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Pulse Pressure

Torsten Schröder
Basic haemodynamic monitoring is an essential part of the anaesthesia work place. This includes Monitoring of ECG, blood pressure and pulse oximetry. For early assessement of perioperative complications every patient should have a basic haemodynamic monitoring, independant of current health status or the type of anaesthesia applied. Knowledge of function, principles and limitations ais necessary for proper interpretation of the measured values. Here, we describe the function and application of ECG, non - invasive intermittent blood pressure and pulse oximetry in the perioperative setting...
October 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Toshihiro Shoji, Atsushi Nakagomi, Sho Okada, Yuji Ohno, Yoshio Kobayashi
BACKGROUND: Studies have established the prognostic value of central SBP and pulse pressure (PP). The SphygmoCor XCEL (AtCor Medical, Sydney, Australia) device provides practical central blood pressure (BP) measurement for daily clinical use with its easy-to-use, operator-independent procedure. However, this device has not been validated against invasive measurement. METHOD: Simultaneous oscillometric and high-fidelity invasive measurements of central SBP and PP were compared for 36 patients who underwent coronary arteriography...
October 19, 2016: Journal of Hypertension
Jun Tanno, Yodo Gatate, Takatoshi Kasai, Shintaro Nakano, Takaaki Senbonmatsu, Osamu Sato, Shigeru Ichioka, Makoto Kuro-O, Shigeyuki Nishimura
In peripheral arterial disease (PAD) of the lower extremities, the presence of flow-limiting stenoses can be objectively detected by the ankle-brachial index (ABI). However, the severity of ischemic symptoms is not necessarily associated with the ABI value. Atherosclerotic plaque in lower extremity PAD induces ankle arterial stiffness and reduces ankle vascular resistance, which may decrease ankle blood flow and cause ischemic symptoms. We hypothesized that the ankle hemodynamic index (AHI), defined as the ratio of ankle arterial stiffness to ankle vascular resistance, could be used to assess the blood supply deficiency in a diseased lower limb in patients with PAD...
2016: PloS One
Ana Rosa Cunha, Jenifer D'El-Rei, Fernanda Medeiros, Bianca Umbelino, Wille Oigman, Rhian M Touyz, Mario F Neves
BACKGROUND: Epidemiological studies demonstrate an inverse association between serum magnesium and incidence of cardiovascular disease. Diuretics commonly cause hypomagneseamia. METHOD: We evaluated effects of magnesium supplementation on blood pressure (BP) and vascular function in thiazide-treated hypertensive women in a randomized, double-blind, clinical trial. Hypertensive women (40-65 years) on hydrochlorothiazide and mean 24-h BP at least 130/80 mmHg were divided into placebo and supplementation (magnesium chelate 600 mg/day) groups...
October 18, 2016: Journal of Hypertension
Ryota Kobayashi, Yuto Hashimoto, Hiroyuki Hatakeyama, Takanobu Okamoto
Arterial stiffness increases after glucose ingestion. Acute low- and moderate-intensity aerobic exercise decreases arterial stiffness. However, the acute effects of 30 min of cycling at low- and moderate-intensity [25% (LE trial) and 65% (ME trial) peak oxygen uptake, respectively] on arterial stiffness at 30, 60 and 120 min of a postexercise glucose ingestion. Ten healthy young men (age, 22·4 ± 0·5 years) performed LE and ME trials on separate days in a randomized controlled crossover fashion. Carotid-femoral (aortic) pulse wave velocity (PWV), femoral-ankle (leg) PWV, carotid augmentation index (AIx) and carotid blood pressure (BP) (applanation tonometry), brachial and ankle BP (oscillometric device), heart rate (HR) (electrocardiography), blood glucose (UV-hexokinase method) and blood insulin (CLEIA method) levels were measured at before (baseline) and at 30, 60 and 120 min after the 75-g OGTT...
October 18, 2016: Clinical Physiology and Functional Imaging
Olga Trojnarska, Ludwina Szczepaniak-Chicheł, Marcin Gabriel, Agnieszka Bartczak-Rutkowska, Joanna Rupa-Matysek, Andrzej Tykarski, Stefan Grajek
BACKGROUND: Mortality in cyanotic patients with congenital heart diseases (CHD) is high, mainly due to cardiovascular complications. It is known that endothelial dysfunction, increased arterial stiffness, and impaired vascular function have negative influence on cardiovascular prognosis. The aim of the study was to assess parameters of arterial stiffness and vascular dysfunction in cyanotic patients with CHD as well as their potential relation to impaired blood oxygen saturation and polycythemia parameters typical for cyanosis...
October 15, 2016: Journal of Cardiology
H H Caline Koh-Tan, Mohammed Dashti, Ting Wang, Wendy Beattie, John Mcclure, Barbara Young, Anna F Dominiczak, Martin W Mcbride, Delyth Graham
BACKGROUND: We have previously confirmed the importance of rat chromosome 3 (RNO3) genetic loci on blood pressure elevation, pulse pressure (PP) variability and renal pathology during salt challenge in the stroke-prone spontaneously hypertensive (SHRSP) rat. The aims of this study were to generate a panel of RNO3 congenic sub-strains to genetically dissect the implicated loci and identify positional candidate genes by microarray expression profiling and analysis of next-generation sequencing data...
October 17, 2016: Journal of Hypertension
Elena Bartoloni, Giacomo Pucci, Francesca Cannarile, Francesca Battista, Alessia Alunno, Marco Giuliani, Giacomo Cafaro, Roberto Gerli, Giuseppe Schillaci
Although microvascular disease is a hallmark of systemic sclerosis (SSc), a higher prevalence of macrovascular disease and a poorer related prognosis have been reported in SSc than in the general population. The simultaneous assessment of prognostically relevant functional properties of larger and smaller arteries, and their effects on central hemodynamics, has never been performed in SSc using the state-of-the-art techniques. Thirty-four women with SSc (aged 61±15 years, disease duration 17±12 years, and blood pressure 123/70±18/11 mm Hg) and 34 healthy women individually matched by age and mean arterial pressure underwent the determination of carotid-femoral (aortic) and carotid-radial (upper limb) pulse wave velocity (a direct measure of arterial stiffness), aortic augmentation (a measure of the contribution of reflected wave to central pulse pressure), and aortobrachial pulse pressure amplification (brachial/aortic pulse pressure) through applanation tonometry (SphygmoCor)...
October 17, 2016: Hypertension
Junichiro Hashimoto
Arterial structure and function change progressively with advancing age. Owing to long-lasting repetitive stretch with intermittent cardiac contraction, elastic fibers in the tunica media of large arteries gradually degenerate and are replaced by collagenous fibers. Such medial degeneration causes elastic arteries to stiffen and dilate. However, the speed of the vascular aging varies considerably among individuals; a discrepancy often exists between the chronological age of an individual and the biological age of his or her arteries...
September 2016: Journal of Hypertension
Jeong Bae Park
High pressure of the blood in artery is a common condition and it is closely related to cardiovascular (CV) diseases in future. Blood pressure itself is the most important criteria for hypertension prognosis but attempts are being made to detect hypertensive vascular changes early. Healthy arteries are flexible, strong and elastic but if the condition of high blood pressure persists, arteries turn narrow, thick and stiff, become a condition of arteriosclerosis. And so now, pulse wave velocity (PWV) which measures arteriosclerosis became one of the clinically significant method that evaluates CV risks among patients in hypertension (yes, it is also very important for general population), detects biological changes in blood vessels caused by hypertension, and it is known as a guide for hypertension management...
September 2016: Journal of Hypertension
Trefor Morgan
Central Systolic Blood Pressure is lower than brachial artery blood Pressure due to reflected waves and greater augmentation at the periphery. The relationship is not consistent during life and alters with aging of the blood vessels. Increasing stiffness means that a greater component of the reflected waves returns to the central aorta during systolic contraction causing more amplification and a higher systolic blood pressure. Diastolic blood pressure on the other hand is always higher in the aorta than at the periphery allowing blood flow...
September 2016: Journal of Hypertension
Darae Kim, Chi Young Shim, Geu-Ru Hong, In Jeong Cho, Hyuk-Jae Chang, Jong-Won Ha, Namsik Chung
OBJECTIVE: The aim of this study was to comprehensively assess mechanical adaptation of LV in subclinical patients with hypertension(HTN) using a layer specific speckle-tracking echocardiography. DESIGN AND METHOD: Conventional transthoracic echocardiography (TTE) with 2D-layer specific speckle-tracking echocardiography was performed on 218 HTN patients with preserved LV ejection fraction (EF > 50%). Endocardial, epicardial, and transmural global longitudinal strain (GLS), global circumferential strains (GCS), and peak LV torsion were measured...
September 2016: Journal of Hypertension
Telmo Pereira, Armindo Almeida, João Maldonado, Jorge Conde
OBJECTIVE: The Moens-Korteweg equation predicts changes in pulse wave velocity (PWV) following changes in arterial radius, therefore an increase in arterial radius, as seen in a reactive hyperaemia (RH) condition, should slow PWV over a given arterial segment. If this assumption is true, than the deceleration of PWV over the brachial artery (flow-mediated slowing - FMS) should be an equivalent signal of endothelial function during a conventional RH flow-mediated dilation (FMD) procedure...
September 2016: Journal of Hypertension
Hugo Huisman, Aletta Schutte, Johannes Van Rooyen, Carla Fourie, Ruan Kruger, Wayne Smith, Leandi Lammertyn, Leone Malan, Shani Botha, Carina Mels
OBJECTIVE: Tetrahydrobiopterin (BH4) is a cofactor for nitric oxide synthase (NOS) and may be a critical agent in endothelial function by improving nitric oxide (NO) mediated effects. It is reported that the NO synthesis capacity seems favourable in blacks despite their adverse cardiovascular profile. We therefore compared the concentrations of BH4, as well as blood pressure (BP) and arterial stiffness between black and white teachers. Furthermore, we tested the associations of BH4 with a product and inhibitor of NO synthesis, namely L-citrulline, and symmetric dimethylarginine (SDMA) respectively, in both ethnic groups...
September 2016: Journal of Hypertension
Anping Cai, Ling Wang, Yingling Zhou, Jiyan Chen, Yingqing Feng, Qi Zhong
OBJECTIVE: Current study sought to evaluate the effects of obstructive sleep apnea (OSA) plus hypertension (HTN) on prevalent cardiovascular diseases (CVD). DESIGN AND METHOD: This was a cross-sectional study and a total of 1889 subjects were enrolled. The apnea-hypopnea index (AHI) was measured by polysomnography and OSA degree was classified as mild (AHI 5-14.9) and moderate-severe (AHI ≥ 15), and AHI < 5 was considered no-OSA. Mean and lowest oxyhemoglobin saturation (SaO2) was detected by pulse oximetry...
September 2016: Journal of Hypertension
Jong-Chan Youn, Hee Tae Yu, Hyeon Chang Kim, Suk-Won Choi, Seong-Woo Han, Kyu-Hyung Ryu, Eui-Cheol Shin, Sungha Park
OBJECTIVE: Chronic kidney disease (CKD) is associated with increased arterial stiffness, which is a well-known predictor of future cardiovascular events. However, the underlying mechanism of arterial stiffening in CKD is not well known. Accelerated immune aging, characterized by expansion of immunosenescent T cell fraction might be involved in the pathogenesis of arterial stiffening in CKD. We aimed to evaluate the relationship between arterial stiffness and immunosenescent T cell (CD8CD57 or CD8CD28 T cell) fraction in patients with CKD...
September 2016: Journal of Hypertension
Michel E Safar
Mid-life elevated BP is classically associated with a raised systemic vascular resistance. A classical interpretation of the association between aortic stiffness and blood pressure (BP) invokes hypertension as a simple form of premature aging that increases stress on the arterial wall and accelerates age-related stiffening of the aorta. Recent clinical and experimental data have called into question the directionality of this sequence of events associating stiffness and hypertension.Therefore an initial abnormality in stiffness may antedate and contribute initially to the pathogenesis of hypertension, namely isolated systolic hypertension...
September 2016: Journal of Hypertension
Masafumi Nishizawa
Until the early part of the 1980 s, home blood pressure (BP) was measured mainly by devices based on the Korotkoff method, in which Korotkoff sounds are detected by a microphone set in a cuff as the BP values are taken. However, when the cuff is not wound in the right place, it causes misalignment between the microphone and an artery, leading to inaccurate measurements. Noise from outside the cuff is also a problem.A mercury sphygmomanometer is generally used with the Korotkoff method. However, mercury mines, mercury use and mercury disposal are receiving increasing attention, and the Minamata Convention on Mercury treaty was adopted in 2013...
September 2016: Journal of Hypertension
Midori Awazu
ABP is more reliable and reproducible than casual BP, enables computation of the mean, daytime, night-time ABP, and 24-h pulse pressure, detects white coat effect or reversed white coat effect, and provides information regarding diurnal BP pattern as well as BP variability. ABP correlates better with target-organ damage than casual BP. ABPM is now widely used also in children. Increasing age and higher mean BP are factors that improve the success rate of ABPM. There is a guideline from American Heart Association to standardize the use of ABPM in children, including the detailed recommendations for the use of ABPM and for the interpretation of the data...
September 2016: Journal of Hypertension
Steven Steinhubl
Despite having the basic tools necessary to appropriately identify and manage individuals with hypertension for over half a century it remains the single greatest contributing risk factor to morbidity and mortality worldwide today. Since diagnosis and effective treatment availability are not issues, this major failing in care can be attributed to inadequate systems of care: systems that have led to only <20% of hypertensive individuals globally having their blood pressure adequately controlled. Even in the US, where it is one of the most common reasons for a primary care visit, and with over $42...
September 2016: Journal of Hypertension
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