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Systemic arterial hypertension

Joseph M Blankush, Robbie Freeman, Joy McIlvaine, Trung Tran, Stephen Nassani, I Michael Leitman
Modified Early Warning Scores (MEWS) provide real-time vital sign (VS) trending and reduce ICU admissions in post-operative patients. These early warning calculations classically incorporate oxygen saturation, heart rate, respiratory rate, systolic blood pressure, and temperature but have not previously included end-tidal CO2 (EtCO2), more recently identified as an independent predictor of critical illness. These systems may be subject to failure when physiologic data is incorrectly measured, leading to false alarms and increased workload...
October 20, 2016: Journal of Clinical Monitoring and Computing
Aart Mookhoek, Kapil Krishnan, Sam Chitsaz, Heide Kuang, Liang Ge, Paul H Schoof, Ad J J C Bogers, Johanna J M Takkenberg, Elaine E Tseng
BACKGROUND: Progressive autograft dilatation after a Ross operation suggests that remodeling does not effectively reproduce native aortic root biomechanics. In the first of this two-part series, we compared mechanical properties of explanted autografts to pulmonary roots at pulmonary pressures. The goal of this study was to compare mechanical properties of explanted autografts to native aortic roots at systemic pressures. METHODS: Autograft specimens were obtained from patients undergoing reoperation after Ross operation...
October 17, 2016: Annals of Thoracic Surgery
Leslie A Blair, April K Haven, Natalie N Bauer
BACKGROUND: Microparticles (MPs) stimulate inflammatory adhesion molecule expression in systemic vascular diseases, however it is unknown whether circulating MPs stimulate localized ICAM-1 expression in the heterogeneically distinct pulmonary endothelium during pulmonary arterial hypertension (PAH). Pulmonary vascular lesions with infiltrating inflammatory cells in PAH form in the pulmonary arteries and arterioles, but not the microcirculation. Therefore, we sought to determine whether circulating MPs from PAH stimulate pulmonary artery endothelial cell-selective ICAM-1 expression...
October 20, 2016: Respiratory Research
M Nagai, K Dote, M Kato, S Sasaki, N Oda, E Kagawa, Y Nakano, A Yamane, Y Kubo, T Higashihara, S Miyauchi, W Harada, H Masuda
In a cross-sectional study, visit-to-visit blood pressure (BP) variability was shown to be associated with artery remodelling. Here, we investigated the impact of visit-to-visit BP variability and average BP on the carotid artery remodelling progression in high-risk elderly according to different classes of antihypertension medication use/non-use. BP measurements and carotid ultrasound were performed in the common carotid artery in 164 subjects (mean age 79.7 years at baseline, 74.7% females) with one or more cardiovascular risk factors...
October 20, 2016: Journal of Human Hypertension
Ricardo Rodrigues Figueiredo, Andréia Aparecida Azevedo, Norma De Oliveira Penido
INTRODUCTION: Tinnitus is the perception of noise in the absence of an external source and is considered by most authors as a multifactorial symptom. A systematic review concerning the association of tinnitus and systemic arterial hypertension retrieved suggestions of a positive association, but the articles included failed to perform a detailed analysis on the theme. PURPOSE: To analyze the presence of arterial hypertension in tinnitus and non-tinnitus patients, to analyze differences between tinnitus impact and psychoacoustic measurements in hypertensive and normotensive patients, and to evaluate the association between the presence of tinnitus and the diverse antihypertensive drugs employed...
2016: Frontiers in Neurology
Seong Hwan Kim
Resistant hypertension is defined as blood pressure that remains above 140/90 mmHg in spite of the concurrent use of three antihypertensive agents of different classes at optimal dosing, of which one should be a diuretic. Accordingly, it is not synonymous with uncontrolled hypertension. Among a variety of risk factors, obstructive sleep apnea (OSA), which is a common type of sleep-disordered breathing, has been recognized a well-established risk factor for resistant hypertension. Indeed, both European and American guidelines for the management of arterial hypertension stated that OSA is a modifiable cause of resistant hypertension...
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
Katie Yates Hood, Hiba Yusuf, Jane E Findlay, Robson A Santos, Carlos H Castro, George S Baillie, Augusto C Montezano, Margaret R MacLean, Rhian M Touyz
ACE2 and Ang-1-7 have been shown to protect against pulmonary hypertension (PH). Mechanisms for this remain unclear. Considering the important role of ET-1 in the pathophysiology of PH and endothelial dysfunction, we questioned whether Ang-(1-7) influences ET-1 signaling in endothelial cells and whether Ang-(1-7) treatment influences the ET-1 system in PH. Human microvascular endothelial cells (HMEC) were stimulated with ET-1 in the absence/presence of Ang 1-7 and showed that Ang 1-7 increased preproET-1 mRNA levels, ET-1 release, and ETBR protein levels...
September 2016: Journal of Hypertension
Donghoon Choi
: Atherosclerotic renal artery stenosis is an increasingly recognized medical problem especially in elderly patients. It commonly occurs with systemic manifestations including hypertension (HTN), chronic kidney disease (CKD) or atherosclerotic diseases including coronary or peripheral artery disease. Significant renal artery stenosis may result in HTN, ischemic nephropathy, however it is still in debate about the benefit of revascularization. Although several randomized controlled trials including Angioplasty and Stenting for Renal Artery Lesions (ASTRAL) and Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) study has failed to reveal a significant benefit of angioplasty, angioplasty with medical therapy is increasingly accepted in some patients with certain clinical conditions...
September 2016: Journal of Hypertension
Thomas Weber
Validation of a medical device measuring a biomarker is a complex process, involving technical aspects (What is actually measured by the device, and how is this done ? Is the measurement reproducible ? Is there a gold standard for measurement of the particular biomarker ? If yes, how accurate and how precise are the measurements by the device, compared to the gold standard ?) and clinical aspects (Do the measurements predict outcome ? If yes, is there added value, when standard clinical parameters are considered ? Is there a treatment strategy, based on the mesurements of the novel device ? Is this strategy cost-effective ?)...
September 2016: Journal of Hypertension
Lin Shi
According to the seventh report of Joint National Committee (JNC 7), hypertensive emergency (HE), a kind of hypertensive crisis, is defined as a sudden and abrupt elevation in blood pressure so as to cause acute target organ dysfunctions, including central nervous system, cardiovascular system or kidneys. Patients with HE require immediate reduction in markedly elevated blood pressure. Currently, there are no international guidelines for children HE, so the JNC definition is commonly used. Hypertensive emergency in children is rare but a life-threatening emergency...
September 2016: Journal of Hypertension
Stephen Robert Daniels
Hypertension in children and adolescents is associated with both short and long-term abnormalities in the cardiovascular system. Ultimately, these changes can lead to myocardial infarction, stroke, congestive heart failure and chronic renal disease, all of which are associated with substantial morbidity and mortality.In the short term, the best evidence that hypertension is adversely impacting the heart and vasculature is the development of left ventricular hypertrophy, increased vascular stiffness and endothelial dysfunction...
September 2016: Journal of Hypertension
Michael J Ryan
Connective tissue diseases including systemic lupus erythematosus (SLE), rheumatoid arthritis, and scleroderma, have a strong predilection for women and are associated with a marked increase in the prevalence of hypertension. The mechanisms leading to the increased risk of hypertension in these patients remain unclear; however, they are likely related to immune mediated changes in cardiovascular and renal function. Over the past several years, we have elucidated a number of factors that contribute to the development of hypertension during SLE using a widely established experimental model of SLE, the female NZBWF1 mouse...
September 2016: Journal of Hypertension
Krasimira Hristova, Vera Bogdanova, Rumen Marinov
OBJECTIVE: Arterial hypertension (HTN) causes left ventricular (LV) dysfunction even if ejection function (EF) remains preserved. The objective of this study was to assess whether complex LAFI (left atrium functional index) had additional value in definition and grading of diastolic dysfunction and compare with indices of atrial deformation - longitudinal strain. DESIGN AND METHOD: Peak atrial longitudinal strain (PALS) was evaluated in 82 patients with systemic HTN and preserved EF (> = 55%) divided in 41 with diastolic dysfunction but no hypertrophy (HTNdd), and 41 with no diastolic dysfunction or hypertrophy (eHTN)...
September 2016: Journal of Hypertension
Levon Kocharyan, Lilit Baghdasaryan
OBJECTIVE: About 40% of adult population suffers from arterial hypertension and its complications are in the leading places among overall and cerebrovascular mortality. Despite the broad range of available medications and its combinations, less than half of the patients have adequately controlled blood pressure worldwide. And arterial hypertension has a great social and economic impact. Our goal was to create a program which will give an opportunity for long term control of arterial hypertension and closer follow up...
September 2016: Journal of Hypertension
Patricia Melin, German Prado-Arechiga, Martha Pulido, Ivette Miramontes
OBJECTIVE: The development of an artificial modular neural network (MNN) method for diagnosing and classification of arterial Hypertension based on the level of the blood pressure (BP) of a patient is presented. The main goal is to diagnose the degree of hypertension based on the BP values using MNN applying response integration via a gating network approach. DESIGN AND METHOD: This study was performed with 28 patients to classify the BP levels, based on the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC) Guidelines of Hypertension...
September 2016: Journal of Hypertension
Cesar Romero, Sumit Monu, Glauber Cabral, Robert Knight, Oscar Carretero
OBJECTIVE: Renal hemodynamics is critical for regulation of glomerular filtration (GFR), sodium excretion and blood pressure (BP), and it depends on myogenic response, tubuloglomerular feedback (TGF) and connecting tubule-glomerular feedback (CTGF). CTGF dilates afferent arteriole in response to high sodium in connecting tubule (CNT), counteracting and resetting TGF; and increasing the plasma flow and glomerular pressure favoring sodium excretion. CTGF is initiated by epithelial sodium channel (ENaC) activation in CNT and inhibited by ENaC blocker Benzamil...
September 2016: Journal of Hypertension
Yuki Imaizumi, Kazuo Eguchi, Toshiki Kaihara, Kumiko Urano, Rieko Shinagawa, Minoru Araki, Koji Inoue, Koichiro Hokao, Yuka Tsujita, Takuya Furusawa, Ryuichiro Kaku, Kazuomi Kario
OBJECTIVE: We tested the hypothesis that sarcopenia, an age-related loss of skeletal muscle mass and function, is associated with arterial stiffness in patients with diabetes (DM). DESIGN AND METHOD: We studied 65 hypertensives in the Real BP study, an observational study of home BP telemonitoring system. As parameters of sarcopenia, we used locomotive syndrome scale, circumference of the wrist, lower leg, and thigh (10 cm above the patella), grip strength, and 6 minute-walk test...
September 2016: Journal of Hypertension
Katie Y Hood, Hiba Yusuf, Jane E Findlay, Robson A Santos, Carlos H Castro, George S Baillie, Margaret R MacLean, Augusto Montezano, Rhian M Touyz
OBJECTIVE: Ang(1-7) has been shown to protect against pulmonary hypertension (PH). Mechanisms remain unclear. Considering the importance of ET-1 in PH pathophysiology and endothelial dysfunction, we questioned whether Ang(1-7) influences ET-1 signaling in endothelial cells and whether Ang(1-7) treatment influences the ET-1 system in PH. DESIGN AND METHOD: Human endothelial cells (hEC) were stimulated with ET-1 in absence/presence of Ang(1-7). Mas and ETBR interaction was observed by immunoprecipitation...
September 2016: Journal of Hypertension
Yang Gyun Kim, Sangho Lee, Ju Young Moon, Se Yeon Kim, Yu Ho Lee, Seok Jong Song, Kyung Whan Jeoung, Tae Won Lee, Chun Gyu Ihm
OBJECTIVE: Intrarenal renin-angiotensin system (RAS) had an important role to generate and maintain hypertension in 2-kidny 1-clip (2K1C) rats. This study purposed to assess how various intrarenal RAS components of 2K1C rats contributed to hypertension in different parts (cortex, medulla) of both sides (CK; clipped-kidney, NCK; non-clipped kidney) at different times (2 weeks; 2w and 5 weeks; 5w after clipping operation). DESIGN AND METHOD: We conducted to insert clip to left renal artery or sham operation to SD rats, then systolic blood pressure (SBP) was measured at one week interval...
September 2016: Journal of Hypertension
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