Pub Date : 2017-02-01Epub Date: 2016-05-14DOI: 10.1080/08037051.2016.1182855
Mohammed F Faramawi, Robert Delongchamp, Qayyim Said, Appathurai Balamurugan, Alaa Hassan, Saly Abouelenien, Mohamed Ismaeil
Objectives: High-normal blood pressure and visit-to-visit blood pressure variability are common in clinical settings. They are associated with cardiovascular outcomes. No population based studies have assessed the association between these two phenomena. Our objective was to test the relationship of high-normal blood pressure with visit-to-visit blood pressure variability.
Design: A cross-sectional study.
Methods: We used data from the cross-sectional Third National Health and Nutrition Examination Survey to test the relationship between high-normal blood pressure and visit-to-visit blood pressure variability; we conducted multivariable regression analyses to evaluate the relationship between these two variables.
Results: The analysis included 6,071 participants. The participants' mean age was 37.16 years. The means of visit-to-visit systolic and diastolic blood pressure variability were 5.84 mmHg and 5.26 mmHg. High-normal blood pressure was significantly associated with systolic and diastolic blood pressure variability (p values <0.05).
Conclusions: High-normal blood pressure is associated with visit-to-visit blood pressure variability. Additional research is required to replicate the reported results in prospective studies and evaluate approaches to reduce blood pressure variability observed in clinical settings among patients with high-normal blood pressure to reduce the subsequent complications of blood pressure variability.
{"title":"High-normal blood pressure is associated with visit-to-visit blood pressure variability in the US adults.","authors":"Mohammed F Faramawi, Robert Delongchamp, Qayyim Said, Appathurai Balamurugan, Alaa Hassan, Saly Abouelenien, Mohamed Ismaeil","doi":"10.1080/08037051.2016.1182855","DOIUrl":"https://doi.org/10.1080/08037051.2016.1182855","url":null,"abstract":"<p><strong>Objectives: </strong>High-normal blood pressure and visit-to-visit blood pressure variability are common in clinical settings. They are associated with cardiovascular outcomes. No population based studies have assessed the association between these two phenomena. Our objective was to test the relationship of high-normal blood pressure with visit-to-visit blood pressure variability.</p><p><strong>Design: </strong>A cross-sectional study.</p><p><strong>Methods: </strong>We used data from the cross-sectional Third National Health and Nutrition Examination Survey to test the relationship between high-normal blood pressure and visit-to-visit blood pressure variability; we conducted multivariable regression analyses to evaluate the relationship between these two variables.</p><p><strong>Results: </strong>The analysis included 6,071 participants. The participants' mean age was 37.16 years. The means of visit-to-visit systolic and diastolic blood pressure variability were 5.84 mmHg and 5.26 mmHg. High-normal blood pressure was significantly associated with systolic and diastolic blood pressure variability (p values <0.05).</p><p><strong>Conclusions: </strong>High-normal blood pressure is associated with visit-to-visit blood pressure variability. Additional research is required to replicate the reported results in prospective studies and evaluate approaches to reduce blood pressure variability observed in clinical settings among patients with high-normal blood pressure to reduce the subsequent complications of blood pressure variability.</p>","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"26 1","pages":"18-23"},"PeriodicalIF":1.8,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2016.1182855","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34384217","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 : 2017-02-01Epub Date: 2016-05-17DOI: 10.1080/08037051.2016.1183460
Chagai Grossman, Gil Bornstein, Avshalom Leibowitz, Ilan Ben-Zvi, Ehud Grossman
Tumor necrosis factor alpha (TNF-α) inhibitors are increasingly being used in inflammatory rheumatic diseases (IRD). The risk of cardiovascular disease is elevated in patients with IRD and TNF-α inhibitors reduce this risk. We assessed whether the beneficial effect of TNF-α inhibitors on cardiovascular risk is mediated by blood pressure reduction. We measured blood pressure levels with 24-h ambulatory blood pressure measurements device in patients with IRD before and 3 months after treatment with TNF-α inhibitors. The study population consisted of 15 subjects (6 men; mean age 45.9 ± 14.1 years). Most patients had either rheumatoid arthritis or psoriatic arthritis and adalimumab was the most common TNF-α inhibitor used. Mean 24-h systolic and diastolic blood pressure levels remained the same after treatment (121 ± 12/66 ± 7 before and 123 ± 11/67 ± 10 mm Hg after; p = 0.88 and 0.66, respectively). The study demonstrates that TNF-α inhibitors have no effect on blood pressure levels.
肿瘤坏死因子α (TNF-α)抑制剂越来越多地用于炎症性风湿病(IRD)。IRD患者发生心血管疾病的风险升高,TNF-α抑制剂可降低这一风险。我们评估了TNF-α抑制剂对心血管风险的有益作用是否通过降低血压介导。我们用24小时动态血压测量仪测量了IRD患者在TNF-α抑制剂治疗前和治疗后3个月的血压水平。研究人群包括15名受试者(6名男性;平均年龄45.9±14.1岁)。大多数患者患有类风湿关节炎或银屑病关节炎,阿达木单抗是最常用的TNF-α抑制剂。治疗后24小时平均收缩压和舒张压水平保持不变(治疗前121±12/66±7,治疗后123±11/67±10 mm Hg;P分别= 0.88和0.66)。研究表明TNF-α抑制剂对血压水平没有影响。
{"title":"Effect of tumor necrosis factor-α inhibitors on ambulatory 24-h blood pressure.","authors":"Chagai Grossman, Gil Bornstein, Avshalom Leibowitz, Ilan Ben-Zvi, Ehud Grossman","doi":"10.1080/08037051.2016.1183460","DOIUrl":"https://doi.org/10.1080/08037051.2016.1183460","url":null,"abstract":"<p><p>Tumor necrosis factor alpha (TNF-α) inhibitors are increasingly being used in inflammatory rheumatic diseases (IRD). The risk of cardiovascular disease is elevated in patients with IRD and TNF-α inhibitors reduce this risk. We assessed whether the beneficial effect of TNF-α inhibitors on cardiovascular risk is mediated by blood pressure reduction. We measured blood pressure levels with 24-h ambulatory blood pressure measurements device in patients with IRD before and 3 months after treatment with TNF-α inhibitors. The study population consisted of 15 subjects (6 men; mean age 45.9 ± 14.1 years). Most patients had either rheumatoid arthritis or psoriatic arthritis and adalimumab was the most common TNF-α inhibitor used. Mean 24-h systolic and diastolic blood pressure levels remained the same after treatment (121 ± 12/66 ± 7 before and 123 ± 11/67 ± 10 mm Hg after; p = 0.88 and 0.66, respectively). The study demonstrates that TNF-α inhibitors have no effect on blood pressure levels.</p>","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"26 1","pages":"24-29"},"PeriodicalIF":1.8,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2016.1183460","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34488825","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 : 2017-02-01Epub Date: 2016-05-13DOI: 10.3109/08037051.2016.1167355
Dominika Klimczak, Krystian Jazdzewski, Marek Kuch
Multiple factors underlie the pathophysiology of hypertension, involving endothelial dysregulation, vascular smooth muscle dysfunction, increased oxidative stress, sympathetic nervous system activation and altered renin -angiotensin -aldosterone regulatory activity. A class of non-coding RNA called microRNA, consisting of 17-25 nucleotides, exert regulatory function over these processes. This paper summarizes the currently available data from preclinical and clinical studies on miRNA in the development of hypertension as well as the impact of anti-hypertensive treatment on their plasma expression. We present microRNAs' characteristics, their biogenesis and role in the regulation of blood pressure together with their potential diagnostic and therapeutic application in clinical practice.
{"title":"Regulatory mechanisms in arterial hypertension: role of microRNA in pathophysiology and therapy.","authors":"Dominika Klimczak, Krystian Jazdzewski, Marek Kuch","doi":"10.3109/08037051.2016.1167355","DOIUrl":"https://doi.org/10.3109/08037051.2016.1167355","url":null,"abstract":"<p><p>Multiple factors underlie the pathophysiology of hypertension, involving endothelial dysregulation, vascular smooth muscle dysfunction, increased oxidative stress, sympathetic nervous system activation and altered renin -angiotensin -aldosterone regulatory activity. A class of non-coding RNA called microRNA, consisting of 17-25 nucleotides, exert regulatory function over these processes. This paper summarizes the currently available data from preclinical and clinical studies on miRNA in the development of hypertension as well as the impact of anti-hypertensive treatment on their plasma expression. We present microRNAs' characteristics, their biogenesis and role in the regulation of blood pressure together with their potential diagnostic and therapeutic application in clinical practice.</p>","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"26 1","pages":"2-8"},"PeriodicalIF":1.8,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/08037051.2016.1167355","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34482847","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 : 2017-02-01Epub Date: 2016-05-13DOI: 10.1080/08037051.2016.1179500
Marcelo P Baldo, Divanei A Zaniqueli, Pedro Magalhães, Daniel P Capingana, Amilcar B Silva, José Geraldo Mill
Background: Hypertension affects African-American adults more than any other ethnic group in the US. However, some of the black populations living outside Africa are well adapted to food and lifestyle. We aimed to describe the clinical characteristics underlying the gender-specific determinants of BP and the risk of hypertension in public-sector workers living in Angola.
Materials and methods: 609 volunteers (48% men) were included in this cross-sectional and descriptive study. Demographic, socioeconomic and life style data were collected during an interview. Systolic BP (SBP) and diastolic BP (DBP) were measured, along with some anthropometric and clinical variables.
Results: The prevalence of hypertension is 45.2% without difference between genders. Obesity was more prevalent in women (29.2% vs. 8.9%, p < 0.05). The age-related increment in SBP is higher in women (14.2 ± 1.1 vs 9.5 ± 1.3 mmHg/decade, p < 0.05). In men, age, BMI, cholesterol and LDLc/HDLc explained 21, 4, 2.5 and 2.9% of SBP variability, respectively. In women, age, BMI and HC explain 27, 2 and 1% of SBP variability, respectively. The risk for hypertension is 5 × high among men aged ≥45 years, and 3.5× in those having BMI ≥25. Women aged 45 years or older have 8 × risk of hypertension and 2× the risk by having BMI ≥25.
Conclusions: We found that advanced age (≥45) and overweight/obesity (BMI ≥25) are the main risk factors for hypertension in adults from Angola. However, our data suggest that age and BMI may have different influence on increasing BP in men and women.
{"title":"Gender-specific determinants of blood pressure elevation in Angolan adults.","authors":"Marcelo P Baldo, Divanei A Zaniqueli, Pedro Magalhães, Daniel P Capingana, Amilcar B Silva, José Geraldo Mill","doi":"10.1080/08037051.2016.1179500","DOIUrl":"https://doi.org/10.1080/08037051.2016.1179500","url":null,"abstract":"<p><strong>Background: </strong>Hypertension affects African-American adults more than any other ethnic group in the US. However, some of the black populations living outside Africa are well adapted to food and lifestyle. We aimed to describe the clinical characteristics underlying the gender-specific determinants of BP and the risk of hypertension in public-sector workers living in Angola.</p><p><strong>Materials and methods: </strong>609 volunteers (48% men) were included in this cross-sectional and descriptive study. Demographic, socioeconomic and life style data were collected during an interview. Systolic BP (SBP) and diastolic BP (DBP) were measured, along with some anthropometric and clinical variables.</p><p><strong>Results: </strong>The prevalence of hypertension is 45.2% without difference between genders. Obesity was more prevalent in women (29.2% vs. 8.9%, p < 0.05). The age-related increment in SBP is higher in women (14.2 ± 1.1 vs 9.5 ± 1.3 mmHg/decade, p < 0.05). In men, age, BMI, cholesterol and LDLc/HDLc explained 21, 4, 2.5 and 2.9% of SBP variability, respectively. In women, age, BMI and HC explain 27, 2 and 1% of SBP variability, respectively. The risk for hypertension is 5 × high among men aged ≥45 years, and 3.5× in those having BMI ≥25. Women aged 45 years or older have 8 × risk of hypertension and 2× the risk by having BMI ≥25.</p><p><strong>Conclusions: </strong>We found that advanced age (≥45) and overweight/obesity (BMI ≥25) are the main risk factors for hypertension in adults from Angola. However, our data suggest that age and BMI may have different influence on increasing BP in men and women.</p>","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"26 1","pages":"9-17"},"PeriodicalIF":1.8,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2016.1179500","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34482853","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 : 2017-02-01Epub Date: 2016-05-19DOI: 10.1080/08037051.2016.1182854
Maxime Cournot, Victorine Lenclume, Nathalie Le Moullec, Xavier Debussche, Eric Doussiet, Anne Fagot-Campagna, François Favier
A better knowledge of prevalence, management and determinants of hypertension is needed in regions in epidemiological transition to adapt the strategies of public health screening and prevention, and to reduce the burden of cardiovascular diseases. We conducted a prospective cohort study including 4610 participants aged between 18 and 69 years and representative of the general population of La Réunion, a French overseas island located in the western Indian Ocean. The median time between inclusion and follow-up was 7.4 years. Blood pressure data at baseline and follow-up of 3087 participants were analyzed. We found a high prevalence of hypertension, especially in women (36.7% [34.5-39.0]) and in men (40.3% [37.6-43.0]) and in the under 30s (17.1% [14.0-20.5]), with an increase of 10% at follow-up. Treatment rates were very low in men (19.5% versus 39.1% in women) as was awareness of their condition (25.7% versus 44.6%). Blood pressure control rates were similar (18% at baseline and 34% at follow-up for both sexes). Diagnosis of hypertension at follow-up among subjects normotensive at baseline was independently associated with obesity at baseline (relative risk (RR) = 1.40 [1.12-1.75] for BMI between 27 and 30 kg/m2 and 1.72 [1.33-2.25] for BMI ≥30 kg/m2 as compared with BMI <27 kg/m2) and HbA1C (RR =1.12 [1.05-1.19] per %), suggesting a prominent role of insulin resistance in our population. Our study provides original data that cannot be assimilated to any existing model and should guide the implementation of original community-based programs in such countries.
{"title":"Prevalence, treatment and control of hypertension in La Réunion: the RÉDIA population-based cohort study.","authors":"Maxime Cournot, Victorine Lenclume, Nathalie Le Moullec, Xavier Debussche, Eric Doussiet, Anne Fagot-Campagna, François Favier","doi":"10.1080/08037051.2016.1182854","DOIUrl":"https://doi.org/10.1080/08037051.2016.1182854","url":null,"abstract":"<p><p>A better knowledge of prevalence, management and determinants of hypertension is needed in regions in epidemiological transition to adapt the strategies of public health screening and prevention, and to reduce the burden of cardiovascular diseases. We conducted a prospective cohort study including 4610 participants aged between 18 and 69 years and representative of the general population of La Réunion, a French overseas island located in the western Indian Ocean. The median time between inclusion and follow-up was 7.4 years. Blood pressure data at baseline and follow-up of 3087 participants were analyzed. We found a high prevalence of hypertension, especially in women (36.7% [34.5-39.0]) and in men (40.3% [37.6-43.0]) and in the under 30s (17.1% [14.0-20.5]), with an increase of 10% at follow-up. Treatment rates were very low in men (19.5% versus 39.1% in women) as was awareness of their condition (25.7% versus 44.6%). Blood pressure control rates were similar (18% at baseline and 34% at follow-up for both sexes). Diagnosis of hypertension at follow-up among subjects normotensive at baseline was independently associated with obesity at baseline (relative risk (RR) = 1.40 [1.12-1.75] for BMI between 27 and 30 kg/m<sup>2</sup> and 1.72 [1.33-2.25] for BMI ≥30 kg/m<sup>2</sup> as compared with BMI <27 kg/m<sup>2</sup>) and HbA1C (RR =1.12 [1.05-1.19] per %), suggesting a prominent role of insulin resistance in our population. Our study provides original data that cannot be assimilated to any existing model and should guide the implementation of original community-based programs in such countries.</p>","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"26 1","pages":"39-47"},"PeriodicalIF":1.8,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2016.1182854","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34561615","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 : 2017-01-31DOI: 10.1080/08037051.2017.1283955
K. Ahn, J. Jeong, Seon-Ah Jin, Mijoo Kim, Jin Kyung Oh, U. Choi, Seok-Woo Seong, Jun Hyung Kim, Si-Wan Choi, H. Jeong, H. Song, Jei Kim, I. Seong
Abstract Background: Although brachial-ankle pulse wave velocity (baPWV) is well-known for predicting the cardiovascular mortality and morbidity, its anticipated value is not demonstrated well concerning acute stroke. Methods: Total 1557 patients with acute stroke who performed baPWV were enrolled. We evaluated the prognostic value of baPWV predicting all-cause death and vascular death in patients with acute stroke Results: Highest quartile of baPWV was ≥23.64 m/s. All-caused deaths (including vascular death; 71) were 109 patients during follow-up periods (median 905 days). Multivariate Cox regression analysis revealed that patients with the highest quartile of baPWV had higher risk for vascular death when they are compared with patients with all other three quartiles of baPWV (Hazard ratio with 95% confidence interval [CI] 1.879 [1.022–3.456], p = .042 for vascular death). Conclusion: High baPWV was a strong prognostic value of vascular death in patients with acute stroke
{"title":"Brachial-ankle PWV for predicting clinical outcomes in patients with acute stroke","authors":"K. Ahn, J. Jeong, Seon-Ah Jin, Mijoo Kim, Jin Kyung Oh, U. Choi, Seok-Woo Seong, Jun Hyung Kim, Si-Wan Choi, H. Jeong, H. Song, Jei Kim, I. Seong","doi":"10.1080/08037051.2017.1283955","DOIUrl":"https://doi.org/10.1080/08037051.2017.1283955","url":null,"abstract":"Abstract Background: Although brachial-ankle pulse wave velocity (baPWV) is well-known for predicting the cardiovascular mortality and morbidity, its anticipated value is not demonstrated well concerning acute stroke. Methods: Total 1557 patients with acute stroke who performed baPWV were enrolled. We evaluated the prognostic value of baPWV predicting all-cause death and vascular death in patients with acute stroke Results: Highest quartile of baPWV was ≥23.64 m/s. All-caused deaths (including vascular death; 71) were 109 patients during follow-up periods (median 905 days). Multivariate Cox regression analysis revealed that patients with the highest quartile of baPWV had higher risk for vascular death when they are compared with patients with all other three quartiles of baPWV (Hazard ratio with 95% confidence interval [CI] 1.879 [1.022–3.456], p = .042 for vascular death). Conclusion: High baPWV was a strong prognostic value of vascular death in patients with acute stroke","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"26 1","pages":"204 - 210"},"PeriodicalIF":1.8,"publicationDate":"2017-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2017.1283955","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41710169","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 : 2017-01-24DOI: 10.1080/08037051.2017.1278678
A. Kıvrak, Süleyman Özbiçer, G. Kalkan, M. Gür
Abstract Objective: We aimed to investigate the relationship between the morning blood pressure (BP) surge and arterial stiffness in patients with newly diagnosed hypertension. Subjects and methods: Three hundred and twenty four (mean age 51.7 ± 11.4 years) patients who had newly diagnosed hypertension with 24 h ambulatory BP monitoring were enrolled. Parameters of arterial stiffness, pulse wave velocity and augmentation index (Aix) were measured by applanation tonometry and aortic distensibility was calculated by echocardiography. Results: Compared with the other groups, pulse wave velocity, day–night systolic BP (SBP) difference (p < 0.001, for all) and hs-CRP (p = 0.005) were higher in morning BP surge high group. Aortic distensibility values were significantly lower in morning BP surge high group compared to the other groups (p < 0.05, for all). Morning BP surge was found to be independently associated with pulse wave velocity (β = 0.286, p < 0.001), aortic distensibility (β= −0.384, p < 0.001) and day–night SBP difference (β = 0.229, p < 0.001) in multivariate linear regression analysis. Conclusions: We found independent relationship between morning BP surge and arterial stiffness which is a surrogate endpoint for cardiovascular diseases. The inverse relationship between morning BP surge and aortic distensibility and direct relation found in our study is new to the literature.
摘要目的:探讨新诊断高血压患者晨起血压(BP)峰值与动脉僵硬度的关系。对象和方法:纳入24小时动态血压监测的新诊断高血压患者324例(平均年龄51.7±11.4岁)。采用压血压计测量动脉硬度、脉搏波速度、增强指数(Aix),超声心动图计算主动脉扩张率。结果:与其他组比较,晨搏高组脉搏波速度、昼夜收缩压(SBP)差值(p < 0.001)和hs-CRP (p = 0.005)均较高。清晨血压升高组主动脉瓣扩张系数显著低于其他组(p < 0.05)。多因素线性回归分析发现,晨间血压升高与脉搏波速(β= 0.286, p < 0.001)、主动脉扩张度(β= - 0.384, p < 0.001)和昼夜收缩压差(β= 0.229, p < 0.001)独立相关。结论:我们发现早晨血压升高与动脉僵硬度之间存在独立关系,动脉僵硬度是心血管疾病的替代终点。本研究发现的晨间血压升高与主动脉瓣扩张呈反比关系,与主动脉瓣扩张有直接关系,这在文献中尚属首次。
{"title":"Morning blood pressure surge and arterial stiffness in newly diagnosed hypertensive patients","authors":"A. Kıvrak, Süleyman Özbiçer, G. Kalkan, M. Gür","doi":"10.1080/08037051.2017.1278678","DOIUrl":"https://doi.org/10.1080/08037051.2017.1278678","url":null,"abstract":"Abstract Objective: We aimed to investigate the relationship between the morning blood pressure (BP) surge and arterial stiffness in patients with newly diagnosed hypertension. Subjects and methods: Three hundred and twenty four (mean age 51.7 ± 11.4 years) patients who had newly diagnosed hypertension with 24 h ambulatory BP monitoring were enrolled. Parameters of arterial stiffness, pulse wave velocity and augmentation index (Aix) were measured by applanation tonometry and aortic distensibility was calculated by echocardiography. Results: Compared with the other groups, pulse wave velocity, day–night systolic BP (SBP) difference (p < 0.001, for all) and hs-CRP (p = 0.005) were higher in morning BP surge high group. Aortic distensibility values were significantly lower in morning BP surge high group compared to the other groups (p < 0.05, for all). Morning BP surge was found to be independently associated with pulse wave velocity (β = 0.286, p < 0.001), aortic distensibility (β= −0.384, p < 0.001) and day–night SBP difference (β = 0.229, p < 0.001) in multivariate linear regression analysis. Conclusions: We found independent relationship between morning BP surge and arterial stiffness which is a surrogate endpoint for cardiovascular diseases. The inverse relationship between morning BP surge and aortic distensibility and direct relation found in our study is new to the literature.","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"26 1","pages":"181 - 190"},"PeriodicalIF":1.8,"publicationDate":"2017-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2017.1278678","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48238876","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 : 2017-01-16DOI: 10.1080/08037051.2016.1270162
O. Saluveer, B. Redfors, O. Angerås, C. Dworeck, I. Haraldsson, C. Ljungman, P. Pétursson, J. Odenstedt, D. Ioanes, P. Lundgren, S. Völz, T. Råmunddal, B. Andersson, E. Omerovic, N. Bergh
Abstract Background: The prognostic role of hypertension on long-term survival after percutaneous coronary intervention (PCI) is limited and inconsistent. We hypothesize that hypertension increases long-term mortality after PCI. Methods: We analyzed data from SCAAR (Swedish Coronary Angiography and Angioplasty Registry) for all consecutive patients admitted coronary care units in Sweden between January 1995 and May 2013 and who underwent PCI due to ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI)/unstable angina (UA) or stable angina pectoris. We used Cox proportional-hazards regression for statistical modelling on complete-case data as well as on imputed data sets. We used interaction test to evaluate possible effect-modulation of hypertension on risk estimates in several pre-specified subgroups: age categories, gender, diabetes, smoking and indication for PCI (STEMI, NSTEMI/UA and stable angina). Results: During the study period, 175,892 consecutive patients underwent coronary angiography due to STEMI, NSTEMI/UA or stable angina. 78,100 (44%) of these had hypertension. Median follow-up was 5.5 years. After adjustment for differences in patient’s characteristics, hypertension was associated with increased risk for mortality (HR 1.12, 95% CI 1.09–1.15, p < .001). In subgroup analysis, risk was highest in patients less than 65 years, in smokers and in patients with STEMI. The risk was lowest in patients with stable angina (p < .001 for interaction test). Conclusion: Hypertension is associated with higher mortality in patients with STEMI, NSTEMI/UA or stable angina who are treated with PCI.
背景:高血压对经皮冠状动脉介入治疗(PCI)术后长期生存的影响有限且不一致。我们假设高血压会增加PCI术后的长期死亡率。方法:我们分析了瑞典冠状动脉造影和血管成形术登记处(SCAAR) 1995年1月至2013年5月期间在瑞典冠状动脉护理单位连续入院的所有患者的数据,这些患者因st段抬高型心肌梗死(STEMI)、非st段抬高型心肌梗死(NSTEMI)/不稳定型心绞痛(UA)或稳定型心绞痛接受了PCI。我们使用Cox比例风险回归对完整病例数据和输入数据集进行统计建模。我们使用相互作用试验来评估高血压对几个预先指定的亚组(年龄类别、性别、糖尿病、吸烟和PCI指证(STEMI、NSTEMI/UA和稳定型心绞痛)的风险估计的可能影响调节。结果:在研究期间,连续175,892例患者因STEMI、NSTEMI/UA或稳定型心绞痛接受了冠状动脉造影。其中78,100人(44%)患有高血压。中位随访时间为5.5年。在调整患者特征差异后,高血压与死亡风险增加相关(HR 1.12, 95% CI 1.09-1.15, p < 0.001)。在亚组分析中,65岁以下患者、吸烟者和STEMI患者的风险最高。稳定性心绞痛患者的风险最低(p < 0.05)。001为相互作用测试)。结论:高血压与接受PCI治疗的STEMI、NSTEMI/UA或稳定型心绞痛患者较高的死亡率相关。
{"title":"Hypertension is associated with increased mortality in patients with ischaemic heart disease after revascularization with percutaneous coronary intervention – a report from SCAAR*","authors":"O. Saluveer, B. Redfors, O. Angerås, C. Dworeck, I. Haraldsson, C. Ljungman, P. Pétursson, J. Odenstedt, D. Ioanes, P. Lundgren, S. Völz, T. Råmunddal, B. Andersson, E. Omerovic, N. Bergh","doi":"10.1080/08037051.2016.1270162","DOIUrl":"https://doi.org/10.1080/08037051.2016.1270162","url":null,"abstract":"Abstract Background: The prognostic role of hypertension on long-term survival after percutaneous coronary intervention (PCI) is limited and inconsistent. We hypothesize that hypertension increases long-term mortality after PCI. Methods: We analyzed data from SCAAR (Swedish Coronary Angiography and Angioplasty Registry) for all consecutive patients admitted coronary care units in Sweden between January 1995 and May 2013 and who underwent PCI due to ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI)/unstable angina (UA) or stable angina pectoris. We used Cox proportional-hazards regression for statistical modelling on complete-case data as well as on imputed data sets. We used interaction test to evaluate possible effect-modulation of hypertension on risk estimates in several pre-specified subgroups: age categories, gender, diabetes, smoking and indication for PCI (STEMI, NSTEMI/UA and stable angina). Results: During the study period, 175,892 consecutive patients underwent coronary angiography due to STEMI, NSTEMI/UA or stable angina. 78,100 (44%) of these had hypertension. Median follow-up was 5.5 years. After adjustment for differences in patient’s characteristics, hypertension was associated with increased risk for mortality (HR 1.12, 95% CI 1.09–1.15, p < .001). In subgroup analysis, risk was highest in patients less than 65 years, in smokers and in patients with STEMI. The risk was lowest in patients with stable angina (p < .001 for interaction test). Conclusion: Hypertension is associated with higher mortality in patients with STEMI, NSTEMI/UA or stable angina who are treated with PCI.","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"26 1","pages":"166 - 173"},"PeriodicalIF":1.8,"publicationDate":"2017-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2016.1270162","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42029885","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 : 2017-01-16DOI: 10.1080/08037051.2016.1273741
M. Wirtwein, O. Melander, M. Sjőgren, M. Hoffmann, K. Narkiewicz, M. Gruchała, W. Sobiczewski
Abstract Objectives: Ambulatory systolic-diastolic pressure regression index (ASDPRI) as a composite marker of cardiovascular (CV) properties is related to CV complications. However, genetic determinants of ASDPRI are not known. The aim of this study is to report the relationship between certain single nucleotide polymorphisms (SNP) and ASDPRI in hypertensive patients with CAD confirmed by coronary angiography. Methods: A total of 1345 hypertensive subjects with CAD were included. SNPs were selected from genome-wide association studies. SNPs were reported to be associated with coronary artery disease risk. There were significant differences in 24 h and daytime and nighttime ASDPRIs for PHCTR1, LPA and ADAMTS7 polymorphisms. Genetic risk score (GRS18) was constructed to evaluate additive effect of 18 SNPs for ASDPRI. Results: Analysis of covariance revealed a significant relationship between the PPAB2B (β − 0.85; 95 CI −1.85–−0.16, p < 0.02), WDR12 (β − 1.31; 95 CI −2.19–−0.43, p < 0.01) polymorphisms and nighttime ASDPRI dipping. Analysis of covariance revealed a significant relationship between GRS 18 and 24-h ASDPRI (β 0.34; 95 CI 0.16–0.31, p < 0.01). Conclusions: In conclusion, ADAMTS7 and LPA polymorphisms are related to 24-h ASDPRI but PPAB2B and WDR12 gene polymorphisms are associated with nighttime ASDPRI dipping. A total of 24-h ASDPRI is determined by GRS18.
{"title":"Elevated ambulatory systolic-diastolic pressure regression index is genetically determined in hypertensive patients with coronary heart disease","authors":"M. Wirtwein, O. Melander, M. Sjőgren, M. Hoffmann, K. Narkiewicz, M. Gruchała, W. Sobiczewski","doi":"10.1080/08037051.2016.1273741","DOIUrl":"https://doi.org/10.1080/08037051.2016.1273741","url":null,"abstract":"Abstract Objectives: Ambulatory systolic-diastolic pressure regression index (ASDPRI) as a composite marker of cardiovascular (CV) properties is related to CV complications. However, genetic determinants of ASDPRI are not known. The aim of this study is to report the relationship between certain single nucleotide polymorphisms (SNP) and ASDPRI in hypertensive patients with CAD confirmed by coronary angiography. Methods: A total of 1345 hypertensive subjects with CAD were included. SNPs were selected from genome-wide association studies. SNPs were reported to be associated with coronary artery disease risk. There were significant differences in 24 h and daytime and nighttime ASDPRIs for PHCTR1, LPA and ADAMTS7 polymorphisms. Genetic risk score (GRS18) was constructed to evaluate additive effect of 18 SNPs for ASDPRI. Results: Analysis of covariance revealed a significant relationship between the PPAB2B (β − 0.85; 95 CI −1.85–−0.16, p < 0.02), WDR12 (β − 1.31; 95 CI −2.19–−0.43, p < 0.01) polymorphisms and nighttime ASDPRI dipping. Analysis of covariance revealed a significant relationship between GRS 18 and 24-h ASDPRI (β 0.34; 95 CI 0.16–0.31, p < 0.01). Conclusions: In conclusion, ADAMTS7 and LPA polymorphisms are related to 24-h ASDPRI but PPAB2B and WDR12 gene polymorphisms are associated with nighttime ASDPRI dipping. A total of 24-h ASDPRI is determined by GRS18.","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"26 1","pages":"174 - 180"},"PeriodicalIF":1.8,"publicationDate":"2017-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2016.1273741","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47708416","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 : 2017-01-12DOI: 10.1080/08037051.2016.1277129
J. Mariampillai, P. A. Eskås, S. Heimark, A. Larstorp, F. F. Fadl Elmula, A. Høieggen, P. Nortvedt
Abstract Background: Poor drug adherence is a major cause of apparent treatment-resistant hypertension. As a consequence, several methods have been developed and attempted implemented in clinical practice to reveal non-adherence and to monitor drug adherence. There are, however, several hitherto unresolved ethical aspects regarding potential methods for drug monitoring in these patients. Results: The most striking challenge is the balance between patient autonomy and the physician’s desire for the patient to adhere to the prescribed therapy. Also, methods for monitoring must only be implemented in the treatment of well-informed and consenting patients. Major resources are used on non-adherent patients; how long the physician should encourage continuation of treatment is an important question. Conclusions: We believe that physicians should reflect and discuss these potential challenges, and that patient education, information and a solid patient–physician relationship are essential for achieving drug adherence. Methods for monitoring adherence represent, however, a useful and often necessary supplement.
{"title":"Apparent treatment-resistant hypertension – patient–physician relationship and ethical issues","authors":"J. Mariampillai, P. A. Eskås, S. Heimark, A. Larstorp, F. F. Fadl Elmula, A. Høieggen, P. Nortvedt","doi":"10.1080/08037051.2016.1277129","DOIUrl":"https://doi.org/10.1080/08037051.2016.1277129","url":null,"abstract":"Abstract Background: Poor drug adherence is a major cause of apparent treatment-resistant hypertension. As a consequence, several methods have been developed and attempted implemented in clinical practice to reveal non-adherence and to monitor drug adherence. There are, however, several hitherto unresolved ethical aspects regarding potential methods for drug monitoring in these patients. Results: The most striking challenge is the balance between patient autonomy and the physician’s desire for the patient to adhere to the prescribed therapy. Also, methods for monitoring must only be implemented in the treatment of well-informed and consenting patients. Major resources are used on non-adherent patients; how long the physician should encourage continuation of treatment is an important question. Conclusions: We believe that physicians should reflect and discuss these potential challenges, and that patient education, information and a solid patient–physician relationship are essential for achieving drug adherence. Methods for monitoring adherence represent, however, a useful and often necessary supplement.","PeriodicalId":55591,"journal":{"name":"Blood Pressure","volume":"26 1","pages":"133 - 138"},"PeriodicalIF":1.8,"publicationDate":"2017-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2016.1277129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44196828","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}