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At least 19 recordsLinked to original sources
PubMedDate not supplied

Ambulatory blood pressure, blood pressure variability and antihypertensive treatment.

Ambulatory blood pressure monitoring is frequently employed in the clinical practice to improve the diagnosis of hypertension and the appropriateness of the decision regarding initiation of antihypertensive treatment. It is also frequently employed to check the efficacy of this treatment in conditions resembling daily life. This paper will describe the effect of a number of antihypertensive drugs on ambulatory blood pressure, based on data collected by our group in the past 10 years. It will then discuss the advantages of ambulatory blood pressure in studies of efficacy of antihypertensive drugs and the importance of this approach for definition of the trough-to-peak ratio of the antihypertensive effect. Some technical and clinical problems inherent to the ambulatory blood pressure monitoring approach will also be discussed.

Antihypertensive Agents↗
PubMedDate not supplied

Errors in assessment of blood pressure: blood pressure measuring technique.

This article reviews the recommended techniques for accurate and reproducible blood pressure measurements. The scientific basis underlying current recommendations for blood pressure measurement is presented. Many of the current recommendations are not followed in ambulatory care clinics and this paper will show how measurement errors in excess of 15 mm Hg or more can occur. Many patients will be misclassified and treated inappropriately when errors in blood pressure measurement of this magnitude are made. Rigorous adherence to proper blood pressure measurement is necessary to evaluate a patient's risk of cardiovascular disease, and to assess the need or efficacy of antihypertensive therapy.

Antihypertensive Agents↗
PubMed2003

[Lowering of blood pressure, blood pressure amplitude and heart rate by treatment with valsartan or valsartan/hydrochlorothiazide. Results of an open observation study of 11,447 hypertensives].

OBJECTIVE: This trial investigated the decrease of blood pressure, safety and tolerability of valsartan, an angiotensin-receptor blocker, alone or combined with the diuretic hydrochlorothiazide. In addition, the effect on pulse pressure, heart rate and mean blood pressure were recorded as independent markers of cardiovascular risk. PATIENTS AND METHODS: 12278 hypertensive patients were treated for 12 weeks with valsartan alone or combined with hydrochlorothiazide in a multi-centre open trial. Previously established antihypertensive treatment was continued. Systolic and diastolic pressure, pulse pressure and resting heart rate were recorded at the start of the trial and at 1, 4 and 12 weeks thereafter. RESULTS: Data on 11447 were complete enough to be evaluated (54% males, 46% females; mean age 60.8 years). 44% of the patients were at the same time receiving other antihypertensive drugs at the start of the trial, but the numbers so treated decreased during the trial period. Systolic pressure was reduced by 27.8 mmHg. diastolic pressure by 14.7 mmHg, with a calculated reduction of pulse pressure from 71.5 to 58.7 mmHg. Heart rate was reduced by 3.4 beats. The treatment had to be stopped prematurely in 2.3% of patients because of side effects. There were no severe or life-threatening side effects. CONCLUSION: Treatment with valsartan alone or combined with hydrochlorothiazide provides effective blood pressure reduction and is well tolerated. This trial suggests that, in addition to the fall in blood pressure, the independent risk factors of cardiovascular disease, pulse pressure and resting heart rate, were also reduced during administration of valsartan.

Angiotensin Receptor Antagonists↗
PubMed2003

Effects of Qigong on blood pressure, blood pressure determinants and ventilatory function in middle-aged patients with essential hypertension.

This study was designed to measure changes in blood pressure (BP), urinary catecholamines and ventilatory functions of patients with mild essential hypertension after 10 weeks of Qigong (Shuxinpingxuegong). Fifty-eight patients volunteered to participate in this study and were randomly divided into either a Qigong group (n = 29), or a control group (n = 29). Systolic blood pressure and diastolic blood pressure decreased significantly in the Qigong group such that both became significantly lower after 10 weeks in the Qigong than in the control group. Also, there was a significant reduction of norepinephrine, metanephrine and epinephrine compared to baseline values in the Qigong group. The ventilatory functions, forced vital capacity and forced expiratory volume per sec, were increased in the Qigong group but not the control. These results suggest that Qigong may stabilize the sympathetic nervous system is effective in modulating levels of urinary catecholamines and BP positively, and in improving ventilatory functions in mildly hypertensive middle-aged patients.

Analysis of Variance↗
PubMed2000

The relationship between change in blood pressure, blood pressure and time.

Physiological homeostatic mechanisms and interventions by anaesthetists attempt to moderate excessive change in many biological variables during anaesthesia. These mechanisms may have fast or slow response times. This study describes how mean arterial blood pressure changes with time and how the change is dependent upon the pre-existing blood pressure. The results demonstrate the 'regression towards the mean' concept; low arterial blood pressures increase and high pressures decrease. The data are the result of all interactions and have been used to produce an 'envelope' into which 80% of all changes fall. Alarm systems using this envelope could warn of excessive changes that occur within short time intervals.

Adult↗
PubMed2002

If only cardiologists did properly measure blood pressure. Blood pressure recordings in daily practice and clinical trials.

Blood pressure (BP) is often measured sloppily, not only in clinical practice, where seemingly more important cardiovascular information, such as ejection fraction, cardiac output, and wedge pressure, is available, but also in clinical trials. Yet, definite conclusions often hinge on accurate BP measurements. In the Heart Outcomes Prevention Evaluation (HOPE) study, the conclusion of the benefits being relatively independent of BP was challenged by 24-h ambulatory BP monitoring in a subgroup that documented a larger fall in BP than reported in the whole population. Whether measured in office or clinical trials, BP is an important clinical tool that should be treasured by practitioners and clinical investigators alike.

Blood Pressure Determination↗
PubMed1994

The association between heart rate and blood pressure, blood lipids and other cardiovascular risk factors.

BACKGROUND: Several studies have shown that an elevated heart rate is associated with an increased risk of ischaemic heart disease. The aim of this study was to examine the relationship between heart rate, blood pressure, blood lipids and other cardiovascular risk factors in middle-aged men. METHODS: A total of 7735 men, aged 40-59 years at screening, were selected at random from one of the general practices in each of the 24 towns participating in the cross-sectional (screening) phase of the British Regional Heart Study. Blood pressure and levels of blood lipids (serum total cholesterol, high-density-lipoprotein (HDL) cholesterol and triglycerides) and blood glucose were measured. RESULTS: All men with pre-existing evidence of ischaemic heart disease and those on regular antihypertensive treatment were excluded from the analysis. In the remaining 5597 men, heart rate showed a strong positive correlation with cigarette smoking and body-mass index and decreased significantly at higher levels of physical activity and FEV1 (forced expiratory volume in 1 s). These associations remained significant after adjustment for each other. Age, alcohol intake and social class were not independently associated with heart rate. There was a significant positive association between heart rate and systolic and diastolic blood pressures, levels of blood cholesterol, triglycerides and blood glucose and a significant inverse association between heart rate and HDL-cholesterol levels, even after adjusting for the above confounding factors. After further adjustment for each of the other physiological variables, heart rate remained independently associated with diastolic and systolic blood pressures and levels of triglycerides and blood glucose. The relationship between heart rate and levels of total cholesterol and HDL cholesterol appeared to be secondary to its association with triglyceride levels. The association between body-mass index and heart rate diminished after further adjustments for systolic blood pressure, suggesting that the primary effect of body weight is on blood pressure rather than on heart rate. CONCLUSION: Our findings indicate that elevated heart rate is associated with hypertension and with an atherogenic lipoprotein profile and support the suggestion that disturbance of the autonomic nervous system may underlie these associations.

Adult↗
PubMed1993

Effects of mannitol on cerebral blood flow, blood pressure, blood viscosity, hematocrit, sodium, and potassium.

In our miniature swine model of brain retraction ischemia under conditions simulating the neurosurgical operating room, we studied the effects of bolus mannitol (2 g/kg) administration on cerebral blood flow, blood pressure, blood viscosity, hematocrit, sodium, and potassium serially for 4 hours following administration, at which time a second bolus was administered. Both viscosity and hematocrit were significantly decreased transiently following both the first and second boluses. Sodium was decreased for 30 minutes following the first bolus, 15 minutes following the second bolus, and increased at 150 minutes and later following the second bolus. There was a mild decrease in blood pressure and a mild increase in cerebral blood flow following mannitol, but little difference between the first hour following a bolus (when the viscosity and hematocrit were decreased) and hours 2-4 (when they were near baseline). Mannitol's effects on blood pressure and cerebral blood flow probably depend on factors in addition to its effects on blood viscosity and hematocrit. The results are discussed in light of previous findings that bolus mannitol administration may improve cerebral blood flow in ischemia, but does not appear to benefit the preservation of brain electrical activity.

Animals↗
PubMed1977

[Correlations between blood pressure, blood volume and plasma renin during therapy with diuretics in essential hypertension. Comparison between the mineralocorticoid antagonist spironolactone and the "loop" diuretic mefruside].

35 patients with benign essential hypertension were treated for 6 weeks with high doses of the mineralocorticoid-antagonist spironolactone (400 mg/day), or with the "loop-diuretic" mefruside (mean maximal dose 110 mg/day). Spironolactone caused greater reductions in blood pressure and blood volume and a more marked increase in plasma renin activity (PRA) than mefruside (p less than 0.05). It appears possible that he weaker antihypertensive effect of mefruside may relate partly to its lesser influence on circulatory volume. With both diuretics, mean decreases in blood pressure were greater in patients with low pre-therapeutic PRA than in patients with normal or high PRA. However, the diuretic-induced changes in blood pressure did not correlate with the associated variations in blood volume or PRA. Thus, the increased blood pressure sensitivity to diuretics in patients with low-renin essential hypertension did not appear to be volume or renin-dependent. Under normal conditions, the maintenance of a constant blood pressure during volume depletion may partly depend on compensatory activation of the sympathetic nervous system. Moreover, patients with low-renin essential hypertension have been found to have decreased adrenergic activity. It seems possible, therefore, that the marked blood pressure sensitivity to diuretic treatment in such patients may be the result of an impaired compensatory sympathetic response to sodium and volume depletion. Analysis of the literature suggests that the diuretic furosemide, a structural relative of mefruside, may also have less blood pressure lowering efficacy in patients with essential hypertension than the distally-acting thiazides, chlorthalidone or spironolactone. Consideration of possible differences in the blood pressure reducing potential of certain diuretics thus appears to be necessary in planning the pharmacotherapy of essential hypertension.

Blood Pressure↗
PubMed1978

Peripheral circulation in the newborn: interaction of peripheral blood flow, blood pressure, blood volume, and blood viscosity.

Peripheral blood flow and systolic blood pressure (strain-gauge plethysmograph), blood volume (Evans blue) and whole blood viscosity (cone-plate viscometer) have been measured in 66 premature and full-term infants 6 to 144h of age. Blood flow and blood volume were moderately decreased in the infants with respiratory distress. Highly significant (P less than 0.001) correlations were found between blood flow and blood volume (r = 0.77), blood pressure and blood volume (r = 0.50), peripheral resistance and blood volume (r = -0.44), blood flow and blood pressure (r = 0.50), blood flow and peripheral resistance (r = -0.67), peripheral resistance and blood viscosity (r = 0.45), and blood viscosity and haematocrit (r = 0.86). There was no correlation between peripheral blood flow and blood viscosity. However, at given blood volume, peripheral blood flow decreased with increasing blood viscosity. These results indicate that in newborn infants peripheral blood flow, blood pressure and peripheral resistance are influenced by blood volume, but also depend on blood viscosity.

Blood Circulation↗
PubMed1976

[Interrelations between blood pressure, blood volume, plasma renin and urinary catecholamines during beta-blockade in essential hypertension (author's transl)].

Studies in 55 patients with benign essential hypertension showed that the beta-blockers bufuralol (22 patients) and propranolol (33 patients) at a dose ratio of 1:4, possess comparable antihypertensive efficacy despite different properties regarding intrinsic sympathomimetic activity. Beta-blocker-monotherapy normalized blood pressure ( less than 140/90 mm Hg) in one fourth of the patients. Body weight and plasma and blood volumes remained unchanged during beta-blockade of four to six weeks duration, the mean plasma potassium was slightly increased. The inhibition of plasma renin activity (PRA) was more pronounced with propranolol (-69%) than with bufuralol (-47%). Wirth both beta-blockers decreases in blood pressure correlated inversely with pre-treatment PRA (p less than 0.05). Propranolol-induced changes in blood pressure correlated also with associated changes in PRA (p less than 0.005); in contrast, no such relationship was observed with bufuralol. The blood pressure effects of bufuralol, however, correlated significantly with changes in urinary noradrenaline excretion (r=0.41; p less than 0.05). Patient sub-groups with low, normal or high pre-treatment PRA in the average showed a comparable pattern of pre-treatment noradrenaline excretion and patients with normal renin levels exreted more adrenaline than those with low renin levels (p less than 0.001). These data are consistent with the concept that in untreated essential hypertension PRA may be an index of adrenergic activiity, the latter representing an important determinant of blood pressure response to beta-blockade. The blood pressure lowering effects of bufuralol in benign essential hypertension seem to be independent of renin and may be related, at least partly, to diminished free peripheral noradrenaline levels.

Adrenergic beta-Antagonists↗
PubMed1985

Epidemiological study on factor VII, factor VIII and fibrinogen in an industrial population--II. Baseline data on the relation to blood pressure, blood glucose, uric acid, and lipid fractions.

In a preceding paper the baseline data in the Münster Arteriosclerosis Study (PROCAM study) of the levels of fibrinogen, factor VIIc and factor VIIIc were described, and their correlation of age, body weight, smoking, alcohol, pill-using and menopause discussed. In this part the relationship of these coagulation factors to blood pressure, blood glucose, uric acid and lipid parameters, which were examined in 4186 apparently healthy individuals, is presented. The correlations are described using two different statistical models, first the Pearson correlation coefficients after allowing each clotting factor for the effects of age, cigarette and alcohol consumption, body weight, menopausal state, pill using and the other clotting factors, and secondly by a multiple regression analysis. The data suggest that there are multiple interrelationships between hemostatic factors and the variables under consideration. The most striking positive correlations were found for factor VIIc to blood glucose and triglycerides in men and women and to HDL-cholesterol in women.

Age Factors↗
PubMed1987

Effect of linoleic and oleic acids on blood pressure, blood viscosity, and erythrocyte cation transport.

It has been proposed that dietary linoleic acid lowers blood pressure (BP) by being converted to arachidonic acid and prostanoids of the two-ene series. We tested the effects of linoleic acid on plasma arachidonic acid, blood pressure, blood viscosity, and RBC cation transport. Oleic acid, the major dietary monounsaturated fat and which is not a prostanoid precursor, was used as a control. Seventeen adults consumed 23 g/d of linoleic acid or oleic acid provided by genetic variants of safflower seed, each for 4 weeks in a double-blind crossover design. Linoleic and oleic acids were enriched significantly in the plasma cholesteryl esters, phospholipids and triglycerides during the respective periods of supplementation but there was no increase in arachidonate. Mean BP was 116.1/76.8 during ingestion of oleic and 113.6/74.6 during ingestion of linoleic acid (p = 0.09 systolic, p = 0.12 diastolic). The power of the study was over 75% for detecting a significant (p less than 0.05) effect of 4 mm Hg in systolic BP or diastolic BP. Whole blood and plasma viscosity, and RBC Li/Na countertransport, Na/K cotransport, and Na pump systems (Vmax) were unchanged during the protocol. Therefore, variations in dietary linoleic or oleic acids are unlikely to have major effects on BP or on several membrane-dependent erythrocyte functions related to hypertension.

Adult↗
PubMed1987

Effect of carvedilol and metoprolol on blood pressure, blood flow, and vascular resistance.

Carvedilol and metoprolol were given for 4 weeks in a double-blind study to patients with essential hypertension. The effects on blood pressure were measured and hemodynamic alterations were assessed by forearm venous plethysmography before and after chronic administration, and 2 h after an acute dose before and during chronic therapy. Carvedilol (50 mg/day) reduced supine and erect blood pressure, and pulse rate similar to the reduction with metoprolol (100 mg b.i.d.). There was a tendency for forearm blood flow to rise and for forearm resistance to fall with both drugs. When administered acutely, there was no fall in pulse rate with carvedilol compared to the fall with metoprolol when on placebo or active therapy. The blood pressure fall with acute administration was similar with both drugs when not on treatment, but when on chronic therapy, there was no fall with metoprolol but a marked fall with carvedilol. In this circumstance, vascular resistance rose with metoprolol but not with carvedilol. No effect of either drug on a modified cold presser test was observed. Both drugs were well tolerated and there were no significant side effects except for an excessive fall in blood pressure in one patient on carvedilol. Plasma renin activity (PRA) fell with both drugs and there was a tendency for both plasma potassium and plasma uric acid to rise. Carvedilol was well tolerated and reduced blood pressure successfully.

Adrenergic beta-Antagonists↗
PubMed2001

Quantitative trait loci for body weight, blood pressure, blood glucose, and serum lipids: linkage analysis with wild rats (Rattus norvegicus).

To study polygenetically inherited human diseases like hypertension, inbred rat strains are usually the preferred models. Because many inbred generations under optimized environmental conditions may have led to the survival of "silent" disease genes, we used a cross between one wild rat and genetically hypertensive SHR rats to analyze quantitative trait loci (QTLs) of blood pressure and related traits. The (Wild x SHR)F1 hybrids were transferred into a pathogen-free environment by wet-hysterectomy and were backcrossed onto SHR to generate first backcross hybrids (BC1). Progeny from one F1 female (n = 72) were phenotypically and genetically characterized to map QTLs. Significant, subsignificant, and suggestive evidence was found for more sex-specific than common linkage of blood pressure and most blood-pressure-related traits. Male- and female-specific regions were determined on different chromosomes for blood pressures (Chrs. 2 and 7 vs 5 and 11), body weight (Chrs. 10 vs 18), and blood glucose (Chr. 17 vs 20). A linkage in both males and females was shown for serum triglycerides on chromosomes 6 and 17, respectively, and blood glucose on chromosome 15. For serum total cholesterol, a significant linkage was found on chromosome 14 only in males. Our findings not only indicate the complex character of quantitative traits per se but also show impressively their dependence on sex, age, and strains in cosegregation analysis.

Animals↗