Pub Date : 2013-11-14DOI: 10.2174/1876526201305010029
Evdoxia Mitsiou
First, is it possible that the use of pomegranate juice (PJ), a functional beverage, will reduce the adherence of hypertensive to the antihypertensive drug treatment that they might need for the effective control of their blood pressure? It has been shown that the use of functional foods or dietary supplements may offer opportunities to reduce health risk factors and risk of diseases, both as monotherapy and in combination with prescription drugs. Nevertheless, the potential caveats or false claims of these products should not be overlooked [2]. Should we jeopardize the necessary drug treatment for a functional food?
{"title":"LETTER TO THE EDITOR: Do we Need Functional Foods for the Treatment of Hypertension?","authors":"Evdoxia Mitsiou","doi":"10.2174/1876526201305010029","DOIUrl":"https://doi.org/10.2174/1876526201305010029","url":null,"abstract":"First, is it possible that the use of pomegranate juice (PJ), a functional beverage, will reduce the adherence of hypertensive to the antihypertensive drug treatment that they might need for the effective control of their blood pressure? It has been shown that the use of functional foods or dietary supplements may offer opportunities to reduce health risk factors and risk of diseases, both as monotherapy and in combination with prescription drugs. Nevertheless, the potential caveats or false claims of these products should not be overlooked [2]. Should we jeopardize the necessary drug treatment for a functional food?","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":"5 1","pages":"29-29"},"PeriodicalIF":0.0,"publicationDate":"2013-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68145552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-11-14DOI: 10.2174/1876526201305010036
P. Anagnostis, G. Sfikas, Efthimios Gotsis, S. Karras, V. Athyros
1 Endocrinology Clinic, Hippocration Hospital, Thessaloniki, Greece; 2 Department of Internal Medicine, Military Hospital of Thessaloniki, Thessaloniki, Greece; 3 Second Prop. Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece; 4 Department of Endocrinology and Metabolism, Agios Pavlos Hospital, Thessaloniki, Greece
{"title":"EDITORIAL: Is the Beneficial Effect of Mediterranean Diet on Cardiovascular Risk Partly Mediated through Better Blood Pressure Control?","authors":"P. Anagnostis, G. Sfikas, Efthimios Gotsis, S. Karras, V. Athyros","doi":"10.2174/1876526201305010036","DOIUrl":"https://doi.org/10.2174/1876526201305010036","url":null,"abstract":"1 Endocrinology Clinic, Hippocration Hospital, Thessaloniki, Greece; 2 Department of Internal Medicine, Military Hospital of Thessaloniki, Thessaloniki, Greece; 3 Second Prop. Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece; 4 Department of Endocrinology and Metabolism, Agios Pavlos Hospital, Thessaloniki, Greece","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":"5 1","pages":"36-39"},"PeriodicalIF":0.0,"publicationDate":"2013-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68145665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-11-14DOI: 10.2174/1876526201305010030
K. Tziomalos, M. Doumas, V. Athyros
First, of course there are false claims of several functional foods. However, pomegranate juice (PJ) was shown in rather small but indisputable clinical studies (Prof. Aviram is engaged with PJ for the last 15 years), that they possess antihypertensive, antioxidant, and antidiabetic effects to the degree that these can halt or even reverse atherosclerosis [2]. Moreover, it is the responsibility of the attending physician to explain to the hypertensive patient (mainly those with hypertension combined with diabetes, metabolic syndrome or smoking) that this is an adjunctive therapy on top of other no-pharmacological interventions or drug treatments for hypertension [2]. There are no data so far that functional foods compromise the adherence of the patient to antihypertensive drug treatment, if their utility is explained by the physician.
{"title":"LETTER TO THE EDITOR: Functional Foods are a Useful Adjunction to Antihypertensive Drug Treatment","authors":"K. Tziomalos, M. Doumas, V. Athyros","doi":"10.2174/1876526201305010030","DOIUrl":"https://doi.org/10.2174/1876526201305010030","url":null,"abstract":"First, of course there are false claims of several functional foods. However, pomegranate juice (PJ) was shown in rather small but indisputable clinical studies (Prof. Aviram is engaged with PJ for the last 15 years), that they possess antihypertensive, antioxidant, and antidiabetic effects to the degree that these can halt or even reverse atherosclerosis [2]. Moreover, it is the responsibility of the attending physician to explain to the hypertensive patient (mainly those with hypertension combined with diabetes, metabolic syndrome or smoking) that this is an adjunctive therapy on top of other no-pharmacological interventions or drug treatments for hypertension [2]. There are no data so far that functional foods compromise the adherence of the patient to antihypertensive drug treatment, if their utility is explained by the physician.","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":"5 1","pages":"30-31"},"PeriodicalIF":0.0,"publicationDate":"2013-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68145570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-10-18DOI: 10.2174/1876526201305010018
A. Cicero, A. Parini, M. Rosticci, Barbara Brancaleoni, G. Derosa, E. Grandi, C. Borghi
The recent literature has put a large interest on nutraceuticals with lipid lowering activity for the management of moderate cholesterolemia in subjects with mildly increased cardiovascular disease risk. The aim of our study was to evaluate the middle-term effect of a combined lipid-lowering nutraceutical on lipid parameters and aortic stiffness. For this study we consecutively enrolled 40 moderately hypercholesterolemic outpatients with mild-to-moderate chronic kidney disease (CKD) and 40 cross-matched hypercholesterolemic subjects without CKD. All the patient were treated daily with a combined nutraceutical containing red yeast rice (3 mg monacolin K) and berberine (500 mg). At the baseline and after 6 months of treatment we measured blood pressure, pulse wave velocity (PWV) and ematochemistry parameters. No significant change has been observed during the study in both groups regarding body mass index, blood pressure, liver transaminases, creatinin-phosfokinase and eGFR. In non CKD patients TC improved by (-21,6%), LDL-Cholesterol by (-24,2%), non HDL-Cholesterol (-24,0%) and TG (- 20,8%). In CKD patients TC improved by (-21,1%), LDL-Cholesterol by (-23,7%), non HDL-Cholesterol (-23,9%) and TG (- 20,4%). No difference among groups has been observed regarding the effects on lipid metabolism. The PWV has significantly improved in both groups (p<0.01) without differences between groups. In summary, a combined lipid-lowering nutraceutical improved lipid pattern and PWV in both non CKD and mild-to-
{"title":"Effect of a Lipid-Lowering Nutraceutical on Pulse-Wave-Velocity in Hypercholesterolemic Patients with or without Chronic Kidney Disease","authors":"A. Cicero, A. Parini, M. Rosticci, Barbara Brancaleoni, G. Derosa, E. Grandi, C. Borghi","doi":"10.2174/1876526201305010018","DOIUrl":"https://doi.org/10.2174/1876526201305010018","url":null,"abstract":"The recent literature has put a large interest on nutraceuticals with lipid lowering activity for the management of moderate cholesterolemia in subjects with mildly increased cardiovascular disease risk. The aim of our study was to evaluate the middle-term effect of a combined lipid-lowering nutraceutical on lipid parameters and aortic stiffness. For this study we consecutively enrolled 40 moderately hypercholesterolemic outpatients with mild-to-moderate chronic kidney disease (CKD) and 40 cross-matched hypercholesterolemic subjects without CKD. All the patient were treated daily with a combined nutraceutical containing red yeast rice (3 mg monacolin K) and berberine (500 mg). At the baseline and after 6 months of treatment we measured blood pressure, pulse wave velocity (PWV) and ematochemistry parameters. No significant change has been observed during the study in both groups regarding body mass index, blood pressure, liver transaminases, creatinin-phosfokinase and eGFR. In non CKD patients TC improved by (-21,6%), LDL-Cholesterol by (-24,2%), non HDL-Cholesterol (-24,0%) and TG (- 20,8%). In CKD patients TC improved by (-21,1%), LDL-Cholesterol by (-23,7%), non HDL-Cholesterol (-23,9%) and TG (- 20,4%). No difference among groups has been observed regarding the effects on lipid metabolism. The PWV has significantly improved in both groups (p<0.01) without differences between groups. In summary, a combined lipid-lowering nutraceutical improved lipid pattern and PWV in both non CKD and mild-to-","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":"85 1","pages":"18-22"},"PeriodicalIF":0.0,"publicationDate":"2013-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68145500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-08-15DOI: 10.2174/1876526201305010012
M. Doumas, V. Athyros, N. Katsiki, Andromachi Reklou, A. Lazaridis, A. Karagiannis
The discovery of endothelin created a lot of enthusiasm and paved new therapeutic avenues for the treatment of arterial hypertension. Endothelin plays a significant role in blood pressure regulation through pronounced vasoconstric- tion and modulation of sodium and water reabsorption in the kidneys. Endothelin receptor antagonists have been tested in many clinical trials in patients with arterial hypertension, heart failure, pulmonary arterial hypertension, systemic sclero- sis, chronic kidney disease, and diabetic nephropathy. However, the results were usually disappointing, except in pulmo- nary hypertension and scleroderma digital ulcers. The future of ERAs for the treatment of arterial hypertension and chronic kidney disease does not seem bright, and only the combination with other classes of antihypertensive drugs might offer a way out.
{"title":"Endothelin Receptor Antagonists (ERA) in Hypertension and ChronicKidney Disease: a Rose with Many Thorns","authors":"M. Doumas, V. Athyros, N. Katsiki, Andromachi Reklou, A. Lazaridis, A. Karagiannis","doi":"10.2174/1876526201305010012","DOIUrl":"https://doi.org/10.2174/1876526201305010012","url":null,"abstract":"The discovery of endothelin created a lot of enthusiasm and paved new therapeutic avenues for the treatment of arterial hypertension. Endothelin plays a significant role in blood pressure regulation through pronounced vasoconstric- tion and modulation of sodium and water reabsorption in the kidneys. Endothelin receptor antagonists have been tested in many clinical trials in patients with arterial hypertension, heart failure, pulmonary arterial hypertension, systemic sclero- sis, chronic kidney disease, and diabetic nephropathy. However, the results were usually disappointing, except in pulmo- nary hypertension and scleroderma digital ulcers. The future of ERAs for the treatment of arterial hypertension and chronic kidney disease does not seem bright, and only the combination with other classes of antihypertensive drugs might offer a way out.","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":"5 1","pages":"12-17"},"PeriodicalIF":0.0,"publicationDate":"2013-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68146001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-04-19DOI: 10.2174/1876526201305010001
Jong Y. Lee, S. Azar
Perinatal diets may affect the cardiovascular-renal functions of offspring. To understand effects of maternal diet on the renal function and blood pressure (BP) of offspring, protein (10% low, LP; 23% normal, NP) and/or NaCl (4% high salt, HS; 0.6% normal, NS) diets were started at pre-pregnancy through pups' weaning to either a 4% high NaCl (hs) or 0.6% NaCl (ns) diet. Telemetered BP data was analyzed by methods of linear least square rhythmometry. Systolic BPs (circadian mean ±SE mm Hg) were: NPNSns, 131±2; NPNShs, 137±2; NPHSns, 137±0.2; NPHShs, 134±3; LPNSns, 138±1; LPNShs, 138±0.6; LPHSns, 135±2; LPHShs, 142±2. Offspring in NPNShs and NPHSns had significantly in- creased SBPs versus NPNSns (both P<0.05). Most LP-offspring had increased SBP (P<0.01 to <0.05) and lower body weight (BW) with smaller glomerular filtration rate changes (renal reserve, RR-GFR) following overnight acute high- protein loads: RR-GFRs (inulin, ml/min/g kidney) for groups stated above were, respectively: 0.935; 0.927; 0.537; -0.064; -0.229; 0.057; -0.515; -0.404. The kidney weight/BW ratio of offspring was higher on hs- than on ns-diets (all P<0.001). Rats on a low caloric diet had reduced sclerotic glomerular numbers compared to those on normal diets (11.2±1 vs. 15.7±2, P<0.001), though glomerular numbers were similar in both groups. In summary, perinatal LP-HS diets significantly affected the BW, BP, renal injuries and kidney function of offspring. RR was seriously reduced, especially among offspring in hs- and perinatal LP groups. The most interesting result was the glomerular maturation staging in the pups, which suggests delayed nephrogenesis by a maternal LP diet.
{"title":"Effects of Perinatal Protein-Nacl Diets on Offspring's Blood Pressure andRenal Function in Lewis Rats","authors":"Jong Y. Lee, S. Azar","doi":"10.2174/1876526201305010001","DOIUrl":"https://doi.org/10.2174/1876526201305010001","url":null,"abstract":"Perinatal diets may affect the cardiovascular-renal functions of offspring. To understand effects of maternal diet on the renal function and blood pressure (BP) of offspring, protein (10% low, LP; 23% normal, NP) and/or NaCl (4% high salt, HS; 0.6% normal, NS) diets were started at pre-pregnancy through pups' weaning to either a 4% high NaCl (hs) or 0.6% NaCl (ns) diet. Telemetered BP data was analyzed by methods of linear least square rhythmometry. Systolic BPs (circadian mean ±SE mm Hg) were: NPNSns, 131±2; NPNShs, 137±2; NPHSns, 137±0.2; NPHShs, 134±3; LPNSns, 138±1; LPNShs, 138±0.6; LPHSns, 135±2; LPHShs, 142±2. Offspring in NPNShs and NPHSns had significantly in- creased SBPs versus NPNSns (both P<0.05). Most LP-offspring had increased SBP (P<0.01 to <0.05) and lower body weight (BW) with smaller glomerular filtration rate changes (renal reserve, RR-GFR) following overnight acute high- protein loads: RR-GFRs (inulin, ml/min/g kidney) for groups stated above were, respectively: 0.935; 0.927; 0.537; -0.064; -0.229; 0.057; -0.515; -0.404. The kidney weight/BW ratio of offspring was higher on hs- than on ns-diets (all P<0.001). Rats on a low caloric diet had reduced sclerotic glomerular numbers compared to those on normal diets (11.2±1 vs. 15.7±2, P<0.001), though glomerular numbers were similar in both groups. In summary, perinatal LP-HS diets significantly affected the BW, BP, renal injuries and kidney function of offspring. RR was seriously reduced, especially among offspring in hs- and perinatal LP groups. The most interesting result was the glomerular maturation staging in the pups, which suggests delayed nephrogenesis by a maternal LP diet.","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":"80 1","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2013-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68145653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-12-30DOI: 10.2174/1876526201104010037
A. Khoshdel, K. Bowen, S. Carney, G. Eather, J. Fowler, A. Gillies, K. James
Background: In modern epidemiology, risk assessment is a crucial step in diabetes care. Clinic blood pressure reading though is not a good measurement for this purpose since both uncontrolled hypertension and white coat hypertension (WCH) are frequent among patients with diabetes mellitus (DM). Given the problems with clinical application of ambulatory blood pressure monitoring (ABPM), in this study we evaluated clinical utility of home self measurement (HSM) with a wrist-cuff device in DM patients with hypertension to make a BP profile. Also, the clinical application of a complex of arterial study, albuminuria and blood pressure profile, in DM risk assessment was investigated. Methods and Materials: Seventy-eight adult DM patients with labile or uncontrolled hypertension were randomly assigned to 24 hour ABPM or HSM for 4 consecutive days and their BP profiles were evaluated in conjunction with an assessment of arterial stiffness and renal function as well as lipid profile. Results: The two groups were of comparable age, gender, BP, DM duration and control, smoking, lipids, renal function, arterial compliance and antihypertensive medication use. ABPM detected 33% WCH and 17.6% evening/night-time dipping, compared to 32% and 16% respectively for HSM, with overlapping 95% confidence intervals for day versus night BP regression coefficients. WCH patients had more compliant arteries as well as less albuminuria compared to the sustained hypertensive group. Conclusion: A complex of BP profile (by either ABPM or HSM), arterial compliance and albuminuria is a reliable and economical alternative to current methods for risk assessment in hypertensive diabetic patients.
{"title":"Clinical Application of a Complex of Blood Pressure Profile, Arterial Stiffness and Albuminuria for Cardiorenal Risk Assessment in Diabetic Patients","authors":"A. Khoshdel, K. Bowen, S. Carney, G. Eather, J. Fowler, A. Gillies, K. James","doi":"10.2174/1876526201104010037","DOIUrl":"https://doi.org/10.2174/1876526201104010037","url":null,"abstract":"Background: In modern epidemiology, risk assessment is a crucial step in diabetes care. Clinic blood pressure reading though is not a good measurement for this purpose since both uncontrolled hypertension and white coat hypertension (WCH) are frequent among patients with diabetes mellitus (DM). Given the problems with clinical application of ambulatory blood pressure monitoring (ABPM), in this study we evaluated clinical utility of home self measurement (HSM) with a wrist-cuff device in DM patients with hypertension to make a BP profile. Also, the clinical application of a complex of arterial study, albuminuria and blood pressure profile, in DM risk assessment was investigated. Methods and Materials: Seventy-eight adult DM patients with labile or uncontrolled hypertension were randomly assigned to 24 hour ABPM or HSM for 4 consecutive days and their BP profiles were evaluated in conjunction with an assessment of arterial stiffness and renal function as well as lipid profile. Results: The two groups were of comparable age, gender, BP, DM duration and control, smoking, lipids, renal function, arterial compliance and antihypertensive medication use. ABPM detected 33% WCH and 17.6% evening/night-time dipping, compared to 32% and 16% respectively for HSM, with overlapping 95% confidence intervals for day versus night BP regression coefficients. WCH patients had more compliant arteries as well as less albuminuria compared to the sustained hypertensive group. Conclusion: A complex of BP profile (by either ABPM or HSM), arterial compliance and albuminuria is a reliable and economical alternative to current methods for risk assessment in hypertensive diabetic patients.","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":"4 1","pages":"37-43"},"PeriodicalIF":0.0,"publicationDate":"2011-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68145523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-11-25DOI: 10.2174/1876526201104010033
H. Stauss, K. Rarick
The arithmetic average of beat-by-beat sampled heart rate (HR) values overestimates true HR defined as number of heart beats per time unit. The aims of this study were to (1) estimate the magnitude of overestimation; (2) illustrate the significance of this issue using data from patients with congestive heart failure (CHF) and control subjects; and (3) outline approaches to correctly calculate mean HR. Linear regression analysis of computer-generated time series, representing beat-by-beat HR values in humans, rats, and mice, revealed that the difference between the arithmetic average of beat-by-beat sampled HR values and the true mean HR (error e) can be approximated by the variance (σ 2 ) divided by the arithmetic average (µ) of the beat-by-beat HR values (e = σ 2 /µ). True mean HR was higher in patients with CHF (92.9±4.3 bpm) than in control subjects (82.6±2.1 bpm, P=0.045). However, if mean HR was calculated as arithmetic average of the beat-by-beat HR values the difference in mean HR was no longer significant (93.4±4.4 bpm in CHF vs. 83.8±2.1 bpm in controls, P=0.059). In conclusion, the arithmetic average of beat-by-beat sampled HR values overestimates true HR by approximately the ratio of σ 2 to µ of the beat-by-beat HR values. Thus, the error (e) is largest in subjects with high HR variability and low average HR and may affect interpretation of mean HR values in studies investigating populations of subjects with differing HR variability, such as CHF patients vs. healthy subject or old vs. young subjects.
{"title":"Overestimation of Mean Heart Rate by the Arithmetic Average of Beat-By-Beat Sampled Heart Rate Values","authors":"H. Stauss, K. Rarick","doi":"10.2174/1876526201104010033","DOIUrl":"https://doi.org/10.2174/1876526201104010033","url":null,"abstract":"The arithmetic average of beat-by-beat sampled heart rate (HR) values overestimates true HR defined as number of heart beats per time unit. The aims of this study were to (1) estimate the magnitude of overestimation; (2) illustrate the significance of this issue using data from patients with congestive heart failure (CHF) and control subjects; and (3) outline approaches to correctly calculate mean HR. Linear regression analysis of computer-generated time series, representing beat-by-beat HR values in humans, rats, and mice, revealed that the difference between the arithmetic average of beat-by-beat sampled HR values and the true mean HR (error e) can be approximated by the variance (σ 2 ) divided by the arithmetic average (µ) of the beat-by-beat HR values (e = σ 2 /µ). True mean HR was higher in patients with CHF (92.9±4.3 bpm) than in control subjects (82.6±2.1 bpm, P=0.045). However, if mean HR was calculated as arithmetic average of the beat-by-beat HR values the difference in mean HR was no longer significant (93.4±4.4 bpm in CHF vs. 83.8±2.1 bpm in controls, P=0.059). In conclusion, the arithmetic average of beat-by-beat sampled HR values overestimates true HR by approximately the ratio of σ 2 to µ of the beat-by-beat HR values. Thus, the error (e) is largest in subjects with high HR variability and low average HR and may affect interpretation of mean HR values in studies investigating populations of subjects with differing HR variability, such as CHF patients vs. healthy subject or old vs. young subjects.","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":"4 1","pages":"33-36"},"PeriodicalIF":0.0,"publicationDate":"2011-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68145485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-11-04DOI: 10.2174/1876526201104010023
Jong Y. Lee, S. Azar
Objective: High blood pressure (BP) is a dominant risk factor in cardiovascular diseases. An experimental model of nitric oxide synthase (NOS) inhibitor induced hypertension was developed to study some etiologic mechanisms in cardiovascular parameters. Methods: Cardiovascular rhythm characteristics were documented in mice following the N-omega-nitro-L-arginine- methyl-ester (L-NAME)-treatment (Rx). Radio-telemetered BP, heart rate (HR), and locomotor activity (LA) were measured every 4 min for 5 days before and for 14 days after Rx. Data was converted into an hourly average and analyzed by the linear least square rhythmometry. Results: L-NAME-Rx increased systolic BP (SBP) significantly without significant changes in diastolic BP and markedly reduced HR: SBP (mm Hg) 143.4 ± 0.6 versus 148.9 ± 0.4, P <0.0001; HR (beat/min): 552.13 ± 2.7 vs. 481 ± 1.8, P <0.0001, with markedly depleted amplitude. SBP variations were mainly during the night time, while HR variations were almost every time-point comparison throughout the 24-h span. Although the overall LA was not significantly changed with L-NAME-Rx, time-point depleted LA was noted, especially when the light was off at 18:00 hour through midnight (P <0.0001), while an opposite result was observed at noon with significantly increased LA in this nocturnal animal (P <0.005), with markedly decreased amplitude (P <0.01). Interestingly, we observe reduced HR with L-NAME-Rx contradicted to other reports. Conclusion: The results suggest that the NOS blockade may impair cardiovascular autonomic adaptations and arterial baroreflex integration, resulting in an increased vascular tone during the systole, but not an end diastole in the relaxed cardiac autonomic tonus.
目的:高血压(BP)是心血管疾病的主要危险因素。建立一氧化氮合酶(NOS)抑制剂诱导高血压的实验模型，探讨其心血管参数的发病机制。方法:用n -omega-硝基- l-精氨酸-甲基酯(L-NAME)治疗(Rx)后记录小鼠的心血管节律特征。在服药前5天和服药后14天，每隔4分钟测一次血压、心率(HR)和运动活动(LA)。数据被转换成每小时的平均值，并用线性最小二乘节律法进行分析。结果:L-NAME-Rx可显著提高收缩压(SBP)，但舒张压无明显变化，并可显著降低HR:收缩压(mm Hg) 143.4±0.6 vs 148.9±0.4,P <0.0001;HR(心跳/分钟):552.13±2.7 vs. 481±1.8,P <0.0001，幅度明显降低。收缩压变化主要发生在夜间，而心率变化几乎发生在整个24小时跨度的每个时间点。虽然L-NAME-Rx对整体LA的影响不显著，但时间点上的LA明显减少，尤其是在18:00至午夜熄灯时(P <0.0001)，而在中午，这种夜行动物的LA显著增加(P <0.005)，幅度明显降低(P <0.01)。有趣的是，我们观察到L-NAME-Rx降低了HR，这与其他报告相矛盾。结论:NOS阻断可能损害心血管自主神经适应和动脉压力反射整合，导致收缩期血管张力增加，而舒张末期血管张力松弛。
{"title":"Ambulatory Cardiovascular Activities in L-NAME-Treated Mice","authors":"Jong Y. Lee, S. Azar","doi":"10.2174/1876526201104010023","DOIUrl":"https://doi.org/10.2174/1876526201104010023","url":null,"abstract":"Objective: High blood pressure (BP) is a dominant risk factor in cardiovascular diseases. An experimental model of nitric oxide synthase (NOS) inhibitor induced hypertension was developed to study some etiologic mechanisms in cardiovascular parameters. Methods: Cardiovascular rhythm characteristics were documented in mice following the N-omega-nitro-L-arginine- methyl-ester (L-NAME)-treatment (Rx). Radio-telemetered BP, heart rate (HR), and locomotor activity (LA) were measured every 4 min for 5 days before and for 14 days after Rx. Data was converted into an hourly average and analyzed by the linear least square rhythmometry. Results: L-NAME-Rx increased systolic BP (SBP) significantly without significant changes in diastolic BP and markedly reduced HR: SBP (mm Hg) 143.4 ± 0.6 versus 148.9 ± 0.4, P <0.0001; HR (beat/min): 552.13 ± 2.7 vs. 481 ± 1.8, P <0.0001, with markedly depleted amplitude. SBP variations were mainly during the night time, while HR variations were almost every time-point comparison throughout the 24-h span. Although the overall LA was not significantly changed with L-NAME-Rx, time-point depleted LA was noted, especially when the light was off at 18:00 hour through midnight (P <0.0001), while an opposite result was observed at noon with significantly increased LA in this nocturnal animal (P <0.005), with markedly decreased amplitude (P <0.01). Interestingly, we observe reduced HR with L-NAME-Rx contradicted to other reports. Conclusion: The results suggest that the NOS blockade may impair cardiovascular autonomic adaptations and arterial baroreflex integration, resulting in an increased vascular tone during the systole, but not an end diastole in the relaxed cardiac autonomic tonus.","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":"4 1","pages":"23-32"},"PeriodicalIF":0.0,"publicationDate":"2011-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68144751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-06-02DOI: 10.2174/1876526201104010018
J. Varis, Heljä Savola, R. Vesalainen, I. Kantola
Introduction of guidelines and more effective cardiovascular prevention have taken place in Finland. This study clarified whether treatment of the Finnish diabetics reflects these changes. Antihypertensive, lipemic and diabetic care of diabetics in Finnish general practice was analyzed nationwide by using a questionnaire. Subjects that participated in the study were consecutive hypertensive patients that had met their general practitioners during a given week in 2006. Only 9.4 % of the diabetics reached the blood pressure target below 130/80 mmHg. Fifty-six % of the patients reached the target of glycocylated haemoglobin (GHbA1c) below 7.0 %. The low density lipoprotein (LDL) cholesterol was below 2.5 mmol/l (96.7 mg/dl) in 43.9 % of the patients. In multivariate model, young age and high GHbA1c associated with high diastolic blood pressure. Fewer patients with GHbA1c > 7 % reached the target pressure below 140/90 mmHg than those with GHbA1c ≤7.0 % (p<0.05), but no difference was found if the target was below 130/80 mmHg. Neither the number of antihypertensive agents nor home blood pressure monitoring did affect the blood pressure. Blood pressure control of the treated Finnish diabetics was poor. Metabolic targets were more commonly reached than the blood pressure target but still too seldom. The cardiovascular prevention is not implemented in Finnish diabetic patients treated in general practice.
{"title":"Appropriate Cardiovascular Prevention is Not Implemented in Diabetic Hypertensive Patients Treated in General Practice","authors":"J. Varis, Heljä Savola, R. Vesalainen, I. Kantola","doi":"10.2174/1876526201104010018","DOIUrl":"https://doi.org/10.2174/1876526201104010018","url":null,"abstract":"Introduction of guidelines and more effective cardiovascular prevention have taken place in Finland. This study clarified whether treatment of the Finnish diabetics reflects these changes. Antihypertensive, lipemic and diabetic care of diabetics in Finnish general practice was analyzed nationwide by using a questionnaire. Subjects that participated in the study were consecutive hypertensive patients that had met their general practitioners during a given week in 2006. Only 9.4 % of the diabetics reached the blood pressure target below 130/80 mmHg. Fifty-six % of the patients reached the target of glycocylated haemoglobin (GHbA1c) below 7.0 %. The low density lipoprotein (LDL) cholesterol was below 2.5 mmol/l (96.7 mg/dl) in 43.9 % of the patients. In multivariate model, young age and high GHbA1c associated with high diastolic blood pressure. Fewer patients with GHbA1c > 7 % reached the target pressure below 140/90 mmHg than those with GHbA1c ≤7.0 % (p<0.05), but no difference was found if the target was below 130/80 mmHg. Neither the number of antihypertensive agents nor home blood pressure monitoring did affect the blood pressure. Blood pressure control of the treated Finnish diabetics was poor. Metabolic targets were more commonly reached than the blood pressure target but still too seldom. The cardiovascular prevention is not implemented in Finnish diabetic patients treated in general practice.","PeriodicalId":38918,"journal":{"name":"Open Hypertension Journal","volume":"4 1","pages":"18-22"},"PeriodicalIF":0.0,"publicationDate":"2011-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68144735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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