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  • Antihypertensive therapy and sudden cardiac death, should we expect the unexpected?
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2020-01-14
    Elias Sanidas; Konstantinos Malliaras; Dimitrios Papadopoulos; Maria Velliou; Konstantinos Tsakalis; Kanella Zerva; John Barbetseas
    更新日期:2020-01-14
  • Effects of different aerobic exercise programs on cardiac autonomic modulation and hemodynamics in hypertension: data from EXERDIET-HTA randomized trial
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2020-01-13
    Aitor MartinezAguirre-Betolaza; Iñigo Mujika; Simon M. Fryer; Pablo Corres; Ilargi Gorostegi-Anduaga; Iñaki Arratibel-Imaz; Javier Pérez-Asenjo; Sara Maldonado-Martín
    更新日期:2020-01-13
  • Risk factors of pulmonary edema in women with preeclampsia from south India: a case-control study
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2020-01-13
    Anish Keepanasseril; Joel Monárrez-Espino; Priyadarshini Vadivelu; Dilip Kumar Maurya

    Pulmonary edema is a potentially life-threatening complication of preeclampsia, but only few studies have looked at possible risk factors. This study assessed the association between various potential risk factors and the development of pulmonary edema. An age-matched case-control design with hospital records from a tertiary care center in south India was used. A total of 55 pregnant women with preeclampsia who developed pulmonary edema were included as cases, who were 4:1 aged-matched as controls with 220 preeclamptic women, and who did not develop pulmonary edema. Multivariate conditional logistic regression was used to produce adjusted odds ratios with 95% confidence intervals for the likelihood to develop pulmonary edema (OR; 95% CI). Nulliparity (3.94; 1.44–10.7), multifetal pregnancy (5.06; 1.59–16.0), mean arterial blood pressure in mmHg (1.08; 1.03–1.13), and mild (3.25; 1.02–1.29) and moderate (4.43; 1.76–11.1) anemia showed increased odds. Multifetal pregnancy in nulliparous women had higher odds (39.5; 6.2–251) compared with those with singleton pregnancies (3.17; 1.13–8.88). While early aggressive blood pressure treatment can reduce the risk of pulmonary edema, the other risk factors are either non-modifiable or relate to disease severity; thus, continuous monitoring would be relevant for early diagnosis and management, especially among nulliparous preeclamptic women with multifetal pregnancies.

    更新日期:2020-01-13
  • Effect of intensive and standard blood pressure control on cardiovascular outcomes based on body mass index: sub-analysis of the sprint trial
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2020-01-07
    Setri Fugar; Alexis K. Okoh; Christopher Dodoo; Ahmed A. Kolkailah; Edwin Okyne; Ebru Özturk; Alfred Solomon; Nana Ama Afari Yeboah; Tania Campagnoli; Annabelle Volgman; Kim Williams
    更新日期:2020-01-07
  • Plasma microRNA-126-3p and neutrophil-to-lymphocyte ratio in patients with chronic kidney disease: relationships to ambulatory 24-h blood pressure
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2019-12-18
    Dominika Klimczak-Tomaniak; Tomasz Pilecki; Dorota Żochowska; Damian Sieńko; Maciej Janiszewski; Marek Kuch; Leszek Pączek
    更新日期:2019-12-19
  • Carotid pulse pressure and intima media thickness are independently associated with cerebral hemodynamic pulsatility in community-living older adults
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2019-12-10
    Andrew D. Robertson, George A. W. Heckman, Myra A. Fernandes, Eric A. Roy, Suzanne L. Tyas, Richard L. Hughson
    更新日期:2019-12-11
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  • Mild primary aldosteronism (PA) followed by overt PA are possibly the most common forms of low renin hypertension: a single-center retrospective study
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2019-12-02
    Qin Luo, Nanfang Li, Menghui Wang, Xiaoguang Yao, Mulalibieke Heizhati, Delian Zhang, Keming Zhou, Guoliang Wang, Junli Hu, Bin Zhu
    更新日期:2019-12-02
  • Using blood pressure height index to define hypertension among secondary school adolescents in southwestern Uganda
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2019-12-02
    Godfrey Katamba, David Collins Agaba, Richard Migisha, Agnes Namaganda, Rosemary Namayanja, Eleanor Turyakira
    更新日期:2019-12-02
  • Reliability of normative tables in assessing elevated blood pressure in children
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2019-11-26
    Mehmet Agirbasli, Hatice Feyza Dilek, Mustafa Adem Tatlisu, Handan Ankarali
    更新日期:2019-11-27
  • Four-year adiposity change and remission of hypertension: an observational evaluation from the Longitudinal Study of Adult Health (ELSA-Brasil)
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2019-11-18
    Joanna M. N. Guimarães, Rosane H. Griep, Maria J. M. Fonseca, Bruce B. Duncan, Maria I. Schmidt, José G. Mill, Paulo A. Lotufo, Isabela J. Bensenor, Sandhi M. Barreto, Luana Giatti, Sheila M. A. Matos, Maria delC B. Molina, Antonio G. Pacheco, Dora Chor
    更新日期:2019-11-18
  • The association between total homocysteine and blood pressure in two independent Chinese populations
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2019-11-12
    Haoyu Weng, Yuxi Li, Fangfang Fan, Hongyun Yang, Guopeng Zhou, Pengfei Sun, Shengcong Liu, Tieci Yi, Yong Huo, Jianping Li
    更新日期:2019-11-13
  • Lower 24-h urinary sodium excretion is associated with hypertension control: the 2010 Heart Follow-Up Study
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2019-11-11
    Tali Elfassy, Shadi Chamany, Katherine Bartley, Stella S. Yi, Sonia Y. Angell
    更新日期:2019-11-13
  • Correlation between blood pressure variability and subclinical target organ damage in patients with essential hypertension
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2019-11-11
    Mostafa El Mokadem, Hesham Boshra, Yasser Abd el Hady, Amany Kasla, Ahmed Gouda

    High blood pressure (BP) variability is associated with the increased risk of cardiovascular and renal damage together with increased cardiovascular mortality. The aim of our study was to investigate the relationship between BP variability and subclinical target organ damage (TOD) in patients with controlled essential hypertension. One hundred patients with controlled essential hypertension were randomly selected from outpatient clinic of Beni-Suef University hospital. All patients were subjected to full history taking, physical examination, three separate office BP measurements for assessment of long-term BP variability, ambulatory BP monitoring for short-term variability, and finally different investigations for subclinical TOD. We had 73 patients with subclinical TOD. Long-term visit-to-visit variability was evaluated by measuring SD (standard deviation) and CV (coefficient of variance) of systolic and diastolic BP. None of the parameters of long-term BP variability were significantly higher among patients with TOD compared with those without TOD. For short-term variability evaluated by ambulatory BP monitoring, average real variability (ARV) was the only parameter that had a significant consistent association with TOD in contrast to SD and CV. Finally, Daytime systolic ARV, nighttime diastolic ARV, and age were independent predictors of TOD (P values = 0.014, 0.018, 0.047, and 0.02, respectively). We concluded that ARV could be an appropriate index of BP variability and a more useful predictor of TOD in contrast to other parameters of BP variability

    更新日期:2019-11-13
  • 更新日期:2019-11-13
  • Which out-of-office measurement technique should be used for diagnosing hypertension in prehypertensives?
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2019-11-07
    Şükrü Ulusoy, Gülsüm Özkan, Mustafa Arıcı, Ülver Derici, T. Akpolat, Şule Şengül, Rahmi Yılmaz, Şehsuvar Ertürk, Yunus Erdem
    更新日期:2019-11-07
  • Invited review: hypertension and atrial fibrillation: epidemiology, pathophysiology, and implications for management
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2019-11-05
    Jakub Gumprecht, Magdalena Domek, Gregory Y. H. Lip, Alena Shantsila
    更新日期:2019-11-05
  • Retraction Note: Effect of L-citrulline supplementation on blood pressure: a systematic review and meta-analysis of randomized controlled trials
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2019-11-05
    Sepideh Mahboobi, Catherine Tsang, Shahla Rezaei, Sadegh Jafarnejad

    An amendment to this paper has been published and can be accessed via a link at the top of the paper.

    更新日期:2019-11-05
  • Retraction Note: Elevated blood pressure reduction after α-lipoic acid supplementation: a meta-analysis of randomized controlled trials
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2019-11-04
    Virginia Boccardi, Mohsen Taghizadeh, Sina Amirjani, Sadegh Jafarnejad

    An amendment to this paper has been published and can be accessed via a link at the top of the paper.

    更新日期:2019-11-04
  • Diagnostic value of carotid intima-media thickness and plaque score for predicting target organ damage in patients with essential hypertension.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2003-12-23
    S Takiuchi,K Kamide,Y Miwa,M Tomiyama,M Yoshii,T Matayoshi,T Horio,Y Kawano

    Carotid intima-media thickness (IMT) assessed by ultrasonography is regarded as an early predictor of general arteriosclerosis in patients with essential hypertension. However, the methods of measuring IMT have not been globally standardized, and it remains unclear whether conventional measurement of IMT represents the prevalence of hypertensive target organ damage. In this study, we verified the association between several commonly used carotid ultrasonographical parameters and the severity of hypertensive target organ damage (retinal arteriosclerosis, microalbuminuria, left ventricular hypertrophy (LVH)). Carotid ultrasonography, echocardiography, urinalysis, and funduscopy were performed in 184 patients (64 +/- 12 years, 96 males and 88 females) with various stages of essential hypertension. Carotid arteriosclerosis was assessed using four methodologically different methods: conventional-IMT, maximum-IMT (Max-IMT), Mean-IMT, and Plaque Score (the sum of all plaque thicknesses). Age and all carotid ultrasonographical parameters were significantly associated with albuminuria, retinal arteriosclerosis, and left ventricular mass index. High-sensitivity CRP was significantly correlated with retinopathy and LVH. Carotid parameters in patients with histories of cardiovascular events were significantly greater in those without events. Among all carotid parameters, Max-IMT showed the highest correlation coefficient of the severity of target organ damage, and showed significant association with CRP. Stepwise regression analysis revealed that Max-IMT was the independent factor for predicting target organ damage. Max-IMT is suggested to be the most reliable and simplest parameter for predicting hypertensive target organ damage including microangiopathy in patients with essential hypertension.

    更新日期:2019-11-01
  • Measurement of blood pressure in people with atrial fibrillation.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2019-10-04
    Christopher E Clark,Sinead T J McDonagh,Richard J McManus,

    更新日期:2019-11-01
  • Comparative antihypertensive efficacy of olmesartan: comparison with other angiotensin II receptor antagonists.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2002-05-31
    S Oparil

    Hypertension is a major risk factor for cardiovascular morbidity and mortality. Effective control of elevated blood pressure (BP) has been shown to reduce this risk. Early studies of risk reduction assumed that the mechanism by which BP was lowered had little impact on the benefit obtained. Recent evidence, however, suggests that agents that inhibit the renin-angiotensin system may be particularly beneficial. The results of the recent Heart Outcomes Prevention Evaluation (HOPE) trial suggest that angiotensin-converting enzyme (ACE) inhibitors have a greater impact on cardiovascular morbidity and mortality than would be anticipated from their antihypertensive effects alone. Angiotensin receptor blockers, the other major class of antihypertensive drugs that inhibit the renin-angiotensin system, have not been widely tested in outcomes trials, but early results suggest that they are beneficial for controlling target organ damage that is related to hypertension. Furthermore, unlike ACE inhibitors, these agents have a side-effect profile that is similar to that of placebo. Based on their efficacy in controlling hypertension and their wider health benefits, together with minimal side effects, angiotensin II (A II) receptor blockers should be considered as first-line agents for the treatment of hypertension, particularly in patients with other cardiovascular risk factors. Preliminary evidence suggests that olmesartan, an A II receptor blocker currently being evaluated for approval for clinical use, may provide antihypertensive efficacy that is superior to other members of the class.

    更新日期:2019-11-01
  • Microvolt T wave alternans in patients with hypertension and left ventricular hypertrophy.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2001-11-01
    D Francis,R Lane,J Mayet,R A Foale,S Thom,N S Peters,

    更新日期:2019-11-01
  • The effects of cardiac events on quality of life and indirect costs.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2001-11-01
    B Jönsson,M Buxton,T Kahan,N R Poulter,P Svarvar,

    更新日期:2019-11-01
  • Ethnic variations in response to a statin (EVIREST).
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2001-11-01
    N R Poulter,M Caulfield,G Feder,

    更新日期:2019-11-01
  • Non-specific effects of inclusion in a clinical trial: information from ASCOT.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2001-11-01
    S Thom,A Whitehouse,P Sever,N Poulter,

    更新日期:2019-11-01
  • 更新日期:2019-11-01
  • 更新日期:2019-11-01
  • Differential response to amlodipine and atenolol mono-therapy for hypertension by ethnic group.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2001-11-01
    P L Kirby,M C Caulfield,D J Collier,S Eldridge,C G Griffiths,H Hemingway,N R Poulter,G S Feder,

    更新日期:2019-11-01
  • 更新日期:2019-11-01
  • 更新日期:2019-11-01
  • Ambulatory blood pressure monitoring and 24-h blood pressure control as predictors of outcome in treated hypertensive patients.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2001-11-01
    E O'Brien,G T McInnes,A Stanton,S Thom,M Caulfield,N Atkins,F M Nichol,

    更新日期:2019-11-01
  • 更新日期:2019-11-01
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  • 更新日期:2019-11-01
  • Evaluation of cardiovascular risk equations using the ASCOT cohort.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2001-11-01
    S Wilson,D Collier,A Johnston,N Poulter,G Feder,J Robson,M Caulfield,

    更新日期:2019-11-01
  • 更新日期:2019-11-01
  • 更新日期:2019-11-01
  • 更新日期:2019-11-01
  • An intensive phenotyping study to enable the future examination of genetic influences on hypertension-associated cardiovascular disease.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2001-11-01
    A Stanton,D Fitzgerald,A Hughes,J Mayet,E O'Brien,N R Poulter,P S Sever,D Shields,S Thom,

    更新日期:2019-11-01
  • Anglo-Scandinavian Cardiac Outcomes Trial: a brief history, rationale and outline protocol.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2001-11-01
    P S Sever,B Dahlöf,N R Poulter,H Wedel,G Beevers,M Caulfield,R Collins,S E Kjeldsen,G T McInnes,J Mehlsen,M Nieminen,E O'Brien,J Ostergren,

    更新日期:2019-11-01
  • 更新日期:2019-11-01
  • Should we do an oral glucose tolerance test in hypertensive men with normal fasting blood-glucose?
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2001-02-27
    S Agewall

    The objective of this study was to examine, using the new WHO criteria for diabetes mellitus, whether insulin and glucose before and after an oral glucose tolerance test would predict cardiovascular mortality in hypertensive men with normal fasting blood glucose. A standard oral glucose challenge was performed after an overnight fast in 113 hypertensive men with either hypercholesterolaemia or smoking. These patients were recruited from an on-going risk factor intervention study. The mean observation time was 6.3 years. During follow-up there were 10 cardiovascular deaths. The Cox regression analyses showed an independent and significant association (P < 0.05) between blood glucose 120 min after the glucose ingestion and cardiovascular death during follow-up. Fasting glucose, fasting insulin and insulin 120 min after glucose ingestion was not related to cardiovascular death during follow-up. In conclusion, this is the first study using the current definition of diabetes mellitus showing that hyperglycaemia following an oral glucose load is an independent risk factor for cardiovascular death in hypertensive men with a normal fasting glucose. In this type of hypertensive patient with normal fasting glucose, an oral glucose tolerance test may help to identify subjects at high cardiovascular risk. Journal of Human Hypertension (2001) 15, 71-74

    更新日期:2019-11-01
  • The spatial QRS-T angle as a marker of ventricular repolarisation in hypertension.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2001-02-27
    P Dilaveris,E Gialafos,A Pantazis,A Synetos,F Triposkiadis,J Gialafos

    Ventricular repolarisation abnormalities are important in arrhythmia provocation. The dispersion of repolarisation duration is not the only aspect of repolarisation heterogeneity. Spatial vectorcardiographic descriptors constitute a novel approach to quantify ventricular repolarisation. To test the ability of vectorcardiographic descriptors to discriminate between hypertensives with high or low blood pressure (BP), 110 treated hypertensives (mean age 63.6 +/- 12.1 years) were classified in the high (systolic BP > or = 160 mm Hg or diastolic BP > or = 95 mm Hg) (n = 67), or the low (systolic BP < 160 mm Hg and diastolic BP <95 mm Hg) (n = 43) BP group. The maximum QT, JT, and T peak-T end intervals and the QT, JT, and T peak--T end dispersion were calculated from a digitally recorded 12-lead electrocardiogram (ECG). X, Y, and Z leads were reconstructed from the 12-lead ECG. The amplitude of the maximum spatial T vector (spatial T amplitude), the angle between the maximum spatial QRS and T vectors (spatial QRS-T angle) and the frontal plane QRS-T angle were calculated. The spatial QRS-T angle was higher in patients with high compared to those with low BP (P = 0.025). All conventional ECG markers of the dispersion of ventricular repolarisation duration failed to demonstrate significant differences between hypertensives with high or low BP. In conclusion, the spatial QRS-T angle was significantly increased in those treated hypertensive patients who showed repeatedly high BP values. Hence, we may suggest that the angle between the directions of ventricular depolarisation and repolarisation is a sensitive marker of the repolarisation alterations in systemic hypertension. Journal of Human Hypertension (2001) 15, 63-70

    更新日期:2019-11-01
  • Improvement of patients' knowledge by a single educational meeting on hypertension.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2001-02-27
    C Cuspidi,L Sampieri,G Macca,I Michev,V Fusi,M Salerno,B Severgnini,J I Rocanova,G Leonetti,A Zanchetti

    OBJECTIVES A poor therapeutic compliance is a major cause of insufficient control of hypertension. As education of patients is fundamental in order to improve their compliance, we organised two pilot educational meetings aimed at (1) assessing the support of patients to this kind of meetings, and (2) verifying the impact on patient's education. METHODS We invited 225 consecutive patients referred to our Hypertension Clinic (some of them regularly followed up and some referred for the first time) to participate to an educational meeting on hypertension. Patients were divided in two groups, for organising reasons each attending a single meeting. Each meeting included four sessions: (1) the first session included a multiple choice questionnaire (nine questions, with answers collected by an interactive electronic system) in order to evaluate the degree of patient's information about hypertension (definition, prevalence, aetiology, complications and treatment), (2) a traditional teaching session, (3) an interactive phase aimed to assess the improvement of knowledge in which the same questions as in the first session have been asked again, and (4) a general discussion session. RESULTS A total of 144 patients (mean age 54 +/- 12 years; 76 M, 68 F) of the 225 invited attended the meeting. The answers to our questions in the initial session were correct in a percentage ranging from 60% to 80%. During the third phase immediately after the teaching session, the percentage of correct answers increased significantly (range: 75--98%, P < 0.05 at least in all questions). CONCLUSIONS This study shows: (1) a satisfactory adherence of patients to this educational initiative; (2) a positive impact of a single educational meeting on patient's knowledge about issues related to hypertension. The potential role of improving patient's education on clinical outcomes such as blood pressure levels and the rate of blood pressure control requires future controlled studies. Journal of Human Hypertension (2001) 15, 57-61

    更新日期:2019-11-01
  • Haplotypes of the human renin gene associated with essential hypertension and stroke.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2001-02-27
    P M Frossard,M J Malloy,G G Lestringant,J P Kane

    The human renin gene (REN) is a good candidate in studies aimed at unravelling the genetic basis of essential hypertension and stroke. We previously established that both a BglI and an MboI dimorphisms (located respectively in the first and ninth introns of the REN gene) were associated with essential hypertension in a population of hyperlipidaemic US subjects. In this association (retrospective case-control) study, we investigated the haplotype distribution of alleles defined by the combination of REN BglI and MboI dimorphic sites in 329 hyperlipidaemic US Caucasian subjects referred to UCSF Medical Center (140 hypertensives, 141 normotensives, and 48 hypertensive patients who had suffered a stroke). A statistically significant association was found between alleles determined by both (BglI(-)/MboI(+)) and (BglI(+)/MboI(+)) haplotypes and clinical diagnosis of EHT (combined odds ratios, OR = 3.35, corrected P < 10(-7)). Haplotypes (-,+) and (+,+) were also found to be associated with clinical diagnosis of stroke (OR = 4.31, P < 10(-7)). These associations do not occur through the effects of classical risk factors related to lipid, lipoprotein and apolipoprotein levels. We conclude that variations of the REN (or of a nearby) gene that may be in linkage disequilibrium with REN (BglI(-)/MboI(+)) and (BglI(+)/MboI(+)) alleles could play a role in contributing to increased individual's genetic susceptibility to EHT and to stroke. Journal of Human Hypertension(2001) 15, 49-55

    更新日期:2019-11-01
  • Relationship between short-term and long-term blood pressure variabilities in essential hypertensives.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2001-02-27
    S Ragot,D Herpin,J P Siché,P Poncelet,J M Mallion

    This study was designed to analyse the relationship between the different blood pressure (BP) variabilities obtained in a non-invasive way and to determine the potential contribution of aging, severity of hypertension and increased ventricular mass to these different BP variabilities. Two hundred and six hypertensive patients underwent a 24-h ambulatory BP measurement (ABPM) as well as a photoplethysmographic BP recording and a standard echocardiography. Nocturnal BP fall and standard deviations of hourly mean BP levels as well as post-prandial fall in BP were calculated from the 24-h ABPM and were considered as indexes of long-term variability. Baroreflex sensitivity (BRS) and spectral powers of systolic BP, diastolic BP and heart rate (HR) over the low frequency band (LF: 0.05--0.14 Hz) were obtained from photoplethysmographic recording and were used as indexes of short-term variability. Short-term variability indexes were shown to be significantly related to those of long-term variability. A decrease in LF spectral powers was associated with a particular profile characterised by an attenuation of nocturnal BP fall, an increase of daytime BP standard deviations, an increase in post-prandial BP fall, a decrease in BRS and to a lesser extent, a diminution in night-time HR standard deviation. Moreover, a negative significant relationship was found between standard deviation of daytime systolic BP and both night systolic BP fall and BRS. Age and nocturnal BP level were associated with all BP variability disorders, whereas left ventricular hypertrophy was associated only with a decrease in LF spectral powers and in night BP fall, and an increase in standard deviation of daytime BP. Finally, LF spectral power of SBP was identified as independently predicted by age and night SBP fall. Journal of Human Hypertension (2001) 15, 41-48

    更新日期:2019-11-01
  • Increased membraneous calcium concentrations in primary hypertension: a causal link to pathogenesis?
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2001-02-27
    M Kosch,M Hausberg,M Barenbrock,A Posadzy-Malaczynska,K H Rahn,K Kisters

    BACKGROUND Disturbance in calcium metabolism has been suggested in the pathogenesis of hypertension, however, membrane calcium content in humans has not been studied in detail yet in primary hypertension. We compared plasma, intracellular and membrane calcium concentrations in erythrocytes of patients with essential hypertension and in healthy, normotensive control subjects to determine a possible alteration of membrane calcium in primary hypertension. SUBJECTS AND METHODS Thirty-four never treated patients with essential hypertension were included and 34 healthy, age- and sex-matched volunteers served as controls. Atomic absorption spectroscopy was used for measurement of intracellular and membrane calcium content in erythrocytes and plasmalemmal preparations. RESULTS Plasma and intracellular Ca(++) concentrations were not significantly different between hypertensives and controls (plasma: 2.59 +/- 0.18 vs2.50 +/- 0.16 mmol/l, intracellular: 1.89 +/- 0.20 mmol/l vs 1.97 +/- 0.24 mmol/l, NS resp., mean +/- s.e.m.). However, membrane calcium content was significantly higher in hypertensive patients compared to control subjects (2.38 +/- 0.28 micromol/g membraneous protein vs0.86 +/- 0.32 micromol/g membrane protein, P < 0.01). Membrane calcium content was correlated to mean arterial blood pressure (r = 0.59, P < 0.01). CONCLUSION Membrane calcium content is significantly increased in patients with untreated primary hypertension and correlates to blood pressure levels. This data suggest, that an membrane mechanism may contribute to alterations in calcium metabolism and to the pathogenesis of primary hypertension.

    更新日期:2019-11-01
  • Assessing hypertension management in the community: trends of prevalence, detection, treatment, and control of hypertension in the MONICA Project, Augsburg 1984-1995.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2001-02-27
    C Gasse,H W Hense,J Stieber,A Döring,A D Liese,U Keil

    OBJECTIVE To assess trends in prevalence and detection, treatment and control of hypertension in a German population between 1984 and 1995. SETTING AND PARTICIPANTS Independent random samples of the population were examined in cross-sectional surveys with identical methods in 1984/85 (age range 25 to 64 years, n = 4022 participants), 1989/90 (age range 25 to 74 years, n = 4940) and 1994/95 (age range 25 to 74 years, n = 4856). MAIN OUTCOME MEASURES Prevalence of hypertension and proportions of hypertensives detected, treated and controlled. Hypertension was defined as blood pressure above 140/90 mm Hg or taking antihypertensive medication. RESULTS The prevalence of hypertension did not change significantly over the 10 years (25--64 years, age-standardised 1984/85: 37.8% in men and 24.6% in women; 1994/95: 39.3% and 24.8%, respectively). Rates of detection, treatment and control of hypertension did not change much either. Of all hypertensives in 1994/95, 54% were detected in men and 64% in women, the treatment rates were 23% and 32%, and the proportions of those with controlled hypertension (below 140/90 mm Hg with treatment) were as low as 7% and 13%, respectively. Rates were higher in the older age groups, however, control rates never exceeded 20% at any age. CONCLUSIONS Despite considerable changes in the pharmacological treatment of hypertension there was a disappointing stagnation with regard to the management of this important risk factor in the community. The reasons for this unfavourable trend need clarification and appropriate public health action. Journal of Human Hypertension (2001) 15, 27-36

    更新日期:2019-11-01
  • Why is plasma renin activity lower in populations of African origin?
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2001-02-27
    G A Sagnella

    Plasma renin activity is significantly lower in black people compared with whites independent of age and blood pressure status. The lower PRA appears to be due to a reduction in the rate of secretion of renin but the exact mechanistic events underlying such differences in renin release between blacks and whites are still not fully understood. Nevertheless, given the paramount importance of the renin-angiotensin system in the control of sodium balance, a most likely explanation is that the lower renin is a consequence of differences in renal sodium handling between blacks and whites. The lower PRA does not reflect differences in dietary sodium intake but the evidence available suggests that the low PRA could be part of the corrective mechanisms designed to maintain sodium balance in the presence of an increased tendency for sodium retention in black people. While it is possible that several factors may contribute to the reduced PRA, more recent investigation at the molecular level suggests that the lower PRA may arise from gene variation in the renal epithelial sodium channel. The functional significance of the lower PRA in relation to the different pattern of cardiovascular and renal disease between blacks and whites remains unclear. Moreover, direct investigations of pre-treatment renin status in hypertensive blacks in relation to blood pressure response have demonstrated that the pre-treatment PRA is not a good index of subsequent blood pressure response to pharmacological treatment. Nevertheless, the blood pressure reduction to short term sodium restriction is greater in blacks compared with whites and, in the black subjects, the greater reduction in blood pressure to sodium restriction appears to be related, at least in part, to the decreased responsiveness of the renin-angiotensin system. Journal of Human Hypertension (2001) 15, 17-25

    更新日期:2019-11-01
  • Franz Volhard and Theodor Fahr: achievements and controversies in their research in renal disease and hypertension.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2001-02-27
    A Heidland,W Gerabek,K Sebekova

    The clinician, Franz Volhard, and the pathologist, Theodor Fahr, worked closely together in Mannheim from 1909 until 1915 and introduced a novel classification of renal diseases. In the monograph entitled 'Die Bright'sche Nierenkrankheit, Klinik, Pathologie und Atlas' (1914) they differentiated between degenerative (nephroses), inflammatory (nephritides) and arteriosclerotic (scleroses) diseases. Nephrosclerosis was divided into the benign and malignant form, of which the latter stood the test of time as a new disease entity. Fahr further divided benign nephrosclerosis into the compensated and decompensated form--depending on the presence or absence of glomerular injury. In the pathogenesis of malignant nephrosclerosis, Volhard stressed the decisive role of severe blood pressure elevation, while Fahr postulated an inflammatory mechanism, a concept later confirmed by Adalbert Bohle for at least a minority of patients. A very far reaching concept of Franz Volhard was his idea that pale (renal) hypertension results from a pressor substance released from ischaemic kidney(s) contributing--via a vicious circle--to a further rise in blood pressure with subsequent renovascular injury and aggravation of hypertension. This hypothesis was supported in 1930 by initial experiments of his collaborator, Hartwich (demonstrating in dogs a mild rise in blood pressure after ligation of branches of the renal artery) and definitively proven by Goldblatt (1934) in dogs by induction of severe and persistent hypertension after clamping of both renal arteries. The consequent detection of the renin angiotensin system was the final confirmation of Volhard's postulated renal pressor substance. In the pathogenesis of red (essential) hypertension, Volhard stressed the role of hereditary factors, age, obesity and potentially of severe alcoholism. He emphasised a premature reduction of vascular distensibility (due to elastosis of the prearterioles), a high cardiac output as well as a dampening of baroceptor function. Additionally, Volhard made crucial advances in cardiology and pneumology. Journal of Human Hypertension (2001) 15, 5-16

    更新日期:2019-11-01
  • Making prevention and management of hypertension work.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2001-02-27
    K Miura,M L Daviglus,P Greenland,J Stamler

    更新日期:2019-11-01
  • Factors influencing the development of malignant hypertension in nigeria
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2000-08-30
    Kadiri,Olutade,Osobamiro

    Hypertension prevalence rates remain comparatively low in Nigeria, although the associated morbidity and mortality including that due to malignant hypertension (MHT) is considerable. To determine the factors that may be associated with the development of MHT we compared 74 patients with essential MHT (age 48 +/- 9 years, 59 male, blood pressure (BP) 234 +/- 31/140 +/- 17 mm Hg) with 74, age, gender and BP-matched patients with essential benign hypertension (BHT) (49 +/- 8 years, 60 male, 227 +/- 26/136 +/- 15 mm Hg). Body mass index was higher in the BHT group by 1.3 (95% Cl: 0.5 to 2.1, P < 0.01). In the subset (25 MHT, 43 BHT) in whom hypertension had been diagnosed before presentation, duration of hypertension was shorter (P < 0.05) in the MHT group. Patients with MHT, were more likely to have been receiving inadequate therapy in the months before (OR 2.7, 95% Cl: 1.4 to 5.4), showed a decreasing proportion with increasing socio-economic class (chi2 = 5.79, P < 0.02) and had been exposed to a greater degree of stress (OR 3.5, 95% Cl: 1.7 to 7. 1). Smoking (OR 1.1, 0.6 to 2.3), alcohol use (OR 0.9, 0.5 to 1.8) and contraceptive pill use (OR 0.9, 0.1 to 8.6) did not impart excess risk. MHT is associated with the underprivileged and measures aimed at raising the general awareness and the socio-economic level of the people are expected to produce a decline in the incidence of MHT. Journal of Human Hypertension (2000) 14, 171-174.

    更新日期:2019-11-01
  • 更新日期:2019-11-01
  • Introduction
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2000-07-06
    Singer,Cappuccio,Carter,Hughes

    更新日期:2019-11-01
  • Dissociation between microalbuminuria and common carotid thickness in essential hypertensive men.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2000-12-15
    R Pedrinelli,G Dell'Omo,G Penno,S Bandinelli,D Giannini,A Balbarini,M Mariani

    BACKGROUND The reasons why microalbuminuria (albuminuria > or = 15 microg/min), an expression of a renal microcirculatory abnormality, predicts cardiovascular disease in essential hypertension are unsettled. To test the hypothesis that microalbuminuria represents a marker of subclinical atherosclerosis, we evaluated its association with common carotid artery (CCA) intima media thickness (IMT), a measure of preclinical atherosclerosis and an independent predictor of cardiac and cerebrovascular events, in uncomplicated essential hypertensive individuals. MATERIALS AND METHODS Albuminuria, ultrasonographic CCA IMT (the mean of six bilateral far wall measurements within 1.5 cm proximally to the flow divider), brachial blood pressure (BP), smoking habits and lipids were evaluated in 136 stage 1-3 untreated essential hypertensive men free of cardiovascular disease. RESULTS CCA IMT did not differ between normo- (n = 99) and microalbuminuric (n = 37) patients. The correlation between CCA IMT and albuminuria was not significant, and the prevalence of microalbuminuria across IMT quartiles was not different. Microalbuminuric patients showed higher systolic BP and that parameter was the only independent correlate in a multivariate logistic regression model including also age, CCA IMT, diastolic BP, lipids and smoking habits as independent variables and microalbuminuria as the dependent one. CONCLUSION This cross-sectional study in hypertensive subjects free of cardiovascular disease has shown a dissociation between microalbuminuria and CCA IMT, a surrogate measure of subclinical atherosclerosis, and a parameter linearly related to cardiovascular events. The data do not support the theory of microalbuminuria as a surrogate measure of subclinical atherosclerosis, while confirming the importance of systolic BP levels as an independent correlate of increased albuminuria in essential hypertension. Journal of Human Hypertension (2000) 14, 831-835

    更新日期:2019-11-01
  • Prevalence, awareness, treatment and control of hypertension in the elderly: results from a population survey.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2000-12-15
    M Prencipe,A R Casini,M Santini,C Ferretti,N Scaldaferri,F Culasso

    Prevalence, awareness, treatment and control of hypertension were assessed in 1032 (90%) of 1147 elderly (> or = 65 years) inhabitants of three Italian villages. Blood pressure (BP) was measured at home on two separate occasions following a standardised protocol. Persons taking antihypertensive drugs or with BP values > or = 140/90 mm Hg were considered as affected by hypertension. Prevalence of hypertension was 64.8%, with higher rates in women than men, and in those aged 75-84 than in those aged 65-74. Diabetes, strokes and hypercholesterolaemia were more frequent in hypertensive than normotensive people, whereas cardiac diseases, overweight and smoking did not differ significantly between hypertensive and normotensive people. Of the 669 hypertensive patients, 439 (65.6%) were aware of their hypertension, 398 (59.5%) were being treated, and 70 (10.5%) had their hypertension controlled. Of the 230 unaware patients, 201 (87.4%) had had their BP measured in the previous year. Of these, 174 (86.6%) had stage 1 hypertension, while 27 had stage 2 hypertension with SBP values <170 mm Hg. Overall, the patients with stage 1 hypertension accounted for 68.3% of the untreated and 50.5% of the treated patients. The use of a single drug was more frequent in patients with controlled (97.1%) or stage 1 (97.0%) than with stages 2-3 (18.9%) hypertension. The drugs prescribed most were angiotensin-converting enzyme (ACE) inhibitors (45%), followed by diuretics (43%). As our findings suggest that BP values can be effectively reduced by treating or increasing drug treatment in stage 1 hypertensive patients, data on safety and effectiveness of this policy are urgently needed. Journal of Human Hypertension (2000) 14, 825-830

    更新日期:2019-11-01
  • Association between a variant in the 11 beta-hydroxysteroid dehydrogenase type 2 gene and primary hypertension.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2000-12-15
    O Melander,M Orho-Melander,K Bengtsson,U Lindblad,L Råstam,L Groop,U L Hulthén

    The enzyme 11 beta-hydroxysteroid dehydrogenase type 2 (11BHSD2) converts cortisol to cortisone in the kidney, thereby protecting the mineralocorticoid receptor from the mineralocorticoid actions of cortisol. The syndrome of Apparent Mineralocorticoid Excess (AME), a rare monogenic form of early onset hypertension with autosomal recessive inheritance, is caused by homozygous or compound heterozygous loss of function mutations in the 11BHSD2 gene. Association has been reported between a microsatellite marker flanking the 11BHSD2 gene (D16S496) and primary hypertension. The aim of this study was to identify variants in the 11BHSD2 gene and to test if such variants or the D16S496 are associated with primary hypertension, in Swedes. To address this, the coding sequences of the 11BHSD2 gene was screened for mutations in 20 patients with primary hypertension with single strand conformation polymorphism and direct DNA sequencing techniques. A polymorphism was identified in exon 3; G534A (Glu178Glu). This polymorphism and the D16S496 microsatellite were tested for association with primary hypertension in a population consisting of 292 patients with primary hypertension and 263 normotensive control subjects. The frequency of G534G homozygotes was higher in patients with primary hypertension than in normotensive control subjects (92.8% vs 87.8%; P < 0.05). The allele frequencies of the D16S496 microsatellite did not differ between the two groups (chi(2) = 11.0, df = 10; P = 0.36). In conclusion, over-representation of individuals homozygous for the G534 allele in hypertensive patients compared with control subjects suggests that a mutation in linkage disequilibrium with the G534A polymorphism could increase susceptibility to primary hypertension. Journal of Human Hypertension (2000) 14, 819-823

    更新日期:2019-11-01
  • Absence of any significant effects of circadian blood pressure variations on carotid artery elastic properties in essential hypertensive subjects.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2000-12-15
    C Tsioufis,C Stefanadis,D Antoniadis,I Kallikazaros,P Zambaras,C Pitsavos,E Tsiamis,P Toutouzas

    We sought in this study to examine the effects of diurnal blood pressure variations upon common carotid artery (CCA) elasticity in selected subjects with uncomplicated moderate essential hypertension. Towards this end, 174 non-smoker subjects with stage I-II essential hypertension and without diabetes mellitus, left ventricular hypertrophy and carotid atherosclerosis, were classified as dippers and non-dippers according to the diurnal variation of >10% between mean daytime and night-time systolic and diastolic blood pressure (BP) in 24-h non-invasive ambulatory BP monitoring. CCA distensibility was derived by a combination of surface ultrasonographic data and simultaneous BP measurements at the brachial artery. The dippers and non-dippers were similar with respect to demographic characteristics. Non-dippers had significantly greater office systolic BP, 24-h systolic BP and ambulatory pulse pressure (PP) and significantly less (daytime-night-time) systolic and diastolic BP fall (by 16 mm Hg and 11 mm Hg respectively, P< 0.0001) compared to dippers. CCA distensibility was significantly reduced in non-dippers compared to dippers (by 0.89 dyne(-1)/cm(2/)10(-6), P < 0.05). Multiple linear regression analysis identified patient age and ambulatory PP as significant predictors of the CCA elasticity index. When patient age, 24-h systolic and diastolic BP were used as covariates in an analysis of covariance, the difference of CCA elasticity between dippers and non-dippers ceased to reach statistical significance. In contrast, when patient age, ambulatory PP, systolic (daytime-night-time) BP fall and diastolic (daytime-night-time) BP fall were used as covariates, the difference of CCA distensibility between dippers and non-dippers continued to be statistically significant. In conclusion, the excessive impairment of CCA elastic properties in non-dippers compared to dippers hypertensive seems to be ascribed to the increased of total 24-h haemodynamic load and not to the circadian pattern of BP. Journal of Human Hypertension (2000) 14, 813-818

    更新日期:2019-11-01
  • The potent role of increased sympathetic tone in pathogenesis of essential hypertension with neurovascular compression.
    J. Hum. Hypertens. (IF 1.935) Pub Date : 2000-12-15
    T Morise,M Horita,I Kitagawa,R Shinzato,Y Hoshiba,H Masuya,M Suzuki,N Takekoshi

    OBJECTIVE To study the role of increased sympathetic tone in pathogenesis of hypertension in patients with essential hypertension with neurovascular compression. METHODS Twenty-three patients with essential hypertension, 13 patients with secondary hypertension, and 46 normotensive subjects were investigated. Neurovascular compression was evaluated by MRT. The power spectral components of heart rate variability as indices of autonomic nerve tone were determined to investigate the possibility that sympathetic tone mediates the neurovascular compression-induced increase in blood pressure. RESULTS Neurovascular compression of the rostral ventrolateral medulla (RVLM) was observed in 70% of essential hypertension group, none of secondary hyperension group and 16% of normotensive group (P < 0.001). The age-adjusted low-frequency power spectral density (A-PSD) (0.04 to 0.15 Hz), which is an index of sympathetic tone, was significantly higher in patients with essential hypertension (139.5 +/- 6.7%) with neurovascular compression than in essential hypertension patients without neurovascular compression (92.2 +/- 6.8%), normotensive subjects with (102.8 +/- 13.0%) and without neurovascular compression (100.1 +/- 4.1%), and patients with secondary hypertension (95.7 +/- 10.2%) (P < 0.001). There was no significant difference in the high-frequency A-PSD (0.15 to 0.40 Hz), which is an index of vagal tone, among groups. CONCLUSIONS Neurovascular compression was not always associated with an increase in sympathetic nerve tone. Hypertension was present in subjects with neurovascular compression, who had increased sympathetic tone but not in those with normal sympathetic tone. An increase in sympathetic tone may mediate the neurovascular compression-induced increase in blood pressure. Journal of Human Hypertension (2000) 14, 807-811

    更新日期:2019-11-01
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