| For medical practitioners and the general public - High Blood Pressure Journal Article Catalog. |
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| Impact of high pressure freezing on DH5alpha Escherichia coli and red blood cells Suppes, G. J., S. Egan, et al. (2003), Cryobiology 47(2): 93-101. Abstract: The impact of high pressure and freezing on survivability of Escherichia coli and human red blood cells was evaluated to determine the utility of high-pressure transitions for preserving living cells. Based on microscopy and survivability, high pressures did not directly impact physical damage to living cells. E. coli studies showed that increased cell death is due to indirect phenomena with decreasing survivability at increasingly high pressures and exposure times. Pressurization rates up to 1.4kbar/min had negligible effects relative to exposures of >5min at high pressures.Both glycine and control of pH near 7.0 were successful in reducing the adverse impacts of high pressure. Survivability increased from <1% at 5min exposure to 2.1kbar of pressure to typical values >20%. The combination of glycine and the buffer salt led to even further improvements in survivability. Pressure changes were used to traverse temperature and pressures consistent with Ice I and Ice III phase boundaries of pure water. |
| Impact of high-normal blood pressure on risk of cardiocerebrovascular disease in 11 provinces in China Wu, G., Z. Wu, et al. (2002), Zhonghua Yi Xue Za Zhi 82(16): 1083-5. Abstract: OBJECTIVE: To explore the impact of high-normal blood pressure on the risk of cardiovascular disease in different sexes in China. METHODS: A cohort baseline study was carried out among 27 739 subjects (age 35 approximately 64 years) to survey the general demographic data, smoking status, blood pressure, blood lipids, height, weight, was circumference, and hip circumference. By the end of each year, a follow-up was made until 31 December 1999 to all 27 739 persons to record the events of cardiocerebrovascular diseases and deaths. No intervention was made to the cohort population during follow-up. Cox regression model was used to carry out multifactoral analysis of the relationship between normal high blood pressure and risk of cardiocerebrovascular diseases. RESULTS: (1) The high-normal blood pressure rate was 13.4% (14.8% for males and 11.8% for females) in this cohort. (2) Those with high normal blood pressure had more risk factors of cardiocerebrovascular diseases than those with ideal blood pressure. (3) During follow-up, the yearly standardized incidence rates of coronary heart diseases, cerebral apoplexy, and cardiocerebrovascular diseases were significantly higher among those with high normal blood pressure than among those with ideal blood pressure. (P < 0.000 1). (4) The relative risk of cardiocerebrovascular disease was 2.8765 among those with high normal blood pressure (95% CI 2.050 6 - 4.035 1 P < 0.000 1), 3.234 6 among males (95% CI 2.113 1 - 4.951 2, P < 0.000 1) and 2.335 0 among females (95% CI 1.318 3 - 4.135 9, P < 0.000 1). CONCLUSION: The relative risk of cardiovascular disease was significant higher among those with high normal blood pressure than those with ideal blood pressure in 11 provinces in China. The necessity of lowering high-normal blood pressure to reduce CVD need to be evaluated. |
| Impact of high-normal blood pressure on the risk of cardiovascular disease Vasan, R. S., M. G. Larson, et al. (2001), N Engl J Med 345(18): 1291-7. Abstract: BACKGROUND: Information is limited regarding the absolute and relative risk of cardiovascular disease in persons with high-normal blood pressure (systolic pressure of 130 to 139 mm Hg, diastolic pressure of 85 to 89 mm Hg, or both). METHODS: We investigated the association between blood-pressure category at base line and the incidence of cardiovascular disease on follow-up among 6859 participants in the Framingham Heart Study who were initially free of hypertension and cardiovascular disease. RESULTS: A stepwise increase in cardiovascular event rates was noted in persons with higher baseline blood-pressure categories. The 10-year cumulative incidence of cardiovascular disease in subjects 35 to 64 years of age who had high-normal blood pressure was 4 percent (95 percent confidence interval, 2 to 5 percent) for women and 8 percent (95 percent confidence interval, 6 to 10 percent) for men; in older subjects (those 65 to 90 years old), the incidence was 18 percent (95 percent confidence interval, 12 to 23 percent) for women and 25 percent (95 percent confidence interval, 17 to 34 percent) for men. As compared with optimal blood pressure, high-normal blood pressure was associated with a risk-factor-adjusted hazard ratio for cardiovascular disease of 2.5 (95 percent confidence interval, 1.6 to 4.1) in women and 1.6 (95 percent confidence interval, 1.1 to 2.2) in men. CONCLUSIONS: High-normal blood pressure is associated with an increased risk of cardiovascular disease. Our findings emphasize the need to determine whether lowering high-normal blood pressure can reduce the risk of cardiovascular disease. |
| Impact of hypertension information on high blood pressure control between 1973 and 1978 Apostolides, A. Y., G. Cutter, et al. (1980), Hypertension 2(5): 708-13. Abstract: To determine whether the immense multifocal efforts in the United States over the past 7 years to detect and treat high blood pressure (BP), had affected the status of hypertension, data from a national household survey in 1973-74 were compared with data obtained in 1977-78 from a second non-overlapping population in the same three communities. The impact of hypertension programs was measured by assessing change over the 5-year period in BP distribution, degree of awareness, and level of treatment in the population. Our data show that a substantial improvement in the status of high BP detection, treatment, and control has occurred since the early 1970s for all age, sex, and race groups studied. |
| Impact of Transcendental Meditation on cardiovascular function at rest and during acute stress in adolescents with high normal blood pressure Barnes, V. A., F. A. Treiber, et al. (2001), J Psychosom Res 51(4): 597-605. Abstract: OBJECTIVE: This study examined the impact of the Transcendental Meditation (TM) program on cardiovascular (CV) reactivity in adolescents with high normal BP. METHOD: Thirty-five adolescents 34 African Americans (AAs), 1 Caucasian American (CA); ages 15-18 years with resting systolic blood pressure (SBP) between the 85th and 95th percentile for their age and gender on three consecutive occasions, were randomly assigned to either TM (n=17) or health education control (CTL, n=18) groups. The TM group engaged in 15-min meditation twice each day for 2 months including sessions during school lunch break. Primary CV outcome measures were changes in blood pressure (BP), heart rate (HR), and cardiac output (CO) at rest and in response to two laboratory stressors, a simulated car driving stressor and an interpersonal social stressor interview. RESULTS: The TM group exhibited greater decreases in resting SBP (P<.03) from pre- to postintervention, compared to the CTL group. The TM group exhibited greater decreases from pre- to postintervention in SBP, HR, and CO reactivity (P's<.03) to the simulated car driving stressor, and in SBP reactivity (P<.03) to the social stressor interview. CONCLUSION: The TM program appears to have a beneficial impact upon CV functioning at rest and during acute laboratory stress in adolescents at-risk for hypertension. |
| Impaired microvascular dilatation and capillary rarefaction in young adults with a predisposition to high blood pressure Noon, J. P., B. R. Walker, et al. (1997), J Clin Invest 99(8): 1873-9. Abstract: Increased vascular resistance in essential hypertension occurs mainly in microvessels with luminal diameters < 100 microm. It is not known whether abnormalities in these vessels are a cause or consequence of high blood pressure (BP). We studied 105 men (aged 23-33 yr) in whom predisposition to high blood pressure has been characterized by both their own BP and those of their parents. Factors that are secondary to high BP correlate with offspring BP irrespective of parental BP, but factors that are components of the familial predisposition to high BP are more closely associated with higher BP in offspring whose parents also have high BP. Offspring with high BP whose parents also have high BP had impaired dermal vasodilatation in the forearm following ischemia and heating (289+/-27 n = 25 versus 529+/-40 n = 26, 476+/-38 n = 30, and 539+/-41 flux units n = 24 in other groups; P < 0.0001) and fewer capillaries on the dorsum of the finger (23+/-0.8 capillaries/0.25 mm2 versus 26+/-0.8 in all other groups; P < 0.003). Except for BP, other hemodynamic indices (including cardiac output and forearm vascular resistance) were not different. The dermal vessels of men who express a familial predisposition to high BP exhibit increased minimum resistance and capillary rarefaction. Defective angiogenesis may be an etiological component in the inheritance of high BP. |
| Implementing high blood pressure control activities in South Carolina Shepard, D. M. (1985), Urban Health 14(9): 29, 34, 48. |
| Importance of eye fundus examination preliminary to surgery for high blood pressure. Streiff, E. B. (1951), Bull Schweiz Akad Med Wiss 7(3-4): 267-75. |
| Importance of high blood pressure and necessity of organized control of the disease Dordevic, B. (1975), Nar Zdrav 31(7-8): 202-3. |
| Importance of hypertension and high blood pressure in results of epidemiological research in our country Dordevic, B., D. Kozarevic, et al. (1975), Nar Zdrav 31(7-8): 208-16. |
| Improved procedure for determination of flucytosine in human blood plasma by high-pressure liquid chromatography Schwertschlag, U., L. M. Nakata, et al. (1984), Antimicrob Agents Chemother 26(3): 303-5. Abstract: Several high-pressure liquid chromatography procedures for the determination of flucytosine in serum or plasma have appeared. Some of these suffer from significant disadvantages, and none was applicable in our routine clinical therapeutic-drug-monitoring laboratory. A new high-pressure liquid chromatography assay for flucytosine was therefore developed. A 100-microliter sample of plasma was treated with an aqueous 5-iodocytosine internal-standard solution, and the mixture was deproteinized with trichloroacetic acid. A portion of the protein-free supernatant was diluted with 0.1 M ammonium phosphate, and an aliquot of the resulting solution was injected into the high-pressure liquid chromatography system. Chromatography was performed on a strong-cation-exchange column with a mobile phase containing aqueous ammonium phosphate, phosphoric acid, methanol, and acetonitrile. Detection was at 254 nm. The assay was shown to be linear in the 10 to 200-micrograms/ml drug-concentration range. Forty other drugs were tested for potential interference with the assay, and none was found. For routine use, a single-point working standard containing 75 micrograms of flucytosine per ml was used, giving intraassay coefficients of variation at 50 and 150 micrograms/ml of 1.8 and 2.3% respectively, whereas the day-to-day coefficient of variation at 50 micrograms/ml was 10.0%. Advantages of the procedure include the small sample size, the use of a convenient and reliable internal standard, speed, and simplicity. The assay is highly suitable for routine clinical drug-analysis laboratories. |
| Improving control of high blood pressure among middle-aged Turkish women of low socio-economic status through public health training Kisioglu, A. N., B. Aslan, et al. (2004), Croat Med J 45(4): 477-82. Abstract: AIM: To assess the effects of health training course aimed at educating middle-aged women of low socio-economic status in Turkey how to better control high blood pressure. METHODS: The intervention study included 400 randomly selected women aged (mean+/-standard deviation) 34.1+/-8.6 years. After their body size and blood pressure were measured, the women were randomly divided into two groups. The intervention group underwent public health training on high blood pressure control and obesity reduction, whereas control group had no training at all. After six months, blood pressure and body size of women in both groups were measured again. RESULTS: Overall, the initial high blood pressure and obesity ratio in the intervention and control group were 20.0% and 31.7%, respectively. After 6 months of the intervention program, the number of women within the optimal weight range significantly increased in the intervention group compared with control group (p=0.009). After the intervention program, the number of women with normal weight and normal blood pressure in the intervention group significantly increased (weight: 130 women before vs 150 after, p=0.001; blood pressure: 160 women before vs 173 after, p<0.001). After the intervention, the percentage of meals consisting of fried food in the intervention group was lower by 31.9%, and by 5.0% in the control group. After the intervention the percentage of boiled food increased by 15.7% in the intervention group, compared with no change in the control group. The consumption of food high in salt decreased by 5.5% in the control and by 72.2% in the intervention group. Similarly, the percentage of women who exercised almost doubled in the intervention group, whereas there was no change in the control group. CONCLUSION: The changes in the lifestyle significantly reduced hypertension and obesity ratio among women. The public health center can provide initial health training support as a part of the broader public health management program, aimed at helping people tackle health problems. |
| In normoglycemic Koreans, insulin resistance and adipocity are independently correlated with high blood pressure Sung, K. C., B. J. Kim, et al. (2004), Circ J 68(10): 898-902. Abstract: BACKGROUND: There is some controversy about the role of insulin resistance (IR) in the regulation of blood pressure (BP). Moreover, a large study of the association between BP and IR has not been conducted in normal glucose tolerance Asians. The present study investigated the relationships between IR, body mass index (BMI) and waist circumference and BP in normoglycemic Koreans. METHODS AND RESULTS: Anthropometric indices of adiposity, metabolic variables (fasting serum insulin and a homeostasis model assessment (HOMA) index of insulin sensitivity), BP and several cardiovascular risk factors were measured during a cross-sectional survey of 49,076 normoglycemic Korean subjects. A high BP was defined as a systolic BP >/=140 mmHg or a diastolic BP >/=90 mmHg. The prevalence of high BP by HOMA grading was 0.985 (95% confidence interval (CI) 0.857-1.132, p=0.835), 1.180 (95% CI 1.032-1.350, p=0.016), 1.289 (95% CI 1.129-1.472, p<0.001), and 1.540 (95% CI 1.341-1.768, p<0.001) times higher in subjects in the second, third, fourth, and fifth quintiles, respectively, compared with those in the first quintile. In addition, age, sex, waist circumference and BMI were found to be significantly associated with a high BP. CONCLUSION: IR, BMI and waist circumference are independently correlated with high BP in normoglycemic Koreans. |
| Inactivation of enhanced expression of G(i) proteins by pertussis toxin attenuates the development of high blood pressure in spontaneously hypertensive rats Li, Y. and M. B. Anand-Srivastava (2002), Circ Res 91(3): 247-54. Abstract: We have previously shown that the enhanced expression of G(i) proteins in spontaneously hypertensive rats (SHR) that precedes the development of high blood pressure may be one of the contributing factors in the pathogenesis of hypertension. In the present study, we demonstrate that the inactivation of G(i) proteins by intraperitoneal injection of pertussis toxin (PT, 1.5 micro g/100 g body wt) into 2-week-old prehypertensive SHR prevented the development of hypertension up to 4 weeks and that, thereafter, it started to increase and reached the same level found in untreated SHR after 6 weeks. A second injection of PT after 4 weeks delayed the increase in blood pressure for another week. The PT-induced decrease in blood pressure in 6-week-old SHR was associated with a decreased level of G(i)alpha-2 and G(i)alpha-3 proteins in the heart, as determined by in vitro ADP ribosylation and immunoblotting. The decreased level of G(i) proteins was reflected in decreased G(i) functions. Furthermore, an augmentation of blood pressure to the same level in PT-treated SHR as found in untreated SHR was associated with enhanced expression and function of G(i). These results indicate that the inactivation of G(i) proteins by PT treatment in prehypertensive SHR attenuates the development of hypertension and suggest that the enhanced levels of G(i) proteins that result in the decreased levels of cAMP and associated impaired cellular functions may be contributing factors in the pathogenesis of hypertension in SHR. |
| Incidence of high blood pressure in a group of tannery workers in Brazil Cordeiro, R., E. R. Penaloza, et al. (2004), Cad Saude Publica 20(4): 1121-4. Abstract: The aim of this study was to measure the incidence of high blood pressure (HBP) in a medium-size tannery in Botucatu, Sao Paulo State, southeast Brazil. A previous study at this tannery showed a high prevalence of arterial hypertension. A positive correlation was found between cumulated work time and arterial pressure. We followed a cohort of workers for seven years. At the end of this period, HBP incidence rate was calculated as 0.0964.year(-1). This was considered high compared to other occupational groups. |
| Incidental high blood pressure in family practice: due to hypertension and/or left ventricular hypertrophy in more than half of the patients Boekhout, I., H. W. Van Marwijk, et al. (1998), Ned Tijdschr Geneeskd 142(44): 2404-8. Abstract: OBJECTIVE: To determine if patients with incidentally high blood pressure actually have hypertension and if these patients have an increased left ventricular mass. DESIGN: Cross-sectional study. SETTING: Two family practices with 8 general practitioners in Leiden and Noordwijk, the Netherlands. METHODS: From the Family Practice Network in the Leiden area 133 (67%) out of 200 patients with incidental high blood pressure, who did not receive antihypertensive medication, participated in the study. Their blood pressure was measured 6 times with a mercury manometer, an automatic, non-invasive ambulatory blood pressure monitoring during 24 hours was performed once and their left ventricular mass was measured by means of echocardiography. RESULTS: Of the 133 selected patients 46% had a mean diastolic blood pressure > 95 mmHg measured with the mercury manometer and 64% had a mean 24-hr diastolic blood pressure > 90 mmHg measured with the ambulatory blood pressure monitor. The correlation between both blood pressure measurements was moderate (correlation coefficient 0.73). Left ventricular hypertrophy was found in 53% of the patients, irrespective of their blood pressures. CONCLUSION: In this investigation 45-65% of patients with an incidentally high blood pressure had a mean diastolic pressure > 95 mmHg as measured with a mercury manometer and (or) a mean 24-hr diastolic blood pressure > 90 mmHg as measured with the ambulatory blood pressure monitor; 53% had left ventricular hypertrophy. |
| Increase in blood viscosity in the sprinting horse: can it account for the high pulmonary arterial pressure? Fedde, M. R. and H. H. Erickson (1998), Equine Vet J 30(4): 329-34. Abstract: Blood was taken from 49 Thoroughbred horses before and after racing at the track to determine if frusemide modified the apparent viscosity of the blood and to determine the effects of changes in shear rate and packed cell volume (PCV), associated with strenuous exercise, on apparent and relative viscosities. Small increases in apparent viscosity of the blood (at a specified PCV and shear rate) occurred in horses given frusemide compared to those receiving no frusemide; however, no differences were seen in relative viscosity. Although 2 groups of horses, those receiving frusemide before racing and those not receiving this drug were studied, the results suggest no influence of frusemide on any red blood cell variable that might modify apparent blood viscosity. Apparent viscosity of the blood was slightly (but significantly) higher after racing than before racing at any given PCV and shear rate, but relative viscosity was lower in the post race than in the prerace blood sample. The most important contributing factor to the increase in apparent viscosity in blood during racing is the increase in PCV, because the blood becomes nearly shear rate independent at shear rates likely to exist in the cardiovascular system during exercise. With an increase in PCV from 40 to 65% at shear rates above 225/s, apparent viscosity approximately doubled. However, this increase alone cannot account for the elevated pulmonary vascular pressure in the running horse, and additional factors, especially those causing the high left atrial pressure, must be considered. The cause of the elevated pressure may be multifactorial in nature. |
| Increased blood pressure in schoolchildren related to high sodium levels in drinking water Hofman, A., H. A. Valkenburg, et al. (1980), J Epidemiol Community Health 34(3): 179-81. Abstract: The relationship between sodium in drinking water and blood pressure was examined in 348 schoolchildren aged 7.7 to 11.7 years. They were born and living in three areas with different levels of sodium in the public drinking water. Sodium content of the water was either long-term low, long-term high, or short-term high. The three communities are closely comparable according to demographic characteristics. The mean values of systolic and diastolic blood pressure were higher in the high sodium areas. After adjustment for dissimilarities in distributions of weight, height, pulse rate, age, family history of hypertension, and time of blood pressure measurement, these differences remained constant, ranging from 1.8 to 4.0 mm Hg. Girls and boys showed essentially the same differences. Mean 24-hour sodium excretion was somewhat higher in the long-term low area; no differences were found in sodium-creatinine ratio. The regression coefficients between sodium excretion and blood pressure were not significant. The findings from this retrospective follow-up study support the hypothesis that sodium intake influences blood pressure. The association seems to be of a relatively short-term nature, as no differences in blood pressure levels were found between the long-term and short-term high areas. |
| Increased myocardial repolarization lability and reduced cardiac baroreflex sensitivity in individuals with high-normal blood pressure Myredal, A., S. Gao, et al. (2005), J Hypertens 23(9): 1751-6. Abstract: BACKGROUND: Recent guidelines for the management of arterial hypertension have proposed that, to prevent cardiovascular disease, lifestyle modifications are required even in the case of high-normal blood pressure (HNBP). OBJECTIVE: To assess myocardial repolarization and spontaneous cardiac baroreflex sensitivity (BRS) in newly diagnosed and never-treated individuals. DESIGN AND PARTICIPANTS: We studied healthy individuals with HNBP according to the 2003 European Society of Hypertension-ESC guidelines and, for comparison, patients with renovascular hypertension (RVH) and healthy individuals with normal blood pressure (NBP). MAIN OUTCOME MEASURES: Electrocardiogram and beat-to-beat blood pressure were recorded and spontaneous cardiac baroreflex sensitivity and the temporal QT interval variability index (QTVI) were calculated. RESULTS: Individuals with HNBP had increased QTVI values compared with those with NBP (-1.23 +/- 0.37 compared with -1.52 +/- 0.26; P < 0.05), whereas patients with RVH had additionally increased QTVI values that were greater than those in healthy individuals with NBP or HNBP (-0.81 +/- 0.75; P < 0.05 compared with both groups). BRS was reduced in both groups of individuals with increased blood pressures compared with NBP (8.2 +/- 4.1 ms/mmHg for individuals with HNBP, 6.1 +/- 4.3 ms/mmHg for patients with RVH and 10.8 +/- 3.5 ms/mmHg for NBP; P < 0.05 for both). CONCLUSION: In otherwise healthy individuals, even a moderate blood pressure increase is associated with increased myocardial repolarization lability and reduced baroreflex sensitivity (BRS). Patients with RVH have an additionally increased QTVI, with values similar to those reported in congestive heart failure. Future studies are needed to establish the value of QTVI and BRS measurements among individuals with HNBP in predicting the risk of progression to hypertension and end-organ damage. |
| Increases in CSF Na+ precede the increases in blood pressure in Dahl S rats and SHR on a high-salt diet Huang, B. S., B. N. Van Vliet, et al. (2004), Am J Physiol Heart Circ Physiol 287(3): H1160-6. Abstract: In Dahl salt-sensitive (S) and salt-resistant (R) rats, and spontaneously hypertensive rats (SHR) and Wistar-Kyoto (WKY) rats, at 5-6 wk of age, a cannula was placed in the cisterna magna, and cerebrospinal fluid (CSF) was withdrawn continuously at 75 microl/12 h. CSF was collected as day- and nighttime samples from rats on a regular salt intake (0.6% Na+; R-Na) and then on a high salt intake (8% Na+; H-Na). In separate groups of rats, the abdominal aorta was cannulated and blood pressure (BP) and heart rate (HR) measured at 10 AM and 10 PM, with rats first on R-Na and then on H-Na. On H-Na, CSF Na+ started to increase in the daytime of day 2 in Dahl S rats and of day 3 in SHR. BP and HR did not rise until day 3 in Dahl S rats and day 4 in SHR. In Dahl R and WKY rats, high salt did not change CSF Na+, BP, or HR. In a third set of Dahl S rats, sampling of both CSF and BP was performed in each individual rat. Again, significant increases in CSF Na+ were observed 1-2 days earlier than the increases in BP and HR. In a fourth set of Dahl S rats, BP and HR were recorded continuously by means of radiotelemetry for 5 days on R-Na and 8 days on H-Na. On H-Na, BP (but not HR) increased first in the nighttime of day 2. In another set of Dahl S rats, intracerebroventricular infusion of antibody Fab fragments binding ouabain-like compounds (OLC) with high affinity prevented the increase in BP and HR by H-Na but further increased CSF Na+. Finally, in Wistar rats on H-Na, intracerebroventricular infusion of ouabain increased BP and HR but decreased CSF Na+. Thus, in both Dahl S and SHR on H-Na, increases in CSF Na+ preceded the increases in BP and HR, consistent with a primary role of increased CSF Na+ in the salt-induced hypertension. An increase in brain OLC in response to the initial increase in CSF Na+ appears to attenuate further increases in CSF Na+ but at the "expense" of sympathoexcitation and hypertension. |
| Independent association of high blood pressure and aortic atherosclerosis: A population-based study Agmon, Y., B. K. Khandheria, et al. (2000), Circulation 102(17): 2087-93. Abstract: BACKGROUND: Atherosclerosis of the thoracic aorta is associated with stroke. The association between hypertension, a major risk factor for stroke, and aortic atherosclerosis has not been determined in the general population. METHODS AND RESULTS: Transesophageal echocardiography was performed in 581 subjects, a random sample of the Olmsted County (Minnesota) population aged >/=45 years participating in the Stroke Prevention: Assessment of Risk in a Community (SPARC) study. Blood pressure was assessed by multiple office measurements and 24-hour ambulatory blood pressure monitoring. The association between blood pressure variables and aortic atherosclerosis was evaluated by multiple logistic regression, adjusting for other associated variables. Among subjects with atherosclerosis, blood pressure variables associated with complex aortic atherosclerosis (protruding plaques >/=4 mm thick, mobile debris, or ulceration) were determined. Age and smoking history were independently associated with aortic atherosclerosis of any degree (P: |
| Independent impact of glycemia and blood pressure in albuminuria on high-risk subjects for metabolic syndrome Rosenbaum, P., S. G. Gimeno, et al. (2004), Clin Nephrol 61(6): 369-76. Abstract: BACKGROUND: Microalbuminuria may reflect diffuse endothelial damage. Considering that diabetes and hypertension cause vasculopathy, we investigated associations of albumin-to-creatinine ratio (ACR) with plasma glucose and blood pressure levels in high-risk subjects for metabolic syndrome. METHODS: A sample of 519 (246 men) Japanese-Brazilians (aged 60 +/- 11 years), who participated in a population-based study, had their ACR determined in a morning urine specimen. Backward models of multiple linear regression were created for each gender including log-transformed values of ACR as dependent variable; an interaction term between diabetes and hypertension was included. RESULTS: Macroalbuminuria was found in 18 subjects. ACR mean values for subjects with normal glucose tolerance, impaired fasting glycemia, impaired glucose tolerance and diabetes were 9.9 +/- 6.0, 19.0 +/- 35.4, 20.7 +/- 35.4, and 33.9 +/- 55.0 mg/g, respectively. Diabetic subjects showed higher ACR than the others (p < 0.05). An increase in the proportion of albuminuric subjects was observed as glucose metabolism deteriorated (4.9, 17.0, 23.0 and 36.0%). Stratifying into 4 groups according to postchallenge glycemia (< 7.8 mmol/l, n = 91; > or = 7.8 mmol/l, n = 410) and hypertension, hypertensive and glucose-intolerant subgroups showed higher ACR values. ACR was associated with gender, waist circumference, blood pressure, plasma glucose and triglyceride (p < 0.05); albuminuric subjects had significantly higher levels of such variables than the normoalbuminuric ones. In the final models of linear regression, systolic blood pressure and 2-hour glycemia were shown to be independent predictors of ACR for both genders (p < 0.05). In men, also waist was independently associated with ACR. No interaction was detected between "diabetes and hypertension". CONCLUSIONS: These findings suggest that both glucose intolerance and hypertension could have independent but not synergistic effects on endothelial function--reflected by albumin loss in urine. Such hypothesis needs to be confirmed in prospective studies. |
| Inderal in the treatment of high blood pressure Trifunovic, S., V. Ancic, et al. (1975), Med Pregl 28(3-4): 137-43. |
| Induction of insulin resistance by high-sucrose feeding does not raise mean arterial blood pressure but impairs haemodynamic responses to insulin in rats Santure, M., M. Pitre, et al. (2002), Br J Pharmacol 137(2): 185-96. Abstract: 1. This study was undertaken to further investigate the effects of a sucrose-enriched diet on vascular function and insulin sensitivity in rats. 2. Male Sprague-Dawley rats were randomized to receive a sucrose- or regular rat chow-diet for 4 weeks. A first group of sucrose- and chow-fed rats was instrumented with pulsed Doppler flow probes and intravascular catheters to determine blood pressure, heart rate, regional blood flows and insulin sensitivity in conscious rats. Insulin sensitivity was assessed by the euglycemic hyperinsulinemic clamp technique. Glucose transport activity was examined in isolated muscles by using the glucose analogue (3)H-2-deoxy-D-glucose. A second group of sucrose- and chow-fed rats was used to obtain information regarding nitric oxide synthase (NOS) isozymes protein expression in muscles, and determine endothelin content in vascular tissues isolated from both dietary groups. 3. Sucrose feeding was found to induce insulin resistance, but had no effect on resting blood pressure, heart rate, or regional haemodynamics. This insulin resistance was accompanied by alteration in the vascular responses to insulin. Insulin-mediated skeletal muscle vasodilation was impaired, whereas the mesenteric vasoconstrictor response was potentiated in sucrose-fed rats. A reduction in eNOS protein content in muscle and an increase in vascular endothelin peptide were noted in these animals. Moreover, a reduction in insulin-simulated glucose transport activity was also noted in muscles isolated from sucrose-fed rats. 4. Together these data suggest that a cluster of metabolic and haemodynamic abnormalities occur in response to the intake of simple sugars in rats. |
| Inexact determination of high blood pressure and its consequences. Geert-Jorgensen, H. (1951), Ugeskr Laeger 113(25): 834. |
| Inference of the existence of high blood pressure as a cause of renal disease in the mid-19th century: observations on vascular structures in the kidney Newton, N. M. and L. G. Fine (1999), Am J Nephrol 19(2): 323-32. Abstract: Histological examination of the kidney was well under way by the mid-19th century. Pathological changes noted to be present in Bright's disease gave rise to considerable debate in the literature of the time. Toynbee was perhaps the first to note medial hypertrophy and intimal narrowing of blood vessels in the kidney, while Johnson, around the same time, thought that kidney disease was the cause of compressed vessels. Although he later proposed a causal relationship between contraction of vessels and hypertrophy, Johnson never went beyond the insights articulated by Bright himself and failed to make the link between hypertrophy of vessels and persistently raised blood pressure. Traube considered the possibility that cardiac and renal disease could be the consequences of the same unknown disease, but rejected hypertrophy per se as a causal factor. Gull and Sutton disagreed strongly with Johnson and proposed the presence of a general disease which leads to both cardiac hypertrophy and renal disease. But it was Ewald, writing in Germany, who was able to ascribe both cardiac and vascular hypertrophy to increasing tension in the arterial system and he was the first to articulate the effect of hypertension on the kidney. |
| Inflammation, endothelial dysfunction, and the risk of high blood pressure: epidemiologic and biological evidence Bautista, L. E. (2003), J Hum Hypertens 17(4): 223-30. Abstract: In spite of its high impact on cardiovascular and renal disease, knowledge on risk factors for the development of high blood pressure (HBP) is limited. Mild chronic inflammation may play a significant role in the incidence of HBP. A persistent low-grade inflammation state could be associated with high but within the 'normal range' cytokine plasma concentration. By impairing the capacity of the endothelium to generate vasodilating factors, particularly nitric oxide (NO), elevated cytokines may lead to the development of endothelial dysfunction, chronic impaired vasodilation, and HBP. These alterations in the L-arginine: NO pathway may play a major role in the development of HBP in young subjects, with inflammation-related alterations in the production of cyclo-oxygenase-derived vasoconstrictors becoming more prominent with advanced age. Cross-sectional independent associations between HBP and plasma levels of C-reactive protein, interleukin-6, and tissue necrosis factor alpha have been reported, but no prospective evidence of these associations is currently available. |
| Influence of 17beta-oestradiol on blood pressure of postmenopausal women at high vascular risk Angerer, P., S. Stork, et al. (2001), J Hypertens 19(12): 2135-42. Abstract: OBJECTIVES: It remains an unsolved issue whether hormone replacement therapy (HRT) lowers blood pressure. This randomized trial examined the effect of 17beta-oestradiol combined cyclically with gestodene on blood pressure of postmenopausal women who were not on antihypertensive medication. All subjects had an increased risk for adverse vascular events as indicated by intima-media thickness of carotid arteries and standard risk factors. DESIGN AND SETTING: Two hundred and twenty-six postmenopausal women were randomized to oral treatment for 48 weeks with 1 mg of 17beta-oestradiol per day continuously, plus 0.025 mg gestodene on days 17-28 of each 4-week cycle (HRT 1), or plus gestodene in each third cycle only (HRT 2), or no HRT. According to predefined criteria, four subjects in HRT 1, 12 in HRT 2 and 13 in no HRT who were started on antihypertensive medication were excluded from the analysis. Thirty subjects ended participation prematurely for other reasons. Resting blood pressure was measured at baseline and after 12, 22 and 48 weeks. RESULTS: During treatment diastolic blood pressure changed significantly in both HRT groups compared to no HRT, by -3.7 +/- 9.8 mmHg, -3.0 +/- 8.8 mmHg and 1.0 +/- 9.9 mmHg at week 48 in groups HRT 2, HRT 1 and no HRT, respectively (P = 0.008 for HRT 2 versus no HRT, P = 0.027 for HRT 1 versus no HRT). The higher the diastolic blood pressure was at beginning the greater was the decrease. The decrease of systolic blood pressure was not significantly different between groups. CONCLUSIONS: For postmenopausal women with high cardiovascular risk but without antihypertensive medication, long-term treatment with 17beta-oestradiol combined with gestodene lowers diastolic blood pressure. |
| Influence of antihypertensive drug treatment on morbidity and mortality in patients over the age of 60 years. European Working Party on High blood pressure in the Elderly (EWPHE) results: sub-group analysis on entry stratification Amery, A., W. Birkenhager, et al. (1986), J Hypertens Suppl 4(6): S642-7. Abstract: The European Working Party on High blood pressure in the Elderly (EWPHE) trial was a double-blind randomized placebo-controlled trial of antihypertensive treatment in patients over the age of 60 years. Entry criteria included both a sitting diastolic blood pressure on placebo treatment in the range of 90-119 mmHg and a systolic blood pressure in the range of 160-239 mmHg. Eight-hundred and forty patients were randomly assigned either to active treatment (hydrochlorothiazide + triamterene) or a matching placebo. If blood pressure remained elevated methyldopa was added to the active regimen and matching placebo to the placebo regimen. Before randomization, the patients were stratified in eight strata according to sex, age groups between 60 and 69 years or 70 years and over, and the presence or absence of cardiovascular complications of hypertension. Both the intention-to-treat and 'on randomized treatment' analyses suggested a benefit from active treatment in men and women. Formal statistical significance was achieved for male cardiovascular mortality (intention-to-treat analyses) and for cardiovascular events in females. Although the event rates were greater for patients with previous cardiovascular events and patients over the age of 70 years, the percentage reduction in cardiovascular events was similar in these groups to those without complications and in patients between 60 and 69 years of age. However, little benefit from treatment could be demonstrated in patients over the age of 80 years. The presence or absence of smoking had no influence on response to treatment in these elderly patients. |
| Influence of anti-hypertensive therapy on serum cholesterol in elderly hypertensive patients. Results of trial by the European Working Party on High blood pressure in the Elderly (EWPHE) Amery, A., W. Birkenhager, et al. (1982), Acta Cardiol 37(4): 235-44. Abstract: In the European Working Party trial on High blood pressure in the Elderly, patients over 60 are randomly allocated either to receive diuretic capsules containing 25 mg hydrochlorothiazide and 50 mg triamterene or matching placebos. If the blood pressure remains high those receiving active diuretic treatment also receive methyldopa. Those receiving a placebo diuretic area given placebo methyldopa tablets. The study is double blind, started in 1974 and is still in progress. Three hundred and thirty-one patients have now been followed for 1 year and of these 190 have been followed for 2 and 90 for 3 years. After 1 year the serum cholesterol in the placebo group fell by an average of 10.4 mg/100 ml; over 2 years the fall was 16.0 mg/100 ml and over 3 years 20.8 mg/100 ml (6.7%). The corresponding results for the actively treated group were falls of 3.1 mg/100 ml; 20.3 mg/100 ml and 17.3 mg/100 ml (6.6%). Over a period of up to 3 years the average fall in cholesterol was 5.9 mg/100 ml/year in the placebo group and 5.0 mg/100 ml/year in the actively treated group. Thus the changes in serum cholesterol were similar whether the patients received active or placebo medication. In particular there was no evidence for an increase in cholesterol nor for a smaller decrease during diuretic therapy. In the actively treated group the fall in blood pressure in the more hypertensive patients was accompanied by a fall both in haematocrit and serum cholesterol. In patients with less severe hypertension, active treatment was not accompanied by a fall in either hematocrit or cholesterol. These different responses of serum cholesterol in the more and less severe hypertensives in the present study could explain some of the previous conflicting reports on the influence of diuretic treatment on serum cholesterol. |
| Influence of familial hypertension on blood pressure, serum cholesterol, high density lipoprotein cholesterol during second and third decade of life in Punjabi population Monga, U., O. P. Mahajan, et al. (2003), Indian J Physiol Pharmacol 47(2): 233-5. |
| Influence of hypotensive drug treatment in elderly hypertensives: study terminating events in the trial of the European Working Party on High Blood Pressure in the Elderly Amery, A., W. Birkenhager, et al. (1985), J Hypertens Suppl 3(3): S501-11. Abstract: The European Working Party on High Blood Pressure in the Elderly (EWPHE) trial was a double-blind randomized placebo-controlled trial of antihypertensive treatment in patients over the age of 60 years. Entry criteria included both a sitting diastolic blood pressure on placebo treatment in the range 90-119 mmHg and a systolic blood pressure in the range of 160-239 mmHg. The patients (n = 840) were randomized either to active treatment (hydrochlorothiazide + triamterene) or matching placebo. If the blood pressure remained elevated, methyldopa was added to the active regimen and matching placebo in the placebo group. An overall intention-to-treat analysis, combining the double-blind part of the trial and all subsequent follow-up, revealed a non-significant change in total mortality rate (-9%, P = 0.41) but a significant reduction of cardiovascular mortality rate (-27%, P = 0.037). The latter was due to a reduction of cardiac mortality (-38%, P = 0.036) and to a non-significant decrease of cerebrovascular mortality (-32%, P = 0.16). In the double-blind part of the trial, total mortality rate was not significantly reduced (-26%, P = 0.077). Cardiovascular mortality was reduced in the actively treated group (-38%, P = 0.023), due to a reduction of cardiac deaths (-47%, P = 0.048) and to a non-significant decrease of cerebrovascular mortality (-43%, P = 0.15). Deaths from myocardial infarction were reduced (-60%, P = 0.043). Study-terminating morbid cardiovascular events were significantly reduced by active treatment (-60%, P = 0.0064). In the patients randomized to active treatment there were 14 fewer cardiovascular deaths per 1000 patient-years during the double-blind part of the trial. Version 3. |
| Influence of poststenotic collateral pressure on blood flow velocities within high-grade carotid artery stenosis: differences between morphologic and functional measurements Zachrisson, H., B. Berthelsen, et al. (2001), J Vasc Surg 34(2): 263-8. Abstract: PURPOSE: The driving force for blood flow through a high-grade stenosis in the internal carotid artery can be expressed as the pressure gradient over the stenosis itself, which, however, might be reduced by the back pressure exerted by distal collateral vessels. Theoretically the maximum blood flow velocity as a measure of the functional grade of obstruction may therefore be lower than what is expected from morphologic gradations of the stenosis. This study was designed to test prospectively the influence of intracranial collateral vessels on blood flow velocities within high-grade internal carotid artery stenoses. PATIENTS AND METHODS: Forty-five consecutive patients (age 66 +/- 11) with high-grade internal carotid artery stenoses were investigated before and during carotid endarterectomy. The preoperative investigations included duplex ultrasound scanning of the neck vessels, transcranial Doppler scanning for assessment of collateral flow to the middle cerebral artery and angiography. Carotid endarterectomy was performed with patients under deep general anesthesia without a shunt. Systolic and diastolic internal carotid artery blood pressures were measured before and during intraoperative cross-clamping (ie, stump pressure) of the carotid arteries. RESULTS: Within high-grade internal carotid artery stenoses, maximum systolic and end-diastolic blood flow velocities showed a significant inverse correlation to the corresponding systolic and diastolic stump blood internal carotid artery blood pressures. All patients with spontaneous collateral flow to the ipsilateral anterior part of the circle of Willis were divided into a group with relatively high and another one with low end-diastolic blood flow velocities. The stump pressure was significantly lower in patients with high end-diastolic blood flow velocities in spite of the fact that the mean angiographic grade of stenosis did not differ significantly between the groups. CONCLUSIONS: Flow velocities within a high-grade internal carotid artery stenosis are inversely dependent on the stump pressure, that is the poststenotic collateral perfusion pressure. This should be taken into consideration in case of discrepancies between angiography and ultrasound outcome. |
| Influence of two doses of irbesartan on non-dipper circadian blood pressure rhythm in salt-sensitive black hypertensives under high salt diet Polonia, J., D. Diogo, et al. (2003), J Cardiovasc Pharmacol 42(1): 98-104. Abstract: The authors examined whether the blockage of angiotensin II receptors by irbesartan (IRB) can reverse the "non-dipper" circadian rhythm of blood pressure (BP) to a "dipper" pattern in black salt-sensitive hypertensive patients submitted to a high-sodium loading. Twelve black salt-sensitive hypertensive patients (seven men; age, 35-58 years) on a high-sodium diet (300 mmol Na+ per day) were followed for 8 weeks. A placebo was given during the first 2 weeks, followed by 2 weeks on IRB 150 mg/d, 2 weeks on placebo, and 2 weeks on IRB 300 mg/d. On the last day of placebo, IRB 150 mg/d, and IRB 300 mg/d treatments, 24-hour BP and urinary 24-hour excretion of Na+ and potassium were measured. On placebo, ambulatory mean arterial pressure (MAP) was 112 mm Hg+/-2 (24 h), 112 mm Hg+/-2 (daytime), and 111 mm Hg+/-2 (nighttime), showing a clear circadian non-dipper profile. Versus placebo, IRB 150 mg/d reduced MAP by 4.2 mm Hg+/-1.1 (24 h), 2.6 mm Hg+/-0.8 (daytime) and 6.0 mm Hg+/-1.3 (nighttime; P<0.05 vs. placebo) and IRB 300 mg/d reduced MAP by 7.8 mm Hg+/-1.4 (24 h), 3.9 mm Hg+/-1.1 (daytime), and 11.8 mm Hg+/-2.1 mm Hg (all P<0.02 vs. placebo); nighttime/daytime MAP decrease was 0.7+/-0.8% on placebo, 3.5+/-2.1% on IRB 150 mg/d, and 7.0+/-1.2% on IRB 300 mg/d (P<0.02 for trend). Compared with placebo, IRB significantly increased serum potassium and plasma renin activity and reduced fractional excretion of potassium and plasma aldosterone levels in a dose-dependent manner. Body weight and urinary sodium excretion did not change throughout the study. It was concluded that the angiotensin receptor blocker IRB can reverse the BP non-dipper profile in salt-sensitive hypertensive patients on a high-salt diet, restoring nocturnal BP decline by a predominantly dose-dependent reduction of nighttime BP. Although the increment of potassium balance and reduction of aldosterone may account for this effect, it occurs independently of increased natriuresis. It is speculated that blunting of nighttime BP decrease in black salt-sensitive hypertensive patients may be related to a deficient suppression of the renin-angiotensin system during the night. |
| Inheritance of high blood-pressure in the spontaneously hypertnsive rat Louis, W. J., R. Tabei, et al. (1969), Lancet 1(7604): 1035-6. |
| Inhibited power motivation and high blood pressure in men McClelland, D. C. (1979), J Abnorm Psychol 88(2): 182-90. |
| Inhibiting Both RAS and SNS for High Blood Pressure Control: Myths and Facts Jamerson, K., T. Giles, et al. (2000), J Clin Hypertens (Greenwich) 2(5): 331-338. |
| Inhibition of kinin degradation on the luminal side of renal tubules reduces high blood pressure in deoxycorticosterone acetate salt-treated rats Nakajima, S., H. Ito, et al. (2000), Clin Exp Pharmacol Physiol 27(1-2): 80-7. Abstract: 1. To determine whether the antihypertensive response in deoxycorticosterone acetate (DOCA) salt-treated rats was mediated by kinins on the luminal side of renal tubules or in the circulation, selective urinary kininase inhibitors were administered to normal Brown Norway Kitasato (BN-Ki) rats and kininogen-deficient Brown Norway Katholiek (BN-Ka) rats. 2. Kinins were degraded by neutral endopeptidase (NEP) and carboxypeptidase Y-like kininase (CPY) in urine, but were inactivated mainly by angiotensin-converting enzyme (ACE) in the plasma. 3. Ebelactone B inhibited CPY, while poststatin inhibited CPY and NEP. 4. Daily administration of poststatin (5 mg/kg per day, s.c.) for 3 days reduced blood pressure (BP) in DOCA salt-treated BN-Ki rats, but not in BN-Ka rats. 5. Ebelactone B (5 mg/kg per day, s.c.) also reduced BP in BN-Ki rats, which was accompanied by increased urinary sodium excretion, but had no effect on BP in BN-Ka rats. 6. Lisinopril (5 mg/kg per day, s.c.) had no effect on BP in either rat strain. 7. Arterial kinin levels in BN-Ki rats increased significantly (2.2-4.6 pg/mL) with captopril (10 mg/kg, s.c.). However, arterial kinin levels that induced hypotension following the infusion of bradykinin (1000 ng/kg per min, i.v.) were 110-fold higher than endogenous arterial kinin levels attained following captopril. 8. These results suggest that inhibition of kinin degradation on the luminal side of the renal tubules may effectively attenuate hypertension. |
| Initial cost of care results in medically supervised water-only fasting for treating high blood pressure and diabetes Goldhamer, A. C. (2002), J Altern Complement Med 8(6): 696-7. |
| Initial medication selection for treatment of high blood pressure Oparil, S. (1995), J Am Board Fam Pract 8(1): 70-2. |