Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ambulatory blood pressure, ABP, was determined every 15 min for 24 h (Spacelabs 5200 system) in 16 hypertensive diabetic subjects treated for high blood pressure. Office blood pressure (OBP) in these subjects (systolic BP greater than 160 mmHg and diastolic BP greater than 95 mmHg before treatment) had been reduced by treatment to the borderline range (systolic less than or equal to 160 mmHg and/or diastolic less than or equal to 95 mmHg). Sixty-five diabetic subjects with normal or borderline OBP were included as controls. The two groups had the same age (58 +/- 10 yrs in both groups), duration of diabetes (15 +/- 9 yrs), 24 hr microalbumin, and included the same percentage of subjects with moderate neuropathy (36% and 29%, NS). The two groups had the same OBP (138 +/- 16 mmHg and 140 +/- 16 mmHg systolic, NS, 84 +/- 9 mmHg and 84 +/- 13 mmHg diastolic, NS). In contrast, ambulatory BP was significantly higher in the treated group, when compared with the controls (123 +/- 13 mmHg and 133 +/- 23 mmHg systolic, P less than 0.025, 77 +/- 7 mmHg and 84 +/- 16 mmHg diastolic, P less than 0.015). The difference was significant both in daytime and in nighttime, and was more significant in nighttime (11 mmHg systolic, P less than 0.02, 9 mmHg diastolic, P less than 0.004) than in daytime (9 mmHg systolic, P less than 0.05 and 5 mmHg diastolic, P less than 0.05). Ambulatory heart rate was also significantly higher in the treated group, but only in daytime (7 b/min difference, P less than 0.02). The study demonstrated the need to survey and investigate ABP in treated hypertensive diabetic subjects.
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PMID:Ambulatory blood pressure is still elevated in treated hypertensive diabetic subjects compared with untreated diabetic subjects with the same office blood pressure. 159 51

Knowledge of daily blood pressure profiles is now an important factor in the management of hypertension. We recently analyzed the relationship of casual blood pressure (CBP) to 24-hour blood pressure (24-h BP) in 9 hypertensive patients and 11 normotensive subjects. A 24-hour ambulatory blood pressure monitoring apparatus (24-h ABPM, A & D Co.) was used to monitor 24-h BP. Data were divided into daytime mean blood pressure (daytime mBP), night mean blood pressure (night mBP), and 24-hour mean blood pressure (24-h mBP). In each subject, the 24-h ABP pattern was highly reproducible. Analysis of CBP disclosed that both the systolic blood pressure (SBP) and diastolic blood pressure (DBP) correlated more closely with 24-h mBP than with any other parameter. In view of the high incidence of cerebral infarction during night time or rest, prior knowledge of a blood pressure change pattern from daytime mBP to night mBP in individual patients is important in the prevention of this condition. The degree of decrease from daytime mBP to night mBP varied greatly among individuals, being higher in hypertensive patients than in normotensive subjects. The degree of this change in blood pressure was difficult to predict based on the CBP change pattern following postural change or 5-min rest. In some cases, 24-h ABPM data were within the hypertensive range (systolic greater than 160 mmHg, diastolic greater than 95 mmHg) for many hours, even though CBP was within the normal range. On the other hand, the duration of this sustained hypertensive level during 24-h ABPM was sometimes short, even in subjects with elevated CBP. To deal with such discrepancies between CBP and 24-h ABPM, the duration of the sustained hypertensive level during 24-h ABPM should be given high priority in assessing the severity and prognosis of hypertension.
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PMID:Management of hypertensive outpatients: clinical evaluation of casual and 24-hour ambulatory blood pressure. 182 Apr 38

The tendency of subjects to maintain their relative position within the distribution of blood pressure (BP) has been defined as "tracking". Regarding this phenomenon, the purpose of the study was to evaluate the interest of ambulatory BP monitoring (ABPM) in the assessment of arterial hypertension in young adults (YA) with childhood hypertension history (CHH). 52 subjects, 20.1 +/- 2.4 years old, 26 men, 26 women issued from a cohort of 150 children with high BP levels (greater than 97.5 th percentile) during their infancy (school check-up), were included in the study. An ABPM was performed with space-labs system 90202 from 8 a.m. to 6 p.m., measurements every 15 minutes (37.6 +/- 7.4 readings). Left ventricular mass index (LVMI) was determined with echocardiography, (Penn convention). Office BP, measured with mercury apparatus in lying and standing position, was respectively, 131.0 +/- 14.6/81.9 +/- 9.7 and 130.1 +/- 14/86.6 +/- 9.9. According to JNC 1988, this casual BP identified 40 normotensives (NT), 9 borderlines (BL) and 5 hypertensives (HT); 10 of them had a "high normal" diastolic BP (85-90 mmHg) ABP recordings of the study group were compared to day-time reference values of NT. Three subgroups are individualized: G1 NT, G2 HT, G3 BL. [table; see text] *p: less than 0.001; p: less than 0.01. Wall thickness (WTh) and LVMI were significantly higher in hypertensives (G2 + G3) than in normotensives (G1): [table; see text] There was a significant correlation between LVMI and mean systolic ABP (p less than 0.01: r = 0.44), but not with office SBP.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Ambulatory blood pressure in the young adult with hypertension history during childhood]. 183 56

The effects on cerebral circulation and intracranial pressure (ICP) of the carotid sinus nerve stimulation were examined in mongrel cats anesthetized with alpha-chloralose. In 214 trials with stimulation at normal ICP (less than 20mm Hg) in seven cats, mean arterial blood pressure (mABP), heart rate (HR), and ICP decreased significantly (p less than 0.05 in paired Student's t-tests), and the decreased magnitudes for mABP, HR and ICP were 29.9mm Hg, 32 beats/min and 0.9mm Hg, respectively. Correlation was linear between changes in the ICP and mABP (r = 0.61). After spinal ligation at the second cervical segment, bradycardia and depressor responses to the stimulation were observed. However, after vagosympathectomy of the cats with ligated cords, sinus nerve stimulation did not change the ABP, HR, ICP, CBF, or cerebral blood volume. This suggested that carotid sinus baroreceptor reflexes had no direct effect on cerebral vasodilation. When the levels before stimulation of the ICP were increased without evocation of Cushing's response by gradual inflation of a balloon placed extradurally, the ABP and the HR still decreased after stimulation. When Cushing's response was brought about, the responses in ABP and HR caused by the stimulation were not apparent at the peak of arterial hypertension. However, the amplitude of the decrease in the ICP caused by stimulation was enhanced with an increase in the levels of ICP before stimulation. Thus, the arterial baroreflex is preserved at increased levels of ICP without Cushing's response, and works more effectively to cancel the possible increase of ICP that can arise when there is a pulsatile increase in the ABP for one of several reasons.
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PMID:Relationship between intracranial pressure and the carotid sinus baroreceptor reflex. 207 76

Hypertension is one of the severest cardiovascular risk factor in subjects affected by end-stage renal disease in chronic hemodialysis. The behavior of blood pressure between the first hemodialysis (day 1) and the next one (day 2) was studied in 24 untreated normotensive hemodialysis patients. Patients were between 34 and 83 years (mean age: 60 +/- 12 yrs) and were hemodialysed 3 x 4 hours a week, between 7 and 12 a.m. ABP was recorded at 15 minutes intervals between 7 and 22 hours, and 30 minutes intervals during the night, during 48 hours with a Spacelabs 90202 or 90207 device. The following results were observed: ABP is greater at day 2 (122/74 mmHg) than at the first (117/70 mmHg, p less than 0.001); that increase is not correlated with gaining weight during interdialytic period; after hemodialysis, blood pressure continues to fall during 2 or 3 hours until a level of 119 mmHg; low values continue during postdialysis and during the first night; the following day, ABP increases progressively during the morning and during the evening; before the second hemodialysis, the increase is suddenly faster; circadian rhythm is lost in 9/24 patients; in 17/24 patients, nocturnal decrease of BP is lower than 5%; age and ancientness of hemodialysis are the most important factor; rest blood pressure measured by physician before HD is continually higher than diurnal ABP (138/74 vs 121/73 mmHg, p less than 0.001), even if ABP is only analysed during one hour before the second hemodialysis (129/77 mmHg).
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PMID:[Ambulatory blood pressure profile during 48 hours in patients treated with chronic hemodialysis]. 212 59

Clinic/office (casual), home (self), and twenty-four-hour ambulatory (ABP) blood pressure determinations were compared in 32 subjects defined by conventional office criteria as mild or borderline hypertensives. Office diastolic blood pressures (mean 93.1 +/- 5.3 mmHg) were significantly higher than either home (mean 88.9 +/- 7.1 mm Hg) or awake ABP (mean 88.4 +/- 8.4 mm Hg) readings for the total group, as well as for the mild hypertension subgroup (office mean 96.0 +/- 3.5 mm Hg, home mean 91.0 +/- 8.0, awake ABP mean 90.4 +/- 8.8) but not for the borderline subgroup. In the total study group, office diastolic blood pressure (DBP) correlated better with home DBP (r = 0.58, p = 0.0005), than with the awake ABP (r = 0.40, p = 0.02). Home DBP correlated well with awake DBP (r = 0.48, p = 0.006). In subgroup analysis, office DBPs correlated well with home (self) readings for both the mild (r = 0.53, p = 0.03) and the borderline (r = 0.62, p = 0.01) subgroups. When office DBPs were compared with awake ABP DBPs, the correlation coefficient for the mild subgroup was significant (r = 0.49, p = 0.04); this was not the case for the borderline subgroup (r = 0.10, p = NS). Comparison of home (self) DBPs with awake ABP determinations revealed a good correlation for the borderline subgroup (r = 0.63, p = 0.01) but not for the mild subgroup (r = 0.35, p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparison of office, home and 24-hour ambulatory blood pressures in borderline and mild hypertension. 342 9

Renin-angiotensin-aldosterone (RAA) function was studied in children with secondary hypertension of 2 varieties: vasorenal hypertension (VRH) and arterial hypertension (AH) associated with chronic pyelonephritis. Children with VRH showed RAA activation that depended on the duration of the disease for its markedness. A direct correlation found between ABP, on the one hand, and plasma renin activity and blood aldosterone level, on the other, is evidence of the latter's involvement in VRH pathogenesis. In AH that is due to chronic pyelonephritis, RAA activation was also demonstrated, however, its pathogenetic involvement was only documented in children with urinary passage disorders (vesico-renal reflux), whereas in the rest RAA activation was not a primary cause of BP elevation.
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PMID:[The renin-angiotensin-aldosterone system in children and adolescents with nephrogenic hypertension]. 352 87

The hypotensive effect and interrelations of some hemodynamic parameters in the course of intravenous administration of sodium nitroprusside (SNP) were examined in an experimental study in cats with induced hypertension. Both in normotensive and hypertensive conditions, the SNP injection produced an almost instantaneous drop in systolic and diastolic ABP, its principal mechanisms being the depression of total peripheral resistance (TPR). The magnitude of decrease in stroke and minute volumes was dependent on the extent of ABP fall that was in turn related to the dose of the drug and the baseline TPR values.
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PMID:[Hypotensive and hemodynamic effects of sodium nitroprusside in experimental ischemic renal arterial hypertension in cats]. 371 43

One-kidney Goldblatt hypertensive rabbits (New Zealand White) were studied after durations of renal artery clipping that varied from 6 to 17 days. Measurements included arterial pressure (ABP), iliac venous pressure (IVP), left atrial pressure (LAP), cardiac output (CO) (by thermodilution), blood volume (BV), cardiopulmonary volume (CPV), and hindleg thermodilution volume (HLV). These were determined at steady-state as well as during acute blood volume expansion. In sham-clipped animals, ABP was 74 +/- 1 mm Hg. This increased to 92 +/- 3 mm Hg by 6 to 9 days post-clipping, to 96 +/- 3 mm Hg by 10 to 13 days, to 89 +/- 4 mm Hg by 14 to 17 days. CO remained near 150 ml/min . kg until Day 13 and fell to 127 +/- 8 ml/min . kg at 14 to 17 days because of a fall in heart rate. Blood volume and stroke volume did not change significantly from 62 +/- 1 ml/kg and 0.60 +/- 0.04 ml/kg, respectively. The development of hypertension was due entirely to changes in peripheral resistance. CPV was 8.5 ml/kg initially and increased significantly as hypertension developed. HLV did not change significantly from about 10 ml/kg. During acute blood volume expansion, hypertensive animals showed smaller transient increases in CO than did sham-clipped normotensives, but the associated blood pressure rise was greater. This reduced vasodilator capacity was accompanied by reduced distensibility of the cardiopulmonary bed. In sham-clipped animals, the cardiopulmonary pressure/volume slope was between 0.05 and 0.07 mm Hg per ml/kg. This increased to 0.44 mm Hg per ml/kg by 14--17 days of clipping. The corresponding value for the hindleg region did not change significantly from 0.2 mm Hg per ml/kg. Cardiac output and stroke volume were directly correlated with cardiopulmonary volume. The slope of this correlation decreased significantly during hypertension. The data suggest that decreased cardiopulmonary compliance in hypertension minimizes transient changes in cardiac output. This is especially important for arterial blood pressure control in view of the impaired vasodilator capacity of the hypertensive circulation.
Hypertension
PMID:Regional vascular capacitance in rabbit one-kidney, one clip hypertension. 661 33

An increased blood pressure variability (BVP) and a loss of nocturnal decline in BP could enhance cardiovascular disease. Peripheral resistances and arterial compliance determine systolic BP. BVP could depend on arterial stiffness. We tested this hypothesis in patients with end-stage renal disease (ERSD) who have arterial elasticity impairment. Twenty one ESRD patients (49.9 +/- 16.7 years) 12 mean and 9 women, undergoing maintenance hemodialysis were studied; 19 had treated hypertension. Ambulatory (ABP) monitoring was performed in all patients: BP was measured every 15 minutes in day-time and every 30 minutes at night. Systolic diurnal variation coefficient was calculated as the ratio between standard deviation and the mean of systolic diurnal BP. Nycthemeral BP pattern was evaluated as the ratio between mean diurnal and nocturnal systolic BP (N/D). Pulse wave velocity (PVW), an index of arterial stiffness, was determined between carotid and femoral sites (11.6 +/- 4.22 m/s). These investigations were performed after the midweek dialysis session. We found a positive correlation between PVW and systolic diurnal BPV (stepwise regression F = 12.9, p < 0.01). This correlation was independent of hypertension, antihypertensive treatment, duration of hemodialysis, and erythropoientin. We also found a positive correlation between N/D and PWV (stepwise regression: F = 8.9 p < 0.05). Our study shows that arterial distensibility links BPV and N/D. It is suggested that an arterial distensibility impairment could enhance BPV and modify nycthemeral BP pattern.
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PMID:[Arterial blood pressure changes, circadian rhythm and arterial elasticity in hemodialysed patients]. 770 36


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