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

A reliable, well-validated home blood pressure (BP) self-measurement device could have an important role in the management of hypertension by the early identification of 'white coat' hypertensives. Under rigorous assessment such devices have not performed well in the estimation of DBP, particularly in the hypertensive range. We assessed the Omron HEM 706 device (oscillometric) for home measurement of BP according to the standards set out by the British Hypertension Society protocol and the Association for the Advancement of Medical Instrumentation (AAMI). The device was compared with simultaneous measurements made by two 'blinded' observers using a standard mercury sphygmomanometer in the same arm in 85 subjects aged 17-76 years with a wide range of BPs. The device was satisfactory over the whole BP range (SBP 89-188 mmHg, DBP 44-118 mmHg), with a B grading for SBP and a C grading for DBP (British Hypertension Society protocol) and a PASS for both SBP and DBP (AAMI). For the diastolic hypertensive range 90-120 mmHg, where most clinical decisions are made, the device scored a B grade for SBP and an A grade for DBP, with a PASS for both SBP and DBP. We conclude the Omron HEM 706 device for home BP measurement is highly satisfactory, particularly in the mild to moderate hypertension range, and is suitable for clinical use.
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PMID:Accuracy of the Omron HEM 706 portable monitor for home measurement of blood pressure. 780 95

To determine if defects in the atrial natriuretic peptide (ANP) system can cause hypertension, mice were generated with a disruption of the proANP gene. Homozygous mutants had no circulating or atrial ANP, and their blood pressures were elevated by 8 to 23 millimeters of mercury when they were fed standard (0.5 percent sodium chloride) and intermediate (2 percent sodium chloride) salt diets. On standard salt diets, heterozygotes had normal amounts of circulating ANP and normal blood pressures. However, on high (8 percent sodium chloride) salt diets they were hypertensive, with blood pressures elevated by 27 millimeters of mercury. These results demonstrate that genetically reduced production of ANP can lead to salt-sensitive hypertension.
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PMID:Genetic decreases in atrial natriuretic peptide and salt-sensitive hypertension. 783 43

Measuring blood pressure in the clinic setting is confounded by 'white coat' hypertension, observer bias and digit preference. In this study a semiautomatic blood pressure measuring device (the UA-751) was tested for its use as a reliable assessment of blood pressure and improved patient management in the hypertension clinic. Blood pressures were recorded in 156 patients and compared with physicians' readings measured using a standard mercury sphygmomanometer. The mean blood pressure differences between the two methods showed that the device gave consistently higher readings for both systolic (1.4-3.6 mmHg) and diastolic (3.6-3.8 mmHg) pressure, whether it was used before or after physician consultation. No reduction in 'white coat' hypertension was thus apparent. There was considerable variability between recordings made by the two methods on the same individual. Digit preference was apparent with physician readings, with zero recorded in 57.8% of systolic readings compared with 12.2% using the machine. Different management decisions would have been taken in 20 (13.6%) patients had the UA-751 recordings been used. The device is thus of no value in patient management in the setting of the hypertension clinic.
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PMID:Evaluating the use of a semiautomated cuff-oscillometric sphygmomanometer in the hypertension clinic. 784 94

Nifedipine, (1,4-dihydro-2,6,dimethyl-4-(2-nitrophenyl)-3, 5-pyridinedicarboxylic acid dimethyl ester) a calcium channel blocker widely used in treatment of hypertension, is strongly photolabile. This may represent a problem in patients taking nifedipine and in handling of nifedipine samples. Reactive radical intermediates were determined and characterized in the process of nifedipine illumination using EPR spectroscopy. On illumination of nifedipine by daylight or by a mercury lamp, a nitroxide radical, RIIL-NIFNO.X was observed (in the first step), in various solvents like benzene, cyclohexane, methanol, acetonitrile, dimethylsulphoxide, or aqueous suspensions of liposomes. RIIL-NIF represents the nifedipine skeleton centered with phenyl group, and X is an EPR silent substituent. The generation of RIIL-NIFNO.X is coupled with the formation of nitroso compound, RIIL-NIFNO, as characterized by UV-visible spectroscopy. In a further step, RIIL-NIFNO abstracts hydrogen from nifedipine skeleton under the formation of RIIL-NIFNO.H radical. In addition to this, in system containing RIIL-NIFNO and unsaturated lipids, nitroxide radicals RIIL-NIFNO.RLIPIDS are formed probably via a pseudo Diels-Alder mechanism (RLIPIDS represents lipidic skeleton). The unusually easy photochemical activation of nifedipine is probably stimulated by photosensitization of its nitro group interacting with suitably positioned hydrogen or carboxylic methyl ester group from the pyridinyl ring.
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PMID:Reactive radical intermediates formed from illuminated nifedipine. 786 71

The purpose of this investigation was to estimate the total hair mercury of diseased people (not including patients of mercury poisoning such as Minamata disease). Hair samples were collected from 133 diseased volunteers in Tokyo and the surrounding areas from Oct. 1992 to June 1993. The total mercury concentrations in the hair of ordinary diseased people (atopic dermatitis, asthma, dementia, cerebral infarct, osteoporosis, hypertension and diabetes) were from 2.08 ppm to 36.5 ppm. Those values were considerably higher than that of healthy people of the same age groups. However, the uptake routes and the metabolic mechanism of high hair mercury concentrations in diseased people are not clear.
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PMID:Concentration of mercury in hair of diseased people in Japan. 787 64

A study was conducted on two thousand five hundred and sixty school children to evaluate the prevalence of hypertension in apparently healthy school children of a prosperous, industrialized city of Punjab. The children belonged to 5-15 years age group of both sexes. The weight (kg) was taken by a standardized weighing machine while height was measured using a calibrated bar. For diagnosing obesity, the body mass index (BMI) was calculated by the formula: [formula: see text] A value of > or = 2.26 was considered as obesity. Blood pressure (BP) measurements were taken by a a mercury sphygmomanometer as per the recommendations of American Heart Association. Hypertension was diagnosed if blood pressure was more than 95th percentile for the age. Family history of hypertension was enquired from the parents of children. The BP of the hypertensive children was reassessed after six and nine months. The prevalence of hypertension was 2.8% at the first screening but decreased to 1.3% and 1.1% by 6 and 9 months, respectively. This fall was statistically significant (p < 0.01). There was no significant difference in the prevalence of hypertension between the two sexes. At the final screening, only children of 11 years or above were hypertensive. A statistically significant correlation with positive family history of hypertension was noted; 85.7% of hypertensive children had positive family history. The prevalence of hypertension was much higher in obese as compared to non-obese children (13.7% vs 0.4%). The correlation between obesity and hypertension was statistically significant (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Obesity and hypertension in children. 788 62

Heart disease still pervades all socioeconomic classes within the United States. Understanding the effects of environmentally-related pathogenesis (e.g., heavy metal accumulation) may aid in developing novel treatments for the prevention of heart dysfunction. The aim of this report was to use experimental investigation in an attempt to expand upon the multivariate importance of divalent cation interactions in the development of heart disease. Calcium and cadmium levels were measured by flame atomic absorption spectrophotometry in various tissues derived from two types of hypertensive rabbit models. Both models of hypertension developed mean arterial pressures of at least 50 mm mercury greater than those of controls over a 5 week period. Interrelationships between calcium and cadmium levels were found to exist for both hypertensive groups in the left ventricle, aorta, and renal medulla. The renal cortex showed no such interrelationship for the renal hypertensive group. Multiple interrelationships between calcium and cadmium levels and hypertrophy were also observed. These studies related the importance of endogenous or exogenous (viz, environmental) factors governing cadmium and calcium accumulation in hypertensive rabbits. The resulting relationships between divalent cations and hypertrophy were presented to draw attention to areas which remain unexplored with perspective to cardiovascular disease.
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PMID:Divalent cations in hypertension with implications to heart disease: calcium, cadmium interactions. 800 48

In a randomized, double-blind, crossover study, 20 patients with mild to severe essential hypertension received 3 weeks of treatment with each of four dosages of spirapril (3, 6, 12 and 24 mg once daily) or placebo. Standing and supine blood pressures were measured by use of both an automatic oscillometric instrument (Dinamap) and a mercury sphygmomanometer over a 24-hour period. Spirapril at 6, 12 and 24 mg once daily produced similar reductions in systolic and diastolic blood pressure. At most time points, there was a statistically significant difference between the reductions with spirapril compared with placebo. Spirapril at 3 mg once daily was less effective than the higher dosages, producing a lower mean blood pressure reduction and a shorter duration of antihypertensive action, mainly as regards systolic pressure. Spirapril was well tolerated and no patients withdrew from the study because of adverse effects. These data suggest that, although all four evaluated spirapril dosages effectively lowered supine and standing blood pressure in patients with mild to severe hypertension, the blood pressure-lowering effect of the 3 mg/day regimen was less than optimal. There were only minor variations in efficacy between dosages > or = to 6 mg/day, which may be attributable to the variability of blood pressure. Further investigations of larger numbers of patients are required to verify these results.
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PMID:Placebo-controlled crossover comparison of spirapril at 3, 6, 12 and 24 mg once daily in mild to severe essential hypertension. 806 48

24 Hour ambulatory blood pressure monitoring (ABPM) was performed to provide data on the normal daily blood pressure of healthy schoolchildren and on patients with hypertension. The subjects studied were 123 healthy schoolchildren with a mean (SD) age of 12.5 (1.6) years (range 9.5-14.5 years), 24 children with borderline or mild hypertension, 17 with renal hypertension and normal renal function, 10 with chronic renal failure, and six with a renal allograft. In eight children with definite renal disease a second measurement was performed after treatment modification. The monitor used for ABPM was validated with a mercury column manometer. The mean (SD) of the signed differences of the blood pressure measured by the two methods was -0.19 (1.75) mmHg for the systolic and -0.21 (2.11) mmHg for the diastolic blood pressure (n = 60). Normal values for daytime and night time blood pressure were determined for those aged 10-14 years. The mean (SD) blood pressure of the 123 children was 109 (7)/66 (8) mmHg (systolic/diastolic) for the daytime and 96 (8)/52 (7) mmHg at night time. Of the 24 children with borderline or mild hypertension 14 had a raised blood pressure on ABPM. The circadian rhythm was disturbed in three children of this group. Even children with normal daytime blood pressure had significantly higher systolic blood pressure in the night when compared with the controls. The incidence of disturbed circadian rhythm was higher in the groups with renal hypertension (4/17 in the subgroup with normal renal function, 5/16 in the group with renal failure and/or transplantation). All children undergoing a second ABPM measurement had a lower average blood pressure after treatment adjustment. ABPM measurements were reproducible and accurate. The method provided new data on the physiological circadian variation of blood pressure in healthy children. It proved to be a helpful tool in the diagnosis of hypertension, particularly in the detection of cases of disturbance of the circadian rhythm of blood pressure pattern and individual adjustment of treatment.
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PMID:24 hour blood pressure monitoring in healthy and hypertensive children. 812 50

The measurement of blood pressure in epidemiological studies is difficult to standardize between centres in multi-centre studies and between repeat surveys over time. The use of standard mercury sphygmomanometers is common but especially prone to measurement error in terms of departure from the protocol and variation in measurement technique. Data from Australia's cardiovascular risk factor prevalence surveys on 21 independent populations, distributed geographically and temporally, has been examined to assess the effect of these errors on cross-sectional and trend analyses. The examination showed that last digit preference for zero may inflate estimates of proportions having high blood pressure. A tendency to record identical duplicate measurements could contribute 0.85 mmHg to time trends or geographic differences in mean systolic blood pressure (but not diastolic blood pressure). Epidemiological studies for geographic and trend differentials in systolic blood pressure need to be mindful of these effects in their analysis. There was some evidence of deterioration in data quality during data collection but no evidence that observers were influenced in their recording practice by observable respondents' characteristics. Training procedures for blood pressure measurement are of critical importance and adherence to the measurement protocol should be continuously monitored during data collection to ensure comparability of results.
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PMID:Blood pressure measurement error: its effect on cross-sectional and trend analyses. 813 39


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