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Ambulatory blood pressure

Michaela L Sundqvist, Jon O Lundberg, Eddie Weitzberg
The nitrate-nitrite-nitric oxide pathway has emerged as a significant source of nitric oxide (NO) bioactivity. Dietary intake of inorganic nitrate has a number of cardiovascular effects as well as a decrease in oxygen cost during exercise and a reduction in resting metabolic rate (RMR). Oral bacteria have a key role in bioactivation of inorganic nitrate since they catalyse the conversion of salivary nitrate to the more reactive nitrite anion. Recent studies demonstrate that blood pressure increases with the use of an antiseptic mouthwash, indicating that endogenous, NO-synthase derived nitrate is recycled into nitrite and NO, sufficiently to modulate cardiovascular function...
October 18, 2016: Nitric Oxide: Biology and Chemistry
Krzysztof Narkiewicz, Laura E K Ratcliffe, Emma C Hart, Linford J B Briant, Marzena Chrostowska, Jacek Wolf, Anna Szyndler, Dagmara Hering, Ana P Abdala, Nathan Manghat, Amy E Burchell, Claire Durant, Melvin D Lobo, Paul A Sobotka, Nikunj K Patel, James C Leiter, Zoar J Engelman, Angus K Nightingale, Julian F R Paton
Animal and human data indicate pathological afferent signaling emanating from the carotid body that drives sympathetically mediated elevations in blood pressure in conditions of hypertension. This first-in-man, proof-of-principle study tested the safety and feasibility of unilateral carotid body resection in 15 patients with drug-resistant hypertension. The procedure proved to be safe and feasible. Overall, no change in blood pressure was found. However, 8 patients showed significant reductions in ambulatory blood pressure coinciding with decreases in sympathetic activity...
August 2016: JACC. Basic to Translational Science
Christina M Cromwell, Kristin R Aichele, Joyann E Oakman, Michael P Neal, Jessica M Lenzo, Avery N Perez, Naomi L Bye, Erica L Santaniello, Jessica A Hill, Rachel C Evans, Karla A Thiele, Lauren N Chavis, Allyson K Getty, Tia R Wisdo, Deborah L Feairheller
Previous studies have investigated carotid artery intima-media thickness (IMT) and blood pressure and found a direct correlation between the two. It is known that adult females have better cardiovascular health than males until a certain stage of life, yet limited research has examined gender differences in vascular function. Thus, the purpose of this study was to investigate vascular structure and function, blood pressure, and blood glucose/cholesterol levels in relation to gender differences in young healthy adults...
2016: International Journal of Exercise Science
Peter Mathijs van Brussel, Bas van den Bogaard, Barbara A de Weijer, Jasper Truijen, Paul Ct Krediet, Ignace M Janssen, Arnold van de Laar, Karin A Kaasjager, Eric Fliers, Johannes J Van Lieshout, Mireille Johanna Serlie, Bert-Jan H van den Born
BACKGROUND: Blood pressure (BP) decreases in the first weeks after Roux-and-Y gastric bypass surgery. Yet, the pathophysiology of the BP lowering effects observed after gastric bypass surgery are incompletely understood. METHODS: We evaluated BP, systemic hemodynamics and baroreflex sensitivity in 15 obese women (mean age 42±7 yrs, body mass index 45±6 kg/m(2)) two weeks before and six weeks following Roux-and-Y gastric bypass surgery. RESULTS: Six weeks after gastric bypass surgery mean body weight decreased by 13±5 kg (10%, p<0...
October 20, 2016: Journal of Applied Physiology
Irma Elizabeth Huayanay-Espinoza, Felix Guerra-Castañon, María Lazo-Porras, Ana Castaneda-Guarderas, Nimmy Josephine Thomas, Ana-Lucia Garcia-Guarniz, Augusto A Valdivia-Bustamante, Germán Málaga
OBJECTIVE: The objective of this study was to assess patients' achievement of ADA (American Diabetes Association) guideline recommendations for glycosylated hemoglobin, lipid profile, and blood pressure in a type 2 diabetes mellitus (T2DM) outpatient clinic in a low-middle income country (LMIC) setting. METHODS: This is a descriptive cross-sectional study with 123 ambulatory T2DM patients who are being treated at a public hospital in Lima, Peru. Data was gathered via standardized interviews, clinical surveys, and anthropomorphic measurements for each patient...
2016: PeerJ
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
Michael Böhm, Christian Ukena, Sebastian Ewen, Dominik Linz, Ina Zivanovic, Uta Hoppe, Krzysztof Narkiewicz, Luis Ruilope, Manuela Negoita, Roland Schmieder, Bryan Williams, Uwe Zeymer, Andreas Zirlik, Guiseppe Mancia, Felix Mahfoud
OBJECTIVES: Renal denervation (RDN) can reduce sympathetic activity and blood pressure (BP) in patients with hypertension. The effects on resting and ambulatory heart rate (HR), also regulated by the sympathetic nervous system, are not established. METHODS: Herein, we report 12-month outcomes from the Global SYMPLICITY Registry on office and ambulatory HR and BP in patients with uncontrolled hypertension (n = 846). RESULTS: HR declined in correlation with the HR at baseline and at 12 months, in particular, in patients in the upper tertile of HR (>74 bpm)...
October 15, 2016: Journal of Hypertension
Margarida Mendes, Julie Dubourg, Anne Blanchard, Damien Bergerot, Pierre-Yves Courand, Valentina Forni, Michael Frank, Guillaume Bobrie, Joel Menard, Michel Azizi
OBJECTIVES: The participation of vasopressin in the mechanisms of resistant hypertension is unclear. We compared plasma copeptin concentration, a surrogate marker for vasopressin secretion, between patients with resistant hypertension and those with controlled blood pressure (CBP), in a post hoc analysis of the Prise en charge de l'Hypertension Artérielle RESistante au traitement trial. METHODS: After 4-week treatment with irbesartan 300 mg/day, hydrochlorothiazide 12...
October 15, 2016: Journal of Hypertension
Eun Joo Cho, Hae Young Lee, Ki Chul Sung, Sungha Park, Chang Gyu Park, Dong-Ju Choi, Jong Won Ha, Young Keun Ahn, Jinho Shin, Soon-Jun Hong, Soon Kil Kim, Wook-Jin Chung, Byung Su Yoo, Taek Jong Hong, Ho Joong Youn, Myeong-Chan Cho, Shung Chull Chae, Young Jo Kim, Chong-Jin Kim
BACKGROUND: The aim of this study was to compare 24-hour central blood pressure (24 hr c-BP) reduction efficacy between angiotensin II receptor blocker (ARB) combined with calcium channel blocker and with diuretics. METHODS: We conducted a prospective, randomized, double-blind trial in 220 hypertensive patients [mean age = 59.6 ± 12.3 years, men = 154(70%)]. Patients received losartan 50 mg monotherapy for 4 weeks, followed by additional use of amlodipine 5 mg (L/A group) or hydrochlorothiazide 12...
September 2016: Journal of Hypertension
Byeong-Keuk Kim
Catheter-based renal sympathetic denervation (RDN) has opened the new world in the treatment of resistant or refractory hypertension. However, SYMPLICITY HTN-3, 2:1 randomization, blinded and sham-controlled study did not show a significant reduction of systolic blood pressure (BP) in patients with resistant hypertension 6 months after RDN as compared with a sham control. After that, substudy investigating the predictors of BP responses in SYMPLICITY HTN-3 trial was reported; racial difference and optimal medical treatment were issued for the optimal denervation therapy...
September 2016: Journal of Hypertension
Kyoung Im Cho, Eun A Cho, Jung Ho Heo, Hyun Su Kim, Sung Il Im, Tae Joon Cha
OBJECTIVE: Increased sympathetic activity is one of the proposed mechanisms underlying exaggerated blood pressure (BP) response to exercise (EBPR). Heart rate recovery (HRR) is a simple non-invasive measurement analyzing autonomic nervous dysfunction, and has been shown to predict cardiovascular disease mortality. We aimed to the association between HRR and EBPR in patients with hypertension according to the circadian pattern and white coat hypertension. DESIGN AND METHOD: A total of 409 consecutive patients who simultaneously underwent Treadmill test and 24-hours ambulatory BP monitoring (ABPM) were included to this cross-sectional case-control study...
September 2016: Journal of Hypertension
Huan Wang, Hui Chen
OBJECTIVE: Circadian rhythm disruption is shown to be the cause of various health disorders. CLOCK and BMAL1, two core circadian transcription factors, were associated with the regulation of glucose homeostasis. This study evaluated the association between single nucleotide polymorphisms in CLOCK and BMAL1 gene and insulin resistance (IR) in hypertensive patients. DESIGN AND METHOD: We collected 334 outpatients with essential hypertension (EH), who have not taken any antihypertensive agents or stopped the medications for at least a week for this case-control study...
September 2016: Journal of Hypertension
Weiwei Zeng, Tanya Chu, Miao Hu, Alice Kong, Brian Tomlinson
OBJECTIVE: The blood pressure (BP) response to antihypertensive drugs varies considerably between different patients. The response to some beta-blockers has been associated with polymorphisms in the beta1-adrenergic receptor (ADRB1) or cytochrome P450 2D6 (CYP2D6) genes. We examined the effects of common polymorphisms in ADRB1 and CYP2D6 on the response to bisoprolol in 100 Chinese patients. DESIGN AND METHOD: Chinese patients with primary hypertension with sitting clinic systolic BP (SBP) 140-169 mmHg and/or diastolic BP (DBP) 90-109 mmHg after placebo run-in were treated with open-label bisoprolol 2...
September 2016: Journal of Hypertension
Yuan-Yuan Kang, Yan Li, Qi-Fang Huang, Jie Song, Xiao-Li Shan, Ji-Guang Wang
OBJECTIVE: Cigarette smoking is associated with chronic and acute endothelial dysfunction, and hence probably also elevated out-of-clinic blood pressure. In the present study, we investigated the association between cigarette smoking and masked hypertension defined as elevated out-of-clinic pressure but normal clinic pressure. DESIGN AND METHOD: Our study included male participants of the China Ambulatory and Home BP Registry, who underwent clinic, 24-hour ambulatory and 7-day home BP monitoring...
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
Jun Oh
Hypertension is a major risk factor for stroke, coronary artery disease and kidney damage in adults and children. There is a paucity of data on the long-term sequelae of persistent hypertension in children, but it is already known that children with hypertension have evidence of end organ damage and are at risk of hypertension into adulthood. The prevalence of hypertension in children is rising, most likely due to a concurrent rise in obesity rates. In children with hypertension, non-pharmacological measures are often recommended as first-line therapy, but a significant proportion of children will eventually require pharmacological treatment to reduce blood pressure, especially those with evidence of end organ damage at presentation or during follow-up...
September 2016: Journal of Hypertension
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
Yutaka Imai
It has been confirmed that clinical significance of home blood pressure measurements (HBPM) is higher than clinic BP measurements and ambulatory BP monitoring. However, several drawbacks of HBPM have also been mentioned, e.g. selection and reporting biases, difficulties of calculation of multiple measurements, difficulties of onsite judgement of numerous recordings, etc. Recent devices for HBPM incorporate memory function. This function can overcome such drawbacks of HBPM. These memorized data can transmit, storage, retrieve, be arithmetic and control, be judged based on algorithm and be got feedback...
September 2016: Journal of Hypertension
Christian Ott, Iris Kistner, Axel Schmid, Stefanie Friedrich, Tilmann Ditting, Roland Veelken, Felix Mahfoud, Michael Böhm, Michael Uder, Roland Schmieder
OBJECTIVE: Renal denervation (RDN) lowers blood pressure (BP) by interruption of sympathetic nerve activity. A high sympathetic tone increases not only BP but also decreases pancreatic beta cell insulin secretion. Hence, the objective of the study was to analyze whether RDN improves secretory capacity of beta cells. DESIGN AND METHOD: In 40 patients (7 diabetics, 19 prediabetics, 14 non diabetics) with treatment resistant hypertension (defined by office BP ≥ 140/90 mmHg and diagnosis confirmed with 24-h ambulatory BP ≥ 130/80 mmHg), insulin secretion was measured before and 6 months after RDN (Simplicity flex catheter, Medtronic) by glucagon test...
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
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