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

The relation between dietary calcium and blood pressure was examined in 1,928 men, ages 40-69 years, from five geographic and two occupational populations in Japan. Dietary calcium intake was estimated using 24-hour dietary recall in systematic samples of participants of population-based cardiovascular surveys from 1983 to 1987. The means of daily calcium intake of the study populations ranged from 449 to 695 mg, approximately 300 mg lower than the recommended US dietary calcium intake. Linear regression analyses were used to examine the relation between dietary calcium and blood pressure within each population, controlling for age, body mass index, alcohol consumption, and sodium intake. Total calcium intake was inversely associated with the systolic blood pressure level in each population, and the pooled estimate of the regression coefficients for millimeters of mercury of blood pressure per 100-mg increase in calcium intake was -0.54 (95% confidence interval -0.89 to -0.19). The inverse association between calcium intake and diastolic blood pressure was less consistent, and the pooled estimate did not reach statistical significance (-0.10, 95% confidence interval -0.34-0.14). Inverse associations existed for both dairy and nondairy food sources of calcium when analyzed separately, and the association was significant only for dairy calcium. Although a causal relation between dietary calcium and blood pressure cannot be established, these results suggest a possible public health implication in Japan of increasing calcium intake for the prevention and control of hypertension, where average dietary calcium intake is low.
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PMID:Calcium intake and blood pressure in seven Japanese populations. 202 Nov 44

The blood pressure response to dynamic exercise was studied in 90 adolescents (45 males and 45 females) mean age 15 years (range 13-16 years) with casual systolic and/or diastolic hypertension (H) and in 50 matched for age adolescents (26 males and 24 females) with casual blood pressure about the fiftieth percentile for age and sex (N). During the third blood pressure control they underwent a maximal bicycle exercise test in sitting position (10 W/min). During exercise and recovery ECG was recorded every 30 s and blood pressure, with a mercury sphygmomanometer, every 3 min. Adolescents with casual hypertension at rest showed, in comparison to normotensives, an increase in blood pressure (H: 176.1 +/- 18.8 mmHg; N: 167.4 +/- 14.2 mmHg, p less than 0.01 at peak of exercise) and in rate-pressure product (H: 326.8 +/- 40.9 X 10(-2); N: 308.7 +/- 29.4 X 10(-2); p less than 0.01 at peak of exercise) during exercise and recovery. Heart rate was greater at rest in hypertensive adolescents, but there was no difference between the 2 groups during exercise. Exercise tolerance was similar in the 2 groups. Casual transient hypertension at rest and excessive increase of systolic blood pressure during exercise could be expression of early cardiovascular changes preceding sustained hypertension.
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PMID:[Cardiovascular response to dynamic physical exercise in adolescents with casual raised values of arterial blood pressure]. 209 29

Four groups from a urban population of Morelia were inquired, to determine frequency of high blood pressure and provide basic information of arterial hypertension in relation with other variables; 2638 persons were checked. Age ranged from 10 to 90 years, (771 men, 1867 women). Age, sex, weight and height were also measured. Evaluations were performed in the morning with mercury sphygmomanometer registering first and fifth korotkoff's sounds in orthostatic position with a second selective evaluation in sitting position. Availability of medical services and knowledge about presence of arterial hypertension were also evaluated. Blood pressure and prevalence of hypertension had similar behavior with regard to age: pressure recordings were higher in men before 40 years. After this age were higher in women. In general, 14% had high blood pressure, in the second evaluation this value dropped to 7%. For 11% of the studied population, high blood pressure had been previously recorded 7 out of 10 cases of hypertension did not have any control. Three of them had not information about this illness. We found a positive correlation between weight and blood pressure (p less than 0.001) specially among women.
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PMID:[Arterial blood pressure in various groups in the urban population of Morelia City]. 209 28

The arterial vasodilator properties of the dihydropyridine calcium antagonist amlodipine were compared with the effects of vascular muscle cyclic guanosine monophosphate production by sodium nitroprusside and with the effects of a combined infusion of amlodipine and the nondihydropyridine calcium antagonist verapamil in 8 untreated patients with primary hypertension. Arterial vasodilation was assessed by measurement of changes of forearm blood flow by mercury in Silastic strain-gauge plethysmography during brachial artery drug infusions. Forearm blood flow increased during amlodipine infusions (0.4 to 45 micrograms/min/100 ml forearm tissue) from 2.9 +/- 1.7 to a maximum of 23.6 +/- 7.6 ml/min/100 ml (687%), while sodium nitroprusside caused an increase from 3.0 +/- 1.8 to 16.2 +/- 5.4 ml/min/100 ml (449%), attesting to the importance of transmembrane calcium influx for the maintenance of vascular tone. The addition of verapamil 40 micrograms/min/100 ml to an infusion of amlodipine 44.5 micrograms/min/100 ml resulted in a further increase of forearm blood flow, from 23.6 +/- 7.6 to 34.4 +/- 9.8 ml/min/100 ml (p less than 0.05). The precise mechanisms of this finding have yet to be elucidated but may be due to interactions of the effects of the binding of these 2 chemically and pharmacologically different calcium antagonists to distinct binding sites at calcium channels. The clinical relevance of this observation for the treatment of coronary artery disease and systemic hypertension needs further study.
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PMID:Arterial vasodilator effects of the dihydropyridine calcium antagonist amlodipine alone and in combination with verapamil in systemic hypertension. 214 37

The diagnosis of mild hypertension and the treatment of hypertension require accurate measurement of blood pressure. Blood pressure readings are altered by various factors that influence the patient, the techniques used and the accuracy of the sphygmomanometer. The variability of readings can be reduced if informed patients prepare in advance by emptying their bladder and bowel, by avoiding over-the-counter vasoactive drugs the day of measurement and by avoiding exposure to cold, caffeine consumption, smoking and physical exertion within half an hour before measurement. The use of standardized techniques to measure blood pressure will help to avoid large systematic errors. Poor technique can account for differences in readings of more than 15 mm Hg and ultimately misdiagnosis. Most of the recommended procedures are simple and, when routinely incorporated into clinical practice, require little additional time. The equipment must be appropriate and in good condition. Physicians should have a suitable selection of cuff sizes readily available; the use of the correct cuff size is essential to minimize systematic errors in blood pressure measurement. Semiannual calibration of aneroid sphygmomanometers and annual inspection of mercury sphygmomanometers and blood pressure cuffs are recommended. We review the methods recommended for measuring blood pressure and discuss the factors known to produce large differences in blood pressure readings.
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PMID:Accurate, reproducible measurement of blood pressure. 219 91

In this study, a recently marketed proprietary finger blood pressure monitor, the Marshall, Astro F-88, was compared with the standard auscultative brachial mercury sphygmomanometer on 125 subjects. Measurements were undertaken according to the standards set by the American Heart Association. Sensitivity of the finger blood pressure measurement was 76% for systolic and 75% for diastolic blood pressure in diagnosis of high blood pressure (systolic greater than 140 mm Hg and diastolic greater than 90 mm Hg). Specificity was 86% for systolic and 82% for diastolic blood pressure. Positive predictive values were 58% for systolic and 38% for diastolic blood pressure in the study population in which prevalence of hypertension was 12%. The correlation coefficient (Pearson) for systolic values between devices was 0.76 (P less than .0001) and 0.57 (P less than .0001) for diastolic pressure. Values obtained by the finger monitor were found to be higher than those obtained by the mercury sphygmomanometer. Mean differences and standard deviations (paired t test) for systolic and diastolic pressures between the two devices were 2.3 +/- 14.9 mm Hg (P less than .08) and 2.9 +/- 14.5 mm Hg (P less than .02), respectively. These values are not in accordance with the proposed national standards because only 48% of the systolic and 37% of the diastolic blood pressure measurements were within 5 mm Hg of the mercury sphygmomanometer measurements. Therefore, although these differences may well be due to different techniques of monitoring employed by the devices, this device is not recommended for evaluation of blood pressure.
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PMID:Oscillometric finger blood pressure versus brachial auscultative blood pressure recording. 221 68

Data were collected from 413 questionnaires sent to general practitioners throughout Slovenia, accounting for half the physicians in this discipline. BP was measured most commonly in the sitting position (72%), mostly on the left arm. Most respondents (93%) used only one cuff size. Correction of BP readings according to the patient's arm circumference was used by 63% of the respondents. Seventy-eight percent of the general practitioners recorded phase V of the Korotkoff sounds for diastolic BP. BP was measured more than once at each examination by 55%. BP measurements were performed by nurses in 27% of cases. Mercury sphygmomanometers were used by 87%. Manometers were calibrated once a year by 73%. Complete diagnostic procedures for the definition of hypertension were conducted in approximately 50% of patients, predominantly in severe cases. Drug treatment was commenced in the range of 'mild hypertension' usually by 93% of the general practitioners. It was started at BP values of 165/99 mmHg and higher. In patients with other risk factors, it was instituted even earlier. General measures (non-drug therapy) were advised by only 30%. Beta-blockers were usually prescribed to younger patients as drug of choice (74%), and diuretic agents to the elderly (48%). General practitioners' sources of new information about hypertension were mainly medical literature, pharmaceutical industry information, and professional meetings. Prevalence of hypertensive BP values in the responding general practitioners themselves was 8%.
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PMID:Hypertension control and management in Slovenia, Yugoslavia. 225 57

To identify the prevalence and magnitude of clinic changes in blood pressure and determine their effects on the diagnosis and treatment of hypertension, 268 patients with a BP greater than or equal to 160/95 mmHg on three consecutive occasions (twice in the general practitioner's surgery and once in the hospital clinic) recorded a home BP series with an electronic sphygmomanometer. Of these patients, 114 had never received antihypertensive treatment and 154 were receiving treatment. On return to the hospital clinic (second clinic visit) the BP was measured independently by the patient and doctor using electronic and mercury sphygmomanometers respectively and compared with the mean BP of the home series. In some 80% of both untreated and treated patients the second clinic BP was higher than the mean BP of the home series and in some 40% of patients a clinic rise of greater than 20/10 mmHg was recorded. Clinic falls in BP occurred in some 20% of both untreated and treated patients, but averaged only 4/4 mmHg. Treatment decisions based on a mean diastolic blood pressure of greater than or equal to 95 mmHg in the home series resulted in antihypertensive treatment not being started in 38% of untreated patients and not increased in 31% or reduced in 16% of treated patients when treatment would have been started, increased or continued unchanged on the basis of the second clinic (fourth recorded) diastolic blood pressure of greater than or equal to 95 mmHg. A patient recorded home series provides a representative sample of BP which distinguishes patients with sustained hypertension from those with clinic hypertension and may help reduce the overdiagnosis and overtreatment of mild hypertension.
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PMID:Home blood pressure recording in mild hypertension: value of distinguishing sustained from clinic hypertension and effect on diagnosis and treatment. Bath Health District Hypertension Study Group. 228 40

A significant reduction of kallikrein activity in urine (assayed by its amidolytic activity) was found in 64 normotensive workers who had been exposed to cadmium for 11 years on average and whose cadmium concentrations in urine ranged from 2.2 to 33.1 micrograms/g creatinine. The mean (geometric) urinary kallikrein activity (in U/g creatinine) amounted to 0.52 (range 0.11-1.90) in the control group (n = 193) against 0.39 (range 0.10-1.03) in the cadmium group, and the prevalence of abnormally low activity levels (less than or equal to 0.20 U/g creatinine) amounted to 17.2% in the cadmium group against 5.2% in the control group. A reduction of aldosterone release (aldosterone in urine) associated with an increased natriuresis was also observed. This might constitute a compensatory mechanism maintaining blood pressure in the normal range. These biological effects of cadmium were not reversible after removal from exposure. This study indicates that cadmium can induce an irreversible toxic effect in the distal nephron. It also suggests that an excessive cadmium body burden alone may not be sufficient to induce hypertension, but in individuals whose blood pressure regulation may be impaired by other factors cadmium could stimulate the development of hypertension. This study also supports the recommendation to prevent hypertensive subjects from being exposed to cadmium. There was no indication that moderate exposure to mercury vapour (n = 53; mercury in urine, range 11-224 micrograms/g creatinine; average duration of exposure: six years) or to inorganic lead (n = 23; lead in blood, range 40-67 micrograms/100 ml; average duration of exposure: eight years) was associated with a reduction of kallikrein production by the kidney.
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PMID:Urinary kallikrein activity in workers exposed to cadmium, lead, or mercury vapour. 235 54

To identify the incidence and magnitude of office hypertension and determine its effect on diagnosis and treatment, 104 patients with a systolic blood pressure greater than or equal to 160 mmHg and a diastolic blood pressure greater than or equal to 95 mmHg on three consecutive office visits recorded a home BP series with an electronic sphygmomanometer. At the fourth office visit the blood pressure was measured independently by the patient and doctor using electronic and mercury sphygmomanometers, respectively, and compared with the mean blood pressure of the home series. In 80% of patients, the fourth office blood pressure was higher than the mean blood pressure of the home series. An office rise greater than or equal to 10/5 mmHg occurred in some 60% of patients, greater than or equal to 20/10 mmHg in 36% and 30/15 mmHg in 19% of patients. Office falls in blood pressure occurred in 20% of patients but averaged 3/2 mmHg. Treatment decisions based on the mean blood pressure of the home series resulted in treatment not being started in 25 patients (24%) who would have received treatment on their fourth office blood pressures. A patient-recorded home series provides a representative sample of blood pressure distinguishing patients with sustained hypertension from those with office hypertension and reducing the over diagnosis and over treatment of mild hypertension.
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PMID:Value of patient-recorded home blood pressure series in distinguishing sustained from office hypertension: effects on diagnosis and treatment of mild hypertension. Bath District Hypertension Study Group. 237 Jun 48


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