| For medical practitioners and the general public - High Blood Pressure Journal Article Catalog. |
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| Moderate- and high-intensity exercise lowers blood pressure in normotensive subjects 60 to 79 years of age Braith, R. W., M. L. Pollock, et al. (1994), Am J Cardiol 73(15): 1124-8. Abstract: To investigate the effects of exercise intensity on resting blood pressure (BP) in normotensive elderly subjects, 44 sedentary healthy subjects aged 60 to 79 years of age were studied during 6 months of walking exercise. Subjects were ranked according to maximal oxygen consumption and randomly stratified to groups that trained at 70% (n = 19) or 80% to 85% (n = 14) of maximal heart rate reserve, or to a control group (n = 11) that did not train. Initial BP was established during a 2- to 3-week control period. During the first 3 months, both exercise groups progressed to 70% of heart rate reserve for 40 minutes 3 times each week. The moderate-intensity group continued to train at 70% (45-minute duration) for an additional 3 months, whereas the high-intensity group progressed to training at 85% of heart rate reserve (35-minute duration). Maximal oxygen consumption increased (p < or = 0.05) during the initial 3 months in both exercise groups (25.2 to 28.1 ml.kg-1.min-1 and 26.3 to 29.3 ml.kg-1.min-1) and continued to increase (p < or = 0.05) after 3 additional months of training, but the increase was greater (p < or = 0.05) in the high-intensity group (28.1 to 29.4 ml.kg-1.min-1 and 29.3 to 32.8 ml.kg-1.min-1). Systolic BP decreased (p < or = 0.05) similarly at 6 months in both training groups (120 to 111 mm Hg and 120 to 112 mm Hg).(ABSTRACT TRUNCATED AT 250 WORDS) |
| Modern system for treating high blood pressure based on renin profiling and vasoconstriction-volume analysis: a primary role for beta blocking drugs such as propranolol Laragh, J. H. (1976), Am J Med 61(5): 797-810. Abstract: A new system is proposed for treating the spectrum of patients with high blood pressure. It is based on studies of the renin axis using renin profiling, pharmacologic probes and our bipolar vasoconstriction-volume hypothesis. The new system does not require renin profiling, pharmacologic testing or a vasoconstriction-volume analysis for widespread application. But these procedures, whenever available, will make treatment more efficient and more certain, and at the same time provide better base line definition. In the new system, all patients, except the elderly and those with congestive heart failure, bradycardia or a history of asthma, are treated first with propranolol alone, a procedure which will diminish or normalize blood pressure in many patients with high and noraml renin levels. For nonresponders, diuretic therapy is then superimposed. Subsequently, a propranolol subtraction trial picks out the low-renin patients who will usually respond to a diuretic alone. This program is likely to be fully effective in possible up to 85 per cent of patients. For the residual smaller fraction, drugs such as hydralazine, methyl DOPA, clonidine, reserpine or guanethidine are then added in traditional trial and error fashion. The proposed system has the theoretic attraction for long-term commitment, implicit in antihypertensive therapy, of achieving blood pressure control in large fractions with one drug instead of two or with two drugs instead of three or more. Moreover, the large groups who respond to therapy with propranolol alone (most high-renin and normal-renin patients) or to diuretics alone (most low-renin patients) gain the advantage of simple, more specific, long-term (i.e., antirenin or antivolume) therapy. The use of propranolol alone has practical and theoretic advantages over diuretics. Control may be achieved with even fewer side effects and without hypokalemia and chronic dehydration with its possibly adverse consequences (hyperuricemia, azotemia, hyperlipidemia, hyperreninemia, increased blood viscosity). Also, propranolol provides more direct control of the increased peripheral resistance and of neurogenically-induced swings in blood pressure. At the same time, the new system efficiently exploits the long-term use of diuretic therapy alone in low-renin patients in whom volume excess seems a causal factor. And it tends to avoid the use of diuretics in high-renin patients and of beta-blockers in low-renin patients in whom these drug types may be contraindicated. |
| Modification of high blood pressure after myocardial infarction Kario, K. and T. G. Pickering (2000), Med Clin North Am 84(1): 1-21, vii. Abstract: The treatment of high blood pressure (BP) after myocardial infarction is extremely important to decrease reinfarction and mortality. BP should be controlled more strictly in this high-risk hypertensive population. Recently, many clinical trials have demonstrated the benefits of lifestyle modification and antihypertensive agents, particularly beta-blockers and angiotensin-converting-enzyme inhibitors for the treatment of acute myocardial infarction. Treatment with these agents that modify BP may benefit even normotensive patients after a myocardial infarction, although the benefit is greater in hypertensives. |
| Molecular mechanisms of cardiac hypertrophy induced by high blood pressure Yamazaki, T. (2000), Nippon Rinsho 58 Suppl 1: 744-8. |
| More bang for the buck in managing high blood pressure Smith, M. D. and W. McGhan (1996), Bus Health 14(5): 44-7. |
| More on high blood pressure Kahn, A., Jr. (1979), J Ark Med Soc 76(4): 179-80. |
| More on the dentist's role in the prevention of high blood pressure Raab, F., E. Schaffer, et al. (1993), Chronobiologia 20(3-4): 245-50. |
| Mortality amongst patients of the Glasgow Blood Pressure Clinic was high in the 1970s and 80s but has fallen since, why? Lever, A. F., D. G. Beevers, et al. (1999), Clin Exp Hypertens 21(5-6): 553-62. Abstract: Established in 1968 the Glasgow Blood Pressure Clinic has over 11,000 patients on its computer record. Up to 1980, mortality from all-causes and from cardiovascular causes was high: relative risks compared with two local control populations were greater than 2.0. Since 1980, all-cause mortality has decreased to 1.31 (859 deaths, CI 1.23-1.39). Lower mortality from cardiovascular causes, particularly coronary heart disease, contributes to the decrease. Reasons for the decrease are under investigation currently. Referral of patients with slightly lower blood pressure contributes, as may better blood pressure control with newer antihypertensive drugs. ACE inhibitors and calcium channel blockers were introduced in 1980 and during the 16-year period to 1995, all-cause mortality has decreased most in patients taking ACE inhibitor. A decrease also occurred in patients taking antihypertensive drugs other than ACE inhibitor. |
| Mortality and morbidity results from the European Working Party on High Blood Pressure in the Elderly trial Amery, A., W. Birkenhager, et al. (1985), Lancet 1(8442): 1349-54. Abstract: A double-blind randomised placebo-controlled trial of antihypertensive treatment was conducted in patients over the age of 60. Entry criteria included both a sitting diastolic blood pressure on placebo treatment in the range 90-119 mm Hg and a systolic pressure in the range 160-239 mm Hg. 840 patients were randomised either to active treatment (hydrochlorothiazide + triamterene) or to matching placebo. If the blood pressure remained raised, 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 in cardiovascular mortality rate (-27%, p = 0.037). The latter was due to a reduction in cardiac mortality (-38%, p = 0.036) and a non-significant decrease in 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), owing to a reduction in cardiac deaths (-47%, p = 0.048) and a non-significant decrease in 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). Non-terminating cerebrovascular events were reduced (-52%, p = 0.026), but the non-terminating cardiac events were not (+3%, p = 0.98). In the patients randomised to active treatment there were 29 fewer cardiovascular events and 14 fewer cardiovascular deaths per 1000 patient years during the double-blind part of the trial. |
| Mortality and treated blood pressure in patients of the European Working Party on High Blood Pressure in the Elderly Staessen, J. (1991), Am J Med 90(3A): 60S-61S. Abstract: Elderly hypertensive patients were randomly assigned to treatment with diuretics and methyldopa (n = 352) or placebo (n = 339), and divided into three groups, each according to their blood pressures, after nine months of treatment. Subsequently, 65 placebo patients and 56 treated patients died. A U-shaped relation was seen in treated patients between mortality and systolic blood pressure, and in placebo patients between mortality and diastolic blood pressure. Whereas in treated patients, the highest mortality was seen in patients with the lowest diastolic pressure, the lowest mortality was seen in the group with the highest diastolic pressure. The increased mortality in treated patients with the lowest blood pressure may not be drug-induced, but an expression of deterioration in general health, as indicated by the decreases in body weight and hemoglobin levels found in patients with the lowest blood pressures in previous analyses of these data. |
| Muscular substance of both ventricle in high blood pressure. Merkel, H. and G. Nadolny (1951), Z Kreislaufforsch 40(11-12): 341-55. |
| Myocardial function in general and regional left ventricular ischaemia in dogs at control and high aortic blood pressure Lekven, J. and F. Kiil (1975), Cardiovasc Res 9(3): 373-83. Abstract: End-diastolic dilation and reduced systolic shortening are the characteristic dimensional changes during myocardial ischaemia. Elevation of systolic aortic blood pressure by 5.3 kPa (40 mm Hg) normalized shortening and reduced myocardial dilatation when the tissue rendered ischaemic by coronary artery occlusion was less than 20% of the left ventricle. However, when the ischaemic lesion was more extensive, an adverse effect of raising aortic blood pressure was observed. |
| Na+, K+ and water balance in young spontaneously hypertensive rats: relationship to blood pressure after high K+ treatment Sugden, A. L., B. L. Bean, et al. (1987), Clin Sci (Lond) 72(3): 321-7. Abstract: These studies were designed to investigate the effects of high dietary K+ on electrolyte and water balance in young spontaneously hypertensive rats (SHR) and to relate these effects to changes in blood pressure. The high K+ diet reduced blood pressure by approximately 10 mmHg during the development of hypertension. Blood pressure, however, plateaued at the same maximum level as control by age 13 weeks. Rats fed the high K+ diet showed a significant increase in water intake and urine volume throughout the treatment period but no change in plasma volume or extracellular fluid volume occurred. A slight natriuresis was also observed in rats on the high K+ diet, but this was not of sufficient magnitude to decrease total body Na+. These results confirm previous findings that K+ causes a diuresis and a natriuresis, but demonstrate that the diuretic action of K+ cannot explain its antihypertensive properties in young SHR. |
| Narrow sphygmomanometer cuff and high blood pressure readings. Chao, C. P. (1957), Zhonghua Nei Ke Za Zhi 5(8): 664; English abstract 76. |
| National high blood pressure conference Levy, R. I. (1978), Urban Health 7(5): 10, 12, 27 passim. |
| National High Blood Pressure Education Program (NHBPEP) review paper on complications of shock wave lithotripsy for urinary calculi Smith, L. H., G. Drach, et al. (1991), Am J Med 91(6): 635-41. Abstract: This decade has witnessed dramatic advances in the surgical management of urinary calculi. Today, most stones can be removed by minimally invasive means. In fact, the treatment of choice in 60% to 90% of patients with renal and ureteral calculi that need to be surgically removed is extracorporeal shock wave lithotripsy (ESWL). This article reviews indications for ESWL and discusses deleterious effects of ESWL. |
| National High Blood Pressure Education Program Lenfant, C. and E. J. Roccella (1986), J Am Optom Assoc 57(5): 347-8. |
| National High Blood Pressure Education Programme using data to focus communications to minority populations Roccella, E. J. and C. Lenfant (1995), J Hum Hypertens 9(1): 53-7. |
| National high blood pressure month Griffenhagen, G. B. (1975), J Am Pharm Assoc 15(4): 175. |
| Natural history of male psychological health, XIII: Who develops high blood pressure and who responds to treatment Vaillant, G. E. and P. D. Gerber (1996), Am J Psychiatry 153(7 Suppl): 24-9. Abstract: OBJECTIVE: This study was an effort to clarify both the psychological contributions to and the long-term consequences of uncomplicated essential hypertension. METHOD: The subjects were 193 healthy college students selected as sophomores and prospectively followed for over 50 years. Independent assessments of physical and mental health were made. RESULTS: Although objective indices of psychopathology predicted both physical morbidity and mortality, they did not predict hypertension. When pyknic somatotype, college diastolic blood pressure, and well-integrated personality in college were controlled, no other preadult variable predicted hypertension. As expected, heart disease, obesity, and alcohol abuse were each correlated with hypertension. After roughly 20 years, 14 of the 41 men with treated hypertension were in stable remission, and 13 men had developed cardiac complications. No differences between these groups could be discerned. CONCLUSIONS: Over time, hypertension appeared to be more a product of biological than of psychosomatic variables. Good psychological health did not diminish the risk of hypertension. |
| Nearly a third of US adults have high blood pressure Gottlieb, S. (2004), Bmj 329(7465): 531. |
| Need to prevent and control high-normal and high blood pressure, particularly so-called "mild" hypertension: epidemiological and clinical data Giumetti, D., K. Liu, et al. (1985), Prev Med 14(4): 396-412. Abstract: The need to prevent and control high blood pressure (HBP), including so-called "mild" hypertension diastolic blood pressure (DBP) 90-104 mm Hg in adults age 30+ stems from the extensive data on the increased risks due to these common blood pressure (BP) levels, including risk of catastrophic cardiovascular events (coronary, cerebrovascular, etc.), both nonfatal and fatal. Prospective population data from the national cooperative Pooling Project and the Chicago Heart Association Detection Project in Industry illustrate the extensively documented facts. They also show that only a small minority of middle-aged and older Americans have optimal low-normal BP levels, i.e., DBP less than 80 mm Hg (SBP less than 120). Thus, the problem of BP above optimal level for health over a long life span is a population-wide problem. The data also show that the great majority of excess catastrophic events attributable to elevated BP occur among people with DBP 90-104 and 80-89 mm Hg, levels very common in the population. Most people with such BP levels also have one or more other major risk factors (e.g., hypercholesterolemia, cigarette use, ECG abnormalities) and thus are at markedly increased risk, both relative and absolute. In addition to these excess risks for major illness, disability, and death, people with BP above optimal levels are more highly prone to other events, clinical and subclinical, that have adverse effects on long-term prognosis, including development of target organ damage and severe hypertension. These data lead to the following inferences about medical care and public health strategy: (a) A key task is, by safe nutritional-hygienic means, to shift the entire population distribution of BP downward, for both primary and secondary prevention of HBP. Such means include prevention and control of obesity, high sodium and alcohol intake, and sedentary habit, from early childhood on. (b) People with DBP 80-89 mm Hg need to be identified promptly, with institution of nutritional-hygienic measures to prevent development of frank hypertension and to correct other risk factors. (c) People with DBP 90-104 and higher need to be identified promptly, with institution of measures to normalize BP and control other major risk factors, by nutritional-hygienic means alone whenever possible or in combination with drug treatment for HBP when necessary to prevent organ system damage, serious illness, disability, and premature death.(ABSTRACT TRUNCATED AT 400 WORDS) |
| Needed: pharmacists in high blood pressure control Williams, R. L. (1978), Am Pharm 18(5): 32-3, 40. |
| Neither perceived job stress nor individual cardiovascular reactivity predict high blood pressure Fauvel, J. P., I. M'Pio, et al. (2003), Hypertension 42(6): 1112-6. Abstract: We have reported that high job strain was associated with a significantly higher diastolic blood pressure (DBP) of 4.5 mm Hg during the working hours, irrespective of BP reactivity to a stress test. We report the final results of the first 5-year follow-up study, which aimed to assess the respective influences of perception of professional strain and cardiovascular reactivity to a mental stress test on BP. A cohort of 292 healthy subjects (mean+/-SEM age, 38+/-1 years) was followed up for progression to hypertension outcome, which was defined as an increase in systolic blood pressure (SBP) or DBP >7 mm Hg or a DBP >95 mm Hg during follow-up. None of the subjects was lost to follow-up, and 209 subjects completed the study. The high-strain (HS) group, representing 20.9% of the subjects, was compared with the remaining subjects (non-high-strain NHS). Similarly, the subjects with the highest BP stress reactivity (HR; 20.9% of subjects) were compared with the remaining subjects (NHR). Progression to hypertension was reached by 93 subjects (31.8%). Kaplan-Meier survival estimates revealed that neither HS nor HR increased the incidence of progression to hypertension. End-of-follow-up 24-hour ambulatory BPs that were similar in HS and NHS (120+/-2 vs 120+/-1 mm Hg, respectively) and in HR and NHR (122+/-2 vs 120+/-1 mm Hg, respectively) confirmed our findings. Age, alcohol, salt diet, body mass index, and occupation did not interfere with our results. In conclusion, cardiovascular HR and HS do not appear to be major risk markers for future high BP in healthy, young adults. |
| Neonatal cardiovascular dynamics in relation to matroclinous and patroclinous history of high blood pressure Hermida, R. C., J. R. Fernandez, et al. (1993), Chronobiol Int 10(3): 214-23. Abstract: Genetic risk is a primary contributing factor to the predisposition of a newborn child to elevated blood pressure later in life. An index of this factor is needed to assess in the neonate the success or failure of preventive interventions instituted for the pregnant women. This index could be based on characteristics of blood pressure and heart rate variability measured during the first 2 days after birth. In the search for such an index, the systolic and diastolic blood pressures and heart rates of 127 newborn babies were automatically monitored at about 30-min intervals for 48 h with a Nippon Colin device, starting early after birth. Circadian parameters (obtained by the linear least-squares fit of a 24-h cosine curve to each individual series) and descriptive statistics for the three circulatory variables were used in a multiple regression analysis to compute a linear prediction function for the cardiovascular risk score. This score was obtained for each neonate on the basis of the presence or absence of overt cardiovascular disease, elevated blood pressure, or obesity across two generations, those of the newborn's parents and grandparents. Results from regression indicate that the best model includes the circadian amplitudes of systolic and diastolic blood pressure and the circadian ranges of systolic blood pressure and heart rate. The contributions from patroclinous versus matroclinous family history were then compared. Results show that linear prediction models include the same variables for both paternal and maternal cardiovascular risk score. These results provide a neonatal index of cardiovascular risk, to be used later for the evaluation of the effects on the newborn of intervention for the pregnant women. |
| Nephrolithiasis and increased blood pressure among females with high body mass index Gillen, D. L., F. L. Coe, et al. (2005), Am J Kidney Dis 46(2): 263-9. Abstract: BACKGROUND: We hypothesized that one reason for the heterogeneity in previously reported links between kidney stones and blood pressure (BP) was the differential effects of nephrolithiasis among subgroups of individuals. In particular, we hypothesized that the association between stone history and BP may vary with respect to sex and body size. METHODS: Data from the Third National Health and Nutrition Examination Survey were used to estimate the association between history of stone disease and odds of prior diagnosis of hypertension and mean difference in systolic BP, diastolic BP, and pulse pressure. Nine hundred nineteen persons with a history of stones and 19,120 persons without stones were available for analysis. RESULTS: In women, it was estimated that stone formers (SFs) experienced a 69% increase in odds of self-reported hypertension (95% confidence interval CI, 1.33 to 2.17; P < 0.001). No significant difference was found in men. The estimated difference in mean systolic and diastolic BP comparing SFs with non-SFs increased with body mass index in both sexes, but was more pronounced in women. Mean systolic BPs in women SFs in quintiles 4 and 5 of body mass index were 7.62 mm Hg (95% CI, 1.04 to 14.2; P = 0.024) and 4.36 mm Hg (95% CI, 0.30 to 8.42; P = 0.036) greater than those in similar women non-SFs, respectively. CONCLUSION: Our findings not only support the link between kidney stone disease and BP, but also suggest that overweight women SFs may be at significantly increased risk for hypertension. |
| Nephron number and blood pressure in rat offspring with maternal high-protein diet Zimanyi, M. A., J. F. Bertram, et al. (2002), Pediatr Nephrol 17(12): 1000-4. Abstract: This study investigated the effects of a high-protein diet during pregnancy on nephron endowment and subsequent levels of blood pressure in the offspring. Female WKY rats were fed either a normal (20%, NPD) or a high (54%, HPD) protein diet during pregnancy. Male offspring were paired at birth. At 4 weeks of age, 1 of the pair was randomly chosen for perfusion fixation, and total glomerular number, and thereby nephron number, was estimated using an unbiased stereological technique. The other rat of the pair was allowed to grow to 30 weeks of age, during which time tail cuff systolic blood pressure was monitored twice weekly. There was no effect of the HPD on birth weight (NPD 4.23+/-0.53 g, HPD 4.26+/-0.45 g, mean+/-SD), kidney weight (NPD 0.372+/-0.049 g, HPD 0.337+/-0.090 g), or total nephron number (NPD 27,191+/-3,512, HPD 26,738+/-4,735). Systolic blood pressure at 30 weeks was 170+/-14 mmHg in NPD and 169+/-14 in HPD offspring. These findings show that a HPD during pregnancy did not lead to an increase in birth weight, kidney weight, or nephron endowment, nor did the HPD affect adult blood pressure. |
| Neuropeptide abnormalities suggest a dopaminergic basis for high blood pressure in the spontaneously hypertensive rat Hutchinson, J. S. and J. S. Mok (1984), Clin Exp Hypertens A 6(10-11): 2055-8. Abstract: The spontaneously hypertensive rat (SHR) and the stroke-prone substrain (sp-SHR) have been reported to have several abnormalities in levels of peptides both in tissue and in plasma (beta-endorphin, prolactin, thyroid stimulating hormone and vasopressin) when compared to the Wistar Kyoto (WKY) normotensive control rat. As the secretion of these peptides is under dopaminergic control and the abnormalities consistently suggest under-activity of the dopaminergic control system in the brain, injections of dopamine (0.4 mg/kg) were given i.c.v. to 10 SHR, 10 renal artery stenosis hypertensive rats (LRAS) and 10 genetically hypertensive rats of the New Zealand strain (GHR). Mean blood pressure fell from 205 +/- 6 (SEM) mmHg to 128 +/- 8 mmHg in the SHR (p less than 0.001), from 184 +/- 7 mmHg to 176 +/- 7 mmHg in the LRAS (p greater 0.05) and from 157 +/- 5 mmHg to 138 +/- 6 mmHg in he GHR (p less than 0.02). These effects were unlikely to be due to leakage of dopamine out into the periphery as i.v. dopamine (0.4 mg/kg) increased blood pressure in these animals. |
| Neuroticism and the discovery of high blood pressure Cochrane, R. (1969), J Psychosom Res 13(1): 21-5. |
| New aspects of calcium antagonists in the treatment of high blood pressure Bengtsson, B. and L. Hansson (1985), Lakartidningen 82(43): 3700-2. |
| New beta-blocker: prolonged reduction in high blood pressure with beta(1) antisense oligodeoxynucleotides Clare Zhang, Y., B. Kimura, et al. (2000), Hypertension 35(1 Pt 2): 219-24. Abstract: beta-Blockers are widely used for hypertension treatment but must be taken daily. We have developed a novel beta-blocker by targeting beta(1)-adrenergic receptor (beta(1)-AR) mRNA with antisense oligodeoxynucleotides (beta(1)-AS-ODN). A single intravenous injection of beta(1)-AS-ODN significantly reduced cardiac contractility and blood pressure (38+/-5 mm Hg, P<0.05) in spontaneously hypertensive rats for 3 weeks. In the present study, we improved the antihypertensive effect of beta(1)-AS-ODN by delivery with the cationic liposomes DOTAP/DOPE and studied its impact on the peripheral renin-angiotensin system. Five charge ratios (+/-) of liposome/ODN from 0 to 3.5 were tested to deliver 0. 5 mg/kg beta(1)-AS-ODN intravenously in spontaneously hypertensive rats (n=30). On the basis of the magnitude and duration of hypotension, 2.5 was determined to be the optimal charge ratio, which decreased blood pressure by up to 35 mm Hg for 20 to 33 days (P<0.05). The effects were specific for beta(1)-AR, because radioligand binding assay and quantitative autoradiography showed a 35% reduction in beta(1)-AR levels in kidney but no change in beta(2)-AR. beta(1)-AS-ODN diminished the preprorenin mRNA levels in renal cortex by 37% 4 days after administration. This transient effect was followed by a delayed yet marked diminution of plasma renin activity and plasma angiotensin II levels on days 10 and 17 (P<0.01). The results show that beta(1)-AS-ODN has an effective long-term antihypertensive effect up to 33 days with a single intravenous injection. The mechanism appears to be through reduced beta(1)-AR number specifically and reduced cardiac contractility. The inhibition of the renin-angiotensin system is probably a second mechanism to produce the sustained antihypertensive effect of beta(1)-AS-ODN. |
| New CBO guideline 'High blood pressure'; family practitioners and specialists in consensus Hart, W. (2001), Ned Tijdschr Geneeskd 145(43): 2065-6. Abstract: Under the auspices of the Dutch Institute for Health Care Improvement (CBO) a final revised version of guidelines for the detection, diagnosis and treatment of hypertension was agreed upon. These guidelines constitute a delicate compromise between the views of general practitioners and hypertension specialists. These guidelines have been published separately from a future standard on hypertension from the Dutch College of General Practitioners but no major discrepancies between these two documents are anticipated. |
| New expression profiles of voltage-gated ion channels in arteries exposed to high blood pressure Cox, R. H. and N. J. Rusch (2002), Microcirculation 9(4): 243-57. Abstract: The diameters of small arteries and arterioles are tightly regulated by the dynamic interaction between Ca(2+) and K(+) channels in the vascular smooth muscle cells. Calcium influx through voltage-gated Ca(2+) channels induces vasoconstriction, whereas the opening of K(+) channels mediates hyperpolarization, inactivation of voltage-gated Ca(2+) channels, and vasodilation. Three types of voltage-sensitive ion channels have been highly implicated in the regulation of resting vascular tone. These include the L-type Ca(2+) (Ca(L)) channels, voltage-gated K(+) (K(V)) channels, and high-conductance voltage- and Ca(2+)-sensitive K(+) (BK(Ca)) channels. Recently, abnormal expression profiles of these ion channels have been identified as part of the pathogenesis of arterial hypertension and other vasospastic diseases. An increasing number of studies suggest that high blood pressure may trigger cellular signaling cascades that dynamically alter the expression profile of arterial ion channels to further modify vascular tone. This article will briefly review the properties of Ca(L), K(V), and BK(Ca) channels, present evidence that their expression profile is altered during systemic hypertension, and suggest potential mechanisms by which the signal of elevated blood pressure may result in altered ion channel expression. A final section will discuss emerging concepts and opportunities for the development of new vasoactive drugs, which may rely on targeting disease-specific changes in ion channel expression as a mechanism to lower vascular tone during hypertensive diseases. |
| New findings on the use of specific alpha-1 adrenergic blockers in the treatment of high blood pressure Horky, K. (1991), Vnitr Lek 37(6): 604-11. Abstract: Adrenergic alpha-receptors blockers have been used for a long time in the treatment of hypertension. The use of original non-selective alpha 1-blockers was restricted by the occurrence of undesirable side-effects. Therapeutic interest in alpha-blockers was restored after the discovery of selective adrenergic alpha 1-blockers. Since 1976 when the first selective alpha 1-blocker, prazosine, appeared on the market a number of quinazoline derivatives was developed (terazosine, doxazosine, trimazosine) and non-quinazoline alpha 1-blockers (indoramine, ketanserine, urapidil etc.). Selective alpha 1-blockers normalize the BP by reducing the pathologically raised peripheral vascular resistance without changing the cardiac output. They influence the capacity as well as resistant vascular system and reduce thus the pre-load and after-load. Alpha 1-blockers do not affect, or increase slightly the renal blood flow without altering glomerular filtration. Treatment with selective alpha 1-blockers is associated with a smaller tachycardia than treatment with direct vasodilatating agents or non-selective alpha-blockers. Contrary to saluretics and some beta-blockers, alpha 1-blockers have a favourable effect on plasma lipoproteins, insulin resistance, glucose metabolism and they support the regression of hypertrophy of the vascular wall and the left ventricle. Alpha 1-blockers are effective as monotherapy and when combined with other antihypertensive drugs. They are well tolerated with a small number of undesirable side-effects. Selective alpha 1-blockers reduce the BP in a haemodynamically favourable way and exert a favourable effect on other risk factors of ischaemic heart disease in hypertonic patients.(ABSTRACT TRUNCATED AT 250 WORDS) |
| New guidelines for prevention, detection, evaluation and treatment of high blood pressure Glick, M. (1998), J Am Dent Assoc 129(11): 1588-94. Abstract: New guidelines for the management of patients at risk of developing hypertension and associated conditions have recently been published. These guidelines include a new risk stratification and blood pressure classification, as well as an altered approach to drug therapy. This article describes the major changes from previous recommendations, highlights the role of oral health care providers and emphasizes the dental implications of caring for patients with blood pressure conditions. |
| New guidelines urge early intervention for high blood pressure in children Rollins, G. (2004), Rep Med Guidel Outcomes Res 15(12): 1, 6-7. |
| New high blood pressure guidelines create new at-risk classification: changes in blood pressure classification by JNC 7 Miller, E. R., 3rd and M. L. Jehn (2004), J Cardiovasc Nurs 19(6): 367-71; quiz 372-3. Abstract: High blood pressure has become increasingly prevalent and is an important risk factor for cardiovascular disease. The Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) has redefined normal blood pressure as less than 120/80 mm Hg and created a new blood pressure category called "prehypertension" for those with a systolic BP of 120 to 139 mm Hg or a diastolic BP of 80 to 89 mm Hg. This new blood pressure category was created to identify adults considered to be at risk for developing hypertension and to alert both patients and healthcare providers of the importance of adopting lifestyle changes. Recognition of prehypertension provides important opportunities to prevent hypertension and cardiovascular disease. |
| New hypertension guidelines set aggressive goals based on risk factors. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Gifford, R. W., Jr. (1998), Cleve Clin J Med 65(1): 18-24. Abstract: Physicians and public health officials need to intensify their efforts to detect and treat high blood pressure, because the incidence of hypertension-related morbidity and mortality has stopped declining, and fewer than 30% of hypertensive patients have their blood pressure under control. The JNC VI report outlines the current standard of care for treating hypertension. |
| New hypertension guidelines. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Hurley, M. L. (1998), Rn 61(3): 25-8. |
| New insights into the effects on blood pressure of diets low in salt and high in fruits and vegetables and low-fat dairy products Vollmer, W. M., F. M. Sacks, et al. (2001), Curr Control Trials Cardiovasc Med 2(2): 71-74. Abstract: Results from the recent Dietary Approaches to Stop Hypertension (DASH)-Sodium trial provide the latest evidence concerning the effects of dietary patterns and sodium intake on blood pressure. Participants ate either the DASH diet (high in fruits, vegetables and low-fat dairy products, and reduced in saturated and total fat) or a typical US diet. Within each diet arm, participants ate higher, intermediate, and lower sodium levels, each for 30 days. The results indicated lower blood pressure with lower sodium intake for both diet groups. Although some critics would argue otherwise, these findings provide important new evidence for the value of the DASH diet and sodium reduction in controlling blood pressure. |