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At least 19 recordsLinked to original sources
PubMed2005

Genetic variance of SGK-1 is associated with blood pressure, blood pressure change over time and strength of the insulin-diastolic blood pressure relationship.

BACKGROUND: Insulin stimulation of the serum- and glucocorticoid-regulated kinase 1 (SGK-1) prolongs the half-life of the epithelial sodium channel, a protein which is essential for blood pressure regulation. The aim of this study was to investigate if variation in the SGK-1 gene is associated with increased blood pressure and strength of the insulin-blood pressure relationship. METHODS: A promoter C/T, an intron 6 C/T and an exon 8 C/T polymorphism in the SGK-1 gene were genotyped in 4830 subjects from the Malmö Diet and Cancer (MDC) material of whom 4001 were free from antihypertensive medication. Of these, 2171 subjects had also been investigated 11.2 +/- 4.4 years earlier in the Malmö Preventive Project (MPP). RESULTS: In untreated MDC subjects, intron 6 CC genotype carriers had higher diastolic blood pressure than carriers of the T allele (P = 0.02) and exon 8 C allele carriers had higher systolic blood pressure than TT genotype carriers (P = 0.05). Subjects simultaneously carrying the intron 6 CC genotype and the exon 8 CC or CT genotype (SGK-1 risk) had higher systolic blood pressure (P = 0.03) and higher diastolic blood pressure (P = 0.009) than noncarriers. From MPP to MDC, the percent change in blood pressure per year was higher for systolic blood pressure (P = 0.002) and diastolic blood pressure (P = 0.001) in SGK-1 risk carriers than noncarriers. The correlation between fasting plasma insulin concentration and diastolic blood pressure was stronger in SGK-1 risk carriers than in non-carriers (P = 0.04). CONCLUSION: Our data suggest that SGK-1 risk carriers are at increased risk of hypertension and are more sensitive to the blood pressure elevating effects associated with hyperinsulinemia.

Adult↗
PubMed2005

Effect of awake Carotid Endarterectomy under local anaesthesia on peri-operative blood pressure: blood pressure is normalised when carotid stenosis is treated under local anaesthesia.

BACKGROUND: Carotid Endarterectomy can be performed under local, regional or general anaesthesia. One of the most important effects of the type of anaesthetic used is on the systemic blood pressure. Although variations in blood pressure during and following carotid endarterectomy have been studied previously, the effects of awake carotid endarterectomy under local anaesthesia on blood pressure and its comparison with similar procedures under similar types of anaesthesia have not. METHODS: Peri-operative blood pressure measurements were collected from the records of 25 consecutive patients for each of the following five procedures; Carotid Endarterectomy under general anaesthesia (CEAGA), Anterior Cervical Discectomy and Fusion under general anaesthesia (ACDF), Cerebral Angiography under local anaesthesia (ANG), Carotid Endarterectomy patients under local anaesthesia who were symptomatic (CEALAS) and Carotid Endarterectomy patients under local anaesthesia who were asymptomatic (CEALAA). The recordings were then analysed to find out if there were any clinically significant variations in peri-operative blood pressure. FINDINGS: There is a significant and consistent difference when the pre-operative value was compared with the 4 hour and 24 hour post-operative recordings between the local and general anaesthetic groups for carotid endarterectomy. Carotid endarterectomy reduces the systolic and diastolic blood pressures post-operatively when performed under local anaesthesia and only the diastolic pressure was reduced when performed under general anaesthesia. CONCLUSION: The study provides evidence about the effect of carotid endarterectomy on the systemic blood pressure and its variations when performed under different types of anaesthesia. There is significant post-operative reduction in both the systolic and diastolic blood pressure values and the intraoperative fluctuation is minimal when local anaesthesia is used. Further studies are required to find out how this affects the long-term blood pressure and clinical outcome of the patient.

Anesthesia, General↗
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↗
PubMed2006

[Digital patient record for remote monitoring of intraocular pressure, blood pressure and serum glucose].

BACKGROUND: At the University Eye Hospital of Greifswald, we have developed a digital patient record that allows close monitoring of glaucoma, diabetes and hypertension. The record stores contemporary, long-term profiles containing intraday variation and interaction of intraocular pressure, blood pressure and serum glucose levels even at night. METHODS: All patients are equipped with a home monitoring system. They subsequently transmit self-measurements via the "telemedical interface" to the server. Physicians use a web front-end to access electronic patient records; this provides a PDF export filter for printing. We intend to include a total number of 120 patients from Mecklenburg-Vorpommern who suffer from glaucoma possibly combined with hypertension/diabetes. This long-term investigation was designed as a randomised cross-over study in two groups. RESULTS: Especially for this project an electronic patient record was developed and implemented. The components of the home monitoring system were modified and connected to a custom-built "telemedical interface". To date the study includes 120 patients, 60 of whom constantly measure and transmit their values to the electronic patient record, while the others are treated without home monitoring. All self-measurements are presented in a tabular form. In addition, dynamically generated graphics provide a diagrammatic view of all values. On demand, a detailed protocol for every single measurement report allows a comprehensive evaluation of the quality of the self-measurements. Ocular perfusion pressure is calculated automatically from intraocular pressure and blood pressure. The presented system documents continuously all information that is relevant for treatment and provides fast access for all attending physicians. CONCLUSIONS: Central data collection and unlocalised access improve information exchange between involved physicians. Flexible measurement periods allow the detection of pressure spikes even at night. In addition, this may help to classify glaucoma (normal-pressure glaucoma) and its causal connection to blood pressure. The patients benefit from individualised therapy adaptation and early therapeutic intervention in case of critical parameters.

Blood Glucose Self-Monitoring↗
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↗
PubMed2006

[A cohort study on the relationship between body mass index and blood pressure, blood lipid, blood glucose, left ventricular structure and function in adolescents during transition period].

OBJECTIVE: To investigate the relationship between body mass index(BMI) and blood pressure, blood lipid level, blood glucose, left ventricular structure and function in adolescents during transition period. METHODS: A vertical sectional survey on 193 pupils aged 7-11 years in primary school in 1996 was performed. 9 years later, the same research subjects aged 16-20 years were studied again in 2005. The subjects were divided into obesity,overweight and normal weight groups according to their BMI in 1996. Height, body weight, blood pressure, total cholesterol, triglyceride and blood glucose were collected and analyzed, and left ventricular structure and function were examined by echocardiography. RESULTS: Body mass index (24.71 kg/m(2)+/-4.57 kg/m(2), 20.54 kg/m(2)+/-2.84 kg/m(2) ), systolic blood pressure (117.22 mm Hg+/-17.44 mm Hg vs. 102.20 mm Hg+/-11.68 mm Hg), thickness of inter-ventricular septum and posterior wall (0.87 cm+/-0.12 cm vs. 0.77 cm+/-0.12 cm, and 0.91 cm+/-0.13 cm vs. 0.79 cm+/-0.31 cm), left ventricular mass and mass index (167.84 g+/-16.29 g vs. 128.95 g+/-63.00 g, and 88.12 g/m(2) +/-17.19 g/m(2) vs. 79.35 g/m(2)+/-39.01 g/m(2)) were found significantly higher in obesity group than in normal weight group 9 years later (P<0.05, P< 0.01 or P< 0.001). End diastolic volume and cardiac output were increased(P <0.05) and ejection fraction and fractional shortening decreased( P< 0.05). There were no differences found in cardiac diastolic function between the studied groups. CONCLUSION: The results suggested that simple obesity in childhood was an important cardiovascular risk factor when they grew into adolescents and adults. ;

Adolescent↗
PubMed2005

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

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 (P<0.001) and 3.3/3.5 mm Hg (P<0.01). The reduction of resting blood pressure was more pronounced in the 30 hypertensive study groups (-6.9/-4.9) than in the others (-1.9/-1.6; P<0.001 for all). Systemic vascular resistance decreased by 7.1% (P<0.05), plasma norepinephrine by 29% (P<0.001), and plasma renin activity by 20% (P<0.05). Body weight decreased by 1.2 kg (P<0.001), waist circumference by 2.8 cm (P<0.001), percent body fat by 1.4% (P<0.001), and the homeostasis model assessment index of insulin resistance by 0.31 U (P<0.01); HDL cholesterol increased by 0.032 mmol/L(-1) (P<0.05). In conclusion, aerobic endurance 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.

Blood Pressure↗
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↗
PubMed2006

The effect of glucose added to the dialysis fluid on blood pressure, blood glucose, and quality of life in hemodialysis patients: a placebo-controlled crossover study.

BACKGROUND: Risk for hypoglycemia increases during hemodialysis sessions. The compensatory homeostatic response to hypoglycemia may increase the risk for abnormal blood pressure regulation. The purpose is to determine blood pressure and blood glucose levels and variability in these variables during dialysis with and without glucose in the dialysis fluid. METHODS: In a randomized, placebo-controlled, unblinded, crossover study of 44 hemodialysis patients, 34 patients without diabetes and 10 patients with diabetes were allocated to treatment with and without glucose in the dialysis fluid during two 10-week periods. Blood pressure and blood glucose levels were determined 5 to 8 times at each dialysis session during both periods. Quality of life was estimated by using the 36-Item Short-Form Health Survey questionnaire at the end of both treatment periods. RESULTS: With glucose in the dialysis fluid, blood pressure was significantly lower (systolic, 144 +/- 20 versus 149 +/- 21 mm Hg; P < 0.003; diastolic, 73 +/- 10 versus 76 +/- 10 mm Hg; P < 0.001), blood glucose level was higher (125 +/- 25 versus 110 +/- 26 mg/dL [6.96 +/- 1.36 versus 6.08 +/- 1.47 mmol/L]; P < 0.001), and quality of life was the same. Variations in systolic and diastolic blood pressures and blood glucose levels were the same during both treatments. In the subgroup of patients with diabetes, variation in blood glucose levels decreased significantly with glucose in the dialysis fluid (mean, 30 versus 37 mg/dL [1.66 versus 2.03 mmol/L]; P = 0.008). CONCLUSION: Systolic and diastolic blood pressures decreased with glucose in the dialysis fluid in patients with chronic renal failure, presumably because of insulin-induced vasodilatation in patients without diabetes. Blood glucose level regulation improved in the diabetic subgroup, and blood glucose levels were not greater in patients with diabetes with glucose in the dialysis water. Quality of life was not changed.

Adult↗