| For medical practitioners and the general public - High Blood Pressure Journal Article Catalog. |
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| Renal function in the elderly: results from the European Working Party on High Blood Pressure in the Elderly trial de Leeuw, P. W. (1991), Am J Med 90(3A): 45S-49S. Abstract: Effects of antihypertensive treatment on renal function were analyzed in data from a prospective, double-blind investigation of 840 patients randomly assigned to placebo or to active treatment with a combination of triamterene and hydrochlorothiazide. Baseline serum creatinine levels were significantly and positively correlated to age, gender (higher in men), systolic blood pressure, and history of cardiovascular complications. During a five-year follow-up period, serum creatinine levels increased significantly in treated patients but not in placebo patients. Five patients died of renal causes (one in the placebo group, four in the treated group), and five patients dropped out of the study because of an increase in serum creatinine of more than 100% (four received active treatment). The incidence of renal complications in the hypertensive elderly is small. The current data do not support the hypothesis that renal deterioration can be prevented by antihypertensive treatment. |
| Renal high-dose extracorporeal shock wave treatment (ESWT) raises blood pressure in borderline hypertensive rats Weber, C., U. Gluck, et al. (1994), Investig Urol (Berl) 5: 107-10. |
| Renal reserve in patients with high blood pressure Gabbai, F. B. (1995), Semin Nephrol 15(5): 482-7. Abstract: The mechanism by which hypertension produces renal damage remains poorly defined. Experimental evidence suggests that glomerular hypertension/hyperfiltration constitutes a potential mechanism by which hypertension leads to chronic renal failure. Renal functional reserve has been used to investigate the presence or absence of hyperfiltration, both in experimental animals and humans. Micropuncture studies using the two-kidney, one-clip hypertension model have shown that glomerular hypertension/hyperfiltration is associated with loss of renal functional reserve. However, loss of renal functional reserve in this experimental model is not always indicative of hyperfiltration because some antihypertensive agents (Verapamil, Losartan) correct glomerular hypertension/hyperfiltration, but do not restore renal reserve. Renal reserve has also been evaluated in patients with essential hypertension. Some investigators have shown that hypertension is associated with loss of renal functional reserve which can be restored in some studies with antihypertensive therapy. However, normal renal reserve has also been shown in hypertensive patients. Altogether, these data suggest that renal functional reserve cannot be used to assess the role of hemodynamic mechanisms in hypertension-induced renal injury. Long-term follow-up studies are required to establish if loss of renal reserve is indicative of risk factors leading to renal failure in patients with systemic hypertension. |
| Reninoma: a rare but curable cause of high blood pressure, a case report Leogite, J., F. Schillo, et al. (2003), Ann Endocrinol (Paris) 64(3): 198-201. Abstract: We report a case of a renin secreting tumor, which is a very rare cause of secondary high blood pressure. A 22-year-old woman was hospitalised for exploration of high blood pressure (160/110 mmHg) with severe hypokaliemia (2,7 mmol/l) and secondary hyperaldosteronism. Physical examination was normal except the high blood pressure. Bioassays show increased kaliuresis (66 mmol/24h), plasma renin (89 pg/ml in clinostastism--108 pg/ml in orthostatism), pro-renin (1207 pg/ml in clinostastism--1412 pg/ml in orthostatism) and aldosterone (210 pg/ml in clinostastism--566 pg/ml in orthostatism). The rest of the endocrine tests were normal (cortisol and ACTH at 8:00 am, urinary free cortisol, overnight 1 mg dexamethasone suppression test). Doppler ultrasound method, performed by an experienced radiologist, did not show renal artery stenosis. Abdominal computerized tomography showed a nodular formation at the upper pole of the right kidney, isodense to renal medullary. The size tumor was 15 mm. The renal vein sampling shows high values of renin on both sides whereas, for the pro-renin, the values were higher on the tumor side. In spite of treatment with CEI (Converting Enzyme Inhibitors) and calcium antagonists, the blood pressure was not controlled. Hypokaliemia persisted (3 mmol/l) in spite of high daily potassium intake (64 mmol/l of potassium chloride). After tumor resection, reninoma was diagnosed by the pathology examination and blood pressure, plasma rennin, plasma aldosterone level returned to normal. |
| Renovascular disease and high blood pressure Carr, A. A. (1975), J Med Assoc Ga 64(7): 272-7. |
| Reply from the SBU about salt and high blood pressure: More controlled long-term trials are required Halldin, M., P. Hjemdahl, et al. (2004), Lakartidningen 101(51-52): 4257. |
| Research on high blood pressure Amery, A., R. Fagard, et al. (1977), Acta Clin Belg 32(3): 161-2. |
| Research profile. High blood pressure in type 2. A new culprit? Kieren J. Mather, MD Kordella, T. (2003), Diabetes Forecast 56(8): 81-3. |
| Research strategies in the genetics of high blood pressure Sharma, A. M., A. Distler, et al. (1994), Dtsch Med Wochenschr 119(20): 742-6. |
| Resistance to insulin-stimulated glucose uptake and hyperinsulinemia: role in non-insulin-dependent diabetes, high blood pressure, dyslipidemia and coronary heart disease Reaven, G. M. (1991), Diabete Metab 17(1 Pt 2): 78-86. Abstract: Patients with impaired glucose tolerance (IGT) and Type 2 diabetes have been shown to be more resistant to insulin-stimulated glucose uptake than individuals with normal glucose tolerance. Evidence has also been published showing that first degree relatives of patients with Type 2 diabetes are insulin resistant when compared to a matched group of relatives of subjects with normal glucose tolerance. In addition, it has recently been shown that the ability of insulin to stimulate glucose uptake varies approximately four-fold in individuals with normal glucose tolerance, and insulin resistance of a degree comparable to that seen in patients with IGT or with Type 2 diabetes is present in a significant portion of the normal population. Given a defect in insulin-stimulated glucose uptake, glucose tolerance can only be maintained if insulin resistant individuals continue to secrete greater than normal amounts of insulin. As a corollary, glucose homeostasis will decompensate when the insulin secretory response begins to fall, and the greater the decline in insulin secretion, the larger the rise in plasma glucose concentration. The net result of these changes is that plasma glucose and insulin response will be positively correlated within a population composed of glucose tolerant individuals and patients with IGT or Type 2 diabetes in the absence of significant fasting hyperglycemia. On the other hand, the relationship between plasma insulin and glucose concentration will be negatively correlated in patients with Type 2 diabetes and varying degrees of fasting hyperglycemia.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Respiratory sleep disorders and high blood pressure Fletcher, E. C. (1997), Cardiologia 42(5): 469-79. |
| Response to high blood pressure screening and referral by medical students in rural communities Blankenship, B. and A. D. Barnett, Jr. (1984), J Tenn Med Assoc 77(2): 82-6. |
| Response to the Advisory Statement from the Council for high blood pressure research of the American Heart Association advocating retention of mercury sphygmomanometers O'Brien, E. (2001), Hypertension 38(4): E19-20. |
| Response: High Blood Pressure in Acute Stroke and Subsequent Outcome: A Systematic Review Willmot, M., J. Leonardi-Bee, et al. (2004), Hypertension |
| Responses of blood pressure and catecholamine metabolism to high salt loading in endothelin-1 knockout mice Morita, H., H. Kurihara, et al. (1999), Hypertens Res 22(1): 11-6. Abstract: The molecular mechanism responsible for salt sensitivity is poorly understood. Mice heterozygous for the null mutation of the endothelin-1 (ET-1) gene, Edn1, may be a potential tool for studying this mechanism, because they have elevated blood pressure and disturbances in central sympathetic nerve regulation. In the present study, we used this mouse model to examine the degree to which ET-1 contributes to the responses of blood pressure and catecholamine metabolism to high salt loading. Male Edn1+/- heterozygous mice and Edn1+/+ wild-type littermates were given either a high salt (8%) or a normal salt (0.7%) diet for 4 wk. During the normal diet, renal ET-1 levels in Edn1+/- mice were approximately 50% lower than ET-1 levels in wild-type mice, whereas the high salt diet decreased renal ET-1 levels by about 50% in both Edn1+/- and wild-type mice. The high salt diet significantly increased urinary sodium excretion and fractional excretion of sodium (FENa) but did not affect circulating plasma volume, serum electrolytes, creatinine clearance, or systemic blood pressure. In addition, urinary norepinephrine and normetanephrine excretion were significantly increased, indicating that salt loading can increase sympathetic nerve activity in normal mice. These responses to salt loading did not differ between Edn1+/- mice and their wild-type littermates. We conclude that physiological changes in ET-1 production do not affect the responses of blood pressure and catecholamine metabolism to salt loading, although the renal ET-1 content is decreased by salt loading. |
| Retinal circulation in high blood pressure Vannas, S. and C. Raitta (1968), Int Ophthalmol Clin 8(2): 291-335. |
| Review: simplifying dosing regimens appears to improve treatment adherence in patients with high blood pressure in ambulatory settings Clifford-Middel, M. (2004), Evid Based Nurs 7(4): 110. |
| Revision of guidelines for high blood pressure management: JNC IV. Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure Hill, M. N. and R. P. Russell (1988), Md Med J 37(9): 698-701. |
| Revision of guidelines for high blood pressure therapy Russell, R. P. (1984), Md State Med J 33(9): 692-3. |
| Risk factors for coronary artery disease and the use of neural networks to predict the presence or absence of high blood pressure Falk, C. T. (2003), BMC Genet 4 Suppl 1: S67. Abstract: BACKGROUND: The Framingham Heart Study was initiated in 1948 as a long-term longitudinal study to identify risk factors associated with cardiovascular disease (CVD). Over the years the scope of the study has expanded to include offspring and other family members of the original cohort, marker data useful for gene mapping and information on other diseases. As a result, it is a rich resource for many areas of research going beyond the original goals. As part of the Genetic Analysis Workshop 13, we used data from the study to evaluate the ability of neural networks to use CVD risk factors as training data for predictions of normal and high blood pressure. RESULTS: Applying two different strategies to the coding of CVD risk data as risk factors (one longitudinal and one independent of time), we found that neural networks could not be trained to clearly separate individuals into normal and high blood pressure groups. When training was successful, validation was not, suggesting over-fitting of the model. When the number of parameters was reduced, training was not as good. An analysis of the input data showed that the neural networks were, in fact, finding consistent patterns, but that these patterns were not correlated with the presence or absence of high blood pressure. CONCLUSION: Neural network analysis, applied to risk factors for CVD in the Framingham data, did not lead to a clear classification of individuals into groups with normal and high blood pressure. Thus, although high blood pressure may itself be a risk factor for CVD, it does not appear to be clearly predictable using observations from a set of other CVD risk factors. |
| Risk factors for high blood pressure among workers in French poultry slaughterhouses and canneries Ledesert, B., M. J. Saurel-Cubizolles, et al. (1994), Eur J Epidemiol 10(5): 609-20. Abstract: The aim of the present study is to examine the relationship between the working conditions of employees in the food industry and blood pressure. An epidemiological survey was conducted between 1987 and 1988 in 17 poultry slaughterhouses and 6 canneries in the French regions of 'Bretagne' and 'Pays de Loire'. One thousand, four hundred and seventy-four workers were included in the study. Data was collected in the course of the medical visit organized annually for employees. Mean diastolic (DBP) and systolic blood pressure (SBP) were analyzed separately for male and female workers. The results indicate a significant relationship between blood pressure, and age and obesity. Amongst the various features of working condition studies, loud noise and the number of work breaks were found to be associated with heightened mean values of DBP or SBP in men only. Type and size of the factory was found to be associated with blood pressure readings for both sexes. A number of working conditions giving rise to heightened mental strain were found to be related to a lowering in mean blood pressure: for example, irregular work finishing times for men and production-line work for women. A discussion of these results reveals the complexity of the relationships which exist between physical and environmental factors in this type of setting and blood pressure of employees. |
| Risk markers and high blood pressure. The Cienfuegos global project. Longitudinal study 1992-1994 Alvarez Li, F. C., A. D. Espinosa Brito, et al. (1999), Rev Invest Clin 51(3): 151-8. Abstract: OBJECTIVE: To determine the significance of the selected risk markers in the development of high blood pressure in a relatively short period of time. DESIGN: Longitudinal or cohort study of a sample of a population from the municipality of Cienfuegos, as a second measurement of the Cienfuegos Global Project. CONTEXT: Community. Municipality of Cienfuegos; geographic area of the subject-object intervention-investigation of the Cienfuegos Global Project. SUBJECT: 1,369 adults aged 15 years of more (619 men and 750 women; 1,294 alive and 75 dead) were followed from January 1992 to February 1994, which constitutes an alleatory, stratified, equiprobabilistic sample by age and sex. Persons diagnosed as hypertensive in the initial evaluation of Cienfuegos Global Project were excluded, so that the new series for hypertensive patients was constituted by 731 individuals with 125 new patients when the risk markers age, sex, color of skin, family history of high blood pressure, salt consumption, sedentarism, alcoholism and tobaccoism were studied. The association of the risk markers hypercholesterolemia or risky cholesterolemia and obesity was studied with another series formed by a second sample of 417 individuals, this sample introduced 74 new cases of high blood pressure. MAIN OUTCOME: It was intended to estimate the odds ratio for high blood pressure for the different risk markers studied, in those patients exposed or not to them. RESULTS: The odds ratio for each of the risk markers was determined. The odds related to age increased from 1.37, to 1.86 in males and decreased to 0.64 in white individuals. These 3 results were statistically significant as risk markers for high blood pressure. The odds ratio for the remaining risk markers had no statistical significance. CONCLUSION: The age, male sex, and black race, in the comparatively short term--slightly over two years--are the main risk markers that will markedly favor the appearance of high blood pressure. |
| Risk of high blood pressure in salt workers working near salt milling plants: a cross-sectional and interventional study Haldiya, K. R., M. L. Mathur, et al. (2005), Environ Health 4: 13. Abstract: BACKGROUND: Workers working close to salt milling plants may inhale salt particles floating in the air, leading to a rise in plasma sodium, which, in turn, may increase the blood pressure and the risk of hypertension. METHODS: To test the above hypothesis, occupational health check-up camps were organized near salt manufacturing units and all workers were invited for a free health examination. The workers who worked with dry salt in the vicinity of salt milling plants were defined as "non-brine workers," while those working in brine pans located far away from milling plants were defined as "brine workers." Blood pressure (BP) was measured during each clinical examination. In all, 474 non-brine workers and 284 brine workers were studied. RESULTS: Mean systolic blood pressure of non-brine workers (122.1 +/- 13.3 mm Hg) was significantly higher than that of brine workers (118.8 +/- 12.8 mm Hg, p < 0.01). Mean diastolic blood pressure of non-brine workers (71.5 +/- 10.4 mm Hg) was significantly higher than that of brine workers (69.7 +/- 9.4 mm Hg, p = 0.02). The prevalence of hypertension was significantly higher in non-brine workers (12.2%) than in brine workers (7.0%, p = 0.02). Nineteen salt workers were monitored while they used face masks and spectacles, for six days. Systolic, as well as diastolic, blood pressure of these workers began declining on the third day and continued to decline on the fourth day, but remained stationary up to the sixth day. The concentration of salt particles in the breathing zone of these workers was 376 mg/m3 air. CONCLUSION: Inhalation of salt particles in non-brine workers may be an occupational cause of increased blood pressure. |
| Risks and benefits in the trial of the European Working Party on High Blood Pressure in the Elderly Fletcher, A., A. Amery, et al. (1991), J Hypertens 9(3): 225-30. Abstract: Hypertensive patients over the age of 60 years were admitted to a double-blind placebo-controlled trial. Patients in the actively treated group received a combined potassium-losing and -sparing diuretic (triamterene 50 mg plus hydrochlorothiazide 25 mg; n = 416); this dose could be doubled and methyldopa (up to 2 g, daily) was added in 35% of patients when blood pressure remained high. The placebo group (n = 424) received matching capsules and tablets. Adverse effects were assessed in the double-blind period of the trial by calculating the incidence of abnormal biochemical results, investigator reports of diseases and prescriptions of concomitant therapy and a self-administered symptom questionnaire completed by patients. In 1000 hypertensive subjects over 60 years of age, 1 year of active treatment would prevent 11 fatal cardiac events, 6 fatal and 11 non-fatal strokes and 8 cases of severe congestive heart failure. No unexpected adverse treatment effects were observed. A significant excess incidence rate (per 1000 person years) was found in the active group compared with placebo for: (1) impaired renal function, a serum creatinine greater than 180 mumol/l (2.0 mg/dl); (2) mild hypokalaemia, a serum potassium less than 3.5 mmol/l; (3) reports of gout; and (4) an elevated serum uric acid greater than 0.52 mmol/l in men or greater than 0.46 in women. Elevated blood sugar and prescriptions for hypoglycaemic drugs tended to be more frequent in the actively treated group, but this difference was not statistically significant. In both groups, there was a low incidence (less than 7 per 1000 person years) of anaemia and depression and diseases of the liver, gall bladder or pancreas.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Risky high blood pressure, lipid and blood glucose values. Are blood pressure patients underserved? Hense, H. W. (2001), MMW Fortschr Med 143(48): 26-8. Abstract: It is now generally accepted that the prognostic relevance of diastolic and systolic blood pressures varies with age. The probable explanation for this is considered to be the age-related hemodynamic changes in central and peripheral arteries. An analysis of 47,000 hypertensives reveals that a therapeutic strategy focused merely on lowering elevated blood pressure is inadequate. Since most hypertensives have multiple risk factors that are readily identifiable and treatable, a multifactorial therapeutic strategy is needed. Accordingly, modern treatment of hypertensives implies a predominant role for risk factor management. A European study on secondary prevention documents an unacceptably high prevalence of unhealthy lifestyles and poorly controlled blood pressure, lipid and glucose levels in patients with clinically diagnosed CHD. It is high time that scientific investigations be carried out to identify the reasons for the inadequate practical implementation of evidence-based preventive and therapeutic measures. It is to be expected that epidemiological investigations will help provide relevant data. |
| Role of ambulatory blood pressure measurement in the evaluation of the cardiovascular load in high altitude workers De Gaudemaris, R., M. Jalbert, et al. (1991), Arch Mal Coeur Vaiss 84(8): 1143-8. Abstract: This study evaluates ambulatory blood pressure ABP measurement as a technique for measuring the cardiovascular load in maintenance mechanics working on mechanical lifts at altitudes of over 2,500 meters (stress due to altitude and intensive static and dynamic work). METHOD: 25 normotensive workers were studied during real working conditions. Each subject underwent a maximal stress test, and echocardiography. An ABP recording (Spacelab 90207) with BP measurement every 15 minutes and continuous heart rate (HR) monitoring (Essilor IFC85), during 24 hours were performed on the same day. Analysis: study of BP levels and their factors of variation, comparison of this data with continuous HR measurements, and with results of the stress test and echocardiography. RESULTS: even in difficult conditions (while balancing on cables and cable towers), ABP measurements is possible (less than 10% missing values). Systolic (SBP) and diastolic (DBP) blood pressure and HR values adjusted for age are significantly higher during work activity (9:00-12:00, 14:00-15:00) in these subjects than in reference normotensive subjects. ABP did not differ significantly between different types of work while the equivalent mechanical load (work load that gives a stress test HR equal to the mean HR during work) reveals a different between work activities. At night SBP remains higher and HR values lower than in control subjects. In comparison with reference criteria, 3 subjects were considered as having an abnormally high ABP during the daytime. ABP results were not linked with number of years in the profession nor with the altitude at which the subject worked or lived. Although 40% of subjects have a left ventricular mass index greater than 135 g:m2, there is no link between ultrasound and ABP parameters. CONCLUSION: while ABP measurement seems possible in this type of professional activity, BP values do not appear to be correlated to work level measured. The absence of correlation with left ventricular mass, suggests that the process of cardiovascular adaptation is different from that in even moderately hypertensive subjects. |
| Role of optometrists in combatting high blood pressure Good, G. W. and A. R. Augsburger (1989), J Am Optom Assoc 60(5): 352-5. Abstract: To determine the contribution made by optometrists in blood pressure measurement and comanagement, a short survey was sent to all the optometrists licensed in Ohio. Of those responding, over 90% reported to routinely question their patients concerning blood pressure, while 72% reported to have blood pressure measuring equipment in their offices. Optometrists can continue to be strong members of the primary health care team by adhering to the recommendations delineated in the 1988 Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Practitioners should measure blood pressure at each patient visit, provide feedback to the patient concerning the findings, and follow the recommended follow-up criteria. |
| Role of salt sensitivity, blood pressure, and hyperinsulinemia in determining high upper normal levels of urinary albumin excretion in a healthy adult population Cubeddu, L. X., I. S. Hoffmann, et al. (2003), Am J Hypertens 16(5 Pt 1): 343-9. Abstract: BACKGROUND: The objective of this study was to investigate the role of blood pressure (BP), salt sensitivity (SS), and the cardiovascular metabolic syndrome in determining the urinary albumin excretion (UAE) in glucose-tolerant, normoalbuminuric (<20 mg/day) healthy adults. METHODS AND RESULTS: We evaluated 177 healthy subjects (age, 38.3 +/- 0.9 years; weight, 75.2 +/- 1.1 kg; body mass index, 28.8 +/- 0.4 kg/m(2); systolic BP, 117 +/- 1 mm Hg; diastolic BP, 77.5 +/- 0.8 mm Hg; UAE, 8.2 +/- 0.3 mg/24 h). Subjects with UAE levels of 15 to 20 mg/day had higher systolic BP, diastolic BP, and pulse pressures than those with UAE levels less than 15 mg/day (P <.0001). Hypertension (HT) and SS were more prevalent in the high normal UAE group (15 to 20 mg/day) than in groups with lower UAE (47% v 8% for HT and 67% v 24% for SS). In normotensives (n = 156), no differences in BP were observed among the different UAE strata; yet, the prevalence of SS was greater in the high (57%) compared to the low normal (17% to 21%) UAE groups. Similar levels of UAE, BP, and similar prevalence of SS were found in men with and without abdominal obesity, despite the fact that obesity was associated with hypertriglyceridemia and hyperinsulinemia. CONCLUSIONS: In healthy normoalbuminuric adults, high normal UAE is associated with SS in normotensives and with SS and higher BP in a mixed population (88% normotensive and 12% hypertensive). Abdominal obesity, hypertriglyceridemia, and hyperinsulinemia were not related to UAE. Therefore, UAE levels of 15 to 20 mg/day should be accepted as microalbuminuria, and these subjects may benefit from early intervention (ie, salt restriction and BP lowering). |
| Round table 2. A critique of the Fifth Joint National Committee Report on Detection, Evaluation and Treatment of High Blood Pressure Moser, M. (1993), J Hypertens Suppl 11(5): S384-8. |
| Salt and high blood pressure McGuffin, W. L., Jr. (1984), Ala J Med Sci 21(1): 20-5. |
| Salt, renal function and high blood pressure--reflections on a current issue Aurell, M. (2002), Lakartidningen 99(47): 4736-40. Abstract: The role of salt intake for blood pressure control has been discussed for a long time. A brief review is given of some pertinent physiological facts to explain this relationship and evolutionary aspects of renal function are emphasized. Salt intake is very high in the modern society, often as high as 15 g sodium chloride per 24 hours while 3-6 g may be more than enough to maintain an adequate salt balance. If the kidneys cannot cope with this severe sodium overload, blood pressure will rise. Therefore, the kidneys' ability to excrete sodium is a key factor and the salt excretion capacity is the kidneys' major barostatic function. As barostats, the kidneys control the blood pressure by ultimately determining the sodium excretion. Reducing sodium intake is, however, difficult as more than 50% of the intake is contained in the food we buy such as bread, sausages, canned food, chips and fast-food. Food products should therefore be "salt declared", but information on this aspect is generally lacking. If the population's salt intake could be reduced by 50%, the prevalence of hypertension will be much reduced, perhaps also by as much as 50%. The cost to society for treating hypertension would be reduced accordingly. Salt intake is also an important aspect of the overweight problem among today's youth. Salt and overweight impose great health risks later in life. Preventive measures in this area must be given high priority in future health care work. |
| Screen detected high blood pressure under 40: a general practice population followed up for 21 years Hart, J. T., C. Edwards, et al. (1993), Bmj 306(6875): 437-40. Abstract: OBJECTIVE--To assess hypertension detected under 40 in a general practice population. DESIGN--Prospective case-control study. SETTING AND SUBJECTS--Former coal mining community in south Wales. Systematic case finding for hypertension and associated risk factors applied to a mean total population of 1945 from age 20 on a five year cycle through 21 years. Mean population aged 20-39, 227 men and 213 women. Case criteria: age < 40 and mean systolic pressure > or = 160 mm Hg or diastolic pressure > or = 100 mm Hg. Age and sex matched controls randomly sampled from the same population. MAIN OUTCOME MEASURES--Mean initial pressures and pressures at follow up in 1989 or preceding death, and all cardiovascular events. RESULTS--25 men and 16 women met criteria. Estimated five yearly inceptions were 26/1000 for men and 18/1000 for women. Male group mean initial blood pressure was 164/110 mm Hg for cases, falling to 148/89 mm Hg at follow up. Five male cases died at mean age 47.8, compared with two controls at 49.5. Female group mean initial pressure was 172/107 mm Hg for cases, falling to 145/86 mm Hg at follow up. One female case died aged 50, no controls. 10 male cases had non-fatal cardiovascular events at mean age 40.2, compared with two controls at mean age 50.5. Four female cases had non-fatal events at mean age 47.2, compared with one control aged 58. Male differences were statistically significant. CONCLUSIONS--Hypertension under 40 is dangerous, commoner in men than women, rarely secondary to classic causes, and may be controlled in general practice on a whole community basis. |
| Screening for high blood pressure Schwartz, S. N. (1978), Bull Eleventh Dist Dent Soc 16(3): 14. |
| Screening for high blood pressure: a review of the evidence for the U.S. Preventive Services Task Force Sheridan, S., M. Pignone, et al. (2003), Am J Prev Med 25(2): 151-8. Abstract: CONTEXT: In 1996, the U.S. Preventive Services Task Force (USPSTF) recommended screening adults for hypertension. Since that time, the published literature on hypertension has expanded rapidly, necessitating a new examination of the evidence supporting screening. OBJECTIVE: Update the 1996 evidence review on screening for hypertension. DATA SOURCES: The 1996 Guide to Clinical Preventive Services, recent systematic reviews, and focused searches of MEDLINE were used to identify new evidence relevant to detecting and treating hypertension. STUDY SELECTION: When a good quality, recent systematic review was available, it was used to summarize previous research; MEDLINE was searched only for more recent articles. Two authors reviewed abstracts (and full texts, if necessary) of potentially relevant articles to determine if they should be included. DATA EXTRACTION: One author extracted data from included studies into evidence tables. DATA SYNTHESIS: Hypertension can be effectively detected through office measurement of blood pressure. Treatment of elevated blood pressure in adults can reduce cardiovascular events. The magnitude of risk reduction depends on the degree of hypertension and the presence of other cardiovascular risk factors. Available studies have found no important adverse effects on psychological well-being and mixed effects on the absenteeism rates of adults who are screened and labeled as being hypertensive. CONCLUSIONS: Substantial indirect evidence supports the effectiveness of screening adults to detect hypertension and treating them to reduce cardiovascular disease. |
| Seasonal influences on blood pressure in high normal to mild hypertensive range Giaconi, S., S. Ghione, et al. (1989), Hypertension 14(1): 22-7. Abstract: To investigate the seasonal influences on various arterial blood pressure measurements, 22 subjects in the high normal to mild hypertensive range were examined twice following the same protocol. In one group (13 subjects), measurements were first done in warm conditions and repeated 5-7 months later in cold conditions; in the second group (nine subjects) a reverse sequence was followed. Blood pressure was measured under casual conditions during a hand grip exercise test, mental arithmetic test, and submaximal multistage bicycle exercise test; during the following 24 hours, blood pressure was measured serially with a noninvasive ambulatory blood pressure recorder. Daily outdoor maximum and indoor laboratory temperatures were also obtained. In the cold season, significantly higher values (on the average by 5-10 mm Hg, p less than 0.01) were obtained in both groups for mean diastolic daytime blood pressure. For other measurements, a trend toward higher values in the cold season was observed in both groups, although statistical significance was not obtained in all instances. For nighttime measurements, irrespective of the seasonal sequence, lower values were observed in the second session. Significant correlations were found between the differences in the average daytime ambulatory blood pressures and the corresponding changes of daily maximum outdoor temperatures after 5-7 months. These observations indicate that arterial blood pressure may be strongly influenced by environmental temperature. This phenomenon should be taken into account both in the evaluation of the individual hypertensive patients and in the design and analysis of studies on arterial hypertension, especially when ambulatory blood pressure techniques are employed. |
| Second Australian National Blood Pressure Study (ANBP2). Australian Comparative Outcome Trial of ACE inhibitor- and diuretic-based treatment of hypertension in the elderly. Management Committee on behalf of the High Blood Pressure Research Council of Australia Wing, L. M., C. M. Reid, et al. (1997), Clin Exp Hypertens 19(5-6): 779-91. Abstract: The Second Australian National Blood Pressure Study (ANBP2) is a comparative outcome trial being conducted in general practices throughout Australia of ACE inhibitor- and diuretic-based treatment in 6000 hypertensive patients aged 65-84 years. The study is using a prospective randomised open-label design with blinding of endpoint assessments. The primary objective is to determine whether there is any difference in total cardiovascular events (fatal and non-fatal) over a five year treatment period between the two treatment regimens. Eligible hypertensive patients (average sitting blood pressure at the 2nd and 3rd screening visits > 160 mm Hg systolic and/or > 90 mm Hg diastolic) may be either untreated or previously treated and should have no history of recent cardiovascular morbidity or serious intercurrent illness. Patients are randomised to one of the treatment arms with randomisation stratified for practice and for age. Following randomisation each patient's blood pressure is managed by his/her general practitioner according to guidelines relevant to each treatment arm. Over 700 patients have now been randomised with recruitment intended to be complete by the end of 1997. |
| Seeking and finding all those patients with high blood pressure Hill, M. N. and S. B. Foster (1982), Nursing 12(2): 72-5. |
| Selection, training, and utilization of health counselors in the management of high blood pressure Frate, D. A., T. Whitehead, et al. (1983), Urban Health 12(5): 52-4. |
| Selective breeding to develop lines of baboons with high and low blood pressure Carey, D., C. M. Kammerer, et al. (1993), Hypertension 21(6 Pt 2): 1076-9. Abstract: Lines of baboons with high and low blood pressure were developed by selective breeding. Blood pressure was measured in 456 adult feral baboons under ketamine immobilization by direct arterial cannulation. Males with blood pressures two standard deviations and females with blood pressures one standard deviation above and below the cumulative mean were selected as progenitors. High males were mated with high females and low males were mated with low females. We measured blood pressure and plasma renin activity on 100 progeny, 54 males and 46 females, greater than 44 months of age with an abbreviated tether protocol and software program for data collection. Mean systolic and diastolic nighttime pressures for the high line were 126/72 and for the low line were 114/65 mm Hg. Line differences for systolic (12 mm Hg) and for diastolic (7 mm Hg) pressures were significant (p < 0.001). The line difference for plasma renin activity (1.1 ng/mL/hr) was not significant. Progeny pressures ranged from 84/49 to 191/126 mm Hg. There was no sex effect on blood pressure or plasma renin activity line differences. Heritability of systolic pressure was 0.46 +/- 0.19 and of diastolic pressure was 0.32 +/- 0.19. These results indicate that, by selective breeding and rigorous measurement of blood pressure, lines of baboons with significant difference in blood pressure can be developed. |
| Self monitoring of high blood pressure Bakx, J. C., M. C. van der Wel, et al. (2005), Bmj 331(7515): 466-7. |