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Resistant hypertension

Satoshi Murao, Yasunori Takata, Mitsugi Yasuda, Haruhiko Osawa, Fumikazu Kohi
Background: Considering sex differences, salt sensitivity and insulin resistance (IR), the effect of sodium restriction and increased potassium intake on blood pressure remains unclear in normotensive Asian individuals, compared to that in hypertensive patients. Methods: To assess the influence of sodium and potassium intake in normotensive individuals, we evaluated the estimated 24-hour urinary sodium and potassium excretion rate in 3,392 drug-naïve normotensive Japanese individuals (average age: 48...
March 14, 2018: American Journal of Hypertension
Afroditi Despina Lalou, Marek Czosnyka, Joseph Donnelly, John D Pickard, FMedSci, Eva Nabbanja, Nicole C Keong, Matthew Garnett, Zofia H Czosnyka
OBJECTIVE Normal pressure hydrocephalus is not simply the result of a disturbance in CSF circulation, but often includes cardiovascular comorbidity and abnormalities within the cerebral mantle. In this study, the authors have examined the relationship between the global autoregulation pressure reactivity index (PRx), the profile of disturbed CSF circulation and pressure-volume compensation, and their possible effects on outcome after surgery. METHODS The authors studied a cohort of 131 patients in whom a clinical suspicion of normal pressure hydrocephalus was investigated...
March 16, 2018: Journal of Neurosurgery
Ye Seul Yang, Min Hyuk Lim, Seong Ok Lee, Eun Roh, Chang Ho Ahn, Soo Heon Kwak, Young Min Cho, Sungwan Kim, Andrea Mari, Kyong Soo Park, Hye Seung Jung
AIMS: Angiotensin receptor blockers (ARB) are anti-hypertensive drugs with renal protective effect. Additionally, they have been associated with the delayed onset of type 2 diabetes in high-risk populations, and some ARB were reported to increase insulin secretion and sensitivity in patients with prediabetes. Therefore, we studied the effects of ARB on insulin secretion in hypertensive patients with type 2 diabetes. MATERIALS AND METHODS: Forty-one patients were enrolled in this open-labeled, active comparator-controlled and crossover study...
March 15, 2018: Diabetes, Obesity & Metabolism
Theodore W Kurtz, Stephen E DiCarlo, Michal Pravenec, R Curtis Morris
High salt intake is one of the major dietary determinants of hypertension and cardiovascular disease in Japan and throughout the world. Although dietary salt restriction may be of clinical benefit in salt-sensitive individuals, many individuals may not wish, or be able to, reduce their intake of salt. Thus, identification of functional foods that can help protect against mechanistic abnormalities mediating salt-induced hypertension is an issue of considerable medical and scientific interest. According to the "vasodysfunction" theory of salt-induced hypertension, the hemodynamic abnormality initiating salt-induced increases in blood pressure usually involves subnormal vasodilation and abnormally increased vascular resistance in response to increased salt intake...
March 12, 2018: Journal of Cardiology
Cinta Moraleda, Rachid Benmessaoud, Jessica Esteban, Yuly López, Hassan Alami, Amina Barkat, Tligui Houssain, Meryem Kabiri, Rachid Bezad, Saad Chaacho, Lola Madrid, Jordi Vila, Carmen Muñoz-Almagro, Jordi Bosch, Sara M Soto, Quique Bassat
PURPOSE: Group B streptococcus (GBS) is an important cause of neonatal sepsis worldwide. Data on the prevalence of maternal GBS colonization, risk factors for carriage, antibiotic susceptibility and circulating serotypes are necessary to tailor adequate locally relevant public health policies. METHODOLOGY: A prospective study including pregnant women and their newborns was conducted between March and July 2013 in Morocco. We collected clinical data and vagino-rectal and urine samples from the recruited pregnant women, together with the clinical characteristics of, and body surface samples from, their newborns...
March 15, 2018: Journal of Medical Microbiology
Ayako Uchinaka, Yuri Kawashima, Yuki Sano, Shogo Ito, Yusuke Sano, Kai Nagasawa, Natsumi Matsuura, Mamoru Yoneda, Yuichiro Yamada, Toyoaki Murohara, Kohzo Nagata
Melatonin regulates circadian rhythms but also has antioxidative and anti-inflammatory effects that ameliorate metabolic disorders. We investigated the effects of the selective melatonin agonist ramelteon on cardiac and adipose tissue pathology in the DahlS.Z-Leprfa /Leprfa (DS/obese) rat, a model of metabolic syndrome (MetS). Rats were treated with a low (0.3 mg/kg per day) or high (8 mg/kg per day) dose of ramelteon from 9 to 13 weeks of age. Ramelteon treatment at either dose attenuated body weight gain, left ventricular fibrosis, and diastolic dysfunction, as well as cardiac oxidative stress and inflammation, without affecting hypertension or insulin resistance...
March 15, 2018: Annals of the New York Academy of Sciences
Rebecca R Vanderpool, Melissa Saul, Mehdi Nouraie, Mark T Gladwin, Marc A Simon
Importance: Heart failure with preserved ejection fraction (HFpEF) is highly prevalent, yet there are no specific therapies, possibly due to phenotypic heterogeneity. The development of pulmonary hypertension (PH) in patients with HFpEF is considered a high-risk phenotype in need of targeted therapies, but there have been limited hemodynamic and outcomes data. Objective: To identify the hemodynamic characteristics and outcomes of PH-HFpEF. Design, Setting, and Participants: Cohort study of participants who had a right heart catheterization from January 2005 to September 2012 (median [interquartile range] follow-up time, 1578 [554-2513] days) were analyzed...
March 14, 2018: JAMA Cardiology
Thenappan Thenappan, Mark L Ormiston, John J Ryan, Stephen L Archer
Pulmonary hypertension is defined as a resting mean pulmonary artery pressure of 25 mm Hg or above. This review deals with pulmonary arterial hypertension (PAH), a type of pulmonary hypertension that primarily affects the pulmonary vasculature. In PAH, the pulmonary vasculature is dynamically obstructed by vasoconstriction, structurally obstructed by adverse vascular remodeling, and pathologically non-compliant as a result of vascular fibrosis and stiffening. Many cell types are abnormal in PAH, including vascular cells (endothelial cells, smooth muscle cells, and fibroblasts) and inflammatory cells...
March 14, 2018: BMJ: British Medical Journal
Ulrich Mayr, Eugen Karsten, Tobias Lahmer, Sebastian Rasch, Philipp Thies, Benedikt Henschel, Gerrit Fischer, Roland M Schmid, Wolfgang Huber
INTRODUCTION: Appropriate mechanical ventilation and prevention of alveolar collaps is mainly dependent on transpulmonary pressure TPP. TPP is assessed by measurement of esophageal pressure EP, largely influenced by pleural and intraabdominal pressure IAP. Consecutively, TPP-guided ventilation might be particularly useful in patients with high IAP. This study investigates the impact of large volume paracentesis LVP on TPP, EP, IAP as well as on hemodynamic and respiratory function in patients with liver cirrhosis and tense ascites...
2018: PloS One
Rebecca R Vanderpool, Robert Naeije
The diagnosis and evaluation of severity of pulmonary vascular disease rests on the invasive determination of a pulmonary vascular resistance (PVR). It is often overlooked that PVR is linearly related to the viscosity of the blood, which in turn is curvilinearly related to hematocrit. We propose a correction diagram for patients with anemia or with polycythemia. Based on a distensibility model of the pulmonary circulation, we show that magnitude of hematocrit correction of PVR is increased in proportion to pulmonary artery wedge pressure (PAWP) and the measured levels of PVR or hematocrit, and decreased in case of preserved resistive vessel distensibility and absence of pulmonary hypertension...
March 14, 2018: American Journal of Respiratory and Critical Care Medicine
Tetsutaro Matayoshi, Kei Kamide, Ryoichi Tanaka, Tetsuya Fukuda, Takeshi Horio, Yoshio Iwashima, Fumiki Yoshihara, Satoko Nakamura, Hajime Nakahama, Yusuke Ohya, Yuhei Kawano
Background: The results of recent trials have brought some confusion to the treatment strategy for renal artery stenosis (RAS). To evaluate the applicability of percutaneous transluminal renal angioplasty (PTRA) for RAS, we extracted the factors that may affect the effectiveness of PTRA from cases experienced at a hypertension center. Methods and Results: We retrospectively assessed the blood pressure (BP) lowering effects and renoprotective effects in 50 consecutive patients that had hemodynamically significant RAS and had undergone PTRA and stenting during 2001-2005...
2018: International Journal of Hypertension
Tadasu Horai, Akitoyo Hishimoto, Ikuo Otsuka, Tatsuhiro So, Kentaro Mouri, Naofumi Shimmyo, Shuken Boku, Noriaki Okishio, Ichiro Sora
Background: Alcohol dependence induces low bone mineral density (BMD), predicting osteoporosis, while low and moderate alcohol consumption may even increase BMD. In recent years, undercarboxylated osteocalcin (ucOC) and tartrate-resistant acid phosphatase-5b (TRACP-5b), bone turnover markers, have gained special interest as useful indicators of low BMD. However, it remains unclear whether other alcohol-related variables (eg, duration of abstinence and continuous drinking) are linked to aberrant BMD...
2018: Neuropsychiatric Disease and Treatment
Margaret O Murphy, Joseph B Herald, Jacqueline Leachman, Alejandro Villasante Tezanos, Dianne M Cohn, Analia S Loria
.: Exposure to early life stress (ELS) is associated with behavioral-related alterations, increases in body mass index and higher systolic blood pressure in humans. Postnatal maternal separation and early weaning (MSEW) is a mouse model of neglect characterized by a long-term dysregulation of the neuroendocrine system. OBJECTIVES: Given the contribution of adrenal-derived hormones to the development of obesity, we hypothesized that exposure to MSEW could contribute to  the worsening of cardiometabolic function in response to chronic high-fat diet (HF) feeding by promoting adipose tissue expansion and insulin resistance...
February 23, 2018: International Journal of Obesity: Journal of the International Association for the Study of Obesity
H Y Ruan, Y G Zhang, R Liu
Objective: To compare the acute hemodynamic effects of intravenous fasudil with different dosage on patients with congenital heart defects (CHD) and severe pulmonary arterial hypertension (PAH). Methods: Sixty patients (37±17 years old) with CHD and PAH were consecutively enrolled. All patients underwent heart catheterization. The patients were randomly divided into two groups: the regular dosage group and the large dosage group. At initiation and 30 min after intravenous fasudil(30 mg and 60 mg respectively), the following hemodynamic parameters were measured and calculated: right atrial pressure(RAP), pulmonary arterypressure(PAP) , systemic artery pressure (SAP), pulmonary capillary wedge pressure(PCWP) , pulmonary vascular resistance(PVR) and systemic vascular resistance( SVR), cardiac index (CI) and artery oxygen saturation (SaO(2))...
March 6, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Ryo Morimoto, Kei Omata, Sadayoshi Ito, Fumitoshi Satoh
Primary aldosteronism (PA) is now considered as one of leading causes of secondary hypertension, accounting for 5-10% of all hypertensive patients and more strikingly 20% of those with resistant hypertension. Importantly, those with the unilateral disease could be surgically cured when diagnosed appropriately. On the other hand, only a very limited portion of those suspected to have PA has been screened, diagnosed, or treated to date. With current advancement in medical technologies and genetic research, expanding knowledge of PA has been accumulated and recent achievements have also been documented in the care of those with PA...
March 8, 2018: American Journal of Hypertension
Zahra Laleh Eslamian, Elahe Zarean, Maryam Moshfeghi, Zahra Heidari
Background: Early prediction of adverse neonatal outcome would be possible by Doppler impedance indices of middle cerebral artery (MCA), umbilical artery (UmA), and descending aortal artery (AO) that result in decrease neonatal morbidity and mortality rate. The aim of the present study was a determination of optimal value for the ratio of MCA to descending aorta blood flow (MCA/AO) impedance indices and its comparison with the ratio of MCA to UmA (MCA/UmA) impedance indices and their relationship with neonatal outcome...
2018: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
Élie Besserer-Offroy, Patrick Bérubé, Jérôme Côté, Alexandre Murza, Jean-Michel Longpré, Robert Dumaine, Olivier Lesur, Mannix Auger-Messier, Richard Leduc, Éric Marsault, Philippe Sarret
The apelinergic system is an important player in the regulation of both vascular tone and cardiovascular function, making this physiological system an attractive target for drug development for hypertension, heart failure and ischemic heart disease. Indeed, apelin exerts a positive inotropic effect in humans whilst reducing peripheral vascular resistance. In this study, we investigated the signaling pathways through which apelin exerts its hypotensive action. We synthesized a series of apelin-13 analogs whereby the C-terminal Phe13 residue was replaced by natural or unnatural amino acids...
March 9, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Alexandra B Cooke, Romina Pace, Deborah Chan, Ellen Rosenberg, Kaberi Dasgupta, Stella S Daskalopoulou
AIMS: The integration of pedometers into clinical practice has the potential to enhance physical activity levels in patients with chronic disease. Our SMARTER randomized controlled trial demonstrated that a physician-delivered step count prescription strategy has measurable effects on daily steps, glycemic control, and insulin resistance in patients with type 2 diabetes and/or hypertension. In this study, we aimed to understand perceived barriers and facilitators influencing successful uptake and sustainability of the strategy, from patient and physician perspectives...
March 9, 2018: Diabetes Research and Clinical Practice
Georgia Brown, Tilman Humpl
PURPOSE OF REVIEW: Pulmonary vascular disease (PVD) complicates the course of many cardiovascular, pulmonary and other systemic diseases in children. The physiological sequelae (pulmonary hypertension and elevated pulmonary vascular resistance) can overwhelm the right ventricle and lead to circulatory collapse. Despite the common end-point, the preceding pathophysiology is complex and variable and requires a tailored approach to diagnosis and management. In this article, we will review the most recent evidence and explore an approach to current controversies in the diagnosis and management of common or challenging patient subgroups...
March 9, 2018: Current Opinion in Pediatrics
Lucía Isidoro, Mercedes Ferrer, Mercedes Perusquía
BACKGROUND: Testosterone, 5α- and 5β-dihydrotestosterone (-DHT) induce an acute in vitro vasorelaxation and in vivo vasodepressor, hypotensive and antihypertensive responses. Our aim was to study whether androgen-induced blood pressure (BP) reduction is involved with a blockade of Ca2+ influx through L-type voltage-operated calcium channels (L-VOCCs) and/or the signaling pathways of α1 -adrenoceptors to induce vasoconstriction, which are one of the major mechanisms of BP maintenance...
March 12, 2018: Endocrine Research
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