Purpose: Outcome after ischaemic stroke (AIS) depends on multiple factors, including values of blood pressure (BP) and arterial stiffness (AS) in the early phase. It is also known that stroke outcome is affected by BP variability; however, the influence of AS oscillations in the early phase of stroke on its prognosis is unknown. The aim of our study was to assess the relationship between changes of AS markers and stroke outcome.Materials and methods: Baseline clinical data, BP parameters, and markers of AS (pulse wave velocity [PWV], augmentation index [AIx]) were assessed 1, 6, and >90 days after AIS. The outcomes were defined using modified Rankin scale (mRS) score: early favourable (EFO) and early poor (EPO), as mRS ≤1 and >2 points at discharge, respectively; late favourable (LFO) and late poor (LPO), as mRS ≤1 and >2 points on day >90, respectively.Results: In the recruited 50 patients (62.2 ± 12.1 years, 68% males), BP and PWV decreased while AIx did not change within 90 days after AIS. Twenty-eight patients (56%) had EFO, 10 (20%) - EPO, 29 (58%) - LFO, and 9 (18%) - LPO. In univariate analysis, rise in AIx in days 1-6 was associated with EFO (odds ratio [OR] = 1.09, 95% confidence interval [CI] = 1.02-1.17, p = 0.01) and LFO (OR = 1.08; 95%CI = 1.01-1.14, p = 0.02), whereas decrease in AIx in days 1-6 was associated with EPO (OR = 1.07, 95%CI = 1.00-1.15, p = 0.05). For EFO and LFO, the relationships remained significant after including confounders (p = 0.03 and p = 0.03, respectively).Conclusions: Rise in AIx within one week after ischaemic stroke may be of additional importance in determining better early and late favourable functional outcome.
{"title":"Changes of augmentation index early after ischaemic stroke predict functional outcome.","authors":"Kamil Kowalczyk, Bartosz Jabłoński, Mariusz Kwarciany, Bartosz Karaszewski, Krzysztof Narkiewicz, Dariusz Gąsecki","doi":"10.1080/08037051.2020.1769468","DOIUrl":"https://doi.org/10.1080/08037051.2020.1769468","url":null,"abstract":"<p><p><b>Purpose:</b> Outcome after ischaemic stroke (AIS) depends on multiple factors, including values of blood pressure (BP) and arterial stiffness (AS) in the early phase. It is also known that stroke outcome is affected by BP variability; however, the influence of AS oscillations in the early phase of stroke on its prognosis is unknown. The aim of our study was to assess the relationship between changes of AS markers and stroke outcome.<b>Materials and methods:</b> Baseline clinical data, BP parameters, and markers of AS (pulse wave velocity [PWV], augmentation index [AIx]) were assessed 1, 6, and >90 days after AIS. The outcomes were defined using modified Rankin scale (mRS) score: early favourable (EFO) and early poor (EPO), as mRS ≤1 and >2 points at discharge, respectively; late favourable (LFO) and late poor (LPO), as mRS ≤1 and >2 points on day >90, respectively.<b>Results:</b> In the recruited 50 patients (62.2 ± 12.1 years, 68% males), BP and PWV decreased while AIx did not change within 90 days after AIS. Twenty-eight patients (56%) had EFO, 10 (20%) - EPO, 29 (58%) - LFO, and 9 (18%) - LPO. In univariate analysis, rise in AIx in days 1-6 was associated with EFO (odds ratio [OR] = 1.09, 95% confidence interval [CI] = 1.02-1.17, <i>p</i> = 0.01) and LFO (OR = 1.08; 95%CI = 1.01-1.14, <i>p</i> = 0.02), whereas decrease in AIx in days 1-6 was associated with EPO (OR = 1.07, 95%CI = 1.00-1.15, <i>p</i> = 0.05). For EFO and LFO, the relationships remained significant after including confounders (<i>p</i> = 0.03 and <i>p</i> = 0.03, respectively).<b>Conclusions:</b> Rise in AIx within one week after ischaemic stroke may be of additional importance in determining better early and late favourable functional outcome.</p>","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"29 5","pages":"327-335"},"PeriodicalIF":1.8,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2020.1769468","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37975944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-01Epub Date: 2020-04-30DOI: 10.1080/08037051.2020.1745055
Mulalibieke Heizhati, Lin Wang, Xiaoguang Yao, Mei Li, Jing Hong, Qin Luo, Delian Zhang, Suofeiya Abulikemu, Ting Wu, Nanfang Li
Purpose: Credible data is scarce in representative population aged ≥18 years, though hypertension is highly prevalent and poorly controlled in population aged ≥30 years in Xinjiang Northwest China. Therefore, we tried to provide data on hypertension status for reference.Materials and methods: We conducted a population-based cross-sectional survey between 2014 and 2015 using stratified multi-stage random sampling as part of a national survey. Hypertension is defined as systolic blood pressure (BP) ≥140 mmHg, and/or diastolic BP ≥90 mmHg and/or taking anti-hypertensive agents. We assessed prevalence, awareness, treatment and control rates of hypertension by rural and urban regions, by gender and by ethnicity, and related factors including agent prescription pattern.Results: Data for 6807 subjects ≥18 years with 79.2% rural and 52.0% women subjects are analyzed. Overall age-adjusted prevalence of hypertension in population aged ≥18 years is 22.2%, and shows no disparity between genders and regions. By ethnicity, the prevalence of hypertension was the highest in Tajik subjects (25.4%), followed by Mongolian (25.3%) and Kazakh (24.8%) subjects and the lowest in Kyrgyz (20.2%) subjects. Of the hypertensives, 55.5% have awareness, 43.9% receive anti-hypertensive treatment, whereas only 14.5% have their BP controlled. In different ethnic groups, the awareness, control and control in treatment rates showed no significant disparities, except for the treatment rate. It was the highest in Kazakh subjects (50.0%) and the lowest in Hui subjects (36.7%). The most common prescribed agent encompassed ACEI/ARBs (41.1%) and calcium channel blockers (30.4%). Over 87.2% of hypertensives were prescribed for single drug regimen.Conclusions: Hypertension is moderately prevalent in Xinjiang, whereas poorly controlled. Standardization of its treatment such as introducing treatment algorithm might be the priorities for future improvement, with healthy life promotion.
{"title":"Prevalence, awareness, treatment and control of hypertension in various ethnic groups (Hui, Kazakh, Kyrgyz, Mongolian, Tajik) in Xinjiang, Northwest China.","authors":"Mulalibieke Heizhati, Lin Wang, Xiaoguang Yao, Mei Li, Jing Hong, Qin Luo, Delian Zhang, Suofeiya Abulikemu, Ting Wu, Nanfang Li","doi":"10.1080/08037051.2020.1745055","DOIUrl":"https://doi.org/10.1080/08037051.2020.1745055","url":null,"abstract":"<p><p><b>Purpose:</b> Credible data is scarce in representative population aged ≥18 years, though hypertension is highly prevalent and poorly controlled in population aged ≥30 years in Xinjiang Northwest China. Therefore, we tried to provide data on hypertension status for reference.<b>Materials and methods:</b> We conducted a population-based cross-sectional survey between 2014 and 2015 using stratified multi-stage random sampling as part of a national survey. Hypertension is defined as systolic blood pressure (BP) ≥140 mmHg, and/or diastolic BP ≥90 mmHg and/or taking anti-hypertensive agents. We assessed prevalence, awareness, treatment and control rates of hypertension by rural and urban regions, by gender and by ethnicity, and related factors including agent prescription pattern.<b>Results:</b> Data for 6807 subjects ≥18 years with 79.2% rural and 52.0% women subjects are analyzed. Overall age-adjusted prevalence of hypertension in population aged ≥18 years is 22.2%, and shows no disparity between genders and regions. By ethnicity, the prevalence of hypertension was the highest in Tajik subjects (25.4%), followed by Mongolian (25.3%) and Kazakh (24.8%) subjects and the lowest in Kyrgyz (20.2%) subjects. Of the hypertensives, 55.5% have awareness, 43.9% receive anti-hypertensive treatment, whereas only 14.5% have their BP controlled. In different ethnic groups, the awareness, control and control in treatment rates showed no significant disparities, except for the treatment rate. It was the highest in Kazakh subjects (50.0%) and the lowest in Hui subjects (36.7%). The most common prescribed agent encompassed ACEI/ARBs (41.1%) and calcium channel blockers (30.4%). Over 87.2% of hypertensives were prescribed for single drug regimen.<b>Conclusions:</b> Hypertension is moderately prevalent in Xinjiang, whereas poorly controlled. Standardization of its treatment such as introducing treatment algorithm might be the priorities for future improvement, with healthy life promotion.</p>","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"29 5","pages":"276-284"},"PeriodicalIF":1.8,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2020.1745055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37884940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-01Epub Date: 2020-06-25DOI: 10.1080/08037051.2020.1782595
Sverre E Kjeldsen, Krzysztof Narkiewicz, Michel Burnier, Suzanne Oparil
An apparent controversy has arisen about whether intensive systolic blood pressure (BP) control prevented new onset atrial fibrillation (AF) in the Systolic Blood Pressure Intervention Trial (SPRIN...
{"title":"Intensive systolic blood pressure control and prevention of new onset atrial fibrillation in the SPRINT study: is the association really controversial?","authors":"Sverre E Kjeldsen, Krzysztof Narkiewicz, Michel Burnier, Suzanne Oparil","doi":"10.1080/08037051.2020.1782595","DOIUrl":"https://doi.org/10.1080/08037051.2020.1782595","url":null,"abstract":"An apparent controversy has arisen about whether intensive systolic blood pressure (BP) control prevented new onset atrial fibrillation (AF) in the Systolic Blood Pressure Intervention Trial (SPRIN...","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"29 4","pages":"199-201"},"PeriodicalIF":1.8,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2020.1782595","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38083501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01Epub Date: 2020-04-27DOI: 10.1080/08037051.2020.1747696
Reinhold Kreutz, Sverre E Kjeldsen, Michel Burnier, Krzysztof Narkiewicz, Suzanne Oparil, Giuseppe Mancia
Because they were intrigued by the results, many colleagues and journalists have made us aware of the paper “Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronot...
{"title":"Blood pressure medication should not be routinely dosed at bedtime. We must disregard the data from the HYGIA project.","authors":"Reinhold Kreutz, Sverre E Kjeldsen, Michel Burnier, Krzysztof Narkiewicz, Suzanne Oparil, Giuseppe Mancia","doi":"10.1080/08037051.2020.1747696","DOIUrl":"https://doi.org/10.1080/08037051.2020.1747696","url":null,"abstract":"Because they were intrigued by the results, many colleagues and journalists have made us aware of the paper “Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronot...","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"29 3","pages":"135-136"},"PeriodicalIF":1.8,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2020.1747696","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37875662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-01Epub Date: 2019-11-11DOI: 10.1080/08037051.2019.1680270
Kaumudi Joshipura, Francisco Muñoz-Torres, Jeanpaul Fernández-Santiago, Rakesh P Patel, Angel Lopez-Candales
Purpose: Mouthwash is used by a large population. Short-term clinical trials have shown that antibacterial mouthwash deplete oral nitrate-reducing bacteria, and decrease systemic nitric oxide bioavailability. Our previous publication from the San Juan Overweight Adults Longitudinal Study (SOALS) was the first to show frequent over-the-counter mouthwash use was independently associated with increased risk of prediabetes/diabetes. This manuscript evaluates whether over-the-counter mouthwash was associated with increased risk of hypertension.Materials and methods: SOALS recruited 40-65 year old overweight/obese individuals; baseline evaluations started in 2011 and the 3-year follow-up exam was completed by 2016. From the 1028 participants (76%) who completed follow-up, we excluded people with reported physician diagnosis of hypertension or systolic or diastolic BP at or above the hypertension cut-offs (n = 481), missing smoking (n = 1), missing physical activity (n = 1) and missing alcohol intake (n = 5) at baseline; 540 participants were included. The primary exposure was mouthwash use twice daily or more. The primary outcome for this manuscript is self-reported physician-diagnosed hypertension over the follow-up. We used Poisson regression controlling for age, sex, smoking, physical activity, waist circumference, alcohol intake, systolic blood pressure, pre-diabetes/diabetes status and cardiac medication use. We additionally evaluated other mouthwash use categorizations.Results: Twelve percent (66/540) developed hypertension over follow-up. People who used mouthwash twice/day or more had higher incidence of hypertension compared to less frequent users (Incidence Rate Ratio = 1.85; 95% Confidence Interval: 1.17, 2.94), and compared to non-users (IRR = 2.17; 95% CI: 1.27, 3.71). Several additional potential confounders evaluated did not impact these associations. Associations persisted among never smokers. Additional outcomes including BP assessed at a single study visit did not show associations.Conclusion: In this study, frequent regular use of over-the-counter mouthwash was associated with increased risk of hypertension, independent of major risk factors for hypertension and several other potential confounders.
{"title":"Over-the-counter mouthwash use, nitric oxide and hypertension risk.","authors":"Kaumudi Joshipura, Francisco Muñoz-Torres, Jeanpaul Fernández-Santiago, Rakesh P Patel, Angel Lopez-Candales","doi":"10.1080/08037051.2019.1680270","DOIUrl":"10.1080/08037051.2019.1680270","url":null,"abstract":"<p><p><b>Purpose:</b> Mouthwash is used by a large population. Short-term clinical trials have shown that antibacterial mouthwash deplete oral nitrate-reducing bacteria, and decrease systemic nitric oxide bioavailability. Our previous publication from the San Juan Overweight Adults Longitudinal Study (SOALS) was the first to show frequent over-the-counter mouthwash use was independently associated with increased risk of prediabetes/diabetes. This manuscript evaluates whether over-the-counter mouthwash was associated with increased risk of hypertension.<b>Materials and methods:</b> SOALS recruited 40-65 year old overweight/obese individuals; baseline evaluations started in 2011 and the 3-year follow-up exam was completed by 2016. From the 1028 participants (76%) who completed follow-up, we excluded people with reported physician diagnosis of hypertension or systolic or diastolic BP at or above the hypertension cut-offs (<i>n</i> = 481), missing smoking (<i>n</i> = 1), missing physical activity (<i>n</i> = 1) and missing alcohol intake (<i>n</i> = 5) at baseline; 540 participants were included. The primary exposure was mouthwash use twice daily or more. The primary outcome for this manuscript is self-reported physician-diagnosed hypertension over the follow-up. We used Poisson regression controlling for age, sex, smoking, physical activity, waist circumference, alcohol intake, systolic blood pressure, pre-diabetes/diabetes status and cardiac medication use. We additionally evaluated other mouthwash use categorizations.<b>Results:</b> Twelve percent (66/540) developed hypertension over follow-up. People who used mouthwash twice/day or more had higher incidence of hypertension compared to less frequent users (Incidence Rate Ratio = 1.85; 95% Confidence Interval: 1.17, 2.94), and compared to non-users (IRR = 2.17; 95% CI: 1.27, 3.71). Several additional potential confounders evaluated did not impact these associations. Associations persisted among never smokers. Additional outcomes including BP assessed at a single study visit did not show associations.<b>Conclusion:</b> In this study, frequent regular use of over-the-counter mouthwash was associated with increased risk of hypertension, independent of major risk factors for hypertension and several other potential confounders.</p>","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"29 1","pages":"103-112"},"PeriodicalIF":1.8,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2019.1680270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44153415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-03DOI: 10.1080/08037051.2019.1685372
Petra Karnosová, M. Mateřánková, J. Seidlerová, O. Mayer, J. Filipovský, Václav Karnos
Abstract Purpose: Advanced glycation end products (AGEs) are a heterogeneous group of highly oxidant compounds which can potentiate microvascular and macrovascular complications through the formation of irreversible cross-links between molecules in the basal membrane and also by engaging the receptor for AGEs (RAGE). Soluble receptor for AGEs (sRAGE) is suggested to have a protective role neutralizing the toxic action of AGEs. We aimed to investigate differences in plasma levels of sRAGE alongside with classic cardiovascular risk factors between offspring of patients with early onset of coronary heart disease (CHD) and healthy controls. Materials and methods: In a cross-sectional design, we examined 114 adult offspring of patients with premature CHD and 194 controls. Concentrations of soluble RAGE were quantified by ELISA methods. Aortic PWV was measured using Sphygmocor device. Multivariate logistic regressions were used to compare differences between the offspring and controls. Results: In the offspring group there were more men (p = 0.023), both groups had similar age (28.5 vs. 28.9 years; p = 0.51). After adjustment for covariates, we observed significantly higher aPWV (6.17 vs. 5.82 m s−1; p = 0.001) and lower sRAGE (1308.11 vs. 1475.59; p = 0.009) in the offspring group compared to controls. The significant determinants of the intergroup difference were sRAGE (p = 0.0017), aPWV (p = 0.011) and current smoking (p = 0.0053). Conclusion: Offspring of patients with early onset of CHD compared to age-matched healthy controls had significantly lower sRAGE levels suggesting a shift in the oxidative balance between stressors and defence mechanisms that may influence a higher cardiovascular risk in the future. The measurement of sRAGE might be a valuable predictor for more precise stratification of cardiovascular risk.
目的:晚期糖基化终产物(AGEs)是一种异质性的高氧化化合物,它可以通过在基膜分子之间形成不可逆的交联以及通过参与AGEs受体(RAGE)来增强微血管和大血管并发症。可溶性AGEs受体(sRAGE)被认为具有中和AGEs毒性作用的保护作用。我们的目的是研究早发冠心病(CHD)患者后代与健康对照者血浆sRAGE水平及经典心血管危险因素的差异。材料和方法:在横断面设计中,我们检查了114例早产儿冠心病患者的成年后代和194例对照组。ELISA法测定可溶性RAGE浓度。采用血压计测量主动脉PWV。采用多变量logistic回归比较子代与对照组之间的差异。结果:子代组男性较多(p = 0.023),两组年龄相近(28.5岁比28.9岁;p = 0.51)。调整协变量后,我们观察到aPWV显著增加(6.17 vs. 5.82 m s - 1;p = 0.001)和较低的sRAGE (1308.11 vs. 1475.59;P = 0.009)。组间差异的显著决定因素是sRAGE (p = 0.0017)、aPWV (p = 0.011)和吸烟史(p = 0.0053)。结论:与年龄匹配的健康对照相比,早发冠心病患者的后代的sRAGE水平显著降低,这表明应激源和防御机制之间的氧化平衡发生了变化,这可能会影响未来更高的心血管风险。sRAGE的测量可能是更精确的心血管风险分层的有价值的预测指标。
{"title":"Soluble RAGEs and cardiovascular risk factors in adult offspring of patients with premature coronary heart disease","authors":"Petra Karnosová, M. Mateřánková, J. Seidlerová, O. Mayer, J. Filipovský, Václav Karnos","doi":"10.1080/08037051.2019.1685372","DOIUrl":"https://doi.org/10.1080/08037051.2019.1685372","url":null,"abstract":"Abstract Purpose: Advanced glycation end products (AGEs) are a heterogeneous group of highly oxidant compounds which can potentiate microvascular and macrovascular complications through the formation of irreversible cross-links between molecules in the basal membrane and also by engaging the receptor for AGEs (RAGE). Soluble receptor for AGEs (sRAGE) is suggested to have a protective role neutralizing the toxic action of AGEs. We aimed to investigate differences in plasma levels of sRAGE alongside with classic cardiovascular risk factors between offspring of patients with early onset of coronary heart disease (CHD) and healthy controls. Materials and methods: In a cross-sectional design, we examined 114 adult offspring of patients with premature CHD and 194 controls. Concentrations of soluble RAGE were quantified by ELISA methods. Aortic PWV was measured using Sphygmocor device. Multivariate logistic regressions were used to compare differences between the offspring and controls. Results: In the offspring group there were more men (p = 0.023), both groups had similar age (28.5 vs. 28.9 years; p = 0.51). After adjustment for covariates, we observed significantly higher aPWV (6.17 vs. 5.82 m s−1; p = 0.001) and lower sRAGE (1308.11 vs. 1475.59; p = 0.009) in the offspring group compared to controls. The significant determinants of the intergroup difference were sRAGE (p = 0.0017), aPWV (p = 0.011) and current smoking (p = 0.0053). Conclusion: Offspring of patients with early onset of CHD compared to age-matched healthy controls had significantly lower sRAGE levels suggesting a shift in the oxidative balance between stressors and defence mechanisms that may influence a higher cardiovascular risk in the future. The measurement of sRAGE might be a valuable predictor for more precise stratification of cardiovascular risk.","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"29 1","pages":"87 - 94"},"PeriodicalIF":1.8,"publicationDate":"2020-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2019.1685372","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46359871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-03DOI: 10.1080/08037051.2019.1675475
Mert Eşme, S. Asil, B. Yavuz, C. Balcı, M. Kılıç, M. C. Kizilarslanoglu, H. Doğan Varan, R. Tuna Doğrul, M. Halil, M. Cankurtaran, B. Yavuz
Abstract Purpose: It is a question whether masked hypertension (MH) leads to end-organ damage in the geriatric age group. The aim of this study is to evaluate the associations between MH and end-organ damage such as left ventricular hypertrophy (LVH) and proteinuria in geriatric population. Materials and methods: One hundred and two patients who were admitted to the outpatient clinic were included in the study. These patients were also included in the GMASH-Cog study in 2016, which examined the relationship between MH and cognitive function. All patients underwent ambulatory blood pressure measurement procedures. Cardiac functions of all patients were determined by echocardiography. Spot urine albumin/creatinine ratio (ACR) was measured in all patients. Results: Forty four of 102 patients (43%) were diagnosed with MH. ACR was 9.61 mg/gr in the MH group and 7.12 mg/gr in the normal group (p = .021). In addition, left ventricular mass index (LVMI) was found to be higher in the MH group than in the normal group. Mean LVMI scores were 107.76 ± 16.37 in patients with MH and 100.39 ± 19.32 in the normotensive group (p = .046). Conclusion: MH is associated with end-organ damage in geriatric patients. Urinary albumin excretion and LVH which are the parameters of end-organ damage were significantly higher in MH patients. MH may cause end-organ damage and should not be overlooked in geriatric patients.
{"title":"Masked hypertension is associated with end organ damage in geriatric age: Geriatric MASked Hypertension and End organ damage (G-MASH-End organ Study)","authors":"Mert Eşme, S. Asil, B. Yavuz, C. Balcı, M. Kılıç, M. C. Kizilarslanoglu, H. Doğan Varan, R. Tuna Doğrul, M. Halil, M. Cankurtaran, B. Yavuz","doi":"10.1080/08037051.2019.1675475","DOIUrl":"https://doi.org/10.1080/08037051.2019.1675475","url":null,"abstract":"Abstract Purpose: It is a question whether masked hypertension (MH) leads to end-organ damage in the geriatric age group. The aim of this study is to evaluate the associations between MH and end-organ damage such as left ventricular hypertrophy (LVH) and proteinuria in geriatric population. Materials and methods: One hundred and two patients who were admitted to the outpatient clinic were included in the study. These patients were also included in the GMASH-Cog study in 2016, which examined the relationship between MH and cognitive function. All patients underwent ambulatory blood pressure measurement procedures. Cardiac functions of all patients were determined by echocardiography. Spot urine albumin/creatinine ratio (ACR) was measured in all patients. Results: Forty four of 102 patients (43%) were diagnosed with MH. ACR was 9.61 mg/gr in the MH group and 7.12 mg/gr in the normal group (p = .021). In addition, left ventricular mass index (LVMI) was found to be higher in the MH group than in the normal group. Mean LVMI scores were 107.76 ± 16.37 in patients with MH and 100.39 ± 19.32 in the normotensive group (p = .046). Conclusion: MH is associated with end-organ damage in geriatric patients. Urinary albumin excretion and LVH which are the parameters of end-organ damage were significantly higher in MH patients. MH may cause end-organ damage and should not be overlooked in geriatric patients.","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"29 1","pages":"80 - 86"},"PeriodicalIF":1.8,"publicationDate":"2020-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2019.1675475","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46309433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-03DOI: 10.1080/08037051.2019.1684818
Anna Chudek, A. Owczarek, J. Ficek, A. Almgren-Rachtan, J. Chudek
Abstract Background: Home blood pressure monitoring (HBPM) became a standard in the management of hypertension. However, there are few data concerning the utilisation of blood pressure (BP) monitors in daily clinical practice. Aim: The aim of this analysis was to show: (1) how frequently hypertensive patients are equipped with BP monitors, (2) how often they perform regular HBPM and running BP diaries, (3) what are the correlates of utilisation of BP monitors, in a large real-life cohort of hypertensives examined for the efficacy of antihypertensive therapy. Patients and methods: The survey was conducted by 570 physicians among 14,200 hypertensive patients, of whom 12,289 (6163 women; mean age 63 ± 12 years) declared use of antihypertensive medicines. Each patient was asked whether at home is having and using regularly or occasionally BP monitor and running BP diary. BP control was assessed based on the mean of two attended office BP measurements. Results: Among patient equipped with BP monitors (87.2%), 73.4% were conducting HBPM regularly, while 26.6% occasionally, and 66.9% were running BP diaries. Controlled BP was achieved by 34.5% (32.9% men and 36.1% women; p < .001), more frequently by equipped with BP monitors (34.9 vs 31.7%, p < .001). Female sex, education, professional activity, active lifestyle, older age, hypertensive polytherapy, longer than 5-year therapy for hypertension, and coexistence of diabetes were factors increasing, while alcohol consumption, visceral obesity and heart failure decreasing the probability of being equipped with BP monitor and running BP diary. Regular HBPM were more frequently among women, physically active, older, diabetics, viscerally obese and patients with coronary artery disease. Conclusions: (1) The majority of hypertensive Poles are already equipped with BP monitors, (2) three-fourth patients perform regular HBPM and two-third run BP diaries, (3) there is still a need to promote utilisation of BP monitors among younger, poorly educated hypertensive males.
背景:家庭血压监测(HBPM)已成为高血压管理的标准。然而,关于在日常临床实践中使用血压(BP)监测仪的数据很少。目的:本分析的目的是显示:(1)高血压患者配备血压监测仪的频率;(2)他们定期进行HBPM和运行血压日记的频率;(3)在一个大型的现实生活高血压患者队列中,血压监测仪的使用与降压治疗的有效性有什么关联。患者和方法:该调查由570名医生对14200名高血压患者进行,其中12289名(6163名女性;平均年龄(63±12岁)申报使用降压药。每位患者被问及是否在家中定期使用或偶尔使用血压监测仪并记录血压日记。根据两次参加办公室血压测量的平均值来评估血压控制。结果:在配备血压监测仪的患者中(87.2%),73.4%的患者定期进行HBPM, 26.6%的患者偶尔进行HBPM, 66.9%的患者记录血压日记。血压控制占34.5%,其中男性32.9%,女性36.1%;p < 0.001),更频繁地配备血压监测仪(34.9% vs 31.7%, p < 0.001)。女性、受教育程度、职业活动、积极的生活方式、年龄较大、高血压综合治疗、高血压治疗超过5年、糖尿病共存是增加的因素,而饮酒、内源性肥胖和心力衰竭则降低了配备血压监测仪和记录血压日记的可能性。定期HBPM在女性、体力活动者、老年人、糖尿病患者、内脏性肥胖和冠状动脉疾病患者中更为常见。结论:(1)大多数高血压患者已经配备了血压监测仪,(2)四分之三的患者定期进行HBPM,三分之二的患者进行血压日记,(3)仍然需要在年轻,受教育程度低的高血压男性中推广使用血压监测仪。
{"title":"Lower utilization of home blood pressure monitoring in younger, poorly educated hypertensive males – real-life data","authors":"Anna Chudek, A. Owczarek, J. Ficek, A. Almgren-Rachtan, J. Chudek","doi":"10.1080/08037051.2019.1684818","DOIUrl":"https://doi.org/10.1080/08037051.2019.1684818","url":null,"abstract":"Abstract Background: Home blood pressure monitoring (HBPM) became a standard in the management of hypertension. However, there are few data concerning the utilisation of blood pressure (BP) monitors in daily clinical practice. Aim: The aim of this analysis was to show: (1) how frequently hypertensive patients are equipped with BP monitors, (2) how often they perform regular HBPM and running BP diaries, (3) what are the correlates of utilisation of BP monitors, in a large real-life cohort of hypertensives examined for the efficacy of antihypertensive therapy. Patients and methods: The survey was conducted by 570 physicians among 14,200 hypertensive patients, of whom 12,289 (6163 women; mean age 63 ± 12 years) declared use of antihypertensive medicines. Each patient was asked whether at home is having and using regularly or occasionally BP monitor and running BP diary. BP control was assessed based on the mean of two attended office BP measurements. Results: Among patient equipped with BP monitors (87.2%), 73.4% were conducting HBPM regularly, while 26.6% occasionally, and 66.9% were running BP diaries. Controlled BP was achieved by 34.5% (32.9% men and 36.1% women; p < .001), more frequently by equipped with BP monitors (34.9 vs 31.7%, p < .001). Female sex, education, professional activity, active lifestyle, older age, hypertensive polytherapy, longer than 5-year therapy for hypertension, and coexistence of diabetes were factors increasing, while alcohol consumption, visceral obesity and heart failure decreasing the probability of being equipped with BP monitor and running BP diary. Regular HBPM were more frequently among women, physically active, older, diabetics, viscerally obese and patients with coronary artery disease. Conclusions: (1) The majority of hypertensive Poles are already equipped with BP monitors, (2) three-fourth patients perform regular HBPM and two-third run BP diaries, (3) there is still a need to promote utilisation of BP monitors among younger, poorly educated hypertensive males.","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"29 1","pages":"102 - 95"},"PeriodicalIF":1.8,"publicationDate":"2020-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2019.1684818","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47610875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-02DOI: 10.1080/08037051.2019.1645587
L. Gafane-Matemane, Nametsegang L Mokae, Y. Breet, L. Malan
Abstract Purpose: The renin-angiotensin-aldosterone system (RAAS) plays an important role in maintaining hemodynamic homeostasis. Ethnic disparities exist regarding RAAS activity due to sympathetic activity and sodium-water retention, however the implications thereof on cardiac damage is unknown. This study investigated the associations of cardiac troponin T (cTnT), N-terminal pro-brain natriuretic peptide (NTproBNP) and subclinical LVH with components of the RAAS (renin, aldosterone and aldosterone-to-renin ratio (ARR)) and copeptin in a black and white South African cohort. Materials and methods: The study population consisted of 305 participants (black = 139, white = 166) aged 20–62 years. Serum cTnT, NTproBNP, Cornell product, components of the RAAS (active renin, aldosterone and ARR) and copeptin were determined. Results: The black group had lower renin (p < 0.001) and higher ARR (p < 0.001), cTnT (p = 0.015) and Cornell product compared to whites (all p < 0.001). NTproBNP and copeptin were similar between the groups. After forward stepwise adjustments for multiple confounders, inverse associations of cTnT with renin (β = −0.17, p = 0.018) and aldosterone (β = −0.14, p = 0.048) as well as an inverse association between NTproBNP and aldosterone (β = −0.25, p < 0.001) were observed in the white population only. In the black group cTnT associated positively with renin (β = 0.16, p = 0.040) and copeptin (β = 0.21, p = 0.020) and inversely with ARR (β = −0.15, p = 0.047). Additionally, NTproBNP associated positively with copeptin (β = 0.18, p = 0.045). No correlations were observed between the RAAS and Cornell product in any of the groups. Conclusions: Our findings suggest that RAAS, together with cardiac stress may function differently in cardiac damage and remodelling in the two ethnic groups; which may influence treatment in clinical practice.
目的:肾素-血管紧张素-醛固酮系统(RAAS)在维持血流动力学稳态中起重要作用。由于交感神经活动和钠-水潴留,RAAS活性存在种族差异,但其对心脏损伤的影响尚不清楚。本研究调查了南非黑人和白人队列中心脏肌钙蛋白T (cTnT)、n端前脑利钠肽(NTproBNP)和亚临床LVH与RAAS成分(肾素、醛固酮和醛固酮-肾素比(ARR))和copeptin的关系。材料和方法:研究人群包括305名参与者(黑人= 139,白人= 166),年龄20-62岁。测定血清cTnT、NTproBNP、Cornell产物、RAAS组分(活性肾素、醛固酮和ARR)和copeptin。结果:黑人组肾素低于白人组(p < 0.001), ARR (p < 0.001)、cTnT (p = 0.015)和Cornell产品高于白人组(p < 0.001)。两组间NTproBNP和copeptin差异无统计学意义。在对多个混杂因素进行逐步调整后,仅在白人人群中观察到cTnT与肾素(β = - 0.17, p = 0.018)和醛固酮(β = - 0.14, p = 0.048)呈负相关,NTproBNP与醛固酮呈负相关(β = - 0.25, p < 0.001)。在黑色组中,cTnT与肾素(β = 0.16, p = 0.040)和copeptin (β = 0.21, p = 0.020)呈正相关,与ARR呈负相关(β = - 0.15, p = 0.047)。此外,NTproBNP与copeptin呈正相关(β = 0.18, p = 0.045)。在任何组中均未观察到RAAS与Cornell产物之间的相关性。结论:我们的研究结果表明,RAAS和心脏应激在两个民族的心脏损伤和重构中可能起着不同的作用;这可能会影响临床治疗。
{"title":"Relation of the renin–angiotensin–aldosterone system with potential cardiac injury and remodelling: the SABPA study","authors":"L. Gafane-Matemane, Nametsegang L Mokae, Y. Breet, L. Malan","doi":"10.1080/08037051.2019.1645587","DOIUrl":"https://doi.org/10.1080/08037051.2019.1645587","url":null,"abstract":"Abstract Purpose: The renin-angiotensin-aldosterone system (RAAS) plays an important role in maintaining hemodynamic homeostasis. Ethnic disparities exist regarding RAAS activity due to sympathetic activity and sodium-water retention, however the implications thereof on cardiac damage is unknown. This study investigated the associations of cardiac troponin T (cTnT), N-terminal pro-brain natriuretic peptide (NTproBNP) and subclinical LVH with components of the RAAS (renin, aldosterone and aldosterone-to-renin ratio (ARR)) and copeptin in a black and white South African cohort. Materials and methods: The study population consisted of 305 participants (black = 139, white = 166) aged 20–62 years. Serum cTnT, NTproBNP, Cornell product, components of the RAAS (active renin, aldosterone and ARR) and copeptin were determined. Results: The black group had lower renin (p < 0.001) and higher ARR (p < 0.001), cTnT (p = 0.015) and Cornell product compared to whites (all p < 0.001). NTproBNP and copeptin were similar between the groups. After forward stepwise adjustments for multiple confounders, inverse associations of cTnT with renin (β = −0.17, p = 0.018) and aldosterone (β = −0.14, p = 0.048) as well as an inverse association between NTproBNP and aldosterone (β = −0.25, p < 0.001) were observed in the white population only. In the black group cTnT associated positively with renin (β = 0.16, p = 0.040) and copeptin (β = 0.21, p = 0.020) and inversely with ARR (β = −0.15, p = 0.047). Additionally, NTproBNP associated positively with copeptin (β = 0.18, p = 0.045). No correlations were observed between the RAAS and Cornell product in any of the groups. Conclusions: Our findings suggest that RAAS, together with cardiac stress may function differently in cardiac damage and remodelling in the two ethnic groups; which may influence treatment in clinical practice.","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"29 1","pages":"31 - 38"},"PeriodicalIF":1.8,"publicationDate":"2020-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2019.1645587","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46558808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-02DOI: 10.1080/08037051.2019.1658517
Jakob Nyvad, Mark Reinhard, K. L. Christensen
Abstract In this report, we present a challenging case of a 63-year-old Caucasian woman with an extreme stress response to blood pressure (BP) measurements. Office- and ambulatory BP measurements consistently found systolic BP above 200 mmHg. However, antihypertensive medication made her dizzy and extremely unwell, and she could barely tolerate treatment with a moderate dose of angiotensin-converting enzyme (ACE) inhibitor. Finger-cuff-based measurements (Finapres Finometer®) revealed extreme hypertension in relation to contact with medical professionals, but hypotension when the patient was seated alone unobserved. Months after, the patient suffered a hemorrhagic stroke possibly related to her extreme BP-fluctuations in stressful situations.
{"title":"A case of an extreme white coat effect","authors":"Jakob Nyvad, Mark Reinhard, K. L. Christensen","doi":"10.1080/08037051.2019.1658517","DOIUrl":"https://doi.org/10.1080/08037051.2019.1658517","url":null,"abstract":"Abstract In this report, we present a challenging case of a 63-year-old Caucasian woman with an extreme stress response to blood pressure (BP) measurements. Office- and ambulatory BP measurements consistently found systolic BP above 200 mmHg. However, antihypertensive medication made her dizzy and extremely unwell, and she could barely tolerate treatment with a moderate dose of angiotensin-converting enzyme (ACE) inhibitor. Finger-cuff-based measurements (Finapres Finometer®) revealed extreme hypertension in relation to contact with medical professionals, but hypotension when the patient was seated alone unobserved. Months after, the patient suffered a hemorrhagic stroke possibly related to her extreme BP-fluctuations in stressful situations.","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"29 1","pages":"63 - 67"},"PeriodicalIF":1.8,"publicationDate":"2020-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2019.1658517","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44696224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}