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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of the present single blind study was the assessment of the effect of placebo on office (OBP) and 24-hour ambulatory (ABP) blood pressure in patients with mild and moderate essential hypertension (WHO stage I). Ten patients (6 males, 4 females, age 51 +/- 9 years) underwent both OBP and ABP measurements at the beginning and the end of a 2-week placebo treatment. The comparison of the results of the first (OBP 156/100 +/- 15/6 mmHg, day ABP 155/96 +/- 12/7 mmHg, night ABP 139/81 +/- 21/10 mmHg) and the second sets of measurements (OBP 152/98 +/- 22/7 mmHg, day ABP 147/90 +/- 15/7 mmHg, night ABP 134/79 +/- 18/7 mmHg) did not show a statistically significant drop in OBP and night ABP, while there was a statistically significant (p < 0.05) decrease in day ABP. Thus, the effect of placebo can influence day ABP measurements, even when OBP is not decreased by placebo administration. Possible explanations involve alerting reactions to the first ABP monitorings in selected patients with mild and even moderate hypertension.
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PMID:[Placebo effect and arterial pressure]. 805 84

Cigarette smoking and hypertension are independent risk factors for cardiovascular disease, but the relationship between them is complex. Smoking raises BP acutely, yet in epidemiological studies smokers have lower clinic BP than nonsmokers. To explore this apparent paradox we have compared 24h ambulatory BP profiles and BP variability of smokers, before and after a week's abstention from smoking, and nonsmoking controls. There was no evidence of a significant acute pressor effect from smoking. All three groups had similar ABP profiles but smokers had significantly more variable BP than nonsmokers and variability increased still further after a week's abstention. An increase in BP variability, possibly related to changes in baroreflex sensitivity, is a further mechanism by which smoking may increase cardiovascular risk.
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PMID:Cardiovascular effects of cigarette smoking: ambulatory blood pressure and BP variability. 815 1

The 24-h ambulatory blood pressure (24h-ABP) was examined in 21 men, aged 38 to 65 years (mean 50.6), with obstructive sleep apnea syndrome (OSAS) and in 123 normal male control subjects, aged 40 to 60 years (mean 48.1) who did not have OSAS, obesity, autonomic nervous system abnormality, cardiac disease, or respiratory disease (group C), to assess the role of apneas in the circadian variation of blood pressure (BP). The 24h-ABP patterns in OSAS patients were classified into three types as follow: normotensive OSAS patients with normal BP throughout the 24-h period with nocturnal BP fall (type 1); hypertensive OSAS patients with progressive BP elevation from onset of sleep to early morning (type 2); and hypertensive OSAS patients with elevated BP (systolic BP > or = 140 mm Hg or diastolic BP > or = 90 mm Hg) at any time during a 24-h period (type 3). It was concluded that the circadian BP variation in type 1 was almost identical to the level and pattern of group C; the circadian variations in types 2 and 3 were significantly different from that of group C; and the patients with types 2 and 3 BP patterns had more severe OSAS than type 1 patients. The severity of OSAS was an important factor in nocturnal elevation of BP, hence affecting the circadian variation of BP. Noninvasive 24h-ABP monitoring is a useful procedure for understanding the clinical features of OSAS patients with or without hypertension.
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PMID:24-hour ambulatory blood pressure variability in obstructive sleep apnea syndrome. 848 8

Microproteinuria is a recognized sign of early nephropathy in the course of arterial hypertension. There is few data concerning the excretion of proteins other than albumin in this group of patients. The aim of the study was to examine circadian rhythm of alfa-l-microglobulin (AlMG), albumin (ALB), immunoglobulin G (IgG) excretion and N-acetyl-beta-glukosaminidase (beta NAG)-activity, then to compare the results with the results of 24 hour ambulatory monitoring of arterial blood pressure in patients with arterial hypertension. The study comprised 28 patients. The control group included 27 healthy volunteers. Albumin concentration was determined by Beckman ICS2 nephelometer, using Beckman and Dako reagents. Blood pressure and ECG were monitored by analysis with ABP-system (AMP-USA). In patients with arterial hypertension significantly higher levels of ALB, AlMG, IgG and increased beta NAG activity were observed in morning urine samples. Despite hypotensive treatment blood pressure values were slightly, though significantly higher than in the control group. Among patients in the study circadian BP rhythm was disturbed. The results obtained suggest that in this group of patients subclinical nephropathy develops involving renal glomeruli and proximal tubules--probably resulting from vascular and humoral disorders, with accompanied hypertension.
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PMID:[Microproteinuria and circadian rhythm of blood pressure in patients with arterial hypertension]. 867 91

The main objective of the Ambulatory Blood Pressure and Treatment of Hypertension (APTH) trial is to test the hypothesis that antihypertensive treatment based on ambulatory monitoring may be more beneficial than treatment guided by conventional sphygmomanometry. After a 2-month run-in period on single-blind placebo, hypertensive patients were randomized to two groups, one in which the target pressure was a sitting diastolic pressure from 80 through 89 mm Hg on conventional sphygmomanometry (conventional blood pressure [CBP] group), and one in which a daytime (from 10 to 20 h) diastolic pressure from 80 through 89 mm Hg had to be achieved (ambulatory blood pressure [ABP] group). After randomization all patients were started on lisinopril 10 mg/day. One month later lisinopril could be continued at 10 or 20 mg/day or discontinued depending on the attained blood pressure level. This article is an interim report on 207 patients followed for two months into the trial. At one month lisinopril was discontinued more frequently in the ABP than the CBP group (24 vs 9 patients, p = 0.004). Nevertheless at two months, blood pressure control was not significantly different in the two treatment groups. The baseline-adjusted differences in systolic pressure between the two treatment arms of the trial (ABP-CBP group) were +2.7 mm Hg (95% confidence interval [CI]): -2.9, +8.3) for the conventional pressure, +0.4 mm Hg (CI: -4.3, +5.1) for the 24 h pressure, -0.1 mm Hg (CI: -5.1, +4.8) for the daytime pressure and -0.7 mm Hg (CI: -6.7, +5.4) for the night-time pressure. The corresponding differences in diastolic pressure were -1.3 mm Hg (CI: -4, +1.4), +0.1 mm Hg (CI: -3, +3.1), -1.1 mmgH (CI: -4.4, +2.1) and +0.3 mm Hg (CI: -3.7, +4.3), respectively. Thus, the present findings do not refute the APTH research hypothesis. In terms of blood pressure control and the number of patients remaining on antihypertensive drugs, treatment based on ambulatory recordings may be preferable to treatment guided by conventional sphygmomanometry.
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PMID:Treatment of hypertensive patients according to the conventional or ambulatory pressure: a progress report on the APTH trial. APTH Investigators. Ambulatory Blood Pressure and Treatment of Hypertension. 881 7

In order to evaluate the disturbances in circadian rhythms of blood pressure in 10 patients with chronic renal failure treated with CAPD, we performed blood pressure monitoring during the two following twenty-four hour periods. 40 healthy young male volunteers were included as a control group. They were divided into two subgroups: men whose parents have or have not hypertension. We used Oxford Medilog ABP equipment. Optimal CAPD parameters were confirmed by calculation Kt/V and pcr. To evaluate circadian rhythms in blood pressure we used Cosinor analysis, and to calculate the day-night blood pressure differences we used Student's t-test. In our study we did not find circadian rhythms of systolic, diastolic and mean arterial pressure in CAPD patients. There were also no statistically significant day-night blood pressure differences. The lack of circadian rhythms in blood pressure and statistically significant day-night differences can be explained in patients as the result of volume expansion and other abnormalities such as the lack of diurnal rhythm in atrial natriuretic peptide, rHuEpo therapy, sympathetic overactivation and others.
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PMID:[Circadian rhythm of blood pressure in patients with chronic kidney failure in the course of diabetes treated with peritoneal dialysis]. 908 41

In our study we tried to assess the abnormalities in circadian blood pressure variations in 20 patients with chronic renal failure treated with hemodialysis. In this group of patients we controlled blood pressure during 48-hours (including the dialytic and the interdialytic day). We used Oxford Medilog ABP equipment. As a control we included 40 healthy men, divided into two subgroups; men whose parents had or had not hypertension (20 men in each subgroup). To confirm the optimal HD parameters we controlled Kt/V and per. To evaluate circadian rhythms in blood pressure we used Cosinor analysis, and to assess the day-night blood pressure differences we used Student's t-test. We did not find that circadian rhythms in blood pressure in HD patients were existed. We found that in HD patients systolic blood pressure was higher at daytime of dialytic day, subsequently fell down to lower levels at night-time and next day, and returned to higher levels the next night (before the next hemodialysis). It can be connected with alterations in body fluid status during dialysis. Other disturbances in circadian rhythms in blood pressure can be explained as the results of other disturbances that existed in patients with chronic renal failure such as the lack of diurnal rhythm in secretion of atrial natriuretic factor, sympathetic overactivation, rHuEpo therapy and others.
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PMID:[Circadian rhythm of blood pressure in patients with chronic renal failure treated with hemodialysis]. 912 15

The aim of our study was to examine the relation between insulin and ambulatory blood pressure (ABPM) in several clinical conditions. ABPM monitoring was performed with Spacelabs device. Fasting plasma insulin (FPI) was measured by radioimmunoassay. In young, non-obese normotensive subjects (n = 32) there were correlations between FPI and both asleep (r = 0.61, p < 0.001), and awake systolic ABPM (r = 0.44, p < 0.01). We have not observed any significant correlation between FPI and ABP in borderline hypertensives or in patients with established hypertension. In a group of 21 hypertensive type 2 diabetics (age 52 +/- 8 years) there was no significant correlation between FPI and ABPM. Among 14 normotensive type 1 diabetics (age 31 +/- 7 years, diabetes duration > 10 years) there was a significant negative correlation between the daily dose of insulin and 24-h systolic ABPM (r =-0.63, p < 0.02). In 20 patients with renal failure on chronic haemodialysis we have found a significant negative correlation between FPI and 24-h systolic APBM (r = 0.80, p < 0.001) and 24-h diastolic ABPM (r = -0.55, p < 0.05). Similar negative correlations were found in 20 nondialysed subjects with moderate chronic renal failure. Taken together, our results suggest that insulin could reveal its hypertensive or vasodilatory effect which depends on a clinical condition of the studied subjects.
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PMID:Ambulatory blood pressure and insulinaemia in different clinical conditions. 916 42

Limited information is available for humans on whether blood viscosity affects total peripheral resistance and, hence, blood pressure. Our study was aimed at assessing the effects of acute changes in blood viscosity on both clinic and 24-hour ambulatory blood pressure (BP) values. In 22 normotensive and hypertensive patients with polycythemia, clinic and 24-hour ambulatory BPs were measured before and 7 to 10 days after isovolumic hemodilution; this was performed through the withdrawal of 400 to 700 mL of blood, with concomitant infusion of an equivalent volume of saline-albumin solution. Hematocrit, plasma renin activity, plasma endothelin-1, right atrial diameter (echocardiography), and blood viscosity were measured under both conditions. Plasma renin activity and right atrial diameter were used as indirect markers of blood volume changes. Plasma endothelin-1 was used to obtain information on a vasomotor substance possibly stimulated by our intervention, which could counteract vasomotor effects. Isovolumic hemodilution reduced hematocrit from 0.53+/-0.05 to 0.49+/-0.05 (P<.01). Plasma renin activity, plasma endothelin-1 and right atrial diameter were unchanged. Clinic blood pressure was reduced by hemodilution (systolic, 144.3+/-5.4 to 136.0+/-3.9 mm Hg[mean+/-SEM]; diastolic, 87.0+/-2.8 to 82.1+/-2.6 mm Hg, P<.05 for both) and a reduction was observed also for 24-hour average ABP (systolic, 133.6+/-2.9 to 129.5+/-2.7 mm Hg; diastolic, 80.0+/-2.0 to 77.3+/-1.7 mm Hg, P<.05 for both). The reduction was consistent in hypertensive patients (n = 12), whereas in normotensive patients (n = 10) it was small and not significant. Both clinic and 24-hour average heart rates were unaffected by the hemodilution. Thus, in polycythemia, reduction in blood viscosity without changing blood volume causes a significant fall in both clinic and 24-hour ambulatory BPs; this is particularly true when, as can often happen, blood pressure is elevated. This emphasizes the importance this variable may have in the determination of blood pressure and the potential therapeutic value of its correction when altered.
Hypertension 1998 Mar
PMID:Hemodilution reduces clinic and ambulatory blood pressure in polycythemic patients. 949 71

Subarachnoid haemorrhage (SAH) is a medical emergency. Extracerebral factors may cause avoidable deaths, secondary cerebral damage and ultraearly rebleeding. Severe hypertension, hypotension, arrhythmias and pulmonary edema frequently occur; rapid referral with adequate treatment and monitoring (clinical, ABP, SO2, ECG) to neurosurgical centers is warranted. Practice guidelines should be addressed to obtain quality and continuity of management in the early diagnostic phase; intensive global medical approach should be ensured by neuranesthesists and intensivists to achieve optimal cerebral conditions before surgical or endovascular treatment.
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PMID:[Immediate treatment of factors leading to death or sever cerebral damage in patients with subarachnoid hemorrhage]. 977 38


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