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

A finger sphygmomanometer was compared with a mercury column sphygmomanometer for its ability to screen for hypertension. A total of 881 patients used each machine, both in initial screening and then for monitoring. The finger sphygmomanometer had a specificity of 98.5% in routine screening as compared with 97.6% for the mercury column device. Sensitivity of the finger device was 98.2%. These findings suggest that the finger sphygmomanometer using finger systolic pressure alone is adequate for screening and monitoring blood pressure.
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PMID:Finger systolic pressure: its use in screening for hypertension and monitoring. 309 54

The objective of this prospective study was to evaluate the effect of nifedipine administered at usual daily doses of 30 to 40 mg on the carotid flow in arterial hypertension. The study included 15 patients (8 men and 7 women), 50 to 79 (mean 59.5) years old suffering from long-standing, fixed essential hypertension becoming instable under central antihypertensive drug therapy. For calculating the carotid blood flow, vascular echotomography combined with Doppler ultrasonography and spectral analysis (Duplex probe) determining the vascular section and flow velocity were used. Arterial pressure using a mercury tonometer, flow velocity, common carotid artery diameter, carotid blood flow, Pourcelot's index, parietal tension and heart rate were measured before treatment and at the 8th day of nifedipine administration. It could be shown that the drug produced a significantly (p less than 0.001) increased carotid blood flow, in spite of a marked (p less than 0.001) decrease in systolic (p less than 0.001) and diastolic (p less than 0.005) blood pressure. The increase in carotid blood flow was directly related to the increase in flow velocity (p less than 0.001) and in the diameter of common carotid artery (p less than 0.01) and was associated with a significant decrease in the Pourcelot's index. Analysis of two groups of patients isolated from the total group according to the elevation of carotid blood flow, showed that the degree of hypotensive effect of nifedipine is negatively correlated with the baroreflex response determined by the variation of parietal tension.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Effects of nifedipine on carotid blood flow and baroreflex response in essential arterial hypertension. Preliminary results]. 309 82

Ambulatory blood pressure recorded with the Spacelabs was compared with both Remler recordings and office blood pressures in 11 normotensive and 13 hypertensive volunteers. Analysis of 324 simultaneous measurements with Remler and Spacelabs showed very high correlation for systolic and for diastolic blood pressure. For systolic blood pressure, measurements with Spacelabs recorder were lower than those with the Remler recorder by a mean of 3.6 +/- 6.5 mmHg, principally in hypertensive subjects. Spacelabs measurements were also lower than Remler measurements for diastolic blood pressure by a mean of 5.3 +/- 6.6 mmHg principally in normotensive subjects. The averages of blood pressure variability (standard deviation as index) recorded by each device were identical. Mean systolic and diastolic blood pressure differed by more than 10 and 5 mmHg respectively between the two devices in 11 and 83% of the subjects. These individual discrepancies were unpredictable. Comparison of Spacelabs records with office blood pressure measured with a standard mercury manometer showed discrepancies of more than 10 mmHg for systolic blood pressure and more than 5 mmHg for diastolic blood pressure in 46 and 42% of the 24 subjects, respectively. These discrepancies could be due, in part, to different methods of blood pressure measurements. These data demonstrate that the Spacelabs apparatus provides records for a group, reasonably close to those obtained with the Remler over a wide range of blood pressure. For the management of hypertension, the advantages--as compared to physician's measurements--of ambulatory blood pressures recorded with indirect methods,need to be weighed, taking into consideration the difference between the ambulatory record and the office blood pressure measured with the same device.
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PMID:[Comparison of ambulatory blood pressure determinations using the Remler and Spacelabs devices]. 309 9

World Health Organization (WHO) recommends antihypertensive therapy for mild to moderate hypertensive patients after 3 or more visits. We tested the hypothesis that an ambulatory blood pressure recording could also help to decide which patient need therapy. Blood pressure was measured in 89 essential, uncomplicated, hypertensive patients (diastolic (DBP): 90-110 mmHg, mean age: 41 +/- 13 years), with a mercury sphygmomanometer at 3 visits and with an ambulatory blood pressure recorder (Spacelabs) during 12 hours. According to WHO recommendations, patients were classified "WHO+" if they need a treatment (n = 44) and "WHO-" if they did not. The mean ambulatory DBP of each subject was compared to the arbitrary limit defined as the mean +2 standard deviations of the ambulatory DBP of a population of normotensive subjects in the same decade and same sex: patients with ambulatory DBP above this limit were defined "AMB+" (n = 27), the others were "AMB-". Ten patients were "WHO- AMB+" and 24 were "WHO+ AMB-". These discordances were independent of age, body weight, duration of hypertension, variability of ambulatory systolic and diastolic blood pressure defined by the standard deviation. By contrast, the difference between the measurements of the simultaneous blood pressure measurements performed with the two methods (mercury sphyngmomanometer and Spacelabs) 2 times by each patient could explain in part these discrepancies. The Spacelabs underestimates DBP measured with the mercury sphyngmomanometer in patients "AMB-" but not in patient "AMB+".(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The decision to treat moderate hypertension: repetition of office visits or ambulatory monitoring of arterial pressure?]. 311 66

Fifteen primigravid patients with severe pregnancy-induced hypertension were studied by catheterization of the right side of the heart. A hemodynamic protocol was implemented that required maintaining colloid osmotic pressure above 17 millimeters of mercury, pulmonary capillary wedge pressure below 15 millimeters of mercury and the mean arterial pressure in a very narrow range throughout labor and delivery and for 48 hours postpartum. The initial colloid osmotic pressures and pulmonary capillary wedge pressures were 18.0 +/- 2.6 and 10.5 +/- 4.0 millimeters of mercury, respectively, and remained essentially unchanged throughout the post partum period. The only benefit derived from volume expansion in these patients appeared to be the absence of acute fetal distress after the initiation of antihypertensive therapy. Six of 15 patients had late fetal stress develop during labor, suggesting that aggressive volume repletion and colloid osmotic pressure correction in pregnancy-induced hypertension does not effect the over-all incidence of fetal distress. We recommend that correction of colloid osmotic pressure be restricted to instances in which extremely low values (less than 12 millimeters of mercury) or a prolonged negative colloid osmotic pressure to pulmonary capillary wedge pressure gradient are identified. Finally, the benefit of volume expansion in pregnancy-induced hypertension appears to be the prevention of sudden and profound drops in blood pressure with antihypertensive therapy--not the prevention of fetal distress during labor.
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PMID:Role of volume expansion in severe pre-eclampsia. 314 Apr

We report a study using Doppler echocardiography looking for pulmonary arterial hypertension (HTAP) in 36 patients presenting with chronic airflow obstruction (BPCO) who are in a stable state. 18 of these (group 1) had confirmed HTAP by right heart catheterisation which had been done the day before and was defined as a mean pulmonary arterial pressure (PAPm) of greater than 20 mm of mercury. The other 18 patients (group 2) did not have HTAP at rest. The systolic ejection flow and the duration of the peak (expressed in msec) was analysed at the time of each examination. The Doppler data was compared between the two groups of patients and also with the results obtained in ten healthy subjects. The Doppler examination was successfully performed in 35 patients in spite of a poor echographic window in 86% of cases. When there was HTAP, the systolic ejection flow had a triangular aspect which contrasted with the dome shaped appearance of the normals. In group 1 the peak time was significantly shortened (p less than 0.01) compared to group 2 and to the healthy subjects. On the other hand there was no linear correlation between the value of the peak time and the level of HTAP measured by the catheter. Thus the severity of HTAP could not be precisely measured using these parameters. In considering that the peak time is normally greater than 100 msec, the sensitivity and specificity of the Doppler examination for the detection of HTAP during the course of BPCO are 90 and 88% respectively, which appears to be superior to the values obtained using other non invasive methods in the diagnosis of HTAP.
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PMID:[The value of Doppler echocardiography in the diagnosis of pulmonary artery hypertension in chronic obstructive bronchopneumopathies]. 321 90

In 28 subjects the cardiovascular response to repeated stimulation was monitored during six daily sessions. Calf blood flow was measured with mercury-in-silastic venous occlusion plethysmography, blood pressure with electronic sphygmomanometer. The stimuli used were: 1 kHz sound of 90 dB and 100 dB intensity and immersion of one foot for 60 s in water at 4 degrees C. Initially sounds induced large vasodilatation in the calf, immersion of one foot in the water induced in the contralateral calf vasodilatation in one group and vasoconstriction in another group of subjects. The blood pressure changes were less prominent and less consistent. After the first session of repeated stimulation the vascular response during the second session was significantly diminished. The reduction of the vasodilatation was the most rapid. During the remaining 5 days the responses were suppressed. It has been established that in the patients in the initial stage of hypertension the ability to habituate vascular response is impaired (Zbrozyna and Krebbel 1985). It is therefore suggested that the test of the ability for long-term vascular habituation could be used as a supplementary diagnostic test.
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PMID:Habituation of vasodilatation in the calf elicited by repeated sensory stimulation in man. 322 68

Both the standard mercury sphygmomanometer and the random-zero sphygmomanometer have been used in epidemiological studies and clinical trials. Problems arise in comparing studies since, in addition to other methodological differences, the readings obtained with the random-zero sphygmomanometer have been found to be lower than those obtained with the standard mercury sphygmomanometer. In the present study, blood pressures were measured in 66 subjects to examine the comparability of findings with the two instruments. Trained observers measured blood pressures simultaneously using a double-headed stethoscope and one cuff connected to the two sphygmomanometers. Use of instrument was randomly assigned for each blood pressure measurement; each observer was unaware of the other's blood pressure reading. Readings were lower with the random-zero sphygmomanometer; mean difference ranged from 2.5 to 3.3 mm Hg for systolic pressure and 1.9 to 2.7 mm Hg for diastolic pressure. Digit distributions recorded by the two observers for the standard mercury sphygmomanometer and the random-zero sphygmomanometer were not significantly different for either systolic or diastolic blood pressure. Intraindividual variation was greater with the random-zero sphygmomanometer than with the standard mercury sphygmomanometer. These data do not indicate that one instrument is clearly superior to the other, although in studies where the observer seeks to reduce the bias of multiple readings per person, the random-zero sphygmomanometer may be the more appropriate instrument. Critical to the use of either instrument are careful training, standardization, certification, and periodic recertification of observers.
Hypertension 1988 Mar
PMID:A comparison of the random-zero and standard mercury sphygmomanometers. 328 Apr 84

We studied 36 hypertensive men, aged 60 years or older, and compared direct intra-arterial diastolic blood pressure (BP) measurements, indirect cuff mercury sphygmomanometer measurements, and automatic infrasonic recorder (IR) measurements. We used a receiver operating characteristic curve to determine whether a difference between the cuff and IR diastolic BP could identify patients likely to have pseudo-hypertension (cuff-intra-arterial diastolic BP difference of 10 mm Hg or greater). We found that a cuff-IR difference of 4 mm Hg could identify the majority of patients with pseudo-hypertension (sensitivity, 93%; specificity, 64%; positive predictive value, 62%; negative predictive value, 93%). We concluded that the IR is an accurate, quantitative, noninvasive substitute for intra-arterial measurements and may be the preferred technique for screening and monitoring of blood pressure in elderly hypertensive patients.
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PMID:Screening for pseudohypertension. A quantitative, noninvasive approach. 334 68

Two variants of nephrosclerosis, roughly corresponding to the arterial and the arteriolar forms, have been examined in a series of autopsy kidneys by five observers using quantitative morphometry. These two variants are both marked by fibroplastic intimal thickening and medial wastage in the arteries, but one of these affects vessels of sizes that are closer to the heart, whereas the other affects sizes that are more remote from the source of arterial pressure. Both types of nephrosclerosis were found to increase with aging in subjects without hypertension. Each year of aging added 0.15 units of intimal thickening to the close vessels and 0.11 to the remote vessels. Each millimeter of mercury of elevated blood pressure was equivalent to 1 year of aging in the close and 2 years in the remote levels of the arterial tree. The four variables, age, blood pressure, remote level intimal thickness, and close level intimal thickness, were found to hold complex curvilinear interrelationships when examined by regression analysis. A dynamic model was suggested by the following findings: The earliest changes shown by young normotensives are in the close vessels, possibly because of the aging effect of the normal pulse wave. Later, the changes extend into the remote level, perhaps because the thickened intima is rigid and propagates the pulse wave abnormally far into the smallest arteries. Hypertension could then be viewed either as a cause for an exaggeration of this normal process or as a consequence of its extension into the remote level vessels where resistance to blood flow is greater or both. The objective morphometric method showed good agreement in the findings by independent observers and is considered to be suitable for epidemiologic studies of nephrosclerosis.
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PMID:Two variants of nephrosclerosis separately related to age and blood pressure. 335 55


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