| For medical practitioners and the general public - High Blood Pressure Journal Article Catalog. |
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| Self-help for high blood pressure Rogers, C. S. (1984), N C Med J 45(3): 175-6. |
| Self-measurement of blood pressure: assessment of equipment. Canadian Coalition for High Blood Pressure Prevention and Control McKay, D. W., N. R. Campbell, et al. (1995), Can J Cardiol 11 Suppl H: 29H-34H. Abstract: Equipment for the self-measurement of blood pressure is readily available to consumers. These devices use one or more surrogate (indirect) measures of pressure to estimate systolic and diastolic blood pressure. Manual auscultatory devices using stethoscope and sphygmomanometer have been adapted for home use, but a variety of automated devices based on auscultation, oscillometry, and other techniques are available and may be more suitable for individuals who have limited vision, hearing or dexterity. Despite the existence of voluntary evaluation protocols and mandatory manufacturing standards, blood pressure readings from some automatic devices may not be accurate. Some devices are packaged with insufficient information to ensure proper use, and most individuals need some form of guidance in their use and calibration testing. If self-measurement of blood pressure is to be of benefit, the health care professional must recommend only those devices that are accurate and suitable to the patient or client. The Canadian Coalition for High Blood Pressure Prevention and Control will endeavour to develop a regular means by which health care professionals can keep informed of available devices for blood pressure self-measurement. |
| Self-measurement of blood pressure: benefits, risks and interpretation of readings. The Canadian Coalition for High Blood Pressure Prevention and Control Campbell, N. R., M. Bass, et al. (1995), Can J Cardiol 11 Suppl H: 18H-22H. Abstract: The literature on the benefits and risks of self-measurement of blood pressure and interpretation of the readings was reviewed. Self-measurement of blood pressure is useful in selected patients with high blood pressure, can be used to monitor blood pressure closely outside health care facilities, and can determine whether patients have white coat hypertension. The involvement of patients in their own blood pressure management is increased and self measurement may result in more rapid achievement of target blood pressure readings, improvement in adherence to antihypertensive therapy and decreased health care utilization. However, some patients may not be suited to monitor their own blood pressure and some may experience an increase in anxiety regarding their health. With careful training and selection of patients, most can accurately assess their blood pressure. Self-measured readings are generally lower than readings in a physician's clinic (or office) and this must be accounted for in assessing response to therapy and usual levels of blood pressure. Self-measured readings are a valuable supplement to clinic readings in many patients. |
| Self-measurement of blood pressure: issues related to the training of patients. Canadian Coalition for High Blood Pressure Prevention and Control Birkett, N. J., D. Abbott, et al. (1995), Can J Cardiol 11 Suppl H: 23H-27H. Abstract: For effective self-measurement of blood pressure, patients need to be able to obtain accurate and reproducible measurements. Criteria for measuring blood pressure have been well developed in research studies, and through the use of standardized training programs it has been established that nonmedically trained individuals can obtain valid measurements. These recommendations for blood pressure measurement were adapted to the self-measurement situation. Either manual sphygmomanometers or automated electronic devices can be used effectively. Although automated devices may be easier to use, the health care practitioner should ensure that any such device has been demonstrated to be accurate and reliable before its adoption. There are no reported programs available for training individuals in the use of self-measurement. A check-list has been developed for use by health care practitioners. It is estimated that proper training will usually take more than 20 mins. Since many health care practitioners do not use the recommended blood pressure measurement technique, there is also a need to develop programs to 'train the trainers'. Finally, individuals undertaking regular self-measurement should have their technique and the calibration of their instruments checked at regular intervals (six to 12 months). |
| Self-measurement of blood pressure: recommendations of the Canadian Coalition for High Blood Pressure Prevention and Control Campbell, N. R., D. Abbott, et al. (1995), Can J Cardiol 11 Suppl H: 5H-17H. Abstract: OBJECTIVE: To provide health care professionals with guidelines on the use of blood pressure self-measurement. METHODS: Recommendations were devised after consideration of expert reviews and guidelines, personal files, international standards documents, personal communication with investigators and the results of a MEDLINE search (1966-94) using the term 'blood pressure determination'. BENEFITS, HARMS, COSTS: Self-measurement of blood pressure can be used to detect white coat hypertension, monitor changes in blood pressure closely, more rapidly achieve desired blood pressure goals, increase adherence to antihypertensive therapy and improve patient self-reliance. However, self-measured blood pressure readings may be misleading because there is insufficient normative, prognostic and outcome data and because some patients may not take accurate measurements. The use of self-measurement of blood pressure has a relatively small direct cost and may result in an overall reduction in treatment costs. RECOMMENDATIONS: Self-measured blood pressure readings can be a valuable supplement to clinic (or office) blood pressure readings. However, self-measurement is appropriate neither for patients who are physically or mentally incapable of accurate assessment and interpretation of readings nor for those who do not want to participate. Patients who self-monitor blood pressure require careful training in blood pressure measurement and instruction on the recording and interpretation of blood pressure readings. Advice to patients using monitoring equipment must take into account the needs and abilities of the patient. Although only a few electronic devices for the self-measurement of blood pressure have met recommended performance standards, their use may be more appropriate for some patients and the training requirements fewer than if manual devices are used. VALIDATION: The guidelines of several expert groups were examined in the preparation of these recommendations. The recommendations were presented at the World Conference on Hypertension Control in 1995 and were reviewed by the parent societies of the Canadian Coalition for High Blood Pressure Prevention and Control. |
| Separation of blood group A-active oligosaccharides by high-pressure liquid affinity chromatography using a monoclonal antibody bound to concanavalin A silica Dakour, J., A. Lundblad, et al. (1987), Anal Biochem 161(1): 140-3. Abstract: A column for high-pressure liquid affinity chromatography is prepared by binding a murine monoclonal anti-blood group A antibody of IgM isotype to concanavalin A-coated silica particles. The column specifically retards blood group A-active oligosaccharides with the nonreducing immunodominant trisaccharide sequence, GalNAc alpha 1-3(Fuc alpha 1-2)Gal beta 1-. and separates three A-active oligosaccharides with different core structures. Retention of the oligosaccharides on the column diminishes with increasing temperatures, permitting thermal elution in the range 25-50 degrees C. |
| Serial studies of heart rate, blood pressure and urinary catecholamine excretion on acute induction to high altitude (3658m) Sharma, S. C., V. Balasubramanian, et al. (1977), Indian J Chest Dis Allied Sci 19(1): 16-20. |
| Serum and erythrocyte magnesium levels in junior high school students: relation to blood pressure and a family history of hypertension Shibutani, Y., K. Sakamoto, et al. (1988), Magnesium 7(4): 188-94. Abstract: Serum and erythrocyte magnesium concentrations (S-Mg, E-Mg) were measured in 380 Japanese junior high school students, and the relationship to blood pressure and a family history of hypertension were studied. Systolic blood pressure was higher in the subjects with a positive family history of hypertension FH(+) than in those with a negative family history FH(-), whereas E-Mg was lower in the FH(+) group than in the FH(-) group with a significant different in boys. Furthermore, in the FH(+) group, systolic blood pressure was significantly higher in the subjects with lower S-Mg and E-Mg than in those with higher S-Mg and E-Mg. In the FH(-) group, however, no difference was observed in blood pressure levels between the two subgroups. These findings suggest that magnesium deficiency is partially responsible for a rise of blood pressure in the FH(+) children, and that a genetic predisposition of hypertension may be closely related to magnesium metabolism. |
| Serum cholesterol levels and survival in elderly hypertensive patients: analysis of data from the European Working Party on High Blood Pressure in the Elderly Fagard, R. (1991), Am J Med 90(3A): 62S-63S. Abstract: The relation between serum cholesterol and mortality was investigated in 822 elderly hypertensive patients randomly assigned to treatment with diuretics, with or without methyldopa, or placebo. Cox's proportional hazards model showed that pretreatment serum total cholesterol levels were independently and inversely correlated with total mortality (p = 0.03), noncardiovascular mortality (p = 0.02), and cancer mortality (p = 0.04) during treatment. Total and noncardiovascular mortality were also negatively correlated with pretreatment hemoglobin levels and body weight. All factors being equal, an increase in total serum cholesterol of 2.3 mmol/L was associated with a one-year prolongation of survival. After adjustment for gender, age, pretreatment cardiovascular complications, and systolic pressure, the correlations between serum cholesterol and cardiovascular and cardiac mortality were not significant. |
| Serum cholesterol levels, blood pressure response to stress and incidence of stable hypertension in young subjects with high normal blood pressure Borghi, C., M. Veronesi, et al. (2004), J Hypertens 22(2): 265-72. Abstract: RATIONALE: Elevated serum cholesterol levels are common in patients with high blood pressure (BP) and could contribute to the progression of the hypertensive disease. OBJECTIVE: To determine whether serum cholesterol levels affect the BP response to mental stress (MA) and the development of stable hypertension in young subjects with high normal BP. METHODS: Seventy young (age < 45 years) high normal BP subjects with elevated (> 200 mg/dl, n = 49; HC) or normal (< or = 199 mg/dl, n = 21; NC) serum cholesterol levels, and 20 normotensive normocholesterolaemic (serum cholesterol < 199 mg/dl; C) subjects undergoing standardized mental challenge (mental arithmetic) were followed up for 15 years according to a prospective, longitudinal, cohort study design conducted in an ambulatory setting. The main outcome measure was the evaluation of the 15-year incidence of stable hypertension (diastolic BP > 95 mmHg). RESULTS: After adjustment for age, resting BP, family history of high BP and body mass index at the study entry, high normal BP subjects with HC showed an enhanced BP reactivity to stress and a higher 15-year incidence of stable hypertension compared to high normal BP and NC subjects relative risk (RR) = 2.1; 95% confidence interval (CI) = 1.7-5.5, P < 0.001 and controls (RR = 3.1; 95% CI = 1.4-5.3, P < 0.001). In a multivariate analysis of data the presence of high cholesterol levels was an independent predictor for the development of hypertension. CONCLUSION: These data suggest that subjects with high normal BP and elevated serum cholesterol might have an exaggerated cardiovascular response to stress and have an increased risk for stable hypertension that can be detected at young age. |
| Serum norharman and harman analysis using high pressure liquid chromatography/mass spectrometry and value of beta-carbolines as blood alcohol markers Potsch, L. and G. Skopp (2002), Arch Kriminol 210(5-6): 146-57. Abstract: Firstly, a method for LC-MS/MS-analysis of the beta-carbolines norharman and harman in serum was established and validated. Secondly, serum samples from persons during ethanol loading conditions were investigated (n = 26). Norharman was regularly found positive only in persons with BAC > 1.6@1000. In this subgroup harman was detected in 5 out of 9 cases. The finding of norharman concentrations > 50 pg/mL in the serum of 4 out of 5 control persons was of high interest. In addition serum samples of smokers (n = 9) were analyzed for the beta-carbolines. All samples from smokers were tested positive for norharman with concentrations > 50 pg/mL in 7 cases. These results were in accordance with recent reports in literature and underline that the beta-carbolines norharman and harman do not meet the criteria of alcohol state-markers and positive serum sample testing may result from endogenous as well as from exogenous sources. |
| Seven generations of selection for high and low blood pressure in chickens Sturkie, P. D. (1970), Poult Sci 49(4): 953-6. |
| Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Chobanian, A. V., G. L. Bakris, et al. (2003), Hypertension 42(6): 1206-52. Abstract: The National High Blood Pressure Education Program presents the complete Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Like its predecessors, the purpose is to provide an evidence-based approach to the prevention and management of hypertension. The key messages of this report are these: in those older than age 50, systolic blood pressure (BP) of greater than 140 mm Hg is a more important cardiovascular disease (CVD) risk factor than diastolic BP; beginning at 115/75 mm Hg, CVD risk doubles for each increment of 20/10 mm Hg; those who are normotensive at 55 years of age will have a 90% lifetime risk of developing hypertension; prehypertensive individuals (systolic BP 120-139 mm Hg or diastolic BP 80-89 mm Hg) require health-promoting lifestyle modifications to prevent the progressive rise in blood pressure and CVD; for uncomplicated hypertension, thiazide diuretic should be used in drug treatment for most, either alone or combined with drugs from other classes; this report delineates specific high-risk conditions that are compelling indications for the use of other antihypertensive drug classes (angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, beta-blockers, calcium channel blockers); two or more antihypertensive medications will be required to achieve goal BP (<140/90 mm Hg, or <130/80 mm Hg) for patients with diabetes and chronic kidney disease; for patients whose BP is more than 20 mm Hg above the systolic BP goal or more than 10 mm Hg above the diastolic BP goal, initiation of therapy using two agents, one of which usually will be a thiazide diuretic, should be considered; regardless of therapy or care, hypertension will be controlled only if patients are motivated to stay on their treatment plan. Positive experiences, trust in the clinician, and empathy improve patient motivation and satisfaction. This report serves as a guide, and the committee continues to recognize that the responsible physician's judgment remains paramount. |
| Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and evidence from new hypertension trials Jones, D. W. and J. E. Hall (2004), Hypertension 43(1): 1-3. |
| Seventh report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7): resetting the hypertension sails Lenfant, C., A. V. Chobanian, et al. (2003), Hypertension 41(6): 1178-9. |
| Severity of human hypertension in relation to the age in which high blood pressure makes its presumptive appearance Cugini, P., P. Ferrari, et al. (2003), Clin Ter 154(1): 21-6. Abstract: PURPOSE: The present study investigates the properties of blood pressure (BP) circadian rhythm (CR) in newly-diagnosed hypertensives (NDH) as a function of the chronological age in which hypertension became manifest. MATERIALS AND METHODS: The study was performed on 141 NDH (71 males and 70 females, ranging in age from 24 year to 79 years), who were monitored in their 24-h BP via a non-invasive, ambulatory, automated recorder. The relation between the properties of BP CR and the age of the development of hypertension was investigated via the Clinospectror method, a trend analysis (periodic-linear regression method) for rhythmic biophenomena. RESULTS: A trend was detected for each one of the three properties of BP CR in relation with the age in which high BP made its appearance. As a matter of fact, the daily mean level (mesor) of BP CR was seen to be progressively less pronounced. The amplitude was found to show a progressive increment of its extent. The acrophase was seen to show a progressive antemeridian rotation of its timing. CONCLUSIONS: These trends suggest that hypertension tends to be less severe when its development occurs in subjects older in age. Such a less pronounced severity is, however, accompanied by a more pronounced oscillation of BP values during the 24-h of the day. Such a higher circadian variability, in turn, tends to show its highest expression during the morning hours of the day. |
| Sexual functioning, health beliefs, and compliance with high blood pressure medications Watts, R. J. (1982), Nurs Res 31(5): 278-83. Abstract: This study compared sexual functioning in 84 hypertensive subjects enrolled in an inner city hypertensive program with a matched group of 84 nonhypertensive subjects attending ambulatory care. Using the Sexual Functioning Questionnaire (SFQ), hypertensive subjects achieved lower levels of sexual functioning than nonhypertensive subjects (F = 21.60, df = 1/164, p less than.001). The 84 hypertensive subjects were categorized according to drug regimen (simple, moderate, and complex) and diastolic blood pressure measurement (DBP) (controlled and uncontrolled). Health beliefs of both sexes, relationship between type of drug regimen and sexual functioning, and association between self-report compliance and sexual functioning were examined. In the health belief survey, males reported a greater frequency of drug-induced sex problems than females (p less than.01), use of a complex drug regimen was associated with low level of sexual functioning (p les than.01), and type of self-report compliance was not related to level of sexual functioning. Hydrochlorothiazide, propranolol, and hydralazine were used by 80 percent, 43 percent, and 20 percent of clients. Self-report compliance was significantly related to controlled DBP (p less than.001). |
| Shared maternal influences in the development of high blood pressure in the spontaneously hypertensive (SHR) and Dahl salt-sensitive (SS/Jr) rat strains Murphy, C. A., C. Fields-Okotcha, et al. (1992), Behav Neural Biol 57(2): 144-8. Abstract: The influence of maternal environment on the development of high blood pressure in spontaneously hypertensive (SHR) and Dahl salt-sensitive (SS/Jr) rats was examined using the technique of reciprocal cross-fostering. Previous experiments from this laboratory demonstrated that adult blood pressures of the SHR and SS/Jr strains were significantly attenuated when hypertensive-strain pups were fostered to a dam of the respective normotensive control strain during the preweaning period. In this study, SHR and SS/Jr pups were assigned to either a cross-fostered (fostered to a dam of the opposite hypertensive strain) or control-reared condition within 24 h of birth. Adult resting blood pressures were similar in control and cross-fostered SHR rats and in control and cross-fostered SS/Jr rats. Heart rates and heart, adrenal, and kidney weights were also similar in control and cross-fostered rats of each strain. However, body weights of SHR rats reared by an SS/Jr dam were somewhat lower compared to control-reared SHR rats. These data indicate that the maternal environments provided by SHR and SS/Jr mothers are similar in some way such that they permit the development and full expression of the hypertensive phenotype in both same-strain and opposite-strain pups. |
| Short report: the effect of fish oil on blood pressure and high-density lipoprotein-cholesterol levels in phase I of the Trials of Hypertension Prevention Sacks, F. M., P. Hebert, et al. (1994), J Hypertens 12(2): 209-13. Abstract: OBJECTIVE: To study the effects of moderate doses of fish oil on blood pressure and high-density lipoprotein (HDL)-cholesterol. METHODS: The participants were 350 normotensive men and women aged 30-54 years who were enrolled from seven academic medical centers in phase I of the Trials of Hypertension Prevention. They were randomly assigned to receive placebo or 6 g purified fish oil once a day, which supplied 3 g n-3 polyunsaturated fatty acids for 6 months. RESULTS: Baseline blood pressure was (mean +/- SD) 123 +/- 9/81 +/- 5 mmHg. The mean differences in the blood pressure changes between the fish oil and placebo groups were not statistically significant. There was no tendency for fish oil to reduce blood pressure more in subjects with baseline blood pressure in the upper versus the lower quartile (132/87 versus 114/75 mmHg), low habitual fish consumption (0.4 versus 2.9 times a week) or low baseline plasma levels of n-3 fatty acids. Fish oil increased HDL2-cholesterol significantly compared with the placebo group. Subgroup analysis showed this effect to be significant in the women but not in the men. Increases in serum phospholipid n-3 fatty acids were significantly correlated with increases in HDL2-cholesterol and decreases in systolic blood pressure. CONCLUSION: Moderate amounts of fish oil (6 g/day) are unlikely to lower blood pressure in normotensive persons, but may increase HDL2-cholesterol, particularly in women. |
| Short-term and long-term effects of a high blood pressure intervention program Frate, D. A., S. A. Johnson, et al. (1984), J Miss State Med Assoc 25(10): 267-70. |
| Should family doctors screen asymptomatic children for high blood pressure? St George, I. M. (1990), Fam Pract 7(3): 219-26. Abstract: Whereas the United States Task Forces on Blood Pressure Control in Children have recommended annual blood pressure screening in all children, a working party of the British Hypertension Society has formed the opposite opinion. Relevant literature is reviewed here, and the conclusion reached that on epidemiological and ethical grounds, screening children for hypertension cannot at present be justified. |
| Should high-normal blood pressure be treated? Wright, C. E., J. A. Angus, et al. (2002), J Hypertens 20(5): 1023-30. |
| Should we be treating high blood pressure in persons over 65? Lichtenstein, M. J. (1988), Compr Ther 14(1): 54-9. |
| Should we treat high-normal blood pressure? Yeo, K. R. and W. W. Yeo (2002), J Hypertens 20(10): 2057-62. Abstract: OBJECTIVES: To examine the risk of cardiovascular disease associated with high-normal blood pressure in English adults and estimate the proportion of these individuals who are at high cardiovascular risk. DESIGN AND SETTING: Cross-sectional survey of England in 1998. PARTICIPANTS: Nationally representative sample of 12,341 individuals aged 18-80 years living in private households in England. MAIN OUTCOME MEASURE: Percentage of individuals with high-normal blood pressure who have cardiovascular disease, diabetes mellitus or a 10-year cardiovascular event risk of at least 20%. RESULTS: Of the 12,341 participants, 2413 (19.6%) had high-normal blood pressure. About 5.3% of those aged 18-80 years with high-normal blood pressure had cardiovascular disease or diabetes, and a further 7.6% were at a predicted cardiovascular event risk of at least 20% over 10 years. The mean predicted risk was 8.7% for men and 6.3% for women in the high-normal blood pressure category. The majority of men aged 61-80 years were at high cardiovascular risk. On average, men and women with high-normal blood pressure had a greater incidence of cardiovascular disease and diabetes mellitus, and a greater predicted mean cardiovascular risk than those with normal blood pressure. Extending antihypertensive treatment to individuals with high-normal blood pressure who are at high cardiovascular risk would involve treating an additional 2.5% of the English population aged 18-80 years. CONCLUSION: These findings support the view that individuals with high-normal blood pressure at high risk for cardiovascular disease should be targeted for blood pressure-lowering treatment. |
| Sick genes, sick individuals or sick populations with chronic disease? The emergence of diabetes and high blood pressure in African-origin populations Cruickshank, J. K., J. C. Mbanya, et al. (2001), Int J Epidemiol 30(1): 111-7. Abstract: AIM AND METHODS: To discuss evidence for and against genetic 'causes' of type 2 diabetes, illustrated by standardized study of glucose intolerance and high blood pressure in four representative African origin populations. Comparison of two genetically closer sites: rural (site 1) and urban Cameroon (2); then Jamaica (3) and Caribbean migrants to Britain (80% from Jamaica-4). BACKGROUND: Alternatives to the reductionist search for genetic 'causes' of chronic disease include Rose's concept that populations give rise to 'sick' individuals. Twin studies offer little support to genetic hypotheses because monozygotic twins share more than genes in utero and suffer from ascertainment bias. Non-genetic intergenerational mechanisms include amniotic fluid growth factors and maternal exposures. Type 2 diabetes and hypertension incidence accelerate in low-risk European populations from body mass > or =23 kg/m2, well within 'desirable' limits. Transition from subsistence agriculture in West Africa occurred this century and from western hemisphere slavery only six generations ago, with slow escape from intergenerational poverty since. RESULTS: 'Caseness' increased clearly within and between genetically similar populations: age-adjusted diabetes rates were 0.8, 2.4, 8.5 and 16.4% for sites 1-4, respectively; for 'hypertension', rates were 7, 16, 21 and 34%, with small shifts in risk factors. Body mass index rose similarly. CONCLUSION: Energy imbalance and intergenerational socioeconomic influences are much more likely causes of diabetes (and most chronic disease) than ethnic/genetic variation, which does occur, poorly related to phenotype. The newer method of 'proteomics' holds promise for identifying environmental triggers influencing gene products. Even in lower prevalence 'westernized' societies, genetic screening per se for diabetes/chronic disease is likely to be imprecise and inefficient hence unreliable and expensive. |
| Significance of high normal blood pressure in occupational health care Izuno, T., K. Yoshida, et al. (1996), Nippon Koshu Eisei Zasshi 43(1): 3-8. Abstract: In order to elucidate the significance of high normal blood pressure in occupational health care, a 5 year follow up survey was performed on 874 men with normal blood pressure and 225 men with high normal blood pressure. The major results of this survey were as follows. 1) Sixty-seven out of 874 with normal blood pressure (7.7%), and 78 out of 225 with high normal blood pressure (34.6%) became hypertensive in 5 years. 2) High normals started with a higher frequency of obesity, hypercholesterolemia, hyper gamma-Glutamyl transpeptidasemia compared with normal blood pressure at the start of the survey. 3) Logistic regression analysis showed that age, SBP, DBP were risk factors of developing hypertension from normal blood pressure, while only the amount of alcohol drinking applied for high normal blood pressure. 4) Logistic regression showed that high normal blood pressure, drinking, obesity and were significantly related to the development of hypertension. These results suggested that interventive activities for high normal blood pressure should be included in occupational health care because of a high tendency of underlying poor life style and a high risk of getting hypertension. |
| Significance Of Transient High Blood Pressure In Children. Hall, P., T. Lundman, et al. (1964), Sven Lakartidn 61: 18-24. |
| Simultaneous determination of chlordiazepoxide and its N-demethyl metabolite in 50-microL blood samples by high pressure liquid chromatography Greizerstein, H. B. and C. Wojtowicz (1977), Anal Chem 49(14): 2235-6. |
| Simultaneous measurement of phenobarbital, diphenylhydantoin, and primidone in blood by high-pressure liquid chromatography Kabra, P. M., G. Gotelli, et al. (1976), Clin Chem 22(6): 824-7. Abstract: We describe a sensitive, precise high-pressure liquid chromatographic method in which 5-(p-methylphenyl)-5-phenylhydantoin is used as the internal standard for simultaneous determination of diphenylhydantoin, phenobarbital, and primidone in whole blood and plasma. These anticonvulsant drugs are well separated from each other and from normal blood constituents in less than 10 min. The lower limit of detection for each drug is 100 ng for primidone, 200 ng for dilantin, and 300 ng for phenobarbital. The eluted drugs were detected by their absorption at 254 nm, and evaluated from their peak heights as compared to internal standard. The method was successfully adapted for pediatric samples (100 to 500 mul of whole blood or plasma). Fifty specimens were analyzed for phenobarbital and diphenylhydantoin and 25 specimens for primidone by a standard gas-chromatographic method and by our liquid-chromatographic method; the resulting correlation coefficient was greater than 0.98. |
| Single column high pressure liquid chromatographic determination of drugs in blood Draper, P., D. Shapcott, et al. (1979), Clin Biochem 12(2): 52-5. Abstract: 1. Analysis of anticonvulsants (phenobarbital, diphenylhydantoin and carbamazepine), theophylline and an antiarrhythmic agent (disopyramide) in blood using a simple high pressure liquid chromatography apparatus equipped with a reversed -- phase column is described. A simple extraction of plasma or serum with organic solvent is used to isolate the anticonvulsants and theophylline. Disopyramide is extracted with ether and is further purified by a back extraction into acid. 2. Hexanesulfonic acid -- methanol solutions are used for chromatography of the anticonvulsants and disopyramide while the mobile phase for theophylline is a NH4H2PO4 -- methanol mixture. Chromatographic analysis time for the drugs is approximately 15 minutes. The drugs are monitored by a UV detector at 254 nm except for theophylline which is measured at 280 nm. Quantitation is accomplished by comparison of peak heights with those of internal standards. Quantities of serum or plasma routinely used for analysis are: 200 ul for the anticonvulsants, 100 ul for theophylline and 0.5 ml for disopyramide. Detection limits are less than 1 ug/ml for these quantities. |
| Sixth report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. A summary Rayburn, W. F. (1998), J Reprod Med 43(5): 444-50. |
| Skaraborg's model for taking care of patients with high blood pressure Isacsson, S. O. and L. Ryden (1978), Vardfacket 2(19): 17-22. |
| Sociotropic cognition moderates blood pressure response to interpersonal stress in high-risk adolescent girls Ewart, C. K., R. S. Jorgensen, et al. (1998), Int J Psychophysiol 28(2): 131-42. Abstract: This article tests the hypothesis that 'sociotropic cognition'--heightened preoccupation with being accepted by others--increase vulnerability to cardiovascular stress in females. Adolescent girls (55 African-American; 23 Caucasian) at increased risk of developing essential hypertension due to persisting high normal blood pressure, completed measures of sociotropic cognition, social competence, trait affect and social support. Later, their blood pressure and heart rate were measured during non-social stress (mirror image tracing) and interpersonal stress Social Competence Interview (SCI). Comparisons of blood pressure responses to the tasks disclosed a significant Task main effect, replicating a previous finding that blood pressure is elevated more by SCI than by non-social stress. When Sociotropy was introduced as a moderator, however, a significant Task by Sociotropy interaction indicated that the comparatively greater reactivity to SCI occurred mainly in girls who exhibited high levels of sociotropic thinking. Cognitive sociotropy was associated with a profile of social emotional and environmental deficits suggesting increased susceptibility to chronic stress and impaired coping. |
| Sodium and potassium intake and high blood pressure MacGregor, G. A. (1987), Eur Heart J 8 Suppl B: 3-8. Abstract: Much circumstantial and some direct evidence links a high sodium, low potassium intake to the development of essential hypertension. However, studies to prove a definite causative relationship in man are unlikely to be done for the practical reason that they need to be carried out over a whole generation. Restriction of sodium intake does lower blood pressure in many hypertensive subjects. This fall appears to be mediated in part by a diminished renin response to the sodium restriction as blood pressure becomes more severe. Less substantive evidence also suggests that increasing potassium intake may lower blood pressure but this effect seems to be more apparent when both animals and man are on a high sodium intake. It would seem sensible, therefore, in the light of present knowledge, to advise communities that have a high sodium, low potassium diet they they may benefit from a reduction in sodium and an increase in potassium intake. Patients who are already known to have high blood pressure should be advised to reduce sodium intake along with other non-pharmacological advice. In some patients this will be sufficient to control the blood pressure. In others who may then require drug treatment, the blood pressure lowering effect of beta-blockers and converting enzyme inhibitors will be enhanced by the sodium restriction. |
| Sodium and potassium intake and high blood pressure McGregor, G. A. (1988), Acta Cardiol Suppl 29: 9-19. Abstract: Much circumstantial and some direct evidence links a high sodium, low potassium intake to the development of essential hypertension. However, studies to prove a definite causative relationship in man are unlikely to be done for the practical reason that they need to carried out over a whole generation. Restriction of sodium intake does lower blood pressure in many hypertensive subjects. This fall appears to be mediated in part by a diminished renin response to the sodium restriction as blood pressure becomes more severe. Less substantive evidence also suggests that increasing potassium intake may lower blood pressure but this effect seems to be more apparent when both animals and man are on a high intake. It would seem sensible, therefore, in the light of present knowledge, to advise communities that have a high sodium, low potassium diet they may benefit from a reduction in sodium and an increase in potassium intake. Patients who are already known to have high blood pressure should be advised to reduce sodium intake along with other non-pharmacological advice. In some patients this will be sufficient to control the blood pressure. In others who may then require drug treatment, the blood pressure lowering effect of beta-blockers and converting enzyme inhibitors will be enhanced by the sodium restriction. |
| Sodium and potassium intake in the management of high blood pressure MacGregor, G. A. (1986), J Clin Hypertens 2(2): 132-40. Abstract: Reduction of sodium intake lowers blood pressure in many patients with essential hypertension. The fall in blood pressure with salt restriction is related to the severity of blood pressure before treatment, and this may explain why there is continuing controversy about the role of sodium restriction in patients with mild or borderline hypertension. The mechanism whereby salt restriction lowers blood pressure appears to be dependent on a relative lack of rise in renin and, thereby, angiotensin II with the salt restriction. Moderate reduction of sodium intake is additive to the effect of blood-pressure-lowering drugs, particularly those that block the renin-angiotensin system such as beta-blockers and converting enzyme inhibitors. Increasing potassium chloride intake has also been shown to cause a fall in blood pressure in patients with essential hypertension when on their normal sodium intake. However, more recent work shows that when patients are already restricting salt intake, potassium chloride supplementation has little or no effect on blood pressure. |
| Sodium balance and blood pressure during high sodium ingestion in spontaneously hypertensive and Wistar Kyoto normotensive rats Peuler, J. D. and K. H. Beyer, Jr. (1985), Pharmacology 30(2): 83-5. Abstract: Objectives of this study were to compare natriuretic capability and arterial pressure elevation at high Na+ ingestion in male spontaneously hypertensive (SH) and normotensive Wistar Kyoto (WKY) rats at the young adult age of 16-19 weeks. 10 SH and 10 WKY male rats at this age were surgically implanted with arterial catheters. After a period of 10 days on low nutritionally adequate Na+ intake they were fed a high Na+ diet for a period of 1 week. Na+ retention (intake-output) on the high Na+ diet was substantial, but similar in both groups of rats. None of the animals displayed meaningful elevation of arterial pressure. Thus, the functional capacity of the young SH rat to excrete Na+ during excessive ingestion without elevation of blood pressure seems adequate as compared to normotensive rats, at least within the age range of 16-19 weeks. |
| Sodium elimination rate and blood pressure during normal and high salt intake in subjects with and without familial predisposition to hypertension Gudmundsson, O., A. Cederblad, et al. (1984), Acta Med Scand 216(4): 345-52. Abstract: We have assessed the elimination rate of 22Na (ER-22Na), total exchangeable sodium (NaE), blood pressure, plasma volume (PV), haematocrit, urinary noradrenaline (U-NA) and urinary 3-methoxy-4-hydroxymandelic acid (U-VMA) in normotensive men with (n = 17) and without (n = 15) familial predisposition to hypertension. All measurements were done during habitual salt intake and after four weeks of increased salt intake (ordinary intake + 12 g NaCl/daily). On ordinary salt intake, ER-22Na, NaE, blood pressure, PV, haematocrit, U-NA and U-VMA did not differ between the groups thus indicating a normal sodium turnover in both groups and a comparable activity of the sympathetic nervous system. After 10 days of high salt intake those without familial predisposition showed signs of volume expansion and decreased sympathetic activity and those with such predisposition showed insignificant changes in the same direction. After four weeks of increased salt intake, ER-22Na had increased significantly and equally in both groups, while blood pressure and NaE remained unchanged. This indicates that the predisposed individuals had a normal ability to cope with a prolonged increase in salt intake. |
| Sodium intake and cardiac sympatho-vagal balance in young men with high blood pressure Tochikubo, O. and K. Nishijima (2004), Hypertens Res 27(6): 393-8. Abstract: We have previously reported that a high sodium intake increases sleep-time blood pressure (BP) in young men. However, there are cases in which this relation does not apply. To account for them, we investigated the relation between sodium intake and cardiac sympatho-vagal balance (SVB) in young men with high BP. Sodium intake was estimated from the amount of urinary sodium excretion over 1 week. Twenty-four-hour (24-h) urinary sodium excretion (Salt24), 24-h ambulatory BP and ECG were obtained on the last day of the observation period. As an index of sodium intake, the expression In(Salt24/Cr24) (Cr24, 24-h urinary creatinine excretion) was used. From power-spectral analysis of ECG-RR intervals during sleep, we obtained the LF/HF ratio between the low-frequency component (LF) and the high frequency component (HF) and used it as an index of SVB. The subjects were male medical students divided into a normal BP group (N-group; n=103) and a high BP group (H-group; n=26, 24-h BP>125/75 mmHg). Mean In(Salt24/Cr24) and LF/HF in the H-group were significantly higher than those in the N-group (LF/HF: 1.86+/-0.44 SD vs. 1.37+/-0.30, p<0.001). The calculated discriminant function (D) for the H-group and N-group was D=1.6x + 5y - 11, where x is In(Salt24/Cr24) and y is LF/HF. This formula (D) resulted in high discriminant predictive accuracy (82%) between the groups. If D=0 (the value of the cut-off line determining separation of the groups), the relation y=-0.32x + 2.2 (negative relation between y and x) was obtained. These results suggest that excessive sodium intake in combination with accentuated SVB (LF/HF) increases BP in young men. |
| Sodium intake, high blood pressure, and calcium channel blockers MacGregor, G. A., F. P. Cappuccio, et al. (1987), Am J Med 82(3B): 16-22. Abstract: Although there is much circumstantial and some direct clinical evidence suggesting that a high consumption of salt predisposes patients to the development of essential hypertension, the mechanism by which such consumption causes high blood pressure is not clear. It has been suggested that due to an inherited abnormality in renal sodium excretion, high salt intake triggers an increase in the levels of sodium transport inhibitor. Although this may help to restore sodium balance, it may also increase the concentration of intracellular sodium in arteriolar smooth muscle and, thereby, stimulate smooth muscle reactivity. It has been shown that intra-arterial infusion of calcium channel blockers into the forearm produces an enhancement of forearm blood flow that is proportional to the degree of hypertension. Other studies have demonstrated a linear relationship between the degree of hypertension and the magnitude of blood pressure reduction following treatment with a calcium channel blocker. These clinical findings, combined with evidence from studies in animals, suggest that a functionally abnormal response of smooth muscle cells to calcium channel blockers occurs as blood pressure increases. Whether this functional abnormality is related to an increased level of intracellular calcium and/or inhibition of the sodium pump is not known. The short-term blood pressure lowering effect of nifedipine appears to be enhanced when sodium intake is increased. |