| For medical practitioners and the general public - High Blood Pressure Journal Article Catalog. |
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| Recommendations for blood pressure measurement in humans: an AHA scientific statement from the Council on High Blood Pressure Research Professional and Public Education Subcommittee Pickering, T. G., J. E. Hall, et al. (2005), J Clin Hypertens (Greenwich) 7(2): 102-9. |
| Recommendations of the Canadian Consensus Conference on Non-Pharmacological Approaches to the Management of High Blood Pressure, Mar. 21-23, 1989, Halifax, Nova Scotia Chockalingam, A., D. Abbott, et al. (1990), Cmaj 142(12): 1397-409. |
| Recovery of high blood pressure after chronic lesions of the commissural NTS in SHR Sato, M. A., G. H. Schoorlemmer, et al. (2003), Hypertension 42(4): 713-8. Abstract: Acute electrolytic lesions of the commissural nucleus of the solitary tract (commNTS) reduce blood pressure (BP) in SHR but not in normotensive Wistar-Kyoto and Wistar rats and abolish the pressor response to intravenous injection of potassium cyanide. We investigated the chronic effect of commNTS lesions on mean arterial pressure (MAP), and on baroreceptor and chemoreceptor reflex responses in SHR. The contribution of the sympathetic nervous system and the hormones vasopressin and angiotensin II to maintenance of BP in lesioned SHR was also investigated. MAP fell to normotensive levels the day after lesioning the commNTS but returned to the hypertensive level 9 days later. The reflex tachycardia evoked by sodium nitroprusside remained attenuated for 10 days after commNTS lesions but became enhanced 30 days after commNTS lesions. The pressor component of the chemoreflex elicited by potassium cyanide remained blocked for 30 days after lesions. Vasopressin antagonist or ACE blocker did not change MAP in sham or commNTS-lesioned SHR. Ganglionic blockade with hexamethonium elicited similar reductions in MAP in sham and commNTS-lesioned SHR. Results demonstrated that commNTS lesions in SHR produce a transient fall in BP and a long-lasting inhibition of the pressor response of the chemoreflex. Therefore, the blockade of the pressor response to peripheral chemoreflex activation is not sufficient to chronically reduce MAP in SHR. In the chronic absence of the commNTS, other subnuclei of the NTS or other brain stem nuclei may reorganize to replace the function of commNTS neurons, restoring sympathetic activity and high BP in SHR. |
| Reduction in blood pressure associated with high polyunsaturated fat diets that reduce blood cholesterol in man Iacono, J. M., M. W. Marshall, et al. (1975), Prev Med 4(4): 426-43. |
| Reduction in blood pressure with a low sodium, high potassium, high magnesium salt in older subjects with mild to moderate hypertension Geleijnse, J. M., J. C. Witteman, et al. (1994), Bmj 309(6952): 436-40. Abstract: OBJECTIVE--To examine the effect of a reduced sodium and increased potassium and magnesium intake on blood pressure. DESIGN--Randomised double blind placebo controlled trial. SETTING--General population of a suburb of Rotterdam. SUBJECTS--100 men and women between 55 and 75 years of age with untreated mild to moderate hypertension. INTERVENTIONS--During 24 weeks the intervention group received a mineral salt (sodium: potassium: magnesium 8:6:1) and foods prepared with the mineral salt. Controls received common salt and foods. MAIN OUTCOME MEASURE--Change in blood pressure. RESULTS--Complete follow up was achieved for 97 of the 100 randomised subjects. Systolic blood pressure (mean of measurements at weeks 8, 16, and 24) fell by 7.6 mm Hg (95% confidence interval 4.0 to 11.2) and diastolic blood pressure by 3.3 mm Hg (0.8 to 5.8) in the mineral salt group compared with the controls, with a 28% decrease in urinary sodium excretion and a 22% increase in urinary potassium excretion. Twenty five weeks after the study the difference in blood pressure between the groups was no longer detectable. CONCLUSION--Replacing common sodium salt by a low sodium, high potassium, high magnesium mineral salt could offer a valuable non-pharmacological approach to lowering blood pressure in older people with mild to moderate hypertension. |
| Reflections on the sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Sheps, S. G. and E. J. Roccella (1999), Curr Hypertens Rep 1(4): 342-5. Abstract: The editors of the Journal have asked us to review the background process to the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI), reflect on criticism, indicate where important changes occurred compared with its predecessor, and predict the purpose and content of the subsequent report. |
| Regional and local high blood pressure control programs Hines, E., C. E. Powell, et al. (1981), J Med Assoc Ga 70(5): 353-5. |
| Regional cerebral blood flow, O2, and EEG in exposures to O2 at high pressure Bean, J. W., J. Lignell, et al. (1971), J Appl Physiol 31(2): 235-42. |
| Regional implementation of the Connecticut high blood pressure program Benn, S. L. (1985), Urban Health 14(9): 27-8. |
| Regional implementation of the Connecticut High Blood Pressure Program Benn, S. L., E. DeMusis, et al. (1987), Bibl Cardiol(42): 26-31. |
| Regional organ blood flow during high-frequency positive-pressure ventilation (HFPPV) and intermittent positive-pressure ventilation (IPPV) Bunegin, L., R. B. Smith, et al. (1984), Anesthesiology 61(4): 416-9. Abstract: The effect of high-frequency ventilation (HFV) on cerebral blood flow (CBF) at normal and elevated intracranial pressure (ICP) was compared with flows measured under the same conditions during intermittent positive pressure ventilation (IPPV). Renal, lung (bronchial artery supply), and cardiac blood flows also were measured during HFV and compared with flows observed during IPPV. Measurements were made in canines with stable hemodynamic variables and arterial CO2 and O2 tensions in the normal range, CBF during HFV was comparable to the CBF during IPPV. Following an increase in ICP to a mean of 44 +/- 18 mmHg (SD), mean CBF decreased to 22.5 +/- 11 ml. 100 g-1. min-1 (SD) during IPPV and 21.7 +/- 13.2 ml. 100 g-1. min-1 (SD) during HFV. No statistical differences could be noted in regional or global flow as a function of ventilatory mode. Renal, lung (bronchial artery supply), and cardiac blood flows also showed no statistical variation between HFV and IPPV. Ventilator-synchronous fluctuations in ICP observed during IPPV were reduced during HFV at normal ICP and eliminated by HFV at elevated ICP. |
| Regression dilution bias in blood total and high-density lipoprotein cholesterol and blood pressure in the Glostrup and Framingham prospective studies Lewington, S., T. Thomsen, et al. (2003), J Cardiovasc Risk 10(2): 143-8. Abstract: BACKGROUND: In epidemiological studies, within-person variability in measured values of a risk factor may underestimate the association between prolonged or 'usual' levels of a risk factor with risk of disease - 'regression dilution'. The importance of regression dilution for high-density lipoprotein (HDL)-cholesterol and the extent to which this may differ from that for total cholesterol is not known. The aim of this study was to assess the magnitude of regression dilution bias for HDL-cholesterol, total cholesterol and blood pressure after varying intervals of follow-up in two prospective cohort studies. METHODS: Regression dilution ratios were estimated for each risk factor using the correlations between baseline and re-survey values in the Glostrup Population Studies and the NHLBI Framingham Heart Study after various time intervals. The regression dilution ratios in each cohort after a fixed interval between measurements were compared. RESULTS: The regression dilution ratios after 10 years were 0.51 and 0.56 for systolic blood pressure in Glostrup and Framingham, respectively; 0.52 and 0.54 for diastolic blood pressure; and 0.68 and 0.63 for total cholesterol. In both studies, the regression dilution ratios for these risk factors became more extreme with increasing intervals between measurements. The regression dilution ratio for HDL-cholesterol after 10 years in Glostrup was 0.72, which suggests that the importance of regression dilution for HDL-cholesterol was similar to that for total cholesterol. CONCLUSION: Failure to correct for increasing regression dilution with longer follow-up may account for some of the discrepant results obtained for the importance of these risk factors in epidemiological studies at varying intervals of follow-up. |
| Relation between mortality and treated blood pressure in elderly patients with hypertension: report of the European Working Party on High Blood Pressure in the Elderly Staessen, J., C. Bulpitt, et al. (1989), Bmj 298(6687): 1552-6. Abstract: OBJECTIVE--To investigate the relation between mortality and treated systolic and diastolic blood pressures. DESIGN--Randomised double blind placebo controlled trial. Mortality in the two treatment groups was examined in thirds of treated systolic and diastolic blood pressures. PATIENTS--339 And 352 patients allocated to placebo and active treatment, respectively. The groups were similar at randomisation in sex ratio (70% women), mean age (71.5 years), blood pressure (182/101 mm Hg), and proportion of patients with cardiovascular complications (35%). MEASUREMENTS AND MAIN RESULTS--In the placebo group total mortality rose with increasing systolic pressure whereas it had a U shaped relation with diastolic pressure, the total lowest mortality being in patients in the middle third of the distribution of diastolic pressure. In the group given active treatment total mortality showed a U shaped relation with systolic pressure and an inverse association with treated diastolic pressure. In both groups cardiovascular and non-cardiovascular mortality followed the same trends as total mortality. The increased mortality in the lowest thirds of pressure was not associated with an increased proportion of patients with cardiovascular complications at randomisation or with a fall in diastolic pressure exceeding the median fall in pressure in each group. In contrast, patients in the lowest thirds of pressure showed greater decreases in body weight and haemoglobin concentration than those in the middle and upper thirds of pressure. CONCLUSIONS--In patients taking active treatment total mortality was increased in the lowest thirds of treated systolic and diastolic blood pressures. This increased mortality is not necessarily explained by an exaggerated reduction in pressure induced by drugs as for diastolic pressure a U shaped relation also existed during treatment with placebo. In addition, patients in the lowest thirds of systolic and diastolic pressures were characterised by decreases in body weight and haemoglobin concentration, and the patients in the lowest thirds of diastolic pressure taking active treatment also by an increased non-cardiovascular mortality, suggesting some deterioration of general health. |
| Relation between the sensitivity of the taste analyzer and high blood pressure Zicha, J. and M. Novotny (1986), Vnitr Lek 32(7): 642-6. |
| Relation of abdominal obesity to hyperinsulinemia and high blood pressure in men Johnson, D., D. Prud'homme, et al. (1992), Int J Obes Relat Metab Disord 16(11): 881-90. Abstract: The relationships between body fatness, adipose tissue distribution, plasma glucose, insulin levels, lipoprotein levels, and resting blood pressure were studied in 81 men aged 36.0 +/- 3.3 years (mean +/- s.d.) (body mass index (BMI): 27.4 +/- 3.8 kg/m2, percentage body fat: 26.4 +/- 6.6%). Systolic and diastolic blood pressures (BP) were significantly associated with the BMI (r = 0.31, r = 0.33, P < 0.01), the waist circumference (r = 0.33, r = 0.27; P < 0.01) as well as with adipose tissue areas measured by computerized tomography (CT) (0.27 < or = r < or = 0.36, P < 0.01). Furthermore, the relative accumulation of subcutaneous abdominal fat, as estimated by the ratio of abdominal to femoral adipose tissue areas measured by CT, was positively correlated with systolic and diastolic BP (P < 0.01). Fasting plasma insulin level (r = 0.30, P < 0.01) as well as the insulin area measured during an oral glucose tolerance test (0.34 < or = r < or = 0.37, P < 0.01) were significantly correlated with blood pressure. Systolic and diastolic BP were significantly associated with HDL2-cholesterol (C) as well as with the HDL2-C/HDL3-C ratio (-0.24 < or = r < or = -0.34), whereas triglycerides (r = 0.23) and the HDL-C/C ratio (r = -0.23) were significantly correlated with diastolic BP only (P < 0.05). Multivariate analysis indicated that the insulin area was the most important variable associated with blood pressure and that this association was independent of total body fatness and regional adipose tissue distribution. Plasma insulin levels explained 14% and 11% of the variance observed in the systolic and diastolic blood pressures respectively. These results suggest that most of the association between abdominal obesity and high blood pressure is mediated by the hyperinsulinemia and/or the related insulin resistant state. |
| Relation of diurnal blood pressure variation and triglyceride-to-high-density lipoprotein cholesterol ratio in patients without diabetes mellitus Davidson, M. B., D. G. Vidt, et al. (2005), Am J Cardiol 95(1): 123-6. Abstract: A night-time decrease in systolic blood pressure that differs <10% from mean daytime values ("nondipping") is associated with increased rates of cardiovascular morbidity and mortality. We hypothesized that insulin resistance would be associated with nondipping in patients who did not have frank diabetes mellitus or hypertension. We included 106 consecutive outpatients who had been referred for 24-hour ambulatory monitoring of blood pressure. Our data suggest that insulin resistance, defined as a high ratio of triglyceride to high-density lipoprotein, is associated with blunted diurnal blood pressure variation (odds ratio 6.3, 95% confidence interval 2.6 to 16.4, p <0.0001) before the development of abnormal levels of fasting blood glucose. |
| Relation of essential hypertension to sodium chloride. I. Clinical & experimental animal experiments on the dependence of high blood pressure in essential hypertension on the quantity of sodium chloride; salt water hypertension in rats. Fungers, A., K. Kaiser, et al. (1958), Dtsch Arch Klin Med 204(5): 603-23. |
| Relation of essential hypertension to sodium chloride. II. Clinical & experimental animal experiments on the dependence of high blood pressure caused by sodium chloride or its separated sodium & chloride ions in essential hypertension & in salt water hypertension in rats. Fungers, A., K. Kaiser, et al. (1958), Dtsch Arch Klin Med 204(5): 624-36. |
| Relation of high blood pressure to glucose intolerance, plasma lipids and educational status in an Arabian Gulf population Al-Mahroos, F., K. Al-Roomi, et al. (2000), Int J Epidemiol 29(1): 71-6. Abstract: BACKGROUND: In Bahrain and other populations of the Arabian Peninsula, glucose intolerance is associated with raised plasma total cholesterol, postmenopausal status and low educational status. These associations are not generally seen in other populations with high diabetes prevalence. A study was undertaken in order to determine if hypertension in Bahrainis is associated with the same factors as those related to glucose intolerance. METHODS: A cross-sectional survey of 2120 Bahrainis aged 40-69 years. RESULTS: The age-adjusted prevalence of hypertension (defined as current treatment for hypertension, systolic blood pressure > or = 160 mmHg or diastolic blood pressure > or = 95 mmHg) rose with increasing degrees of glucose intolerance. Age- and sex-standardized prevalence of hypertension was 21% (95% CI: 19-24%) in those with normal glucose tolerance, 31% (95% CI: 27-36%) in those with impaired glucose tolerance, and 38% (95% CI: 34-42%) in those with diabetes. In a multivariate analysis adjusting for age and sex, raised blood pressure was independently associated with waist girth, plasma cholesterol, glucose intolerance, family history of hypertension and (in women) postmenopausal status. There was an inverse relationship between blood pressure and educational status that was independent of other variables. This association parallels the inverse relationship of diabetes to educational level and is consistent with low educational level being a marker for socioeconomic deprivation in early life in this population. CONCLUSION: The high prevalence rates of hypertension and diabetes in Bahrainis are manifestations of a pattern of metabolic disturbances that includes raised plasma cholesterol levels. Both hypertension and diabetes are associated with low educational status, which in this population is a marker for socioeconomic deprivation in early life. This suggests that the risk of hypertension may be set by environmental factors in early life. |
| Relation of high blood pressure to headache, epistaxis, and selected other symptoms. The United States Health Examination Survey of Adults Weiss, N. S. (1972), N Engl J Med 287(13): 631-3. |
| Relation of high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-alpha, and fibrinogen to abdominal adipose tissue, blood pressure, and cholesterol and triglyceride levels in healthy postmenopausal women Piche, M. E., S. Lemieux, et al. (2005), Am J Cardiol 96(1): 92-7. Abstract: The associations of inflammatory markers (high-sensitivity C-reactive protein hs-CRP, interleukin-6 IL-6, tumor necrosis factor-alpha, and fibrinogen) with anthropometric and metabolic variables were examined in a sample of 112 postmenopausal women not receiving hormone therapy. Body fat distribution was measured by computed tomography, and insulin sensitivity was determined by an euglycemic-hyperinsulinemic clamp. hs-CRP (0.10 < or = r(2) < or =0.37) and IL-6 (0.06 < or = r(2) < or =0.31) were significantly associated with anthropometric and metabolic variables, including visceral and subcutaneous adipose tissue, systolic and diastolic blood pressure, triglycerides, high-density lipoprotein (HDL) cholesterol, and insulin sensitivity (p <0.05). Women with greater hs-CRP concentrations showed deterioration in their metabolic risk profiles, including abdominal obesity, greater triglyceride and lower HDL cholesterol concentrations, and lower insulin sensitivity compared with women with lower hs-CRP levels. Fifty-nine percent of women with high hs-CRP concentrations had the metabolic syndrome as recently defined by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. After adjustment for visceral adipose tissue, most of the differences in the plasma lipid-lipoprotein profile were eliminated between women with high hs-CRP levels and women with low hs-CRP levels, whereas some differences in blood pressure variables, insulin sensitivity, and inflammatory markers (IL-6 and fibrinogen) remained significant. In conclusion, these results suggest that increased visceral adipose tissue levels appear to be a determinant covariable of the association between high hs-CRP concentrations and alteration in the metabolic profile. |
| Relation of urinary sodium excretion to blood pressure, glucose metabolism, and lipid metabolism in residents of an area of Japan with high sodium intake Kawamura, M., Y. Kimura, et al. (1997), Hypertens Res 20(4): 287-93. Abstract: To evaluate the effects of prolonged intake of a high-sodium diet on glucose and lipid metabolism, we examined the relation of daily urinary sodium excretion to blood pressure, glucose metabolism, and lipid metabolism in 140 Japanese adults who lived in a region where the average daily consumption of sodium was high and stable during the past 15 yr; no subject had received any treatment for hypertension or metabolic disorders. Each subject was admitted to our health examination center for 2 d for measurement of blood pressure, sampling of blood, and glucose tolerance testing. A 24-h urine specimen was collected by each subject after discharge. Multiple regression analysis revealed that urinary sodium excretion was significantly independent of the mean blood pressure and was unrelated to the area under the serum glucose curve after glucose administration. The urinary sodium level was also unrelated to low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. The prevalence of hypertension in the group with a daily sodium excretion below 140 mEq (low sodium group) was 0%, while that in the group with a daily sodium excretion above 280 mEq (high sodium group) was 44%; this difference was significant (p < 0.01). No significant difference was observed in the prevalence of metabolic disorders between the two groups. Our results suggest that sodium intake has little influence on glucose and lipid metabolism but has a significant influence on blood pressure in normotensive and untreated hypertensive subjects who reside in an area with a relatively high sodium intake. |
| Relations of left ventricular geometry and function to body composition in children with high casual blood pressure de Simone, G., G. F. Mureddu, et al. (1997), Hypertension 30(3 Pt 1): 377-82. Abstract: To determine whether abnormal casual blood pressure (BP) is associated with left ventricular (LV) abnormalities in children, 190 6- to 11-year-old children (77 girls, 113 boys) were studied at a school site in Naples, Italy, by limited echocardiography and bioelectric impedance to calculate fat-free body mass (FFM). Single-visit BP measurements (defined as casual BP) were high (based on the Italian tables of BP) in 34 children (18%; 9 girls, 25 boys; 133+/-8/81+/-10 mm Hg) and obesity was present in 44 (23%; 15 girls, 29 boys). Sex- and age-independent risk of high casual BP value was 2.9-fold (odds ratio) greater in obese than in normal-weight children (95% confidence interval, 1.3 to 6.5; P<.01). LV mass (as both absolute value and normalized for height or FFM) was higher and relative wall thickness increased in children with high casual BP (all P<.01). Prevalence of LV hypertrophy was 21% among children with high casual BP (P<.004 versus 4.3% in normal group). Risk of LV hypertrophy was 5.5-fold higher in the presence of high casual BP (P<.004), whereas obesity, age, and sex did not have independent effects. Endocardial shortening was slightly higher in children with high casual BP (36.8+/-8.2%) than in children with normal BP (34.3+/-4.8%, P<.02), whereas midwall shortening was identical in the two groups (20%). Both endocardial shortening and midwall shortening were negatively related to end-systolic stress (r=-.62, SEE=3.8% and r=-.32, SEE=2.4% in normal children). Shortening as a percentage of predicted from wall stress was increased in children with high casual BP at the endocardial level (P<.001), whereas it was normal at the midwall. Therefore, (1) casual detection of high BP in school children is associated with LV geometric abnormalities similar to those found in adults with sustained hypertension (LV hypertrophy, concentric pattern); (2) similar to in adult hypertension, endocardial chamber function in children is supranormal; and (3) in contrast to findings in adults, midwall shortening is normal in children with high casual BP. |
| Relationship between development of hypertension and a family history of high blood pressure in urban residents-analysis based on results of annual health examinations, 1984 to 1998 Kikukawa, N. (2004), Nippon Koshu Eisei Zasshi 51(10): 833-44. Abstract: Relationship between development of hypertension and a family history of high blood pressure in urban residents-analysis based on results of annual health examinations, 1984 to 1998. OBJECTIVE: To clarify the relationship between development of hypertension and a family history of this condition in urban residents. METHODS: Findings from a 15-year follow-up study of annual health examinations carried out in a community adjoining Osaka city, from 1984 to 1998, were analyzed. Any person who indicated in a self-administered questionnaire that they had either a parent or a sibling with hypertension was considered as having a family history of hypertension. RESULTS: In each year analyzed, mean systolic and diastolic blood pressure, by both sex and age group, was generally higher for those with a family history of hypertension than those without. We examined the proportion of people with such a family history and found that among those who received examinations for 5 consecutive years, the number of times at which the proved normotensive was generally lower than in the control group. When we looked at the odds ratio for hypertension according to combinations of family history, obesity, and use of alcohol, those with all three risk factors had the largest values in each year, followed by those with a family history plus obesity, but without drinking. The population attributable risks were 6.6%-16.0% for family history in men and 6.6%-18.4% in women, 6.0%-18.1% and 9.0%-25.2% for obesity and 3.5%-29.4% and 0.3%-4.0% for drinking. These results show that the tree-distributions of normotensiven (optimal, normal, high-normal) were normotensive overall the first time (1984), and for those who received examinations in 1993 and 1998, hazard ratios with a positive family history were higher than with a negative family history. CONCLUSIONS: The main new findings of this study are that the incidence of hypertension is significantly higher in people with a family history of the disease than in those without, and looking at odds ratios for population attributable risk, family history proved to be a factor almost as important for high blood pressure as obesity and drinking. The results indicate family history is a significant risk factor for hypertension. |
| Relationship between leucocyte sodium content and high blood pressure during development and resolution of pre-eclampsia Seon, R. and T. Forrester (1989), Clin Sci (Lond) 76(2): 199-203. Abstract: 1. One hundred and five primigravidae were followed sequentially at 4-weekly intervals starting at gestational week 31. They were seen again at 6 weeks post partum. 2. At each visit measurements were made of blood pressure as well as of leucocyte and erythrocyte sodium and potassium content. 3. Eighty-five subjects completed the study. Seven developed pre-eclampsia. 4. In both controls and patients who developed pre-eclampsia, leucocyte and erythrocyte sodium content increased with gestational age and fell post partum. These changes were of greater magnitude in the patients with pre-eclampsia. Cell potassium fell in both groups, but to a greater extent in patients with pre-eclampsia. 5. These changes in cell sodium paralleled those in blood pressure in both groups. 6. These data suggest that the excessive blood pressure changes in pre-eclampsia might be related to similar changes in cell sodium content. |
| Relationship between medical treatment compliance and the degree of control in patients with high blood pressure, non-insulin dependent diabetes mellitus and dyslipidemia Pineiro, F., V. Gil, et al. (1998), Med Clin (Barc) 111(15): 565-7. Abstract: BACKGROUND: To study the relationship between therapeutic compliance and the control of arterial hypertension, non insulin dependent diabetes mellitus and hyperlipidemia. PATIENTS AND METHODS: Prospective study performed on 174 hypertensive patients, 107 with diabetes and 107 with hyperlipidemia evaluating compliance by counting of tablets in two home visits. RESULTS: 34% hypertensive patients, 20% diabetics and 37% hyperlipidemics that took medication as instructed or more than they should were badly controlled. CONCLUSIONS: The control grade of high blood pressure, non insulin dependent diabetes mellitus and hyperlipidemia not only depends on improving compliance but also in adapting pharmacologic prescriptions. |
| Relationship between socio-demographic and behaviour variables, and body mass index in a population with high-normal blood pressure: Hypertension Prevention Trial Shah, M., R. W. Jeffery, et al. (1989), Eur J Clin Nutr 43(9): 583-96. Abstract: The relationship between socio-demographic and behaviour variables and body mass index (BMI: weight/height2) adjusted for age were studied in a population with high-normal blood pressure who participated in the Hypertension Prevention Trial. The BMI of the participants ranged from 19.1 to 35.1 kg/m2 in men and from 16.0 to 35.1 kg/m2 in women. The prevalence of obesity (BMI greater than or equal to 25.0 kg/m2) was 77 per cent in men and 61 per cent in women, with prevalence of severe obesity (BMI greater than or equal to 30.0 kg/m2) being 23 per cent and 19 per cent respectively. Stepwise regression was carried out to identify the most important correlates of BMI. In men, they were family income (+), occupation (-), leisure time exercise frequency (-), number of meals eaten out (-), alcohol intake (-), smoking (-), caffeinated drink intake (+), and meal planner. Men who planned meals with their partners had a higher BMI than men who planned their own meals or had someone else plan their meals. Correlates of little importance were marital status, race, education, number of members in household, energy intake, percentage of total calories from fat, occupation activity level, and vitamin/mineral supplement intake. In women the most important correlates of BMI were alcohol intake (-), caffeinated drink intake (+), and race. Black women had a higher mean BMI than white women. The important socio-demographic and behaviour variables in both men and women accounted for about 20 per cent of the variance in BMI which leaves about 80 per cent of the variation unexplained. This indicates the presence of other factor(s) which may be determining body weight. |
| Relationship between the genetic and the ecologic factor in the determination of high blood pressure Steinbach, M., M. Constantineanu, et al. (1975), Med Interne 13(4): 261-3. |
| Relationship of alcohol and illicit drug use with high blood pressure care and control among urban hypertensive Black men Kim, M. T., C. R. Dennison, et al. (2000), Ethn Dis 10(2): 175-83. Abstract: OBJECTIVE: To examine the relationships among alcohol and illicit drug use and high blood pressure (HBP) care and control. DESIGN: Baseline cross-sectional data from an ongoing clinical trial evaluating the effectiveness of a HBP care program was utilized. METHODS: Data collected at baseline on 309 urban hypertensive Black men, aged 18-54, included: socio-demographics, health status, HBP care behaviors, alcohol and illicit drug use, urine screen for illicit drug use, and blood pressure (BP). RESULTS: Men using alcohol and illicit drugs were less likely to report having medical insurance, having a doctor for HBP care, engaging in critical patient behaviors for HBP control, being on HBP medications, and compliance with HBP medication regimen. Alcohol and illicit drug users were more likely to eat high fat/high salt foods and significantly more likely to smoke cigarettes. In comparison to abstainers, men who used both alcohol and illicit drugs were significantly more likely to have uncontrolled BP and higher systolic blood pressure (SBP). CONCLUSIONS: Alcohol and illicit drug use were negatively associated with HBP care behaviors. Thus, BP was poorly controlled in this group of alcohol and illicit drug users. Screening, counseling, and treatment for alcohol and illicit drug use should be essential components in comprehensive HBP care. |
| Relationship of casual blood pressure to smoking, education and occupation in a high density town near Harare, Zimbabwe Siziya, S., T. Marufu, et al. (1995), Cent Afr J Med 41(7): 219-24. Abstract: An analysis is presented on associations of smoking, education and occupation with blood pressure among residents of a high density town near Harare, Zimbabwe. A total of 973 persons aged five years and above were surveyed in 1993. Obesity was significantly (p < 0.001) correlated with blood pressure (systolic or diastolic). A significant linear relationship between blood pressure and age for each sex was observed (p < 0.001). Smoking was not associated with blood pressure in both sexes. There was little evidence to suggest that education was associated with systolic blood pressure in both sexes. Meanwhile, there was strong evidence to suggest that education was associated with diastolic blood pressure in males and not in females. Mean differences in diastolic blood pressure levels between unemployed females and females in formal employment (mean difference (MD) = -7.57; standard error (SE) = 3.15; p < 0.05), in self employment (MD = -10.28; SE = 3.27; p < 0.01) and in school (MD = -6.57; SE = 3.06; p < 0.05) were statistically significant. We suggest that further studies utilizing longitudinal data on the risk factors for hypertension be conducted. |
| Relationship of clinic, ambulatory, and laboratory stress blood pressure to left ventricular mass in overweight men and women with high blood pressure Sherwood, A., E. C. Gullette, et al. (2002), Psychosom Med 64(2): 247-57. Abstract: OBJECTIVE: This study was designed to evaluate the relationship between left ventricular (LV) mass and blood pressure (BP) recorded in the following contexts: in the clinic, using standard auscultatory procedures, during a typical day using ambulatory BP monitoring, and in the laboratory environment during behavioral stress testing. METHODS: Ninety-seven men and women with clinic systolic blood pressure (SBP) of 130 to 180 mm Hg and/or diastolic blood pressure (DBP) of 85 to 110 mm Hg and mild to moderate obesity were included in the study. Laboratory stressors included the following tasks: Public Speaking; Anger Interview; Mirror Trace; and Cold Pressor. LV mass was measured using echocardiography and adjusted for body size by dividing by height(2.7) to yield LV mass index (LVMI). RESULTS: LVMI was positively correlated with clinic SBP (r = 0.24, p <.05), ambulatory SBP (r = 0.34, p <.01), and aggregated laboratory stress SBP (r = 0.28, p <.01). Of the individual stressors, only SBP responses to the Mirror Trace and Cold Pressor tasks were independently correlated with LVMI (r = 0.35 and 0.34, respectively, p values <.01). Hierarchical regression analyses revealed that laboratory stress SBP remained a significant predictor of LVMI, after controlling for BMI and clinic pressure. CONCLUSIONS: These findings suggest that cardiovascular responses to behavioral stress are associated with individual differences in LVMI in men and women with high blood pressure who are overweight. Laboratory studies of behavioral stress may help promote our understanding of the pathophysiology of LVH. |
| Relationship of parental history of high blood pressure to blood pressure: combined findings of three Japanese population samples, the INTERSALT study Naruse, Y., H. Nakagawa, et al. (1998), J Hum Hypertens 12(4): 215-20. Abstract: The relationship of parental history of high blood pressure (HBP) to blood pressure (BP) was estimated in three Japanese population samples, totalling 591 men and women aged 20-59 years, from the INTERSALT study. Parental history of HBP was defined as reported HBP by their father and/or mother. With adjustment for antihypertensive medication, body mass index, alcohol intake, and Na/K ratio in 24-h urine, for participants with a parental history of HBP compared to those without a history, BP was higher for three to four age-sex strata, both for systolic and diastolic pressure (SBP, DBP), by 3.3 to 6.8 and 2.7 to 5.5 mm Hg respectively, with four of these six positive associations statistically significant. This finding was stronger for persons aged 40-59 than for those aged 20-39. These data support the judgment that for persons with a parental history of HBP, BP is apt to increase more with age due to combined effects of genetic and environmental factors. Such people especially need to control their lifestyles carefully, including to maintain an optimal intake of salt (eg, <70 mmol/day) and a high potassium intake, to avoid high alcohol consumption, and keep weight moderate, for the prevention of hypertension. |
| Relationship of tachycardia with high blood pressure and metabolic abnormalities: a study with mixture analysis in three populations Palatini, P., E. Casiglia, et al. (1997), Hypertension 30(5): 1267-73. Abstract: Faster resting heart rate has been shown to be associated with a higher risk of developing hypertension and a greater incidence of cardiovascular morbidity and mortality. The aim of this study was to investigate the distribution of heart rate and its relationship with blood pressure and other cardiovascular risk factors in three populations. One European general population (Belgian study), one North American general population (Tecumseh study), and one European hypertensive population (HARVEST trial) were studied. Within each population, mixture analysis was used to investigate whether a mixture of two normal distributions explained the variance in heart rate better than a single distribution. In the men of all populations, mixture analysis identified a larger subpopulation of subjects with normal heart rate and a smaller one with fast heart rate. The subgroups with tachycardia had higher blood pressure and lipid levels than those with normal heart rate. In the populations in which they were measured, fasting insulin and postload glucose were also higher in the men with faster heart rate. A subgroup with tachycardia could also be singled out among the women from Tecumseh, but no relation between heart rate and blood pressure could be found. These findings show that in Western societies, high heart rate pertains to a distinct subgroup of subjects, who are more frequently men and exhibit the characteristic features of the insulin resistance syndrome. Sympathetic overactivity is likely to be the mechanism underlying this clinical condition. |
| Relationship of the Trp64Arg polymorphism of the beta3-adrenoceptor gene to central adiposity and high blood pressure: interaction with age. Cross-sectional and longitudinal findings of the Olivetti Prospective Heart Study Strazzullo, P., R. Iacone, et al. (2001), J Hypertens 19(3): 399-406. Abstract: METHODS: The association of the Trp64Arg polymorphism of the beta3-adrenoceptor (beta3-AR) gene with high blood pressure, central adiposity and other features of the metabolic syndrome was investigated in a large unselected sample of a white male working population in Southern Italy (n = 979). RESULTS: In the whole population, subjects heterozygous for the Trp64Arg mutation (11.2%) were not different from the homozygous Trp64Trp for any of the variables investigated. However, upon stratification for age, among men in the upper tertile of age (> 53 years), the Trp64Arg genotype was associated with higher waist: hip ratio (0.992 +/- 0.021 versus 0.982 +/- 0.037, P< 0.05), serum uric acid (6.34 +/- 1.50 versus 5.75 +/- 1.30 micromol/l, P < 0.05) and systolic blood pressure (144.3 +/- 19.4 versus 136.9 +/- 18.9 mmHg, P< 0.05) compared with the wild-type homozygotes. Accordingly, in the same age group, the carriers of Trp64Arg genotype were more often in the upper tertile of abdominal adiposity (69.7 versus 43.7%, P< 0.02) and serum uric acid (56.3 versus 34.8%, P < 0.02) and were more often hypertensive (68.6 versus 57.6%, P< 0.058) than the Trp64Trp homozygotes. No such differences were observed in younger age groups. No association was found with fasting serum insulin and the homeostasis model assessment (HOMA) index of insulin resistance. Furthermore, in a subgroup of 457 men for whom retrospective 20-year follow-up data were available, the variant genotype was associated with a higher probability of developing overweight (44.7 versus 27.0%, P < 0.05) and a trend to higher blood pressure (52.6 versus 38.4%, P = 0.09) over 20 years. CONCLUSION: We conclude that the Trp64Arg variant of the beta3-AR receptor predicts a greater tendency to develop abdominal adiposity and high blood pressure with advancing age. |
| Relationships between blood pressure, anthropometric characteristics and blood lipids in high- and low-altitude populations from Central Asia Fiori, G., F. Facchini, et al. (2000), Ann Hum Biol 27(1): 19-28. Abstract: We studied the relationships between blood pressure, anthropometric characteristics and blood lipids in 72 low altitude (LA) Uighurs (600 m), 91 LA-Kirghizs (900 m), 117 medium altitude (MA) Kazakhs (2100 m) and 94 high altitude (HA) Kirghizs (3200 m). All subjects were male and had a similar age (p = ns, ANOVA; range for all 374 subjects: 18-66 yr). Body weight (Wt), body mass index (BM1) and the sum of four skinfolds (4SF) were significantly lower in HA-Kirghizs than the remaining groups (p < 0.0005, p < 0.0005 and p < 0.05 respectively, ANOVA). However, no difference was found in body fat distribution as detected by waist:hip circumference (WHR) and triceps:subscapular skinfold ratios (TSR; p = ns, ANOVA). Stage 1 hypertension was detected in 18% of LA-Uighurs, 2% of LA-Kirghizs, 4% of MA-Kazakhs and 1% of HA-Kirghizs; stage 2 hypertension was detected in 2% of LA-Uighurs and none of the remaining groups; no subject had stage 3 hypertension (The Joint National Committee on Prevention. Detection, Evaluation and Treatment of High Blood Pressure 1997). Blood cholesterol (CH) and triglycerides (TG) did not differ between groups (p = ns, ANOVA). The relationships between systolic (SBP) or diastolic (DBP) blood pressure and age, Wt, BMI, 4SF, WHR, TSR, CH and TG were independent from altitude (p = ns, ANCOVA). In the pooled sample (n = 374), age explained 1 and 3% of SBP (p < 0.05) and DBP (p < 0.005) variance respectively, Wt was the best predictor of SBP and DBP explaining 11 and 10% of their variance respectively (p < 0.0001) and CH explained 5% of DBP variance (p < 0.0001). In conclusion, hypertension is more frequent in LA- than MA- and HA-subjects from Central Asia. However, anthropometric characteristics and blood lipids do similarly contribute to explain blood pressure in these subjects. |
| Relaxation therapy and high blood pressure Taylor, C. B., J. W. Farquhar, et al. (1977), Arch Gen Psychiatry 34(3): 339-42. Abstract: Thirty-one patients receiving medical treatment for essential hypertension were randomly distributed into three groups: (1) relaxation therapy, (2) nonspecific therapy, and (3) medical treatment only. The nonspecific therapy group spent the same amount of time with the therapists as the relaxation group but was not given a specific therapy. Blood pressures were measured at a different time and in a different place from the behavioral treatments. The relaxation therapy group showed a significant reduction in blood pressure postreatment compared with the nonspecific therapy and medical treatment only groups, even when those patients whose medication was increased were excluded from the data analysis. At follow-up six months post-treatment, the relaxation group showed a slight decrement in treatment effects, while both the nonspecific therapy and medical treatment only groups showed continued improvement; thus, there was not a significant difference between groups. |
| Relief of oedema and high blood-pressure by concentrated human salt-poor serum-albumin in Ellis type-II nephritis Edwards, A. G. (1957), Lancet 272(6968): 563-4. |
| Remarks on surgical treatment of high blood pressure. Mandl, F. (1951), Wien Med Wochenschr 101(22): 404-6. |
| Remission of high blood pressure reverses arterial potassium channel alterations Rusch, N. J. and A. M. Runnells (1994), Hypertension 23(6 Pt 2): 941-5. Abstract: Rat arterial muscle cells show an elevated Ca(2+)-dependent K+ efflux during the established phase of hypertension. This association of enhanced K+ efflux with high arterial pressure implies that changes of in vivo blood pressure can alter the level of K+ channel current in arterial membranes. We directly tested this hypothesis by comparing K+ current density between patch-clamped aortic muscle membranes of normotensive Wistar-Kyoto (WKY) rats, spontaneously hypertensive rats (SHR), and SHR treated with the angiotensin-converting enzyme inhibitor ramipril (3.5 mg/kg per day PO) to normalize blood pressure. Peak macroscopic K+ current was measured during progressive depolarizing steps (10 mV) from -60 and +60 mV in cells dialyzed with pipette solution containing 10(-6) mol/L calcium to amplify Ca(2+)-dependent K+ current. With the use of this approach, maximum K+ current density in aortic muscle membranes of untreated SHR was 2.6-fold higher than in untreated WKY rats (SHR, 31 +/- 3 pA/pF; WKY, 12 +/- 1 pA/pF) and was predominantly blocked by 2 mmol/L tetraethylammonium. K+ current density in SHR aortic membranes was unchanged after 1 week of ramipril therapy, but it was reduced 42% (to 18 +/- 1 pA/pF) after 2 weeks of treatment. Parallel tension-recording studies showed that untreated SHR aortic segments but not aortic segments from WKY rats or ramipril-treated SHR constricted strongly after block of Ca(2+)-dependent K+ channels by tetraethylammonium. Our findings imply that Ca(2+)-dependent K+ current density in arterial muscle membranes shows a positive correlation with chronic arterial blood pressure levels.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Renal considerations in angiotensin converting enzyme inhibitor therapy: a statement for healthcare professionals from the Council on the Kidney in Cardiovascular Disease and the Council for High Blood Pressure Research of the American Heart Association Schoolwerth, A. C., D. A. Sica, et al. (2001), Circulation 104(16): 1985-91. |