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Masked Hypertension

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https://www.readbyqxmd.com/read/28219980/activation-of-neuronal-endothelin-b-receptors-mediates-pressor-response-through-alpha-1-adrenergic-receptors
#1
Bryan K Becker, Joshua S Speed, Mackenzie Powell, David M Pollock
Abnormalities in activity of the endothelin (ET) system have been widely reported in a number of cardiovascular disease states such as hypertension and heart failure. Although the vascular responses to ET are well established, the interaction between ET and other important modulators of blood pressure, such as the sympathetic nervous system, are less understood. Previous reports implicate ET signaling through ET type B (ETB) receptors in increasing neuronal activity. Therefore, we hypothesized that activation of ETB receptors on sympathetic nerves would increase blood pressure through an adrenergic-mediated mechanism...
February 2017: Physiological Reports
https://www.readbyqxmd.com/read/28192475/adverse-cardiac-effects-of-exogenous-angiotensin-1-7-in-rats-with-subtotal-nephrectomy-are-prevented-by-ace-inhibition
#2
Louise M Burrell, Daniel Gayed, Karen Griggs, Sheila K Patel, Elena Velkoska
We previously reported that exogenous angiotensin (Ang) 1-7 has adverse cardiac effects in experimental kidney failure due to its action to increase cardiac angiotensin converting enzyme (ACE) activity. This study investigated if the addition of an ACE inhibitor (ACEi) to Ang 1-7 infusion would unmask any beneficial effects of Ang 1-7 on the heart in experimental kidney failure. Male Sprague-Dawley rats underwent subtotal nephrectomy (STNx) and were treated with vehicle, the ACEi ramipril (oral 1mg/kg/day), Ang 1-7 (subcutaneous 24 μg/kg/h) or dual therapy (all groups, n = 12)...
2017: PloS One
https://www.readbyqxmd.com/read/28190578/quarter-dose-quadruple-combination-therapy-for-initial-treatment-of-hypertension-placebo-controlled-crossover-randomised-trial-and-systematic-review
#3
Clara K Chow, Jay Thakkar, Alex Bennett, Graham Hillis, Michael Burke, Tim Usherwood, Kha Vo, Kris Rogers, Emily Atkins, Ruth Webster, Michael Chou, Hakim-Moulay Dehbi, Abdul Salam, Anushka Patel, Bruce Neal, David Peiris, Henry Krum, John Chalmers, Mark Nelson, Christopher M Reid, Mark Woodward, Sarah Hilmer, Simon Thom, Anthony Rodgers
BACKGROUND: Globally, most patients with hypertension are treated with monotherapy, and control rates are poor because monotherapy only reduces blood pressure by around 9/5 mm Hg on average. There is a pressing need for blood pressure-control strategies with improved efficacy and tolerability. We aimed to assess whether ultra-low-dose combination therapy could meet these needs. METHODS: We did a randomised, placebo-controlled, double-blind, crossover trial of a quadpill-a single capsule containing four blood pressure-lowering drugs each at quarter-dose (irbesartan 37·5 mg, amlodipine 1·25 mg, hydrochlorothiazide 6·25 mg, and atenolol 12·5 mg)...
February 9, 2017: Lancet
https://www.readbyqxmd.com/read/28179625/short-term-variability-and-nocturnal-decline-in-ambulatory-blood-pressure-in-normotension-white-coat-hypertension-masked-hypertension-and-sustained-hypertension-a-population-based-study-of-older-individuals-in-spain
#4
Teresa Gijón-Conde, Auxiliadora Graciani, Esther López-García, Pilar Guallar-Castillón, Esther García-Esquinas, Fernando Rodríguez-Artalejo, José R Banegas
Blood pressure (BP) variability and nocturnal decline in blood pressure are associated with cardiovascular outcomes. However, little is known about whether these indexes are associated with white-coat and masked hypertension. We performed a cross-sectional analysis of 1047 community-dwelling individuals aged ⩾60 years in Spain in 2012. Three observer-measured home BPs and 24-h ambulatory blood pressure monitoring (ABPM) were performed under standardized conditions. BP variability was defined as BP s.d. and coefficient of variation...
February 9, 2017: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/28165190/metabolic-syndrome-and-masked-hypertension-among-african-americans-the-jackson-heart-study
#5
Lisandro D Colantonio, D Edmund Anstey, April P Carson, Gbenga Ogedegbe, Marwah Abdalla, Mario Sims, Daichi Shimbo, Paul Muntner
The metabolic syndrome is associated with higher ambulatory blood pressure. The authors studied the association of metabolic syndrome and masked hypertension (MHT) among African Americans with clinic-measured systolic/diastolic blood pressure (SBP/DBP) <140/90 mm Hg in the Jackson Heart Study. MHT was defined as daytime, nighttime, or 24-hour hypertension on ambulatory blood pressure monitoring. Among 359 participants not taking antihypertensive medication, the metabolic syndrome was associated with MHT (prevalence ratio, 1...
February 6, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28159431/cost-effectiveness-of-ambulatory-blood-pressure-monitoring-in-the-management-of-hypertension
#6
Diogo Costa, Ricardo Peixoto Lima
INTRODUCTION AND OBJECTIVES: The prevalence of hypertension in Portugal is between 29.1% and 42.2%. International studies show that 13% of individuals have masked hypertension and 13% of diagnoses based on office blood pressure measurements are in fact white coat hypertension. More sensitive and specific blood pressure measuring methods could avoid costs associated with misdiagnosis. The aim of this study was to review the cost-effectiveness of ambulatory blood pressure monitoring (ABPM) compared to other methods in the management of hypertension...
February 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28143688/sleep-apnea-state-of-the-art
#7
REVIEW
Martin R Cowie
Many patient with, or at risk of, cardiovascular disease have sleep disordered breathing (SDB), which can be either obstructive (with intermittent collapse of the upper airway) or central (episodic loss of respiratory drive). SDB is associated with sleep disturbance, hypoxemia, hemodynamic changes, and sympathetic activation. Such patients have a worse prognosis than those without SDB. Mask-based therapies of positive airway pressure targeted at SDB can improve measures of sleep quality and partially normalize the sleep and respiratory physiology, but recent randomized trials of cardiovascular outcomes in SDB have either been neutral (obstructive sleep apnea) or suggested the possibility of harm, likely from increased sudden death, in central sleep apnea...
December 20, 2016: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28137662/is-waist-circumference-%C3%A2-102-88cm-better-than-body-mass-index-%C3%A2-30-to-predict-hypertension-and-diabetes-development-regardless-of-gender-age-group-and-race-ethnicity-meta-analysis
#8
REVIEW
Dong-Chul Seo, Siyoung Choe, Mohammad R Torabi
Between body mass index (BMI) ≥30 and waist circumference (WC) ≥102/88cm, we investigated which of the two measures is a better predictor of two of the most common chronic diseases - diabetes mellitus and hypertension while also examining differential association by gender, age group, and race/ethnicity. Meta-analysis was conducted for all longitudinal studies with at least 12months of follow-up published up to April 2015. Ratio of relative risk (rRR) and relative risk of diseases were computed and compared by baseline obesity measurement...
January 27, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28129738/a-novel-case-of-renal-pathergy-reaction-in-a-beh%C3%A3-et-s-disease-patient-complicated-by-iga-vasculitis
#9
Takaaki Higashihara, Akira Okada, Taiko Kusano, Kazuyoshi Ishigaki, Akira Shimizu, Hideki Takano
BACKGROUND: A pathergy reaction is defined as a hyperreactivity of the skin in response to minimal trauma, which is important in the diagnosis of Behçet's disease (BD). However, a pathergy reaction may not be restricted to the skin, and little is known about whether an invasive medical procedure can induce the reaction. Here we present a pathergy reaction induced by renal biopsy, an invasive procedure. CASE PRESENTATION: A 46-year-old man who was diagnosed with IgA vasculitis (IgAV) at the age of 38 was treated with prednisolone and mizoribine...
January 28, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28121837/prognostic-significance-of-masked-tachycardia-in-hypertension-evidence-from-a-prospective-international-registry
#10
Dagmara Hering, Guido Grassi
No abstract text is available yet for this article.
March 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28118277/24-h-pulse-pressure-cutoff-point-definition-by-office-pulse-pressure-in-a-population-of-spanish-older-hypertensive-patients
#11
Ernest Vinyoles, Alejandro de la Sierra, Albert Roso-Llorach, José R Banegas, Juan José de la Cruz, Manuel Gorostidi, Julián Segura, Juan Antonio Divisón, Gema Ruíz-Hurtado, Luis Miguel Ruilope
OBJECTIVE: The European Guidelines on Hypertension define an office pulse pressure (PP) at least 60 mmHg in the elderly patient as asymptomatic organ damage. Our objective was to estimate the cutoff point of 24-h PP that best predicts office PP associated with higher cardiovascular risk (≥60 mmHg) in hypertensive older patients. METHODS: We studied all hypertensive patients at least 60 years with a first valid ambulatory blood pressure monitoring drawn from the Spanish ambulatory blood pressure monitoring registry...
January 23, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28114655/disaggregation-of-cause-specific-cardiovascular-disease-mortality-among-hispanic-subgroups
#12
Fatima Rodriguez, Katherine G Hastings, Derek B Boothroyd, Sandra Echeverria, Lenny Lopez, Mark Cullen, Robert A Harrington, Latha P Palaniappan
Importance: Hispanics are the largest minority group in the United States and face a disproportionate burden of risk factors for cardiovascular disease (CVD) and low socioeconomic position. However, Hispanics paradoxically experience lower all-cause mortality rates compared with their non-Hispanic white (NHW) counterparts. This phenomenon has been largely observed in Mexicans, and whether this holds true for other Hispanic subgroups or whether these favorable trends persist over time remains unknown...
January 18, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28100465/prevalence-of-masked-hypertension-among-us-adults-with-nonelevated-clinic-blood-pressure
#13
Y Claire Wang, Daichi Shimbo, Paul Muntner, Andrew E Moran, Lawrence R Krakoff, Joseph E Schwartz
Masked hypertension (MHT), defined as nonelevated blood pressure (BP) in the clinic setting and elevated BP assessed by ambulatory monitoring, is associated with increased risk of target organ damage, cardiovascular disease, and mortality. Currently, no estimate of MHT prevalence exists for the general US population. After pooling data from the Masked Hypertension Study (n = 811), a cross-sectional clinical investigation of systematic differences between clinic BP and ambulatory BP (ABP) in a community sample of employed adults in the New York City metropolitan area (2005-2012), and the National Health and Nutrition Examination Survey (NHANES; 2005-2010; n = 9,316), an ongoing nationally representative US survey, we used multiple imputation to impute ABP-defined hypertension status for NHANES participants and estimate MHT prevalence among the 139 million US adults with nonelevated clinic BP, no history of overt cardiovascular disease, and no use of antihypertensive medication...
January 18, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28099129/the-association-between-obesity-hypertension-and-left-ventricular-mass-in-adolescents
#14
Saime Ergen Dibeklioglu, Berna Şaylan Çevik, Banu Acar, Zeynep Birsin Özçakar, Nermin Uncu, Nazlı Kara, Şemsa Çaycı, Nilgün Çakar
BACKGROUND: Obesity and hypertension (HT) are well known cardiac risk factors. Our goal was to show that even if arterial blood pressure (BP) measurements of obese adolescents are normal during clinical examination, ambulatory blood pressure monitoring (ABPM) can be high, may include cardiac involvement and can also detect left ventricular mass indices (LVMI) value for obese adolescents to diagnose left ventricular hypertrophy (LVH). METHODS: This study included 130 children (57 obese hypertensive, 36 obese normotensive, 14 normal weight hypertensive and 23 normal weight normotensive)...
February 1, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28070059/differences-in-cardiovascular-responses-to-alamandine-in-two-kidney-one-clip-hypertensive-and-normotensive-rats
#15
Ava Soltani Hekmat, Kazem Javanmardi, Amin Kouhpayeh, Ehsan Baharamali, Mojtaba Farjam
BACKGROUND: Alamandine is a newly discovered component of the renin-angiotensin system, which regulates blood pressure. In this study, the effect of alamandine on cardiovascular parameters in two-kidney, one clip (2K1C) hypertensive rats and normotensive rats, and the possible roles of the angiotensin II type 1 receptor (AT1R) and the PD123319-sensitive receptors in mediating this effect was investigated.Methods and Results:The cardiovascular parameters were monitored for 10 min before the infusion of the drugs or saline, and for 30 min afterward...
January 7, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28052877/blood-pressure-measurement-anno-2016
#16
REVIEW
Jan A Staessen, Yan Li, Azusa Hara, Kei Asayama, Eamon Dolan, Eoin O'Brien
The rational management of hypertension (HT) inevitably starts with accurate measurement of blood pressure (BP). The recently published Systolic Blood Pressure Intervention Trial implemented automated office BP measurement. However, event-driven studies have overwhelmingly indicated that out-of-the-office BP monitoring is a prerequisite for risk stratification and for identifying the need of initiating or adjusting antihypertensive drug treatment. 24-Hour ambulatory BP monitoring is the preferred method of BP measurement and addresses major issues not covered by conventional or automated office BP measurement or home BP monitoring, such as reliably diagnosing nocturnal HT (the time window of the day during which BP is most predictive of adverse cardiovascular outcome), hypotension, or masked HT, a condition that affects 15% of the general populations and carries a risk equal to that of HT on both office and out-of-the-office BP measurement...
January 4, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28034462/masked-hypertension-rather-than-white-coat-hypertension-has-a-prognostic-role-in-patients-with-non-dialysis-chronic-kidney-disease
#17
Cheng Wang, Jun Zhang, Yan Li, Xinxin Ma, Zengchun Ye, Hui Peng, Tanqi Lou
OBJECTIVE: Masked hypertension (MHT) and white-coat hypertension (WCHT) have been studied among the general population and hypertensive patients. However, little insight is available on the prognosis of MHT and WCHT in patients with chronic kidney disease (CKD). We investigated the role of MHT and WCHT in the prognosis of patients with non-dialysis CKD. METHODS: A prospective cohort study was conducted between July 2010 and December 2014. A total of 588 patients with non-dialysis CKD were enrolled for ambulatory and clinic blood pressure (BP) monitoring...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28033135/omega-3-fatty-acid-supplementation-and-warfarin-a-lethal-combination-in-traumatic-brain-injury
#18
Brian W Gross, Maria Gillio, Cole D Rinehart, Caitlin A Lynch, Frederick B Rogers
Polyunsaturated fatty acids such as omega-3 eicosapentaenoic acid and omega-6 docosahexaenoic acid, found in over-the-counter fish oil supplements, are often consumed for their beneficial, prophylactic, anti-inflammatory effects. Although the mechanisms of action are not fully known, a diet rich in polyunsaturated fats may reduce the risk of hyperlipidemia, atherosclerosis, high low-density lipoprotein cholesterol levels, hypertension, and inflammatory diseases. Masked by its many benefits, the risks of omega-3 fatty acid supplementation are often underappreciated, particularly its ability to inhibit platelet aggregation and promote bleeding in patients taking anticoagulant medications...
January 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28028191/clinic-versus-daytime-ambulatory-blood-pressure-difference-in-hypertensive-patients-the-impact-of-age-and-clinic-blood-pressure
#19
José R Banegas, Luis M Ruilope, Alejandro de la Sierra, Ernest Vinyoles, Manuel Gorostidi, Juan J de la Cruz, Julián Segura, Anna Oliveras, Nieves Martell, Juan García-Puig, Bryan Williams
Clinic blood pressure (BP) is usually higher than daytime ambulatory BP in hypertensive patients, but some recent studies have challenged this view, suggesting that this relationship is strongly influenced by age. We used the Spanish ambulatory BP monitoring cohort to examine differences between clinic and daytime BP by age among 104 639 adult hypertensive patients (office systolic/diastolic BP ≥140/90 mm Hg or treated) in usual primary-care practice, across the wide age spectrum. To assess the impact of age, cardiovascular variables, and clinic BP on the clinic-daytime BP differences, we built multivariable regression models of the average BP differences, white-coat hypertension (high clinic BP and normal daytime BP), and masked hypertension (normal clinic BP and high daytime BP)...
February 2017: Hypertension
https://www.readbyqxmd.com/read/28012774/-intermittent-left-bundle-branch-block-reversal-to-normal-conduction-during-general-anesthesia
#20
Ana Maria Oliveira Correia da Silva, Emília Alexandra Gaspar Lima da Silva
BACKGROUND AND OBJECTIVES: Transient changes in intraoperative cardiac conduction are uncommon. Rare cases of the development or remission of complete left bundle branch block under general and locoregional anesthesia associated with myocardial ischemia, hypertension, tachycardia, and drugs have been reported. Complete left bundle branch block is an important clinical manifestation in some chronic hypertensive patients, which may also be a sign of coronary artery disease, aortic valve disease, or underlying cardiomyopathy...
December 21, 2016: Revista Brasileira de Anestesiologia
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