blood pressure values were higher in obese and overweight groups than in normal weight groups for both sexes. Although BMI among girls was higher than among boys in all three percentile groups, there were no significant differences between sexes with respect to blood pressure values. The present findings emphasize the importance of the prevention of obesity in order to prevent future related problems such as hypertension in children and adolescents.

  13. Value of systolic pulmonary arterial pressure as a prognostic factor of death in the systemic sclerosis EUSTAR population

    DEFF Research Database (Denmark)

    Hachulla, Eric; Clerson, Pierre; Airò, Paolo

    2015-01-01

    OBJECTIVE: The aim of this study was to assess the prognostic value of systolic pulmonary artery pressure (sPAP) estimated by echocardiography in the multinational European League Against Rheumatism Scleroderma Trial and Research (EUSTAR) cohort. METHODS: Data for patients with echocardiography...

  14. Prevalence of high blood pressure subtypes and its associations with BMI in Chinese children: a national cross-sectional survey.

    Science.gov (United States)

    Yang, Yide; Dong, Bin; Wang, Shuo; Dong, Yanhui; Zou, Zhiyong; Fu, Lianguo; Ma, Jun

    2017-06-26

    Data on prevalence and characteristics of different high blood pressure subtypes are lacking among Chinese children. Regarding the mechanistic differences between isolated systolic high blood pressure and isolated diastolic high blood pressure and their different impact on end organ diseases, it is necessary to examine the prevalence of different high blood pressure subtypes in Chinese children and explore their associations with adiposity. Data were derived from the baseline data of a multi-centered cluster randomized controlled trial involving participants from China. High blood pressure was defined according to age-, gender- and height-specific 95th percentile developed by the National High Blood Pressure Education Program Working Group. Body mass index was used to classify underweight, normal weight, overweight and obesity. The prevalence of HBP was 10.2% and 8.9% for boys and girls, respectively. Isolated systolic high blood pressure is the dominant high blood pressure subtype among Chinese boys aged 6-17 years and girls aged 12-17 years, while isolated diastolic high blood pressure was the most common high blood pressure subtype in girls aged 6-11 years. In boys, the status of overweight doubled the risk of isolated systolic high blood pressure (95% CI, 1.73, 2.31; P high blood pressure and adiposity. The distribution of high blood pressure subtypes in boys differed from those in girls, and boys with adiposity showed a higher risk of high blood pressure than their female counterpart. Difference in strength of association between isolated diastolic high blood pressure and isolated systolic high blood pressure with body mass index was also found. These results may aid current strategies for preventing and controlling pediatric hypertension.

  15. What Physical Fitness Component Is Most Closely Associated With Adolescents' Blood Pressure?

    Science.gov (United States)

    Nunes, Heloyse E G; Alves, Carlos A S; Gonçalves, Eliane C A; Silva, Diego A S

    2017-12-01

    This study aimed to determine which of four selected physical fitness variables, would be most associated with blood pressure changes (systolic and diastolic) in a large sample of adolescents. This was a descriptive and cross-sectional, epidemiological study of 1,117 adolescents aged 14-19 years from southern Brazil. Systolic and diastolic blood pressure were measured by a digital pressure device, and the selected physical fitness variables were body composition (body mass index), flexibility (sit-and-reach test), muscle strength/resistance (manual dynamometer), and aerobic fitness (Modified Canadian Aerobic Fitness Test). Simple and multiple linear regression analyses revealed that aerobic fitness and muscle strength/resistance best explained variations in systolic blood pressure for boys (17.3% and 7.4% of variance) and girls (7.4% of variance). Aerobic fitness, body composition, and muscle strength/resistance are all important indicators of blood pressure control, but aerobic fitness was a stronger predictor of systolic blood pressure in boys and of diastolic blood pressure in both sexes.

  16. Does chocolate reduce blood pressure? A meta-analysis.

    Science.gov (United States)

    Ried, Karin; Sullivan, Thomas; Fakler, Peter; Frank, Oliver R; Stocks, Nigel P

    2010-06-28

    Dark chocolate and flavanol-rich cocoa products have attracted interest as an alternative treatment option for hypertension, a known risk factor for cardiovascular disease. Previous meta-analyses concluded that cocoa-rich foods may reduce blood pressure. Recently, several additional trials have been conducted with conflicting results. Our study summarises current evidence on the effect of flavanol-rich cocoa products on blood pressure in hypertensive and normotensive individuals. We searched Medline, Cochrane and international trial registries between 1955 and 2009 for randomised controlled trials investigating the effect of cocoa as food or drink compared with placebo on systolic and diastolic blood pressure (SBP/DBP) for a minimum duration of 2 weeks. We conducted random effects meta-analysis of all studies fitting the inclusion criteria, as well as subgroup analysis by baseline blood pressure (hypertensive/normotensive). Meta-regression analysis explored the association between type of treatment, dosage, duration or baseline blood pressure and blood pressure outcome. Statistical significance was set at P chocolate compared with control (mean BP change +/- SE: SBP: -3.2 +/- 1.9 mmHg, P = 0.001; DBP: -2.0 +/- 1.3 mmHg, P = 0.003). However, subgroup meta-analysis was significant only for the hypertensive or prehypertensive subgroups (SBP: -5.0 +/- 3.0 mmHg; P = 0.0009; DBP: -2.7 +/- 2.2 mm Hg, P = 0.01), while BP was not significantly reduced in the normotensive subgroups (SBP: -1.6 +/- 2.3 mmHg, P = 0.17; DBP: -1.3 +/- 1.6 mmHg, P = 0.12). Nine trials used chocolate containing 50% to 70% cocoa compared with white chocolate or other cocoa-free controls, while six trials compared high- with low-flavanol cocoa products. Daily flavanol dosages ranged from 30 mg to 1000 mg in the active treatment groups, and interventions ran for 2 to 18 weeks. Meta-regression analysis found study design and type of control to be borderline significant but possibly indirect predictors

  17. Validity of predicting left ventricular end systolic pressure changes following an acute bout of exercise.

    Science.gov (United States)

    Kappus, Rebecca M; Ranadive, Sushant M; Yan, Huimin; Lane, Abbi D; Cook, Marc D; Hall, Grenita; Harvey, I Shevon; Wilund, Kenneth R; Woods, Jeffrey A; Fernhall, Bo

    2013-01-01

    Left ventricular end systolic pressure (LV ESP) is important in assessing left ventricular performance and is usually derived from prediction equations. It is unknown whether these equations are accurate at rest or following exercise in a young, healthy population. Measured LV ESP vs. LV ESP values from the prediction equations were compared at rest, 15 min and 30 min following peak aerobic exercise in 60 participants. LV ESP was obtained by applanation tonometry at rest, 15 min post and 30 min post peak cycle exercise. Measured LV ESP was significantly lower (p<0.05) at all time points in comparison to the two calculated values. Measured LV ESP decreased significantly from rest at both the post15 and post30 time points (p<0.05) and changed differently in comparison to the calculated values (significant interaction; p<0.05). The two LV ESP equations were also significantly different from each other (p<0.05) and changed differently over time (significant interaction; p<0.05). The two commonly used prediction equations did not accurately predict either resting or post exercise LV ESP in a young, healthy population. Thus, LV ESP needs to be individually determined in young, healthy participants. Non-invasive measurement through applanation tonometry appears to allow for a more accurate determination of LV ESP. Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  18. Serum Endoglin Levels in Patients Suffering from Systemic Sclerosis and Elevated Systolic Pulmonary Arterial Pressure

    Directory of Open Access Journals (Sweden)

    Paola Ximena Coral-Alvarado

    2010-01-01

    Full Text Available Background. Pulmonary arterial hypertension (PAH is the main cause of morbimortality in systemic sclerosis (SSc. Increased Eng expression has been demonstrated in SSc patients. Objective. Ascertaining serum levels of Eng in SSc patients with and without elevated systolic pulmonary arterial pressure (sPAP and comparing them with that of healthy volunteers. Methods. A cross-sectional study was carried out. A commercial ELISA kit was used for measuring serum concentrations of Eng in 60 subjects: 40 patients with SSc with and without elevated sPAP, compared to 20 healthy control subjects. Elevated sPAP was detected by echocardiogram. Results. No association between positive Eng and elevated sPAP was found when compared to the SSc without elevated sPAP group (OR=2.85; 0.65–12.88 95% CI; P=.11; however, an association was found between positive Eng and elevated sPAP compared to healthy controls (OR=23.22; 2.46–1050.33 95% CI; P=.001, and weak association was found between the positive Eng with SSc without elevated sPAP group compared to healthy controls (OR=8.14, 0.8–393.74 95% CI; P=.046. Conclusion. Raised serum levels of Eng in SSc patients compared to healthy controls were found, suggesting a role for Eng in SSc vasculopathy and not just in elevated sPAP. However, prospective studies are needed to verify such observations.

  19. Home blood pressure measurement in elderly patients with cognitive impairment: comparison of agreement between relative-measured blood pressure and automated blood pressure measurement.

    Science.gov (United States)

    Plichart, Matthieu; Seux, Marie-Laure; Caillard, Laure; Chaussade, Edouard; Vidal, Jean-Sébastien; Boully, Clémence; Hanon, Olivier

    2013-08-01

    Home blood pressure measurement (HBPM) is recommended by guidelines for hypertension management. However, this method might be difficult to use in elderly individuals with cognitive disorders. Our aim was to assess the agreement and the feasibility of HBPM by a relative as compared with 24-h ambulatory blood pressure monitoring (ABPM) in elderly patients with dementia. Sixty outpatients with dementia aged 75 years and older with office hypertension (≥140/90 mmHg) were subjected successively to HBPM by a trained relative and 24-h ABPM. The order of the two methods was randomized. Current guidelines' thresholds for the diagnosis of hypertension were used. The mean (SD) age of the patients was 80.8 (6.1) years (55% women) and the mean (SD) mini-mental state examination score was 20.1 (6.9). The feasibility of relative-HBPM was very high, with a 97% success rate (defined by ≥12/18 measurements reported). The blood pressure measurements were highly correlated between the two methods (r=0.75 and 0.64 for systolic blood pressure and diastolic blood pressure, respectively; Pmethods for the diagnosis of sustained hypertension and white-coat hypertension was excellent (overall agreement, 92%; κ coefficient, 0.81; 95% CI, 0.61-0.93). Similar results were found for daytime-ABPM. In cognitively impaired elderly patients, HBPM by a relative using an automated device was a good alternative to 24-h ABPM.

  20. Pomegranate Consumption and Blood Pressure: A Review.

    Science.gov (United States)

    Asgary, Sedigheh; Keshvari, Mahtab; Sahebkar, Amirhossein; Sarrafzadegan, Nizal

    2017-01-01

    Pomegranate (Punica granatum L.) is a polyphenol-rich fruit with diverse medicinal properties. Several lines of experimental and clinical evidence have shown that pomegranate intake helps lowering blood pressure (BP) through different mechanisms. This study aimed to present a narrative review on the anti-hypertensive properties of different parts of pomegranate such as pomegranate juice (PJ), pomegranate peels (PP), pomegranate seed oil (PSO), pomegranate fruit extract (PFE) and the mechanisms and phytochemicals responsible for these effects. A review on the efficacy of consuming different parts of pomegranate (juice, peels, fruit extract and seed oil) in lowering BP has been performed. To find relevant studies, a search in PubMed, Science Direct and Scopus up from inception to May 4, 2015 was performed. Human, animals and in vitro studies investigating the anti-hypertensive effects of pomegranate were included in the search. Findings arising from animal and clinical studies have shown pomegranate juice can reduce BP in both short-term and long-term course. These effects are accompanied by antioxidant and anti-atherosclerotic actions that collectively improve cardiovascular health. The anti-hypertensive effects have been reported for both pomegranate juice and seed oil. Both systolic and diastolic pressures are affected. Pomegranate juice possesses antioxidant, anti-hypertensive and anti-atherosclerotic properties. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  1. Does a colour-coded blood pressure diary improve blood pressure control for patients in general practice: the CoCo trial.

    Science.gov (United States)

    Steurer-Stey, Claudia; Zoller, Marco; Chmiel Moshinsky, Corinne; Senn, Oliver; Rosemann, Thomas

    2010-04-14

    Insufficient blood pressure control is a frequent problem despite the existence of effective treatment. Insufficient adherence to self-monitoring as well as to therapy is a common reason. Blood pressure self-measurement at home (Home Blood Pressure Measurement, HBPM) has positive effects on treatment adherence and is helpful in achieving the target blood pressure. Only a few studies have investigated whether adherence to HBPM can be improved through simple measures resulting also in better blood pressure control. Improvement of self-monitoring and improved blood pressure control by using a new colour-coded blood pressure diary. Change in systolic and/or diastolic blood pressure 6 months after using the new colour-coded blood pressure diary.Secondary outcome: Adherence to blood pressure self-measurement (number of measurements/entries). Randomised controlled study. 138 adult patients in primary care with uncontrolled hypertension despite therapy. The control group uses a conventional blood pressure diary; the intervention group uses the new colour-coded blood pressure diary (green, yellow, red according a traffic light system). EXPECTED RESULTS/CONCLUSION: The visual separation and entries in three colour-coded areas reflecting risk (green: blood pressure in the target range 140/>90 mmHg, red: blood pressure in danger zone > 180 mmHg/>110 mmHg) lead to better self-monitoring compared with the conventional (non-colour-coded) blood pressure booklet. The colour-coded, visualised information supports improved perception (awareness and interpretation) of blood pressure and triggers correct behaviour, in the means of improved adherence to the recommended treatment as well as better communication between patients and doctors resulting in improved blood pressure control. ClinicalTrials.gov ID NCT01013467.

  2. Achieved Blood Pressure and Outcomes in the Secondary Prevention of Small Subcortical Strokes Trial.

    Science.gov (United States)

    Odden, Michelle C; McClure, Leslie A; Sawaya, B Peter; White, Carole L; Peralta, Carmen A; Field, Thalia S; Hart, Robert G; Benavente, Oscar R; Pergola, Pablo E

    2016-01-01

    Studies suggest a J-shaped association between blood pressure and cardiovascular events in the setting of intensive systolic blood pressure control; whether there is a similar association with stroke remains less well established. The Secondary Prevention of Small Subcortical Strokes was a randomized trial to evaluate higher (130-149 mm Hg) versus lower (blood pressure targets in participants with recent lacunar infarcts. We evaluated the association of mean achieved blood pressure, 6 months after randomization, and recurrent stroke, major vascular events, and all-cause mortality. After a mean follow up of 3.7 years, there was a J-shaped association between achieved blood pressure and outcomes; the lowest risk was at ≈124 and 67 mm Hg systolic and diastolic blood pressure, respectively. For example, above a systolic blood pressure of 124 mm Hg, 1 standard deviation higher (11.1 mm Hg) was associated with increased mortality (adjusted hazard ratio: 1.9; 95% confidence interval: 1.4, 2.7), whereas below this level, this relationship was inverted (0.29; 0.10, 0.79), Pblood pressure of 67 mm Hg, a 1 standard deviation higher (8.2 mm Hg) was associated with an increased risk of stroke (2.2; 1.4, 3.6), whereas below this level, the association was in the opposite direction (0.34; 0.13, 0.89), P=0.02 for interaction. The lowest risk of all events occurred at a nadir of ≈120 to 128 mm Hg systolic blood pressure and 65 to 70 mm Hg diastolic blood pressure. Future studies should evaluate the impact of excessive blood pressure reduction, especially in older populations with preexisting vascular disease. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00059306. © 2015 American Heart Association, Inc.

  3. [Annual blood pressure dynamics and weather sensitivity in women].

    Science.gov (United States)

    Varlamova, N G; Zenchenko, T A; Boyko, E R

    To study the annual cycle of blood pressure (BP) and weather sensitivity in normotensive women aged 20-59 years. The same group of 25 non-smoking women who had been living in the European North of Russia (62° N, 51° E) almost since their birth and were engaged in moderate-intensity mental labor was daily examined. During a year, there were 11823 blood pressure measurements using the Korotkoff technique; heart rate was calculated by palpation. These meteorological parameters were taken at the websites: http://meteo.infospace.ru and ftp://ftp.ngdc.noaa.gov/stp/geomagnetic_data/indices/kp_ap. The statistical significance of differences in the indicators was determined using the Fisher's test and the Newman-Keuls test. The study used a correlation analysis with the calculation of the Spearman's rank correlation coefficient. The maximum systolic and diastolic BP values were revealed in February and January, respectively. The minimum values of systolic BP were detected in July; those of diastolic BP were in August. An individual-based analysis of sensitivity to environmental variations showed that about 88% of the women responded to atmospheric temperature; nearly 44% did to geomagnetic activity; almost 24% were sensitive to relative air humidity, and about 16% of the women were to atmospheric pressure. The dynamics of systolic and diastolic BP in the annual cycle of women depends on meteorological factors and suggests that there is a change in the priorities of its control in different periods of a year.

  4. Effects of nattokinase on blood pressure: a randomized, controlled trial.

    Science.gov (United States)

    Kim, Ji Young; Gum, Si Nae; Paik, Jean Kyung; Lim, Hyo Hee; Kim, Kyong-Chol; Ogasawara, Kazuya; Inoue, Kenichi; Park, Sungha; Jang, Yangsoo; Lee, Jong Ho

    2008-08-01

    The objective of this study was to examine the effects of nattokinase supplementation on blood pressure in subjects with pre-hypertension or stage 1 hypertension. In a randomized, double-blind, placebo-controlled trial, 86 participants ranging from 20 to 80 years of age with an initial untreated systolic blood pressure (SBP) of 130 to 159 mmHg received nattokinase (2,000 FU/capsule) or a placebo capsule for 8 weeks. Seventy-three subjects completed the protocol. Compared with the control group, the net changes in SBP and diastolic blood pressure (DBP) were -5.55 mmHg (95% confidence interval [CI], -10.5 to -0.57 mmHg; pnattokinase group compared with the control group (pnattokinase supplementation resulted in a reduction in SBP and DBP. These findings suggest that increased intake of nattokinase may play an important role in preventing and treating hypertension.

  5. Accuracy of home blood pressure readings: monitors and operators.

    Science.gov (United States)

    Stryker, Trina; Wilson, Merne; Wilson, Thomas W

    2004-06-01

    To evaluate the accuracy of automated digital blood pressure monitoring devices and operators in the community. Also, we tested the effects of a simple education program, and looked for arm-arm differences. Subjects who had bought their own automated digital blood pressure monitor were recruited via an advertisement in the local newspaper. On arrival, they were asked to record their blood pressure exactly as they would at home. The investigator noted any technique deficiencies then corrected them. Blood pressures were then recorded by the investigator and the subject, on opposite arms, simultaneously, and repeated with the arms switched. Finally, subjects recorded their blood pressure again. The subjects' readings were compared to the average of monitor and mercury readings using Bland-Altman methods. A total of 80 subjects were tested. Before educating, subjects' systolic blood pressure (SBP) readings were +5.8+/-6.4 (standard deviation) mmHg greater than the mean of all readings, and diastolic blood pressure (DBP) were +1.3+/-4.0 mmHg; after educating they were +1.3+/-4.0 and -1.3+/-2.7 respectively. The monitors, as a group, were accurate, and met British Hypertension Society and AAMI highest standards. We found no differences among monitors that had been validated (n=26) and those that had not. There were differences between the arms: 5.3+/-5.2 mmHg for SBP and 3.4+/-3.3 mmHg for DBP. Most patients had never been informed by anyone of proper blood pressure measuring techniques. We conclude that home blood pressure measurement, as practiced in our community, is prone to error, mostly due to mistakes by the operator. These can easily be corrected, so that readings become more accurate. Attention should be paid to arm-arm differences.

  6. Abnormal albuminuria and blood pressure rise in incipient diabetic nephropathy induced by exercise

    DEFF Research Database (Denmark)

    Christensen, Cramer

    1984-01-01

    The aim of the study was to evaluate the influence of light to moderate dynamic work (450 kpm/min followed by 600 kpm/min during 20 min each) on the blood pressure and renal protein handling in insulin-dependent diabetic patients with incipient nephropathy (D3) (elevated baseline albumin excretion...... diastolic blood pressure was elevated [92.1 mm Hg +/- 6.0 (mean +/- SD)] compared to D2 (80.9 mm Hg +/- 4.8, 2P = 0.003%) and C (79.5 mm Hg +/- 12.4, 2P = 1.2%). Baseline systolic blood pressure was not significantly different in the three groups, but systolic blood pressure was more elevated at 600 kpm...... blood pressure and maximal exercise induced albumin excretion was demonstrable in D3.(ABSTRACT TRUNCATED AT 250 WORDS)...

  7. Differences Between Right and Left Arm Blood Pressures in the Elderly

    OpenAIRE

    Hashimoto, Fred; Hunt, William C.; Hardy, Linda

    1984-01-01

    Recommendations vary on whether blood pressures should be measured in the right or in the left arm because no frequency distributions for a pressure difference between the arms exist. We took a total of 12 blood pressure determinations in both arms of 174 elderly persons and analyzed the data by a least-squares components of variance method. The mean difference between the arms (right minus left) was 0.93 mm of mercury for systole and 0.70 mm of mercury for diastole. For systole the proportio...

  8. Allergic rhinitis and arterial blood pressure: a population-based study.

    Science.gov (United States)

    Sakallioglu, O; Polat, C; Akyigit, A; Cetiner, H; Duzer, S

    2018-05-01

    To investigate the likelihood of allergic rhinitis and potential co-morbidities, and to assess whether allergic rhinitis is associated with arterial blood pressure and hypertension. In this population-based study, 369 adults with allergic rhinitis and asthma were assessed via a questionnaire and immunoglobulin E levels. There were four groups: control (n = 90), allergic rhinitis (n = 99), asthma (n = 87) and hypertension (n = 93). Arterial blood pressure was measured in all groups. There were no significant differences in systolic or diastolic blood pressure between males and females in any group. Pairwise comparisons revealed no significant differences between: the control and allergic rhinitis groups, the control and asthma groups, or the allergic rhinitis and asthma groups. The systolic and diastolic blood pressure values of males and females were significantly higher in the hypertension group than the allergic rhinitis group. There were no significant differences in systolic blood pressure or diastolic blood pressure for seasonal and perennial allergic rhinitis patients. Rhinitis was not associated with increased blood pressure. Allergic rhinitis can coincide with asthma and hypertension. The findings do not support the need for blood pressure follow up in allergic rhinitis patients.

  9. Blood pressure levels in male carriers of Arg82Cys in CD300LG

    DEFF Research Database (Denmark)

    Støy, Julie; Grarup, Niels; Hørlyck, Arne

    2014-01-01

    found to be associated with fasting HDL-cholesterol and triglyceride levels. The polymorphism has not been detected in hypertension GWAS potentially due to its low frequency, but CD300LG has been linked to blood pressure as CD300LG knockout mice have changes in blood pressure. Twenty......-four-hour ambulatory blood pressure was obtained in human CD300LG CT-carriers to follow up on these observations. METHODS: Twenty healthy male CD300LG rs72836561 CT-carriers matched for age and BMI with 20 healthy male CC-carriers. Office blood pressure, 24-hour ambulatory blood pressure, carotid intima......-media thickness (CIMT), and fasting blood samples were evaluated. The clinical study was combined with a genetic-epidemiological study to replicate the association between blood pressure and CD300LG Arg82Cys in 2,637 men and 3,249 women. RESULTS: CT-carriers had a higher 24-hour ambulatory systolic blood pressure...

  10. Evaluating combined effect of noise and heat on blood pressure changes among males in climatic chamber.

    Science.gov (United States)

    Dehghan, Habibollah; Bastami, Mohamad Taghi; Mahaki, Behzad

    2017-01-01

    Exposure to noise and heat causes individuals to experience some changes in the function of cardiovascular system in workplaces. This study aimed to find the combined effect of heat and noise on systolic and diastolic types of blood pressure in experimentally controlled conditions. This quasi-experimental study was performed with 12 male students in a climatic chamber in 2014. Blood pressure including systolic and diastolic was measured in the following conditions: 15 min after rest in exposure to heat (40°C, relative humidity [RH]: 30%), exposure to noise with 75, 85, and 95 dB rates in thermal comfort condition (22.1 ± 0.9 wet-bulb globe temperature), and combined exposure to heat (40°C, RH: 30%) and noise with 75, 85, and 95 dB. Friedman test was used to analyze the data. The mean change of systolic blood pressure was different significantly before and after exposure to heat and noise levels including 75, 85, and 95 dB ( P = 0.015, P = 0.001, P > 0.001, P = 0.027, respectively). Although systolic and diastolic blood pressures changed drastically, it was not significantly different in simultaneous exposure to heat and noise. Both systolic and diastolic blood pressures decreased in exposure to heat, while exposure to different levels of noise elevates systolic and diastolic blood pressures. However, when exposed to a combination of heat and noise, subtle changes of blood pressure were traced, which can be characterized as average, considering heat-only and noise-only tension situations.

  11. Elevated preoperative blood pressures in adult surgical patients are highly predictive of elevated home blood pressures.

    Science.gov (United States)

    Schonberger, Robert B; Nwozuzu, Adambeke; Zafar, Jill; Chen, Eric; Kigwana, Simon; Monteiro, Miriam M; Charchaflieh, Jean; Sophanphattana, Sophisa; Dai, Feng; Burg, Matthew M

    2018-04-01

    Blood pressure (BP) measurement during the presurgical assessment has been suggested as a way to improve longitudinal detection and treatment of hypertension. The relationship between BP measured during this assessment and home blood pressure (HBP), a better indicator of hypertension, is unknown. The purpose of the present study was to determine the positive predictive value of presurgical BP for predicting elevated HBP. We prospectively enrolled 200 patients at a presurgical evaluation clinic with clinic blood pressures (CBPs) ≥130/85 mm Hg, as measured using a previously validated automated upper-arm device (Welch Allyn Vital Sign Monitor 6000 Series), to undergo daily HBP monitoring (Omron Model BP742N) between the index clinic visit and their day of surgery. Elevated HBP was defined, per American Heart Association guidelines, as mean systolic HBP ≥135 mm Hg or mean diastolic HBP ≥85 mm Hg. Of the 200 participants, 188 (94%) returned their home blood pressure monitors with valid data. The median number of HBP recordings was 10 (interquartile range, 7-14). Presurgical CBP thresholds of 140/90, 150/95, and 160/100 mm Hg yielded positive predictive values (95% confidence interval) for elevated HBP of 84.1% (0.78-0.89), 87.5% (0.81-0.92), and 94.6% (0.87-0.99), respectively. In contrast, self-reported BP control, antihypertensive treatment, availability of primary care, and preoperative pain scores demonstrated poor agreement with elevated HBP. Elevated preoperative CBP is highly predictive of longitudinally elevated HBP. BP measurement during presurgical assessment may provide a way to improve longitudinal detection and treatment of hypertension. Copyright © 2018 American Heart Association. Published by Elsevier Inc. All rights reserved.

  12. Validation of the Rossmax CF175 upper-arm blood pressure monitor for home blood pressure monitoring according to the European Society of Hypertension International Protocol revision 2010.

    Science.gov (United States)

    Zhang, Lu; Kang, Yuan-Yuan; Zeng, Wei-Fang; Li, Yan; Wang, Ji-Guang

    2015-04-01

    The present study aimed to evaluate the accuracy of the Rossmax CF175 upper-arm blood pressure monitor for home blood pressure monitoring according to the International Protocol of the European Society of Hypertension revision 2010. Systolic and diastolic blood pressures were sequentially measured in 33 adult Chinese (17 women, mean age 46 years) using a mercury sphygmomanometer (two observers) and the Rossmax CF175 device (one supervisor). A total of 99 pairs of comparisons were obtained from 33 participants for judgments in two parts with three grading phases. All the blood pressure requirements were fulfilled. The Rossmax CF175 device achieved the targets in part 1 of the validation study. The number of absolute differences between the device and observers within 5, 10, and 15 mmHg was 78/99, 94/99, and 98/99, respectively, for systolic blood pressure, and 81/99, 96/99, and 97/99, respectively, for diastolic blood pressure. The device also achieved the criteria in part 2 of the validation study. Twenty-nine participants, for both of systolic and diastolic blood pressure, had at least two of the three device-observers differences within 5 mmHg (required ≥24). Only one participant for diastolic blood pressure had all three device-observers comparisons greater than 5 mmHg. The Rossmax automated oscillometric upper-arm blood pressure monitor CF175 fulfilled the requirements of the International Protocol revision 2010, and hence can be recommended for blood pressure measurement in adults.

  13. Baseline Blood Pressure, the 2017 ACC/AHA High Blood Pressure Guidelines, and Long-Term Cardiovascular Risk in SPRINT.

    Science.gov (United States)

    Vaduganathan, Muthiah; Pareek, Manan; Qamar, Arman; Pandey, Ambarish; Olsen, Michael H; Bhatt, Deepak L

    2018-02-05

    The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines include lower thresholds to define hypertension than previous guidelines. Little is known about the impact of these guideline changes in patients with or at high risk for cardiovascular disease. In this exploratory analysis using baseline blood pressure assessments in Systolic Blood Pressure Intervention Trial (SPRINT), we evaluated the prevalence and associated cardiovascular prognosis of patients newly reclassified with hypertension based on the 2017 ACC/AHA (systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥80 mm Hg) compared with the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC 7) guidelines (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg). The primary endpoint was the composite of myocardial infarction, other acute coronary syndromes, stroke, heart failure, or cardiovascular death. In 4683 patients assigned to the standard treatment arm of SPRINT, 2328 (49.7%) met hypertension thresholds by JNC 7 guidelines, and another 1424 (30.4%) were newly reclassified as having hypertension based on the 2017 ACC/AHA guidelines. Over 3.3-year median follow-up, 319 patients experienced the primary endpoint (87 of whom were newly reclassified with hypertension based on the revised guidelines). Patients with hypertension based on prior guidelines compared with those newly identified with hypertension based on the new guidelines had similar risk of the primary endpoint (2.3 [95% confidence interval {CI}, 2.0-2.7] vs 2.0 [95% CI, 1.6-2.4] events per 100 patient-years; adjusted HR, 1.10 [95% CI, 0.84-1.44]; P = .48). The 2017 ACC/AHA high blood pressure guidelines are expected to significantly increase the prevalence of patients with hypertension (perhaps to a greater extent in higher-risk patient cohorts compared with the general population) and

  14. Emergence of ethnic differences in blood pressure in adolescence: the determinants of adolescent social well-being and health study.

    Science.gov (United States)

    Harding, Seeromanie; Whitrow, Melissa; Lenguerrand, Erik; Maynard, Maria; Teyhan, Alison; Cruickshank, J Kennedy; Der, Geoff

    2010-04-01

    The cause of ethnic differences in cardiovascular disease remains a scientific challenge. Blood pressure tracks from late childhood to adulthood. We examined ethnic differences in changes in blood pressure between early and late adolescence in the United Kingdom. Longitudinal measures of blood pressure, height, weight, leg length, smoking, and socioeconomic circumstances were obtained from London, United Kingdom, schoolchildren of White British (n=692), Black Caribbean (n=670), Black African (n=772), Indian (n=384), and Pakistani and Bangladeshi (n=402) ethnicity at 11 to 13 years and 14 to 16 years. Predicted age- and ethnic-specific means of blood pressure, adjusted for anthropometry and social exposures, were derived using mixed models. Among boys, systolic blood pressure did not differ by ethnicity at 12 years, but the greater increase among Black Africans than Whites led to higher systolic blood pressure at 16 years (+2.9 mm Hg). Among girls, ethnic differences in mean systolic blood pressure were not significant at any age, but while systolic blood pressure hardly changed with age among White girls, it increased among Black Caribbeans and Black Africans. Ethnic differences in diastolic blood pressure were more marked than those for systolic blood pressure. Body mass index, height, and leg length were independent predictors of blood pressure, with few ethnic-specific effects. Socioeconomic disadvantage had a disproportionate effect on blood pressure for girls in minority groups. The findings suggest that ethnic divergences in blood pressure begin in adolescence and are particularly striking for boys. They signal the need for early prevention of adverse cardiovascular disease risks in later life.

  15. Impact of calibration on estimates of central blood pressures.

    Science.gov (United States)

    Soender, T K; Van Bortel, L M; Møller, J E; Lambrechtsen, J; Hangaard, J; Egstrup, K

    2012-12-01

    Using the Sphygmocor device it is recommended that the radial pressure wave is calibrated for brachial systolic blood pressure (SBP) and diastolic blood pressure (DBP). However it has been suggested that brachial-to-radial pressure amplification causes underestimation of central blood pressures (BPs) using this calibration. In the present study we examined if different calibrations had an impact on estimates of central BPs and on the clinical interpretation of our results. On the basis of ambulatory BP measurements, patients were categorized into patients with controlled, uncontrolled or resistant hypertension. We first calibrated the radial pressure wave as recommended and afterwards recalibrated the same pressure wave using brachial DBP and calculated mean arterial pressure. Recalibration of the pressure wave generated significantly higher estimates of central SBP (P=0.0003 and Plost in patients with resistant hypertension (P=0.15). We conclude that calibration with DBP and mean arterial pressure produces higher estimates of central BPs than recommended calibration. The present study also shows that this difference between the two calibration methods can produce more than a systematic error and has an impact on interpretation of clinical results.

  16. Methyl mercury, but not inorganic mercury, associated with higher blood pressure during pregnancy.

    Science.gov (United States)

    Wells, Ellen M; Herbstman, Julie B; Lin, Yu Hong; Hibbeln, Joseph R; Halden, Rolf U; Witter, Frank R; Goldman, Lynn R

    2017-04-01

    Prior studies addressing associations between mercury and blood pressure have produced inconsistent findings; some of this may result from measuring total instead of speciated mercury. This cross-sectional study of 263 pregnant women assessed total mercury, speciated mercury, selenium, and n-3 polyunsaturated fatty acids in umbilical cord blood and blood pressure during labor and delivery. Models with a) total mercury or b) methyl and inorganic mercury were evaluated. Regression models adjusted for maternal age, race/ethnicity, prepregnancy body mass index, neighborhood income, parity, smoking, n-3 fatty acids and selenium. Geometric mean total, methyl, and inorganic mercury concentrations were 1.40µg/L (95% confidence interval: 1.29, 1.52); 0.95µg/L (0.84, 1.07); and 0.13µg/L (0.10, 0.17), respectively. Elevated systolic BP, diastolic BP, and pulse pressure were found, respectively, in 11.4%, 6.8%, and 19.8% of mothers. In adjusted multivariable models, a one-tertile increase of methyl mercury was associated with 2.83mmHg (0.17, 5.50) higher systolic blood pressure and 2.99mmHg (0.91, 5.08) higher pulse pressure. In the same models, an increase of one tertile of inorganic mercury was associated with -1.18mmHg (-3.72, 1.35) lower systolic blood pressure and -2.51mmHg (-4.49, -0.53) lower pulse pressure. No associations were observed with diastolic pressure. There was a non-significant trend of higher total mercury with higher systolic blood pressure. We observed a significant association of higher methyl mercury with higher systolic and pulse pressure, yet higher inorganic mercury was significantly associated with lower pulse pressure. These results should be confirmed with larger, longitudinal studies. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2015-11-01

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

  18. Deuterium oxide normalizes blood pressure and vascular calcium uptake in Dahl salt-sensitive hypertensive rats

    International Nuclear Information System (INIS)

    Vasdev, S.; Prabhakaran, V.; Sampson, C.A.

    1990-01-01

    This study examined the effect of 25% deuterium oxide in drinking water on systolic blood pressure, uptakes of calcium, and rubidium 86 by aortas of Dahl salt-sensitive rats on 0.4% (low) and 8% (high) sodium chloride (salt) diet. Twenty-four rats were divided into four groups. Groups I and II were on the low salt diet and groups III and IV on the high salt diet from 6 weeks of age. Additionally, at 10 weeks of age groups I and III were placed on 100% water and groups II and IV on 25% deuterium oxide. At 14 weeks, systolic blood pressure, uptakes of calcium, and rubidium 86 by aortas were significantly higher (p less than 0.01) in rats on the high salt diet as compared with those on the low salt diet. Deuterium oxide intake normalized systolic blood pressure and aortic calcium uptake but not aortic rubidium 86 uptake in hypertensive rats on the high salt diet. Deuterium oxide had no effect on blood pressure or aortic calcium uptake in rats on the low salt diet. The parallel increase in systolic blood pressure and vascular calcium uptake suggests that increased calcium uptake mechanisms are associated with hypertension in salt-sensitive Dahl rats. Furthermore, deuterium oxide appears to normalize elevated blood pressure in salt-sensitive hypertensive rats by normalizing elevated vascular (aortic) calcium uptake

  19. The hidden magnitude of raised blood pressure and elevated blood ...

    African Journals Online (AJOL)

    Conclusions: The prevalence of undiagnosed raised blood pressure and elevated blood sugar was high in Ethiopia and only very small percentage of people had been aware of their high blood pressure and elevated blood sugar. Policy makers in the health sector including other health development partners need to ...

  20. Caffeine: How Does It Affect Blood Pressure?

    Science.gov (United States)

    ... naturally increase your blood pressure, such as exercise, weightlifting or hard physical labor. To see if caffeine ... blood pressure and stress indices in healthy individuals. Nutrition Journal. 2016;15:26. Cano-Marquina A, et ...

  1. What Is High Blood Pressure Medicine?

    Science.gov (United States)

    ... a medicine calendar. • Set a reminder on your smartphone. What types of medicine may be prescribed? One ... High Blood Pressure Medicine? What are their side effects? For many people, high blood pressure medicine can ...

  2. Ambulatory blood pressure monitoring - comparison with office ...

    African Journals Online (AJOL)

    ambulatory blood pressure recordings in private practice ... position according to established guidelines. ... white-coat effect was defined as a difference of at least 20 .... patients with hypertension: Importance of blood pressure response to ...

  3. High blood pressure - medicine-related

    Science.gov (United States)

    Drug-induced hypertension is high blood pressure caused by using a chemical substance or medicine. ... of the arteries There are several types of high blood pressure : Essential hypertension has no cause that can be ...

  4. REGULATION OF BLOOD PRESSURE IN PATIENTS WITH PRIMARY HYPERTENSION WITH SMOOTHIE BANANA (MUSA PARADISIACA

    Directory of Open Access Journals (Sweden)

    Eni Puji Lestari

    2017-04-01

    Full Text Available Introduction: Hypertension is a major problem that often happen in Indonesia. Hypertension can cause many complications. In Indonesia almost patients with hypertension got farmacologic therapy, but there is no difference. Banana smoothie is one of nonfarmacologic therapy that can be used to lower blood pressure. The purpose of this study was to analyze the effect of banana smoothie on regulation in patients with primary hypertension. Method: This study used quasy experimental design. The population in this study were patients with primary hypertension in Kedungturi village Taman Sidoarjo. The sampling technique used nonprobability sampling type of purposive sampling. The total number of sample were 16 respondents who were selected based on inclusion and exclusion criteria. Result:The Result of paired t-test at the systolic blood pressure and diastolic blood pressure in experiment group showed p value = 0.000. Independent t test between experiment group post-test and control group post-test showed p value = 0.000 for systolic blood pressure and p value = 0.002 for diastolic blood pressure. This result showed that there was a difference value of pretest and post-test systolic and diastolic blood pressure. With the result of independen t-test we know that there is a difference value between exsperiment and control blood pressure. Discussion: This study explain that there was significant effect of banana smoothie to regulate blood pressure in patients with primary hypertention. Banana smoothie can regulate the blood pressure because of high kalium substance. The function of kalium is to reduce the effect of natrium so the blood pressure can down. It can be conclude that banana smoothie can regulate the blood pressure in patients with primary hypertention. In further day patients with hypertension can choose banana smoothie to regulate their blood pressure.

  5. The impact of parity on life course blood pressure trajectories: the HUNT study in Norway.

    Science.gov (United States)

    Haug, Eirin B; Horn, Julie; Markovitz, Amanda Rose; Fraser, Abigail; Macdonald-Wallis, Corrie; Tilling, Kate; Romundstad, Pål Richard; Rich-Edwards, Janet Wilson; Åsvold, Bjørn Olav

    2018-01-24

    The drop in blood pressure during pregnancy may persist postpartum, but the impact of pregnancy on blood pressure across the life course is not known. In this study we examined blood pressure trajectories for women in the years preceding and following pregnancy and compared life course trajectories of blood pressure for parous and nulliparous women. We linked information on all women who participated in the population-based, longitudinal HUNT Study, Norway with pregnancy information from the Medical Birth Registry of Norway. A total of 23,438 women were included with up to 3 blood pressure measurements per woman. Blood pressure trajectories were compared using a mixed effects linear spline model. Before first pregnancy, women who later gave birth had similar mean blood pressure to women who never gave birth. Women who delivered experienced a drop after their first birth of - 3.32 mmHg (95% CI, - 3.93, - 2.71) and - 1.98 mmHg (95% CI, - 2.43, - 1.53) in systolic and diastolic blood pressure, respectively. Subsequent pregnancies were associated with smaller reductions. These pregnancy-related reductions in blood pressure led to persistent differences in mean blood pressure, and at age 50, parous women still had lower systolic (- 1.93 mmHg; 95% CI, - 3.33, - 0.53) and diastolic (- 1.36 mmHg; 95% CI, - 2.26, - 0.46) blood pressure compared to nulliparous women. The findings suggest that the first pregnancy and, to a lesser extent, successive pregnancies are associated with lasting and clinically relevant reductions in systolic and diastolic blood pressure.

  6. The impact of arm position on the measurement of orthostatic blood pressure.

    Science.gov (United States)

    Guss, David A; Abdelnur, Diego; Hemingway, Thomas J

    2008-05-01

    Blood pressure is a standard vital sign in patients evaluated in an Emergency Department. The American Heart Association has recommended a preferred position of the arm and cuff when measuring blood pressure. There is no formal recommendation for arm position when measuring orthostatic blood pressure. The objective of this study was to assess the impact of different arm positions on the measurement of postural changes in blood pressure. This was a prospective, unblinded, convenience study involving Emergency Department patients with complaints unrelated to cardiovascular instability. Repeated blood pressure measurements were obtained using an automatic non-invasive device with each subject in a supine and standing position and with the arm parallel and perpendicular to the torso. Orthostatic hypotension was defined as a difference of >or= 20 mm Hg systolic or >or= 10 mm Hg diastolic when subtracting standing from supine measurements. There were four comparisons made: group W, arm perpendicular supine and standing; group X, arm parallel supine and standing; group Y, arm parallel supine and perpendicular standing; and group Z, arm perpendicular supine and parallel standing. There were 100 patients enrolled, 55 men, mean age 44 years. Four blood pressure measurements were obtained on each patient. The percentage of patients meeting orthostatic hypotension criteria in each group was: W systolic 6% (95% CI 1%, 11%), diastolic 4% (95% CI 0%, 8%), X systolic 8% (95% CI 3%, 13%), diastolic 9% (95% CI 3%, 13%), Y systolic 19% (95% CI 11%, 27%), diastolic 30% (95% CI 21%, 39%), Z systolic 2% (95% CI 0%, 5%), diastolic 2% (95% CI 0%, 5%). Comparison of Group Y vs. X, Z, and W was statistically significant (p postural changes in blood pressure. The combination of the arm parallel when supine and perpendicular when standing may significantly overestimate the orthostatic change. Arm position should be held constant in supine and standing positions when assessing for orthostatic

  7. HIGH BLOOD PRESSURE: DOES THIS CONCERN ME?

    CERN Multimedia

    2007-01-01

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

  8. HIGH BLOOD PRESSURE: DOES THIS CONCERN ME?

    CERN Multimedia

    2007-01-01

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

  9. Child Abuse, Resting Blood Pressure, and Blood Pressure Reactivity to Psychosocial Stress.

    Science.gov (United States)

    Gooding, Holly C; Milliren, Carly E; Austin, S Bryn; Sheridan, Margaret A; McLaughlin, Katie A

    2016-01-01

    Childhood trauma is associated with hypertension in adults. It is unknown whether childhood trauma predicts elevated blood pressure earlier in development. We investigated whether the trauma of child abuse was associated with blood pressure in adolescents. The sample included 145 adolescents aged 13-17 years, 40% with exposure to child abuse. The mean age of participants was 14.93 years (SD = 1.33); 58% were female. The majority self-identified as non-Hispanic White (43%), with the remainder identifying as non-Hispanic Black (17%), Hispanic (17%), or other/mixed race (23%). We used established age/sex/height-specific cutoffs to determine the prevalence of prehypertension and hypertension in the sample. We used two-sample t tests to examine associations of abuse with resting systolic blood pressure (SBP) and diastolic blood pressure (DBP) and blood pressure reactivity to the Trier Social Stress Test and a frustration task. We used linear regression to adjust for potential confounders including sociodemographic variables, body mass index, smoking, and psychopathology. Mean resting SBP and DBP were 114.07 mmHg and 61.35 mmHg in those with a history of abuse and 111.39 mmHg and 56.89 mmHg in those without a history of abuse. This difference was significant for DBP only. Twelve percent of participants met criteria for prehypertension or hypertension based on resting blood pressure values; this did not differ between those with and without an abuse history. Child abuse was associated with lower DBP and SBP reactivity to laboratory stress tasks and reduced DBP reactivity to frustration. These associations were robust to adjustment for potential confounders. Child abuse is associated with higher resting DBP and blunted DBP and SBP reactivity to laboratory stress in adolescence. These findings suggest a potential pathway by which child abuse leads to hypertension. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All

  10. Effects of vegetarian diets on blood pressure

    Directory of Open Access Journals (Sweden)

    Yokoyama Y

    2016-04-01

    Full Text Available Yoko Yokoyama,1,2 Kazuo Tsubota,2,3 Mitsuhiro Watanabe1,2,4,5 1Graduate School of Media and Governance, Keio University, Fujisawa, Kanagawa, 2Health Science Laboratory, 3Department of Ophthalmology, 4Department of Internal Medicine, Keio University School of Medicine, Tokyo, 5Faculty of Environment and Information Studies, Keio University, Fujisawa, Kanagawa, Japan Abstract: Hypertension is a major independent risk factor for coronary artery diseases, and the prevalence of hypertension is continuously increasing. Diet is an important factor that can be modified to prevent hypertension. According to the US Department of Health and Human Services, dietary patterns are defined as the quantities, proportions, and variety or combinations of different foods and beverages in diets and the frequency with which they are habitually consumed. In this review, the vegetarian dietary pattern is introduced with a focus on the effect on blood pressure (BP. Although the available evidence is limited, according to a previous meta-analysis of controlled trials, vegetarian dietary patterns significantly reduced systolic and diastolic BPs. One of the common features of a vegetarian diet is weight loss, which might, at least partially, explain the effect on BP. Other possible factors such as sodium, potassium, protein, amino acids, vitamin B-12, antioxidants, fiber, and the microbiome are introduced as possible mechanisms. Further studies are needed with non-Western populations to determine the most effective vegetarian dietary pattern and to explore the exact mechanisms by which these dietary patterns affect BP. Keywords: vegetarian diet, plant-based diet, blood pressure, hypertension, meta-analysis

  11. Improving Blood Pressure Control Using Smart Technology.

    Science.gov (United States)

    Ciemins, Elizabeth L; Arora, Anupama; Coombs, Nicholas C; Holloway, Barbara; Mullette, Elizabeth J; Garland, Robin; Walsh Bishop-Green, Shannon; Penso, Jerry; Coon, Patricia J

    2018-03-01

    The authors sought to determine if wireless oscillometric home blood pressure monitoring (HBPM) that integrates with smartphone technology improves blood pressure (BP) control among patients with new or existing uncontrolled hypertension (HTN). A prospective observational cohort study monitored BP control before and after an educational intervention and introduction to HBPM. Patients in the intervention group were instructed to track their BP using a smartphone device three to seven times per week. Cases were matched to controls at a 1:3 allocation ratio on several clinical characteristics over the same period and received usual care. The proportion of patients with controlled BP was compared between groups at pre- and postintervention, ∼9 months later. Results and Materials: The total study population included 484 patients with mean age 60 years (range 23-102 years), 47.7% female, and 84.6% Caucasian. Mean preintervention BP was 137.8 mm Hg systolic and 81.4 mm Hg diastolic. Mean BP control rates improved for patients who received HBPM from 42% to 67% compared with matched control patients who improved from 59% to 67% (p technology has the potential to improve HTN management among patients with uncontrolled or newly diagnosed HTN. Technology needs to be easy to use and operate and would work best when integrated into local electronic health record systems. In systems without this capability, medical assistants or other personnel may be trained to facilitate the process. Nurse navigator involvement was instrumental in bridging communication between the patients and provider.

  12. Frequency of different blood groups and its association with BMI and blood pressure among the female medical students of Faisalabad.

    Science.gov (United States)

    Jawed, Shireen; Zia, Sadaf; Tariq, Sundus

    2017-08-01

    To determine the frequency of different blood groups among female medical students and to find the association of blood groups and body mass index with blood pressure. This cross-sectional study was performed at the University Medical and Dental College, Faisalabad, Pakistan, from March to April 2016, and comprised female medical students. Participants were divided into groups on the basis of their ABO blood groups and on body mass index criteria. Blood groups were determined by simple conventional slide method. Blood pressure was estimated by manual auscultatory technique with a mercury sphygmomanometer. Data was analysed usingSPSS20. There were 145 students with an overall mean age of18.4±0.75 years (range: 17-23 years). Blood group B was the predominant group 65(44.8%). Besides, 130(89.6%) subjects were rhesus positive and 23(53%) subjects of blood group O were pre-hypertensive. Multiple regression analysis indicated significant positive association of blood group O with both systolic and diastolic blood pressure (p=0.002, 0.001). However, subsequent logistic regression showed significant association only with diastolic blood pressure (p=0.001). Relative risk of pre-hypertension for obese (p=0.001) was greater than non-obese subjects. Body mass index was significantly associated with both systolic and diastolic blood pressure (p=0.004, 0.042). Blood group B was the most common blood group. Blood group O was associated with diastolic pre-hypertension, while body mass index was associated with both systolic and diastolic pre-hypertension.

  13. Multidisciplinary Treatment of the Metabolic Syndrome Lowers Blood Pressure Variability Independent of Blood Pressure Control.

    Science.gov (United States)

    Marcus, Yonit; Segev, Elad; Shefer, Gabi; Sack, Jessica; Tal, Brurya; Yaron, Marianna; Carmeli, Eli; Shefer, Lili; Margaliot, Miri; Limor, Rona; Gilad, Suzan; Sofer, Yael; Stern, Naftali

    2016-01-01

    Blood pressure (BP) variability (BPV) contributes to target organ damage independent of BP. The authors examined the effect of a 1-year multidisciplinary intervention on BPV in patients with the metabolic syndrome (MetS) as defined by criteria from the Third Report of the Adult Treatment Panel. Forty-four nondiabetic patients underwent clinical and biochemical profiling, 24-hour ambulatory BP monitoring (ABPM), body composition, carotid intima-media thickness, and carotid-femoral pulse wave velocity (PWV). The intervention targeted all MetS components. BPV was assessed by the standard deviation of daytime systolic BP derived from ABPM. Patients with low and high BPV (lower or higher than the median daytime standard deviation of 11.6 mm Hg) did not differ in regards to systolic and diastolic BP, age, fasting glucose, glycated hemoglobin, and body mass index, but the high-variability group had higher values of low-density lipoprotein and leg fat. The 1-year intervention resulted in weight reduction but not BP-lowering. BPV declined in the high-variability group in association with lowering of PWV, C-reactive protein, glycated hemoglobin, alanine aminotransferase, asymmetric dimethylarginine, and increased high-density lipoprotein cholesterol. A multidisciplinary intervention independent of BP-lowering normalized BPV, lowered PWV, and enhanced metabolic control. © 2015 Wiley Periodicals, Inc.

  14. Simultaneous compared with sequential blood pressure measurement results in smaller inter-arm blood pressure differences.

    Science.gov (United States)

    van der Hoeven, Niels V; Lodestijn, Sophie; Nanninga, Stephanie; van Montfrans, Gert A; van den Born, Bert-Jan H

    2013-11-01

    There are currently few recommendations on how to assess inter-arm blood pressure (BP) differences. The authors compared simultaneous with sequential measurement on mean BP, inter-arm BP differences, and within-visit reproducibility in 240 patients stratified according to age (simultaneous and three sequential BP measurements were taken in each patient. Starting measurement type and starting arm for sequential measurements were randomized. Mean BP and inter-arm BP differences of the first pair and reproducibility of inter-arm BP differences of the first and second pair were compared between both methods. Mean systolic BP was 1.3±7.5 mm Hg lower during sequential compared with simultaneous measurement (Psequential measurement was on average higher than the second, suggesting an order effect. Absolute systolic inter-arm BP differences were smaller on simultaneous (6.2±6.7/3.3±3.5 mm Hg) compared with sequential BP measurement (7.8±7.3/4.6±5.6 mm Hg, PSimultaneous measurement of BP at both arms reduces order effects and results in smaller inter-arm BP differences, thereby potentially reducing unnecessary referral and diagnostic procedures. ©2013 Wiley Periodicals, Inc.

  15. Renal Nerve Stimulation-Induced Blood Pressure Changes Predict Ambulatory Blood Pressure Response After Renal Denervation.

    Science.gov (United States)

    de Jong, Mark R; Adiyaman, Ahmet; Gal, Pim; Smit, Jaap Jan J; Delnoy, Peter Paul H M; Heeg, Jan-Evert; van Hasselt, Boudewijn A A M; Lau, Elizabeth O Y; Persu, Alexandre; Staessen, Jan A; Ramdat Misier, Anand R; Steinberg, Jonathan S; Elvan, Arif

    2016-09-01

    Blood pressure (BP) response to renal denervation (RDN) is highly variable and its effectiveness debated. A procedural end point for RDN may improve consistency of response. The objective of the current analysis was to look for the association between renal nerve stimulation (RNS)-induced BP increase before and after RDN and changes in ambulatory BP monitoring (ABPM) after RDN. Fourteen patients with drug-resistant hypertension referred for RDN were included. RNS was performed under general anesthesia at 4 sites in the right and left renal arteries, both before and immediately after RDN. RNS-induced BP changes were monitored and correlated to changes in ambulatory BP at a follow-up of 3 to 6 months after RDN. RNS resulted in a systolic BP increase of 50±27 mm Hg before RDN and systolic BP increase of 13±16 mm Hg after RDN (Pefficacy of RDN and predict BP response to RDN. © 2016 American Heart Association, Inc.

  16. Blood pressure and anthropometric measurements in healthy ...

    African Journals Online (AJOL)

    Methods. We measured the blood pressures of 650 healthy, randomly ... In addition, blood pressure measurement should be a part of the routine clinical examination of children. ... familial risk factors.2 ... common cause of elevated blood pressure in children.4 They ... sphygmomanometer (Accoson, hospital model BS 274,.

  17. Data Of Daily Blood Pressure Monitoring In Patients With Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    A.P. Rebrov

    2009-06-01

    Full Text Available The aim of present work is to study the frequency of hypertension and the peculiarity of 24-hour blood pressure monitoring in patients with rheumatoid arthritis. We studied 584 patients with rheumatoid arthritis. Daily blood pressure monitoring was carried out in 46 patients with arthritis and 18 patients with essential hypertension. Frequency of hypertension was higher in patients with arthritis then in general population. Elevation of systolic blood pressure, heart rate and arterial blood pressure adequate decrease at night were developed to associate with advance of the disease.

  18. Student measurement of blood pressure using a simulator arm compared with a live subject's arm.

    Science.gov (United States)

    Lee, Jennifer J; Sobieraj, Diana M; Kuti, Effie L

    2010-06-15

    To compare accuracy of blood pressure measurements using a live subject and a simulator arm, and to determine students' preferences regarding measurement. This was a crossover study comparing blood pressure measurements from a live subject and a simulator arm. Students completed an anonymous survey instrument defining opinions on ease of measurement. Fifty-seven students completed blood pressure measurements on live subjects while 72 students completed blood pressure measurements using the simulator arm. There were no significant systematic differences between the 2 measurement techniques. Systolic blood pressure measurements from a live subject arm were less likely to be within 4 mm Hg compared with measurements of a simulator arm. Diastolic blood pressure measurements were not significantly different between the 2 techniques. Accuracy of student measurement of blood pressure using a simulator arm was similar to the accuracy with a live subject. There was no difference in students' preferences regarding measurement techniques.

  19. Physiological effects of a companion robot on blood pressure of older people in residential care facility: a pilot study.

    Science.gov (United States)

    Robinson, Hayley; MacDonald, Bruce; Broadbent, Elizabeth

    2015-03-01

    To investigate the effects of interacting with the companion robot, Paro, on blood pressure and heart rate of older people in a residential care facility. This study used a repeated measures design. Twenty-one residents in rest home and hospital level care had their blood pressure taken three times; before, during and after interacting with the seal robot. Four residents who did not interact with the robot were excluded from the final analysis (final n = 17). The final analysis found that systolic and diastolic blood pressure changed significantly over time as did heart rate. Planned comparisons revealed that systolic and diastolic blood pressure decreased significantly from baseline to when residents had Paro (systolic, P = 0.048; diastolic, P = 0.05). Diastolic blood pressure increased significantly after Paro was withdrawn (P = 0.03). Interacting with Paro has a physiological effect on cardiovascular measures, which is similar to findings with live animals. © 2013 ACOTA.

  20. Blood pressure and falls in community-dwelling people aged 60 years and older in the VHM&PP cohort.

    Science.gov (United States)

    Klein, Diana; Nagel, Gabriele; Kleiner, Andrea; Ulmer, Hanno; Rehberger, Barbara; Concin, Hans; Rapp, Kilian

    2013-05-21

    Falls are one of the major health problems in old people. Different risk factors were identified but only few epidemiological studies analysed the influence of conventionally measured blood pressure on falls. The objective of our study was to investigate the relationship between systolic and diastolic blood pressure and falls. In 3,544 community-dwelling Austrian women and men aged 60 years and older, data on falls within the previous three months were collected by questionnaire. Blood pressure was measured by general practitioners within the Vorarlberg Health Monitoring and Prevention Programme (VHM&PP) 90 to 1095 days before the fall assessment. A multiple logistic regression analysis was conducted. The models were stratified by gender and adjusted by age, number of medical conditions and subjective feeling of illness. In total, 257 falls in 3,544 persons were reported. In women, high systolic and diastolic blood pressure was associated with a decreased risk of falls. An increase of systolic blood pressure by 10 mmHg and of diastolic blood pressure by 5 mmHg reduced the risk of falling by 9% (OR 0.91, 95% Cl 0.84-0.98) and 8% (OR 0.92, 95% Cl 0.85-0.99), respectively. In men, an increased risk of falls was observed in participants with low systolic or low diastolic blood pressure. Blood pressure was associated with the risk of falls. Hypertensive values decreased the risk in women and low blood pressure increased the risk in men.

  1. The association between smoking and blood pressure in men: a cross-sectional study.

    Science.gov (United States)

    Li, Guoju; Wang, Hailing; Wang, Ke; Wang, Wenrui; Dong, Fen; Qian, Yonggang; Gong, Haiying; Hui, Chunxia; Xu, Guodong; Li, Yanlong; Pan, Li; Zhang, Biao; Shan, Guangliang

    2017-10-10

    Cigarette smoking is a known risk factor for cardiovascular disease (CVD), but the association between smoking and blood pressure is unclear. Thus, the current study examined the association between cigarette smoking and blood pressure in men. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP) were examined using digital blood pressure measuring device, and smoking status was determined with China National Health Survey. The ANCOVA showed that the adjusted DBP and MAP were lower in current smokers versus nonsmokers and the adjusted SBP was lower in current smokers versus former smokers (P smoking on blood pressure indices except PP was observed. Smoking cessation was significantly associated with an increased risk of hypertension. However, current smoking was not a risk factor of hypertension.

  2. Reference data for distal blood pressure in healthy elderly and middle-aged individuals measured with the strain gauge technique. Part I: Resting distal blood pressure

    DEFF Research Database (Denmark)

    Arveschoug, Anne Kirstine; Vammen, Birthe; Yoshinaka, Emmy

    2008-01-01

    pressure and DBPtoe - DBPankle) were found in the new reference data compared to the old. No significant difference between the mean values of the gradient (DBPankle - systolic arm blood pressure) was found between the old and new reference data, although the variation was significantly wider in the new......Objective. Most patients referred to our department for distal blood pressure (DBP) determination on suspicion of arterial peripheral vascular disease (apvd) are more than 60 years of age, whereas the only available reference data for resting pressure are based on data from healthy individuals aged....... Material and methods. Group I comprised 31 healthy persons aged between 61 and 87 years and group II 14 healthy middle-aged hospital staff members aged between 45 and 58 years. Strict rules of inclusion were followed. Results. For group I, significantly greater gradients (DBPtoe - systolic arm blood...

  3. Blood pressure and control of cardiovascular risk

    OpenAIRE

    Judith A Whitworth

    2005-01-01

    Judith A WhitworthJohn Curtin School of Medical Research, Australian National University, Canberra, ACT, AustraliaAbstract: Two key early 20th century notions, the first the primacy of diastolic pressure in determining risk, and the second that hypertension is a discrete disorder, have proved to be incorrect. We now recognize the primacy of systolic pressure as a risk factor for cardiovascular disease and that hypertension is an arbitrary definition. In the early 21st century, we are moving a...

  4. Automated Office Blood Pressure Measurement.

    Science.gov (United States)

    Myers, Martin G

    2018-04-01

    Manual blood pressure (BP) recorded in routine clinical practice is relatively inaccurate and associated with higher readings compared to BP measured in research studies in accordance with standardized measurement guidelines. The increase in routine office BP is the result of several factors, especially the presence of office staff, which tends to make patients nervous and also allows for conversation to occur. With the disappearance of the mercury sphygmomanometer because of environmental concerns, there is greater use of oscillometric BP recorders, both in the office setting and elsewhere. Although oscillometric devices may reduce some aspects of observer BP measurement error in the clinical setting, they are still associated with higher BP readings, known as white coat hypertension (for diagnosis) or white coat effect (with treated hypertension). Now that fully automated sphygmomanometers are available which are capable of recording several readings with the patient resting quietly, there is no longer any need to have office staff present when BP is being recorded. Such readings are called automated office blood pressure (AOBP) and they are both more accurate than conventional manual office BP and not associated with the white coat phenomena. AOBP readings are also similar to the awake ambulatory BP and home BP, both of which are relatively good predictors of cardiovascular risk. The available evidence suggests that AOBP should now replace manual or electronic office BP readings when screening patients for hypertension and also after antihypertensive drug therapy is initiated. Copyright © 2018. The Korean Society of Cardiology.

  5. Effects of Topical Phenylephrine HCl 2.5% used before Cataract Surgery on Systemic Blood Pressure

    Directory of Open Access Journals (Sweden)

    Emre Ayıntap

    2011-06-01

    Full Text Available Purpose: To evaluate the effect of topical phenylephrine HCl 2.5% (Mydfrin, used as a fast and effective mydriatic before cataract surgery, on systemic blood pressure. Material and Method: Topical phenylephrine HCl 2.5% was administered 3 times with 5-minute intervals before cataract surgery to 44 eyes of 44 patients. The systemic blood pressure was measured preoperatively and at 15 and 30 minutes. Results: The mean systolic blood pressure before the topical administration of phenylephrine HCl 2.5% was 119.7mmHg, while 15 and 30 minutes later, it was 125.3 mmHg and 121.2 mmHg, respectively. The mean diastolic blood pressure before the topical administration of phenylephrine HCl 2.5% was 75.9 mmHg; 15 and 30 minutes later, it was 76.9 mmHg and 75.3 mmHg, respectively. The increase in systolic blood pressure at 15 and 30 minutes was statistically significant (p=0.003 and p=0.042. The change in diastolic blood pressure was not statistically significant. Discussion: Phenylephrine HCl 2.5%, which is used preoperatively as a fast and effective mydriatic for cataract surgery, can increase the systolic blood pressure. This effect is most significant at 15 minutes and lasts at least 30 minutes. This agent should be used with care in hypertensive patients. (Turk J Ophthalmol 2011; 41: 164-6

  6. Daily blood pressure profile in Cushing's syndrome before and after surgery

    Directory of Open Access Journals (Sweden)

    Kreze A.

    1999-01-01

    Full Text Available No significant difference has been demonstrated in the altered circadian blood pressure pattern between the pituitary-dependent and adrenal forms of Cushing's syndrome before surgery. The effect of therapy, however, proved to be different. The mesor was normalized in the pituitary-dependent Cushing's syndrome more conspicuously for systolic than for diastolic blood pressure. In Cushing's syndrome due to adrenal adenoma, systolic and diastolic blood pressure mesors have been even significantly "overnormalized" after treatment, being 11 to 27 and 2 to 13 mmHg (95% confidence lower than corresponding mesors in controls. There was no difference between forms in the effect of treatment on blood pressure amplitudes, which remained significantly lower than in controls. Finally, acrophase patterns were partly normalized after treatment of the pituitary-dependent form only for diastolic blood pressure, while both systolic and diastolic blood pressure acrophases were normalized in the treated adrenal form. In conclusion, complete normalization of the pattern of daily blood pressure profile has not been achieved in either form of the syndrome. This may be one of the reasons for the reduced long-term survival after surgical cure of hypercortisolism, than expected.

  7. Miniaturized Blood Pressure Telemetry System with RFID Interface

    Directory of Open Access Journals (Sweden)

    Michele Caldara

    2016-08-01

    Full Text Available This work deals with the development and characterization of a potentially implantable blood pressure telemetry system, based on an active Radio-Frequency IDentification (RFID tag, International Organization for Standardization (ISO 15693 compliant. This approach aims to continuously measure the average, systolic and diastolic blood pressure of the small/medium animals. The measured pressure wave undergoes embedded processing and results are stored onboard in a non-volatile memory, providing the data under interrogation by an external RFID reader. In order to extend battery lifetime, RFID energy harvesting has been investigated. The paper presents the experimental characterization in a laboratory and preliminary in-vivo tests. The device is a prototype mainly intended, in a future engineered version, for monitoring freely moving test animals for pharmaceutical research and drug safety assessment purposes, but it could have multiple uses in environmental and industrial applications.

  8. ABPM vs office blood pressure to define blood pressure control in treated hypertensive paediatric renal transplant recipients.

    Science.gov (United States)

    Ferraris, Jorge R; Ghezzi, Lidia; Waisman, Gabriel; Krmar, Rafael T

    2007-02-01

    While 24-h ambulatory blood pressure monitoring (ABPM) is an established tool for monitoring antihypertensive therapy in adults, data in children are scarce. We retrospectively analysed whether office blood pressure (BP) is reliable for the diagnosis of BP control in 26 treated hypertensive paediatric renal transplants. Controlled office BP was defined as the mean of three replicate systolic and diastolic BP recordings less than or equal to the 95th age-, sex- and height-matched percentile on the three-outpatient visits closest to ABPM. Controlled ABPM was defined as systolic and diastolic daytime BP ABPM reference. Eight recipients (30%) with controlled office BP were in fact categorized as having non-controlled BP by ABPM criteria. Overall, when office BP and ABPM were compared using the Bland and Altman method, the 95% limits of agreement between office and daytime values ranged from -12.6 to 34.1 mmHg for systolic and -23.9 to 31.7 mmHg for diastolic BP, and the mean difference was 10.7 and 3.9 mmHg respectively. Office readings miss a substantial number of recipients who are hypertensive by ABPM criteria. Undertreatment of hypertension could be avoided if ABPM is applied as an adjunct to office readings.

  9. Circadian blood pressure patterns and blood pressure control in patients with chronic kidney disease.

    Science.gov (United States)

    Di Daniele, Nicola; Fegatelli, Danilo Alunni; Rovella, Valentina; Castagnola, Veronica; Gabriele, Marco; Scuteri, Angelo

    2017-12-01

    Hypertension is a major risk factor for chronic kidney disease (CKD), and CKD progression is associated with suboptimal blood pressure (BP) control. Here we evaluate the impact of CKD on the attainment of BP control and the circadian BP profile in older subjects. In this observational study, we studied 547 patients referred to the hypertension clinic, of whom 224 (40.9%) had CKD. Blood pressure (BP) control and circadian BP patterns were evaluated by 24-hour ambulatory BP monitoring. Circadian BP variability was measured as the within-subject SD of BP, the percentage of measurements exceeding normal values, hypotension, and dipping status. The attainment of adequate BP control was similar in subjects with or without CKD (around 31%). Logistic regression analysis indicated that CKD was not a determinant of adequate BP control (OR 1.004; 95% CI 0.989-1.019; p = 0.58). Patients with CKD presented as twice as higher prevalence of reverse dipper (night-time peak) for systolic BP and episodes of hypotension during daytime, independently of BP control. Knowledge of the circadian pattern of BP in hypertensive subjects with CKD could inform better than attainment of BP target about risky condition for CKD progression and cognitive decline and allow a more personalized antihypertensive treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Seaweed intake and blood pressure levels in healthy pre-school Japanese children

    Directory of Open Access Journals (Sweden)

    Yamamoto Keiko

    2011-08-01

    Full Text Available Abstract Background Few studies have examined whether dietary factors might affect blood pressure in children. We purposed to investigate whether seaweed intake is associated with blood pressure level among Japanese preschool children. Methods The design of the study was cross-sectional and it was conducted in autumn 2006. Subjects were healthy preschoolers aged 3-6 years in Aichi, Japan. Blood pressure and pulse were measured once by an automated sphygmomanometer, which uses oscillometric methods. Dietary data, including seaweed intake, were assessed using 3-day dietary records covering 2 consecutive weekdays and 1 weekend day. Of a total of 533 children, 459 (86.1 percent agreed to be enrolled in our study. Finally, blood pressure measurement, complete dietary records and parent-reported height and weight were obtained for 223 boys and 194 girls. Results When we examined Spearman's correlation coefficients, seaweed intake was significantly negatively related to systolic blood pressure in girls (P = 0.008. In the one-way analysis of covariance for blood pressure and pulse after adjustments for age and BMI, the boys with the lowest, middle and highest tertiles of seaweed intake had diastolic blood pressure readings of 62.8, 59.3 and 59.6 mmHg, respectively (P = 0.11, trend P = 0.038. Girls with higher seaweed intake had significantly lower systolic blood pressure readings (102.4, 99.2 and 96.9 mmHg for girls with the lowest, middle and highest tertiles of seaweed intake, respectively; P = 0.037, trend P = 0.030. Conclusion Our study showed that seaweed intake was negatively related to diastolic blood pressure in boys and to systolic blood pressure in girls. This suggests that seaweed might have beneficial effects on blood pressure among children.

  11. Blood pressure in young adulthood and residential greenness in the early-life environment of twins.

    Science.gov (United States)

    Bijnens, Esmée M; Nawrot, Tim S; Loos, Ruth Jf; Gielen, Marij; Vlietinck, Robert; Derom, Catherine; Zeegers, Maurice P

    2017-06-05

    Previous research shows that, besides risk factors in adult life, the early-life environment can influence blood pressure and hypertension in adults. However, the effects of residential traffic exposure and residential greenness in the early-life on blood pressure in young adulthood are currently unknown. Ambulatory (24-h) blood pressures of 278 twins (132 pairs) of the East Flanders Prospective Twins Study were obtained at the age of 18 to 25 years. Prenatal and adulthood residential addresses were geocoded and used to assign prenatal and postnatal traffic and greenness indicators. Mixed modelling was performed to investigate blood pressure in association with greenness while adjusting for potential confounding factors. Night-time systolic blood pressure was inversely associated with greenness at the residential address in twins living at the same address their entire life (non-movers, n = 97, 34.9%). An interquartile increase in residential greenness exposure (1000 m radius) was associated with a 3.59 mmHg (95% CI: -6.0 to -1.23; p = 0.005) lower adult night systolic blood pressure. Among twins who were living at a different address than their birth address at time of the measurement (n = 181, 65.1%), night-time blood pressure was inversely associated with residential surrounding greenness at adult age as well as with residential greenness in early-life. However after additional adjustment for residential greenness exposure in adulthood, only residential greenness exposure in early-life was significantly associated with night systolic blood pressure. While no significant effect of adult residential greenness with adult blood pressure was observed, while accounting for the early-life greenness exposure. Lower residential greenness in the early-life environment was independently associated with a higher adult blood pressure. This indicates that residential greenness has persistent effects on blood pressure.

  12. Central blood pressure and chronic kidney disease

    Science.gov (United States)

    Ohno, Yoichi; Kanno, Yoshihiko; Takenaka, Tsuneo

    2016-01-01

    In this