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Control hypertension and heart rate

Basmah Safdar, Gail D'Onofrio, James Dziura, Raymond R Russell, Caitlin Johnson, Albert J Sinusas
AIMS: Coronary microvascular dysfunction (CMD) is common in patients with non-obstructive coronary arteries but has not been described in low-risk symptomatic patients. We therefore assessed the prevalence and characteristics of CMD in low to moderate risk patients with chest pain in an emergency department. METHODS AND RESULTS: We used three-dimensional Rb82 cardiac positron emission tomography/computed tomography to diagnose coronary artery disease (known or new regional defect, any coronary calcification) and CMD (low coronary flow reserve without coronary artery disease) in chest pain patients after being ruled out for acute myocardial infarction...
March 1, 2018: European Heart Journal. Acute Cardiovascular Care
Samantha Sabo, Catalina Denman Champion, Melanie L Bell, Elsa Cornejo Vucovich, Maia Ingram, Celina Valenica, Maria Del Carmen Castro Vasquez, Eduardo Gonzalez-Fagoaga, Jill Geurnsey de Zapien, Cecilia B Rosales
INTRODUCTION: Northern Mexico has among the highest rates of cardiovascular disease (CVD) and diabetes in the world. This research addresses core gaps in implementation science to develop, test and scale-up CVD risk-reduction interventions in diabetics through a national primary care health system. METHODS AND ANALYSIS: The Meta Salud Diabetes (MSD) research project is a parallel two-arm cluster-randomised clinical behavioural trial based in 22 (n=22) health centres in Sonora, Mexico...
March 12, 2018: BMJ Open
M Crowther, K van der Spuy, F Roodt, M B Nejthardt, J G Davids, J Roos, E Cloete, T Pretorius, G L Davies, J G van der Walt, C van der Westhuizen, M Flint, J L C Swanevelder, B M Biccard
Hypertension is not consistently associated with postoperative cardiovascular morbidity and is therefore not considered a major peri-operative risk factor. However, hypertension may predispose to peri-operative haemodynamic changes known to be associated with peri-operative morbidity and mortality, such as intra-operative hypotension and tachycardia. The objective of this study was to determine whether pre-operative hypertension was independently associated with haemodynamic changes known to be associated with adverse peri-operative outcomes...
March 12, 2018: Anaesthesia
Ronald G Victor, Kathleen Lynch, Ning Li, Ciantel Blyler, Eric Muhammad, Joel Handler, Jeffrey Brettler, Mohamad Rashid, Brent Hsu, Davontae Foxx-Drew, Norma Moy, Anthony E Reid, Robert M Elashoff
Background Uncontrolled hypertension is a major problem among non-Hispanic black men, who are underrepresented in pharmacist intervention trials in traditional health care settings. Methods We enrolled a cohort of 319 black male patrons with systolic blood pressure of 140 mm Hg or more from 52 black-owned barbershops (nontraditional health care setting) in a cluster-randomized trial in which barbershops were assigned to a pharmacist-led intervention (in which barbers encouraged meetings in barbershops with specialty-trained pharmacists who prescribed drug therapy under a collaborative practice agreement with the participants' doctors) or to an active control approach (in which barbers encouraged lifestyle modification and doctor appointments)...
March 12, 2018: New England Journal of Medicine
Douglas W Jones, Philip P Goodney, Jens Eldrup-Jorgensen, Marc L Schermerhorn, Jeffrey J Siracuse, Jeanwan Kang, Jesse A Columbo, Bjoern D Suckow, David H Stone
OBJECTIVE: Performing lower extremity bypass (LEB) in actively smoking claudicants remains controversial. Whereas some surgeons advocate a strict nonoperative approach to active smokers, citing perceived inferior outcomes, others will proceed with surgical bypass if the patient is anatomically suited and medical management has failed. The purpose of this study was to determine the impact of active smoking on LEB outcomes among claudicants. METHODS: All patients undergoing infrainguinal LEB for claudication in the Vascular Study Group of New England from 2003 to 2016 were analyzed...
March 6, 2018: Journal of Vascular Surgery
E Shawkat, H Mistry, C Chmiel, L Webster, L Chappell, E D Johnstone, J E Myers
AIM: To compare the blood pressure (BP) lowering effects of labetalol and nifedipine modified release (MR) in hypertensive pregnant women. We also investigated the effect on the heart rate (HR) and determined the proportion of time spent in target. METHODS: This was an exploratory study. Women with chronic hypertension taking either labetalol or nifedipine were offered 24-h ambulatory blood pressure monitoring (ABPM). Sleep, wake and drug ingestion times were self-reported...
January 2018: Pregnancy Hypertension
Jason R Carter, Daniela Grimaldi, Ida T Fonkoue, Lisa Medalie, Babak Mokhlesi, Eve Van Cauter
Study Objectives: Chronic insomnia affects up to 15% of adults. Recent cross-sectional and prospective epidemiological studies report an association between insomnia and hypertension, including incident hypertension, yet mechanisms underlying the association remain unknown. We hypothesized that subjects with chronic insomnia would have elevated sympathetic neural outflow, blunted baroreflex sensitivity, and augmented sympathetic neural and cardiovascular reactivity to stress when compared to good-sleeper controls...
March 7, 2018: Sleep
Rachel Nicoll, Michael Y Henein
Essential hypertension, fast heart rate, low heart rate variability, sympathetic nervous system dominance over parasympathetic, arterial stiffness, endothelial dysfunction and poor flow-mediated arterial dilatation are all associated with cardiovascular mortality and morbidity. This review of randomised controlled trials and other studies demonstrates that caloric restriction (CR) is capable of significantly improving all these parameters, normalising blood pressure (BP) and allowing patients to discontinue antihypertensive medication, while never becoming hypotensive...
March 7, 2018: International Journal of Molecular Sciences
Jonathan D Wiles, Katrina Taylor, Damian Coleman, Rajan Sharma, Jamie M O'Driscoll
Few studies have investigated the relative safety of prescribing isometric exercise (IE) to reduce resting blood pressure (BP). This study aimed to ascertain the safety of the hemodynamic response during an IE wall squat protocol.Twenty-six hypertensive (BP of 120-139 mm Hg systolic and/or 80-90 mm Hg diastolic) males (45 ± 8 years; 1.78 ± 0.07 m; 89.7 ± 12.3 kg; mean ± SD), visited the laboratory on 2 separate occasions. Heart rate (HR) and BP were measured at rest and continuously throughout exercise...
March 2018: Medicine (Baltimore)
Hong-Yu Kuang, Yu-Hao Wu, Qi-Jian Yi, Jie Tian, Chun Wu, We Nian Shou, Tie-Wei Lu
BACKGROUND: Oral bosentan has been widely applied in pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD). A systemic review and meta-analysis was conducted for a therapeutic evaluation of oral bosentan in both adult and pediatric patients with PAH-CHD. The acute responses and a long-term effect were respectively assessed in a comparison with baseline characteristics, and the improvement of exercise tolerance was analyzed. METHODS: PubMed, Medline, Embase, and Cochrane Central Register of clinical controlled trails or observational studies have been searched for a recording of bosentan effects on the PAH-CHD participants...
March 2018: Medicine (Baltimore)
Louise Prestipino, Jaimie W Polson, Elisabeth Brolin, Helen E Ritchie
A slow embryonic heart rate in early-mid gestation is associated with increased risk of embryonic death and malformation, however, the long-term consequences remain unknown. We administered Dofetilide (Dof, 2.5 mg/kg), a drug that produces embryo-specific bradycardia, to pregnant rats from gestational days 11-14. Embryonic heart rate and rhythm were determined using embryo culture. Cardiovascular function was assessed in surviving adult offspring at rest, during acute psychological stress (air jet stress, AJS), and after 7 days of repeated AJS...
March 2018: Physiological Reports
Daniel Canuto, Kwitae Chong, Cayley Bowles, Erik P Dutson, Jeff D Eldredge, Peyman Benharash
A computational tool is developed for simulating the dynamic response of the human cardiovascular system to various stressors and injuries. The tool couples zero-dimensional models of the heart, pulmonary vasculature, and peripheral vasculature to one-dimensional models of the major systemic arteries. To simulate autonomic response, this multiscale circulatory model is integrated with a feedback model of the baroreflex, allowing control of heart rate, cardiac contractility, and peripheral impedance. The performance of the tool is demonstrated in two scenarios: neurogenic hypertension by sustained stimulation of the sympathetic nervous system, and an acute 10 percent hemorrhage from the left femoral artery...
March 2, 2018: International Journal for Numerical Methods in Biomedical Engineering
Ignatios Ikonomidis, Astrinos Voumvourakis, George Makavos, Helen Triantafyllidi, George Pavlidis, Konstantinos Katogiannis, Dimitris Benas, Dimitris Vlastos, Paraskevi Trivilou, Maria Varoudi, John Parissis, Efstathios Iliodromitis, John Lekakis
We investigated the association of endothelial glycocalyx damage with arterial stiffness, impairment of coronary microcirculatory function, and LV myocardial deformation in 320 untreated hypertensives and 160 controls. We measured perfused boundary region (PBR) of the sublingual microvessels, a marker inversely related with glycocalyx thickness, coronary flow reserve (CFR), and Global Longitudinal strain (GLS) by echocardiography, pulse wave velocity (PWV), and central systolic blood pressure (cSBP). Hypertensives had higher PBR, PWV cSBP, and lower CFR and GLS than controls (P < ...
March 2, 2018: Journal of Clinical Hypertension
Hélio José Coelho-Júnior, Ricardo Yukio Asano, Ivan de Oliveira Gonçalvez, Cayque Brietzke, Flávio Oliveira Pires, Samuel da Silva Aguiar, Daniele Jardim Feriani, Erico Chagas Caperuto, Marco Carlos Uchida, Bruno Rodrigues
OBJECTIVE: The present study aimed to investigate the effects of a 6-month multicomponent exercise program on blood pressure, heart rate, and double product of uncontrolled and controlled normotensive and hypertensive older patients. METHODS: The study included 183 subjects, 97 normotensives, of which 53 were controlled normotensives (CNS), and 44 uncontrolled normotensives (UNS), as well as 86 hypertensives, of which 43 were controlled hypertensives (CHS), and 43 uncontrolled hypertensives (UHS)...
February 26, 2018: Archivos de Cardiología de México
Woo Hyun Lee, Jeong-Whun Kim, Jae-Sung Lim, Il Gyu Kong, Hyo Geun Choi
BACKGROUND: Several studies have reported that chronic rhinosinusitis (CRS) increases the risk of stroke. The aim of this study is to elucidate the putative association between CRS and stroke (ischemic or hemorrhagic) using large population-based national health insurance data. METHODS: Using the national cohort study from the Korean Health Insurance Review and Assessment Service, CRS patients (n = 22,959) and control participants (n = 91,836) were selected and matched at a rate of 1:4 (age, sex, income, region, hypertension, diabetes, and dyslipidemia)...
2018: PloS One
Ioannis Felekos, Constantina Aggeli, Elias Gialafos, Vasileios Kouranos, Aggeliki Rapti, Petros Sfikakis, Nikolaos Koulouris, Dimitris Tousoulis
PURPOSE: Global longitudinal strain (GLS) is increasingly accepted as a predictor of mortality in various clinical settings. This study tested the hypothesis that GLS is associated with increased event rate in patients with extracardiac sarcoidosis, who have no overt symptoms of cardiovascular disease and preserved ejection fraction (EF). METHODS: We retrospectively studied 117 patients with extracardiac sarcoidosis and 45 age- and sex-matched controls, who underwent comprehensive echocardiographic study, while GLS was measured by an offline speckle tracking algorithm...
February 28, 2018: Echocardiography
Eric A Schmidt, Fabien Despas, Anne Pavy-Le Traon, Zofia Czosnyka, John D Pickard, Kamal Rahmouni, Atul Pathak, Jean M Senard
Intracranial pressure (ICP) is the pressure within the cranium . ICP rise compresses brain vessels and reduces cerebral blood delivery. Massive ICP rise leads to cerebral ischemia, but it is also known to produce hypertension, bradycardia and respiratory irregularities due to a sympatho-adrenal mechanism termed Cushing response. One still unresolved question is whether the Cushing response is a non-synaptic acute brainstem ischemic mechanism or part of a larger physiological reflex for arterial blood pressure control and homeostasis regulation...
2018: Frontiers in Physiology
Nicola Wilck, Lajos Markó, András Balogh, Kristin Kräker, Florian Herse, Hendrik Bartolomaeus, István A Szijártó, Maik Gollasch, Nadine Reichhart, Olaf Strauss, Arnd Heuser, Damian Brockschnieder, Axel Kretschmer, Ralf Lesche, Florian Sohler, Johannes-Peter Stasch, Peter Sandner, Friedrich C Luft, Dominik N Müller, Ralf Dechend, Nadine Haase
Heart failure with preserved ejection fraction (HFpEF) can arise from cardiac and vascular remodeling processes following long-lasting hypertension. Efficacy of common HF therapeutics is unsatisfactory in HFpEF. Evidence suggests that stimulators of the nitric oxide-sensitive soluble guanylyl cyclase (NOsGC) could be of use here. We aimed to characterize the complex cardiovascular effects of NOsGC stimulation using NO-independent stimulator BAY 41-8543 in a double-transgenic rat (dTGR) model of HFpEF. We show a drastically improved survival rate of treated dTGR...
February 22, 2018: JCI Insight
Josária Ferraz Amaral, Diana de Medeiros Andrade Borsato, Isabelle Magalhães Guedes Freitas, Edgar Toschi-Dias, Daniel Godoy Martinez, Mateus Camaroti Laterza
BACKGROUND: Individuals with a family history of systemic arterial hypertension (FHSAH) and / or prehypertension have a higher risk of developing this pathology. OBJECTIVE: To evaluate the autonomic and vascular functions of prehypertensive patients with FHSAH. METHODS: Twenty-five young volunteers with FHSAH, 14 normotensive and 11 prehypertensive subjects were submitted to vascular function evaluation by forearm vascular conductance(VC) during resting and reactive hyperemia (Hokanson®) and cardiac and peripheral autonomic modulation, quantified, respectively, by spectral analysis of heart rate (ECG) and systolic blood pressure (SBP) (FinometerPRO®)...
February 19, 2018: Arquivos Brasileiros de Cardiologia
Binita Riya Chacko, Gauri R Karur, Kim A Connelly, Raymond T Yan, Anish Kirpalani, Rachel Wald, Laura Jimenez-Juan, John Roshan Jacob, Djeven P Deva, Andrew T Yan
OBJECTIVE: Diastolic dysfunction is common in hypertrophic cardiomyopathy (HCM) and hypertensive heart disease (HHD), but its relationships with left ventricular (LV) parameters have not been well studied. Our objective was to assess the relationship of various measures of diastolic function, and maximum left ventricular wall thickness (MLVWT) and left ventricular mass index (LVMI) in HCM, HHD and normal controls using cardiac magnetic resonance imaging (CMR). We also assessed LV parameters and diastolic function in relation to late gadolinium enhancement (LGE) and right ventricular (RV) hypertrophy in HCM...
January 2018: Indian Heart Journal
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