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  Subjects -> HISTORY (Total: 1268 journals)
    - HISTORY (798 journals)
    - History (General) (51 journals)
    - HISTORY OF AFRICA (48 journals)
    - HISTORY OF ASIA (54 journals)
    - HISTORY OF AUSTRALASIA AREAS (7 journals)
    - HISTORY OF EUROPE (162 journals)
    - HISTORY OF THE AMERICAS (124 journals)
    - HISTORY OF THE NEAR EAST (24 journals)

HISTORY (798 journals)            First | 1 2 3 4     

Showing 601 - 452 of 452 Journals sorted alphabetically
Proceedings of the Royal Society of Queensland, The     Full-text available via subscription   (Followers: 1)
Proceedings of the Zoological Society     Hybrid Journal   (Followers: 2)
Procesos Historicos     Open Access  
Prose Studies: History, Theory, Criticism     Hybrid Journal   (Followers: 3)
Psychoanalysis and History     Hybrid Journal   (Followers: 3)
Psychoanalysis Culture & Society     Hybrid Journal   (Followers: 8)
Publications du Centre Européen d'Etudes Bourguignonnes     Full-text available via subscription  
Purdue Historian     Open Access  
Quaderns d’Història de l’Enginyeria     Open Access  
Quaker History     Full-text available via subscription   (Followers: 6)
Queensland Naturalist     Full-text available via subscription  
Questes : Revue pluridisciplinaire d'études médiévales     Open Access  
Quintana. Revista de Estudos do Departamento de Historia da Arte     Open Access  
Radical History Review     Full-text available via subscription   (Followers: 22)
Rasenna : Journal of the Center for Etruscan Studies     Open Access   (Followers: 1)
Rationality and Society     Hybrid Journal   (Followers: 6)
Raven : A Journal of Vexillology     Hybrid Journal  
Reinardus     Hybrid Journal  
Relaciones. Estudios de historia y sociedad     Open Access  
Renaissance Drama     Full-text available via subscription   (Followers: 6)
Renaissance Quarterly     Full-text available via subscription   (Followers: 38)
Renaissance Studies     Hybrid Journal   (Followers: 19)
Rethinking History: The Journal of Theory and Practice     Hybrid Journal   (Followers: 26)
Reti Medievali Rivista     Open Access   (Followers: 2)
Review of Central and East European Law     Hybrid Journal   (Followers: 8)
Reviews in American History     Full-text available via subscription   (Followers: 15)
Revista Análisis Internacional     Open Access  
Revista Brasileira de Historia     Open Access   (Followers: 3)
Revista Brasileira de História das Religiões     Open Access  
Revista Chilena de Historia del Derecho     Open Access  
Revista de Estudios Historico-Juridicos     Open Access   (Followers: 1)
Revista de História     Open Access  
Revista de História Bilros. História(s), Sociedade(s) e Cultura(s)     Open Access  
Revista de História da UEG     Open Access  
Revista do Instituto Histórico e Geográfico do Rio Grande do Sul     Open Access  
Revista Historia Autónoma     Open Access  
Revista História da Educação - History of Education Journal     Open Access  
Revista Maracanan     Open Access  
Revista Mosaico     Open Access  
Revista Paginas     Open Access  
Revolutionary Russia     Hybrid Journal   (Followers: 8)
Revue archéologique de l'Est     Open Access   (Followers: 3)
Revue archéologique du Centre de la France     Open Access   (Followers: 2)
Revue d'histoire de l'Amérique française     Full-text available via subscription   (Followers: 1)
Revue d'Histoire de l'Eglise de France     Full-text available via subscription   (Followers: 3)
Revue d'histoire de l'enfance     Open Access  
Revue d'Histoire des Textes     Full-text available via subscription  
Revue d'histoire du XIXe siècle     Open Access   (Followers: 7)
Revue d'Histoire Ecclésiastique     Full-text available via subscription  
Revue de l’Histoire des Religions     Open Access   (Followers: 11)
Revue des Études Arméniennes     Full-text available via subscription   (Followers: 2)
Revue historique des armées     Open Access   (Followers: 3)
Revue Mabillon     Full-text available via subscription   (Followers: 6)
Rhetoric Society Quarterly     Hybrid Journal   (Followers: 15)
RIMA: Review of Indonesian and Malaysian Affairs     Full-text available via subscription   (Followers: 1)
Romanticism     Hybrid Journal   (Followers: 5)
Romanticism and Victorianism on the Net     Open Access   (Followers: 6)
Royal Studies Journal     Open Access  
Rúbrica Contemporánea     Open Access  
Russian Education & Society     Full-text available via subscription   (Followers: 5)
Russian History     Hybrid Journal   (Followers: 14)
Russian Review     Hybrid Journal   (Followers: 18)
Sacris Erudiri     Full-text available via subscription   (Followers: 6)
Saeculum : Jahrbuch für Universalgeschichte     Hybrid Journal  
Safundi : The Journal of South African and American Studies     Hybrid Journal   (Followers: 1)
Scandinavian Journal of History     Hybrid Journal   (Followers: 13)
Scando-Slavica     Hybrid Journal   (Followers: 4)
Science & Society     Full-text available via subscription   (Followers: 5)
Science Journal of Volgograd State University. History. Area Studies. International Relations     Open Access  
Scientia Canadensis: Canadian Journal of the History of Science, Technology and Medicine / Scientia Canadensis : revue canadienne d'histoire des sciences, des techniques et de la médecine     Full-text available via subscription   (Followers: 4)
Scientia Militaria : South African Journal of Military Studies     Open Access   (Followers: 5)
Scientiae Studia     Open Access  
Scottish Historical Review     Hybrid Journal   (Followers: 15)
Scrineum Rivista     Open Access  
Scrutiny2: Issues in English Studies in Southern Africa     Hybrid Journal   (Followers: 1)
Senses and Society     Hybrid Journal   (Followers: 4)
Sibirica     Full-text available via subscription  
Siècles     Open Access   (Followers: 1)
Signals     Full-text available via subscription   (Followers: 2)
Signos Historicos     Open Access  
Slagmark - Tidsskrift for idéhistorie     Open Access   (Followers: 3)
Slavery & Abolition: A Journal of Slave and Post-Slave Studies     Hybrid Journal   (Followers: 10)
Slavonica     Hybrid Journal   (Followers: 3)
Social History     Hybrid Journal   (Followers: 43)
Social History of Medicine     Hybrid Journal   (Followers: 17)
Social Sciences and Missions     Hybrid Journal   (Followers: 4)
Società e Storia     Full-text available via subscription   (Followers: 1)
Society     Hybrid Journal   (Followers: 5)
Society and Economy     Full-text available via subscription   (Followers: 2)
SourceOECD National Accounts & Historical Statistics     Full-text available via subscription  
South African Historical Journal     Hybrid Journal   (Followers: 6)
South African Journal of Art History     Full-text available via subscription   (Followers: 2)
South African Journal of Cultural History     Full-text available via subscription   (Followers: 1)
South African Journal of Economic History     Full-text available via subscription   (Followers: 3)
South Asia Research     Hybrid Journal   (Followers: 8)
South Asia: Journal of South Asian Studies     Hybrid Journal   (Followers: 14)
South Asian History and Culture     Hybrid Journal   (Followers: 3)
South Asian Popular Culture     Hybrid Journal   (Followers: 2)
South Asian Survey     Hybrid Journal   (Followers: 5)
South Australian Naturalist, The     Full-text available via subscription  
South Central Review     Full-text available via subscription  
South European Society and Politics     Hybrid Journal   (Followers: 9)
Southeast European and Black Sea Studies     Hybrid Journal   (Followers: 5)
Southwestern Historical Quarterly     Full-text available via subscription   (Followers: 5)
Soviet and Post-Soviet Review     Hybrid Journal   (Followers: 9)
Spontaneous Generations : A Journal for the History and Philosophy of Science     Open Access   (Followers: 2)
Sport in History     Hybrid Journal   (Followers: 10)
Studia Aurea : Revista de Literatura Española y Teoría Literaria del Renacimiento y Siglo de Oro     Open Access   (Followers: 1)
Studia Historiae Ecclesiasticae     Open Access   (Followers: 2)
Studia Historiae Oeconomicae     Open Access  
Studia Iranica     Full-text available via subscription   (Followers: 4)
Studia Litteraria et Historica     Open Access  
Studia z Historii Filozofii     Open Access  
Studies in East European Thought     Hybrid Journal   (Followers: 6)
Studies in Eighteenth Century Culture     Full-text available via subscription   (Followers: 20)
Studies in History     Hybrid Journal   (Followers: 24)
Studies in History and Philosophy of Science Part A     Hybrid Journal   (Followers: 7)
Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences     Hybrid Journal   (Followers: 12)
Studies in People’s History     Hybrid Journal  
Studies in the History of Gardens & Designed Landscapes: An International Quarterly     Hybrid Journal   (Followers: 7)
Studies in Western Australian History     Full-text available via subscription   (Followers: 3)
Studium : Tijdschrift voor Wetenschaps- en Universiteits-geschiedenis / Revue d'Histoire des Sciences et des Universités     Open Access   (Followers: 1)
Suomen Sukututkimusseuran Vuosikirja     Open Access  
Sydney Institute Quarterly     Full-text available via subscription  
T'oung Pao     Hybrid Journal   (Followers: 11)
Tangence     Full-text available via subscription  
Tasmanian Historical Studies     Full-text available via subscription   (Followers: 1)
Teaching History     Full-text available via subscription   (Followers: 7)
Technology and Culture     Full-text available via subscription   (Followers: 24)
temp - tidsskrift for historie     Full-text available via subscription  
Tempo     Open Access   (Followers: 2)
Tempo e Argumento     Open Access  
The Corvette     Open Access  
The Court Historian : The International Journal of Court Studies     Full-text available via subscription   (Followers: 1)
The Eighteenth Century     Full-text available via subscription   (Followers: 26)
The European Legacy: Toward New Paradigms     Hybrid Journal   (Followers: 2)
The Hilltop Review : A Journal of Western Michigan University Graduate Student Research     Open Access  
The Historian     Hybrid Journal   (Followers: 33)
The International History Review     Hybrid Journal   (Followers: 21)
The Irish Review     Full-text available via subscription   (Followers: 14)
The Italianist     Hybrid Journal   (Followers: 5)
The Journal of the Historical Society     Hybrid Journal   (Followers: 12)
The Public Historian     Full-text available via subscription   (Followers: 10)
The Seventeenth Century     Hybrid Journal   (Followers: 16)
The Sixties: A Journal of History, Politics and Culture     Hybrid Journal   (Followers: 10)
The South African Journal of Economics     Hybrid Journal   (Followers: 4)
Theatre History Studies     Full-text available via subscription   (Followers: 4)
Theoria et Historia Scientiarum     Open Access  
Tiempo devorado     Open Access  
Tiempo y Espacio     Open Access  
Tijdschrift voor Geschiedenis     Full-text available via subscription   (Followers: 2)
Tijdschrift voor Rechtsgeschiedenis / Revue d'Histoire du Droit / The Legal History Review     Hybrid Journal   (Followers: 21)
Time & Society     Hybrid Journal   (Followers: 10)
Trabajos y Comunicaciones     Open Access   (Followers: 1)
Traditio     Full-text available via subscription   (Followers: 1)
Transactions of the Philological Society     Hybrid Journal   (Followers: 2)
Transactions of the Royal Society of South Africa     Hybrid Journal   (Followers: 2)
Transfers     Full-text available via subscription  
Transition     Full-text available via subscription   (Followers: 1)
Transmodernity : Journal of Peripheral Cultural Production of the Luso-Hispanic World     Open Access   (Followers: 3)
Trocadero     Open Access  
Troianalexandrina     Full-text available via subscription   (Followers: 1)
Turcica     Full-text available via subscription   (Followers: 9)
Turkish Historical Review     Hybrid Journal   (Followers: 6)
Turkish Studies     Hybrid Journal   (Followers: 9)
Twentieth Century British History     Hybrid Journal   (Followers: 17)
U.S. Catholic Historian     Full-text available via subscription   (Followers: 2)
UCLA Historical Journal     Open Access  
Ufahamu : A Journal of African Studies     Open Access   (Followers: 2)
United Service     Full-text available via subscription   (Followers: 2)
Urban History Review / Revue d'histoire urbaine     Full-text available via subscription   (Followers: 6)
Varia Historia     Open Access   (Followers: 2)
Vegueta : Anuario de la Facultad de Geografía e Historia     Open Access  
Vestiges : Traces of Record     Full-text available via subscription  
Viator     Full-text available via subscription   (Followers: 12)
Victorian Naturalist, The     Full-text available via subscription   (Followers: 3)
Victorian Periodicals Review     Full-text available via subscription   (Followers: 8)
Vigiliae Christianae     Hybrid Journal   (Followers: 12)
Viking and Medieval Scandinavia     Full-text available via subscription   (Followers: 14)
Vínculos de Historia. Revista del Departamento de Historia de la Universidad de Castilla-La Mancha     Open Access  
Visual Resources: An International Journal of Documentation     Hybrid Journal   (Followers: 2)
Vivarium     Hybrid Journal   (Followers: 2)
Vulcan     Hybrid Journal  
War & Society     Hybrid Journal   (Followers: 25)
Water History     Hybrid Journal   (Followers: 11)
Welsh History Review     Full-text available via subscription   (Followers: 12)
West 86th     Full-text available via subscription   (Followers: 5)
West Virginia History: A Journal of Regional Studies     Full-text available via subscription   (Followers: 3)
Whispering Wind     Full-text available via subscription   (Followers: 1)
Wicazo Sa Review     Full-text available via subscription  
Winterthur Portfolio     Full-text available via subscription   (Followers: 7)
Women in German Yearbook : Feminist Studies in German Literature & Culture     Full-text available via subscription   (Followers: 7)
Women's History Review     Hybrid Journal   (Followers: 10)
Yesterday and Today     Open Access   (Followers: 2)
Zeitschrift für Historische Forschung     Full-text available via subscription   (Followers: 9)
Zeitschrift für Weltgeschichte     Full-text available via subscription   (Followers: 1)
Zutot     Hybrid Journal   (Followers: 4)
Βυζαντινά Σύμμεικτα     Open Access   (Followers: 1)

  First | 1 2 3 4     

Journal Cover Journal of the American Society of Hypertension
  [SJR: 1.039]   [H-I: 31]   [8 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1933-1711
   Published by Elsevier Homepage  [3043 journals]
  • Omega-3 fatty acids supplementation improves endothelial function and
           arterial stiffness in hypertensive patients with hypertriglyceridemia and
           high cardiovascular risk
    • Authors: Marcela A. Casanova; Fernanda Medeiros; Michelle Trindade; Célia Cohen; Wille Oigman; Mario Fritsch Neves
      Pages: 10 - 19
      Abstract: Publication date: January 2017
      Source:Journal of the American Society of Hypertension, Volume 11, Issue 1
      Author(s): Marcela A. Casanova, Fernanda Medeiros, Michelle Trindade, Célia Cohen, Wille Oigman, Mario Fritsch Neves
      Association between hypertriglyceridemia and cardiovascular (CV) disease is still controversial. The purpose of this study was to compare omega-3 and ciprofibrate effects on the vascular structure and function in low and high CV risk hypertensive patients with hypertriglyceridemia. Twenty-nine adults with triglycerides 150–499 mg/dL were divided into low (<7.5%) and high (≥7.5%) CV risk, randomized to receive omega-3 fatty acids 1800 mg/d or ciprofibrate 100 mg/d for 12 weeks. Treatment was switched after 8-week washout. Clinical evaluation and vascular tests were assessed at baseline and after intervention. Peripheral (131 ± 3 to 125 ± 3 mm Hg, P < .05) and aortic (124 ± 3 to 118 ± 2 mg/dL, P < .05) systolic blood pressure were decreased by ciprofibrate in low-risk patients. In high-risk patients, pulse wave velocity was reduced (10.4 ± 0.4 to 9.4 ± 0.3 m/s, P < .05) and flow-mediated dilation was increased (11.1 ± 1.6 to 13.5 ± 1.2%, P < .05) by omega-3. In conclusion, omega-3 improved arterial stiffness and endothelial function, pointing out the beneficial effect of this therapy on vascular aging, in high-risk patients.

      PubDate: 2017-03-09T14:42:43Z
      DOI: 10.1016/j.jash.2016.10.004
       
  • Contributions of Aortic Pulse Wave Velocity and Backward Wave Pressure to
           Variations in Left Ventricular Mass are Independent of Each Other
    • Authors: Hamza Bello; Gavin R. Norton; Imraan Ballim; Carlos D. Libhaber; Pinhas Sareli; Angela J. Woodiwiss
      Abstract: Publication date: Available online 14 March 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Hamza Bello, Gavin R. Norton, Imraan Ballim, Carlos D. Libhaber, Pinhas Sareli, Angela J. Woodiwiss
      Aortic pulse wave velocity (PWV) and backward waves, as determined from wave separation analysis, predict cardiovascular events beyond brachial blood pressure (BP). However, the extent to which these aortic hemodynamic variables contribute independent of each other is uncertain. In 749 randomly selected participants of African ancestry we therefore assessed the extent to which relationships between aortic PWV or backward wave pressures (Pb)(and hence central aortic pulse pressure [PPc]) and left ventricular mass index (LVMI) occur independent of each other. Aortic PWV, PPc, forward wave pressure (Pf) and Pb were determined using radial applanation tonometry and SphygmoCor software and LVMI using echocardiography. 44.5% of participants had an increased LVMI-ht1.7. With adjustments for age, brachial systolic BP or PP and additional confounders, PPc and Pb, but not Pf was independently related to LVMI and LV hypertrophy (LVH) in both men and women. However, PWV was independently associated with LVMI in women (partial r=0.16, p<0.001), but not in men (partial r=0.03) and PWV was independently associated with LVH in women (p<0.05), but not in men (p=0.07). With PWV and Pb included in the same multivariate regression models, PWV (partial r=0.14, p<0.005) and Pb (partial r=0.10, p<0.05) contributed to a similar extent to variations in LVMI in women. In addition, with PWV and Pb included in the same multivariate regression models, PWV (p<0.05) and Pb (p<0.02) contributed to LVH in women. In conclusion, aortic PWV and backward wave pressure (and hence pulse pressure) although both associated with LVMI and LVH, produce effects which are independent of each other.

      PubDate: 2017-03-17T15:26:03Z
      DOI: 10.1016/j.jash.2017.03.001
       
  • Effect of gender and adiposity on in vivo vascular function in young
           African Americans
    • Authors: Namrata Dass; Sindhu Kilakkathi; Brittaney Obi; Andrea Moosreiner; Shanthi Krishnaswami; Michael E. Widlansky; Srividya Kidambi
      Abstract: Publication date: Available online 14 March 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Namrata Dass, Sindhu Kilakkathi, Brittaney Obi, Andrea Moosreiner, Shanthi Krishnaswami, Michael E. Widlansky, Srividya Kidambi
      Background The relationship between obesity and high blood pressure is not as strong among African Americans (AA) as compared to Caucasians. We designed the current study to determine the effect of adiposity on vascular endothelial function (a harbinger of hypertension) among young healthy AA without additional cardiovascular disease (CVD) risk factors. Methods A total of 108 AA subjects (46 women) between the ages of 18-45 years were recruited. All the subjects were normotensive, non-smokers, and normoglycemic. Anthropometric and CVD risk factor measurements (lipid, insulin resistance, and inflammatory markers) were obtained. Vascular endothelial function was measured by brachial artery flow mediated dilation. Adiposity distribution was measured by using MRI scan. Results There were no gender differences in age and levels of blood pressure, lipids, insulin resistance, and inflammatory markers. Women had higher total body fat percentage and higher peripheral adiposity compared to men. We observed that total and central adiposity did not correlate significantly with brachial artery flow-mediated dilation (FMD) in women (r= -0.12 and r=0.23 respectively; p=NS). However, in men waist circumference was positively associated with FMD (r= 0.3, p = <0.05). Hyperemic flow was negatively correlated significantly with total and central adiposity (r= -0.34 and r=-0.48 respectively; p < 0.05) in men, but not in women (r= -0.26 and r=0.03 respectively; p=NS) in women. Conclusions Our study suggests that increased adiposity may pose greater risk to AA men compared to AA women by adversely affecting resistance vessel function (as measured by hyperemic flow). Larger studies are necessary to validate these findings.

      PubDate: 2017-03-17T15:26:03Z
      DOI: 10.1016/j.jash.2017.03.002
       
  • From the Editor
    • Authors: Daniel Levy
      Abstract: Publication date: January 2017
      Source:Journal of the American Society of Hypertension, Volume 11, Issue 1
      Author(s): Daniel Levy


      PubDate: 2017-03-09T14:42:43Z
       
  • Instructions for Authors
    • Abstract: Publication date: January 2017
      Source:Journal of the American Society of Hypertension, Volume 11, Issue 1


      PubDate: 2017-03-09T14:42:43Z
       
  • Low dose sustained-release deoxycorticosterone acetate induced
           hypertension in Bama miniature pigs for renal sympathetic nerve
           denervation
    • Authors: Wenzheng Han; Weiyi Fang; Qian Gan; Shaofeng Guan; Yanjie Li; Ming Wang; Kaizheng Gong; Xinkai Qu
      Abstract: Publication date: Available online 2 March 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Wenzheng Han, Weiyi Fang, Qian Gan, Shaofeng Guan, Yanjie Li, Ming Wang, Kaizheng Gong, Xinkai Qu
      Background Recently, the effectiveness of renal sympathetic nerve denervation for treatment of hypertension has been doubted after SYMPLICITY HTN-3 trial. An ideal animal model is still unavailable for pre-clinical study about catheter-based renal sympathetic nerve denervation (RDN) for treatment of hypertension. Traditional high dose deoxycorticosterone acetate (DOCA) induced hypertension pig model has some problems due to extensive end-organ damage. Based on the similarity in the anatomic characteristics of renal artery between pigs and humans, this study was undertaken to establish a low dose sustained-release DOCA-induced hypertension model in pigs. Methods A total of 14 pigs were subcutaneously implanted with low dose DOCA in the abdomen and cannulated from the femoral artery for the measurement of blood pressure (BP). Plasma angiotensin-I (Ang-I), angiotensin-II (Ang-II), plasma renin activity (PRA), aldosterone (Ald), creatinine (CREA), epinephrine (E) and norepinephrine (NE) were determined before and after treatments. The kidneys were collected and processed for haematoxylin & eosin staining, Masson–Goldner trichromic and periodic acid Schiff (PAS) staining. Results 10 pigs survived for one month. Mean BP significantly increased after 2-week treatment (P<0.001). The plasma Ang I, Ang II, PRA and Ald significantly decreased (Ang I: 6.92±6.06 vs 2.22±3.08, P=0.002; Ang II: 768.85±525.8 vs 213.76±148.63, P=0.003; PRA: 1.68±1.67 vs 0.29±0.39, P=0.008; Ald: 0.37±0.12 vs 0.25±0.09, P<0.001), but NE significantly increased (7.59±4.57 vs 16.96±10.38, P=0.021). Plasma CREA remained unchanged. Hisotological examination showed mild damage to the kidney. Conclusion: Low dose sustained-release DOCA is able to induce hypertension in pigs. A femoral catheter is not only helpful for monitoring BP, but can be used to quickly exchange the RDN equipment.

      PubDate: 2017-03-04T14:11:49Z
      DOI: 10.1016/j.jash.2017.02.006
       
  • Effects of Carvedilol or Amlodipine on Target Organ Damage in L-Name
           Hypertensive Rats: Their Relationship with Blood Pressure Variability
    • Authors: Julieta S. Del Mauro; Paula D. Prince; Martín Donato; Nahuel Fernandez Machulsky; Marcela A. Morettón; Germán E. González; Facundo M. Bertera; Andrea Carranza; Susana B. Gorzalczany; Diego A. Chiappetta; Gabriela Berg; Celina Morales; Ricardo J. Gelpi; Carlos A. Taira; Christian Höcht
      Abstract: Publication date: Available online 2 March 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Julieta S. Del Mauro, Paula D. Prince, Martín Donato, Nahuel Fernandez Machulsky, Marcela A. Morettón, Germán E. González, Facundo M. Bertera, Andrea Carranza, Susana B. Gorzalczany, Diego A. Chiappetta, Gabriela Berg, Celina Morales, Ricardo J. Gelpi, Carlos A. Taira, Christian Höcht
      Objectives To compare the effects of chronic oral treatment with carvedilol or amlodipine on blood pressure and blood pressure variability and target organ damage in N-nitro-l-arginine methyl ester (L-NAME) hypertensive rats. Methods Wistar rats were treated with L-NAME administered in the drinking water for 8 weeks together with oral administration of carvedilol 30 mg/kg (n=6), amlodipine 10 mg/kg (n=6) or vehicle (n=6). At the end of the treatment, echocardiographic evaluation, blood pressure and short-term variability measurements were performed. Left ventricular and thoracic aortas were removed to assess activity of metalloproteinase 2 and 9 and expression levels of transforming growth factor β, tumor necrosis factor α and interleukin-6. Histological samples were prepared from both tissues. Results Carvedilol and amlodipine induced a comparable reduction of systolic and mean arterial pressure and its short-term variability in L-NAME rats. The expression of transforming growth factor β, tumor necrosis factor α and interleukin-6 decreased in both organs after carvedilol or amlodipine treatment and the activity of metalloproteinase was reduced in aortic tissue. Treatment with carvedilol or amlodipine completely prevented left ventricular collagen deposition and morphometric alterations in aorta. Conclusion Oral chronic treatment with carvedilol or amlodipine significantly attenuates blood pressure variability and reduces target organ damage and biomarkers of tissue fibrosis and inflammation in L-NAME hypertensive rats.

      PubDate: 2017-03-04T14:11:49Z
      DOI: 10.1016/j.jash.2017.02.007
       
  • From the Editor
    • Authors: Daniel Levy
      Abstract: Publication date: Available online 24 February 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Daniel Levy


      PubDate: 2017-02-25T11:12:13Z
       
  • Metformin lowers blood pressure in obese and insulin-resistant
           individuals without diabetes
    • Authors: Brent M. Egan
      Abstract: Publication date: Available online 21 February 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Brent M. Egan


      PubDate: 2017-02-25T11:12:13Z
      DOI: 10.1016/j.jash.2017.01.002
       
  • The relationship of alcohol consumption with left ventricular mass in
           people 35 years old or older in rural areas of western China
    • Authors: Yunjing Yang; Nan Zhang; Huang Wei; Rui Feng; Panpan Feng; Jun Gu; Gang Liu; Han Lei
      Abstract: Publication date: Available online 20 February 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Yunjing Yang, Nan Zhang, Huang Wei, Rui Feng, Panpan Feng, Jun Gu, Gang Liu, Han Lei
      The aim of this study was to investigate the association between alcohol intake and left ventricular mass (LVM) independent of the effects of blood pressure and other factors in rural areas of western China. One thousand and seven subjects (487 men and 520 women) aged ≥35 years from the Tongan district, Chongqing, China. The quantity and frequency of alcohol consumption was estimated from a validated questionnaire. Echocardiography was used to assess left ventricular dimensions. Drinkers was associated with higher LVM compared with non-drinkers (β=6.9, 95% CI 1.3-12.5, P=0.015). A dose-dependent higher LVM across increasing alcohol consumption was observed (P < 0.05). LVM was significantly correlated with regular drinking (β=10.0, 95% CI 3.6-16.4). In subjects with hypertension, quantity of alcohol consumption (P for interaction= 0.013) and frequency of alcohol consumption (P for interaction= 0.025) were strongly associated with higher LVM when stratified by blood pressure. However, interactions linked to age, BMI and gender were found to be no significant difference. These results indicate that both quantity and frequency of alcohol consumption are independent predictors of LVM in rural areas of western China. The effects of alcohol consumption on LVM is enhanced among subjects with hypertension.

      PubDate: 2017-02-25T11:12:13Z
      DOI: 10.1016/j.jash.2017.02.002
       
  • Echocardiographic characteristics of Hypertensive patients affected by
           transient Ischemic attack: a cross-sectional study
    • Authors: Daniela Degli Esposti; Simone Stefano Finzi; Angelo Parini; Arrigo FG. Cicero; Giovanni Tomassoli; Stefano Bacchelli; Maria Guarino; Francesca Rondelli; Claudio Borghi
      Abstract: Publication date: Available online 20 February 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Daniela Degli Esposti, Simone Stefano Finzi, Angelo Parini, Arrigo FG. Cicero, Giovanni Tomassoli, Stefano Bacchelli, Maria Guarino, Francesca Rondelli, Claudio Borghi
      Atrial septal aneurysm (ASA), common finding in normal echocardiographies, has been described in association with transient ischemic attacks (TIA)/strokes, as well as hypertensive end organ damage such as left ventricular (LV) hypertrophy. Aim of this study was to assess if a cluster of echocardiographic aspects could characterize TIA hypertensive patients. A cross-sectional study on patients with history of TIA, referring to a Hypertension Center echolab, has been performed. 5223 patients received trans-thoracic echocardiography. TIA patients were 292 (5.6%). 102 age/sex matched patients without TIA have been collected as controls. The main characteristic of TIA patients resulted ASA/bulging (TIA 61%, controls 6%, p=0,0001). Other aspect were LV concentric remodeling (TIA 32.3%, controls 20.8%, p= 0.029) and mitral flow aspects of diastolic dysfunction. After adjustment for age and hypertension, ASA/bulging (O.R.=62.4, 95%CI: 13.6 – 73.9, p<0.001), followed by LV concentric hypertrophy (O.R.=2.1, 95%CI: 1.1–4.3, p=0.043), were associated with a positive TIA history. A binary logistic regression performed in ASA/bulging patients, identified relative wall thickness as the strongest TIA associated aspect (OR=53.4, 95%CI: 11.9–74.18, p=0.001). ASA/bulging, common finds in general population, could carry a significant incremental possibility of association with TIA when concentric geometry, frequent hypertensive aspect, is present as well.

      PubDate: 2017-02-25T11:12:13Z
      DOI: 10.1016/j.jash.2017.02.003
       
  • Lessons learned from the recent history of technologies for non-invasive
           estimation of aortic blood pressure using transfer functions and pulse
           wave analysis
    • Authors: Theodore G. Papaioannou; Costas P. Tsioufis; Marianna Karamanou; Dimitrios Tousoulis
      Abstract: Publication date: Available online 20 February 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Theodore G. Papaioannou, Costas P. Tsioufis, Marianna Karamanou, Dimitrios Tousoulis


      PubDate: 2017-02-25T11:12:13Z
      DOI: 10.1016/j.jash.2017.02.004
       
  • Clinic and Ambulatory Blood Pressure in a Population-Based Sample of
           African Americans: the Jackson Heart Study
    • Authors: S. Justin Thomas; John N. Booth; Samantha G. Bromfield; Samantha R. Seals; Tanya M. Spruill; Gbenga Ogedegbe; Srividya Kidambi; Daichi Shimbo; David Calhoun; Paul Muntner
      Abstract: Publication date: Available online 16 February 2017
      Source:Journal of the American Society of Hypertension
      Author(s): S. Justin Thomas, John N. Booth, Samantha G. Bromfield, Samantha R. Seals, Tanya M. Spruill, Gbenga Ogedegbe, Srividya Kidambi, Daichi Shimbo, David Calhoun, Paul Muntner
      Blood pressure (BP) can differ substantially when measured in the clinic versus outside of the clinic setting. Few population-based studies with ambulatory blood pressure monitoring (ABPM) include African Americans. We calculated the prevalence of clinic hypertension and ABPM phenotypes among 1,016 participants in the population-based Jackson Heart Study, an exclusively African-American cohort. Mean daytime systolic BP was higher than mean clinic systolic BP among participants not taking antihypertensive medication (127.1[standard deviation 12.8] versus 124.5[15.7] mmHg, respectively) and taking antihypertensive medication (131.2[13.6] versus 130.0[15.6] mmHg, respectively). Mean daytime diastolic BP was higher than clinic diastolic BP among participants not taking antihypertensive medication (78.2[standard deviation 8.9] versus 74.6[8.4] mmHg, respectively) and taking antihypertensive medication (77.6[9.4] versus 74.3[8.5] mmHg, respectively). The prevalence of daytime hypertension was higher than clinic hypertension for participants not taking antihypertensive medication (31.8% versus 14.3%) and taking antihypertensive medication (43.0% versus 23.1%). A high percentage of participants not taking and taking antihypertensive medication had nocturnal hypertension (49.4% and 61.7%, respectively), white coat hypertension (30.2% and 29.3%, respectively), masked hypertension (25.4% and 34.6%, respectively), and a non-dipping BP pattern (62.4% and 69.6%, respectively). In conclusion, these data suggest hypertension may be misdiagnosed among African Americans without using ABPM.

      PubDate: 2017-02-18T02:30:45Z
      DOI: 10.1016/j.jash.2017.02.001
       
  • Association between Modified Shuttle Walk Test and Cardiorespiratory
           Fitness in Overweight/Obese Adults with Primary Hypertension: EXERDIET-HTA
           Study
    • Authors: Borja Jurio-Iriarte; Ilargi Gorostegi-Anduaga; G. Rodrigo Aispuru; Javier Pérez-Asenjo; Peter H. Brubaker; Sara Maldonado-Martín
      Abstract: Publication date: Available online 7 February 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Borja Jurio-Iriarte, Ilargi Gorostegi-Anduaga, G. Rodrigo Aispuru, Javier Pérez-Asenjo, Peter H. Brubaker, Sara Maldonado-Martín
      Background The aims of the study were: to evaluate the relationship between Modified Shuttle Walk Test (MSWT) with peak oxygen uptake (V̇O2peak) in overweight/obese people with primary hypertension (HTN), and to develop an equation for the MSWT to predict VO2peak. Methods Participants (N=256, 53.9±8.1 yr old) with HTN and overweight/obesity performed a cardiorespiratory exercise test to peak exertion on an upright bicycle ergometer using an incremental ramp protocol and the 15-level MSWT. The formula of Singh et al. was used as a template to predict V̇O2peak, and a new equation was generated from the measured V̇O2peak-MSWT relationship in this investigation. Results The correlation between measured and predicted V̇O2peak for Singh et al. equation was moderate (r=0.60, P<0.001) with a standard error of estimate (SEE) of 4.92 mL·kg-1·min-1; SEE%=21%. The correlation between MSWT and measured V̇O2peak, as well as for the new equation was strong (r=0.72, P<0.001) with a SEE of 4.35 mL·kg-1·min-1; SEE%=19%. Conclusion These results indicate that MSWT does not accurately predict functional capacity in overweight/obese people with HTN and questions the validity of using this test to evaluate exercise intolerance. A more accurate determination from a new equation in the current study incorporating more variables from MSWT to estimate V̇O2peak has been performed, but still results in substantial error.

      PubDate: 2017-02-12T00:42:00Z
      DOI: 10.1016/j.jash.2017.01.008
       
  • Anthropometric profile of Hong Kong children and adolescents: The Wellness
           Population of Youth Study
    • Authors: Regina L.T. Lee; Paul H. Lee; Daniel M.Y. Sze; Wai Tong Chien
      Abstract: Publication date: Available online 6 February 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Regina L.T. Lee, Paul H. Lee, Daniel M.Y. Sze, Wai Tong Chien
      Childhood obesity has been a public health concern increasingly. We investigated the age- and sex-specific BMI, blood pressure level, and other obesity measures in Hong Kong children and adolescents. We used the data from Wellness Population of Youth Study, a health examination for anthropometric measurements among children and adolescents (aged 9 to 15 years) in Hong Kong, conducted in Oct 2012 – Jun 2013 (n=4,410). Anthropometric measures including weight, height, pulse, systolic and diastolic blood pressures, triceps and scapula skinfold thickness, and waist circumference, were measured following universal standard protocol. Overweight and obesity were classified using the 2000 International Obesity Task Force (IOTF), 2007 World Health Organization (WHO), and 2000 Centers of Disease Control and Prevention (CDC) age- and sex-specific growth charts. Hypertension was categorized using CDC and Chinese standards. The prevalence of obesity, overweight, and hypertension of Hong Kong adolescents according to the above definitions were 5.4%-15.1%, 20.8%-25.9%, and 12.0%-13.8%, respectively. Boys had higher SBP, waist, BMI, and waist-to-height ratio (all p < 0.001). Systolic and diastolic blood pressures, scapula skinfold, waist, and BMI increased with age, while pulse and waist-to-height ratio decreased with age. To conclude, compared with worldwide data, the situations of obesity and overweight among Hong Kong children and adolescents were more severe.

      PubDate: 2017-02-12T00:42:00Z
      DOI: 10.1016/j.jash.2017.01.007
       
  • Activation of chemokine receptor CXCR2 is a crucial factor in the
           development of experimental hypertension
    • Authors: Michael J. Bloch
      Abstract: Publication date: Available online 3 February 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Michael J. Bloch


      PubDate: 2017-02-05T23:48:06Z
      DOI: 10.1016/j.jash.2017.01.001
       
  • Interleukin-6 -572C/G polymorphism is associated with serum interleukin-6
           levels and risk of idiopathic pulmonary arterial hypertension
    • Authors: Ming Fang; Yueye Huang; Yuan Zhang; Zhongping Ning; Luoning Zhu; Xinming Li
      Abstract: Publication date: Available online 3 February 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Ming Fang, Yueye Huang, Yuan Zhang, Zhongping Ning, Luoning Zhu, Xinming Li
      Interleukin (IL)-6 is a multifunctional proinflammatory cytokine that is elevated in patients with pulmonary arterial hypertension (PAH). Single nucleotide polymorphisms in the promoter region of IL-6 have been reported to transcriptional regulate the expression of IL-6. The aim of the present study is to investigate the roles of two common polymorphisms [-572C/G (rs1800796) and -6331T/C (rs10499563)] of IL-6 in idiopathic PAH (IPAH). A total of 338 IPAH patients and 352 age- and gender-matched healthy controls were enrolled. Genotyping of the two polymorphisms were performed by PCR and direct sequencing. Serum IL-6 levels were determined by ELISA assay. The frequencies of -572C/G genotypes CC, CG, and GG were found to be 63.6%, 32.3%, and 4.1% in IPAH patients group, and 51.7%, 39.5%, and 8.8% in the controls, respectively. Compared with the individuals carrying the common genotype CC, the individuals carrying the GG genotype had a decreased risk of IPAH (adjusted odds ratio, 0.40; 95% confidence interval, 0.20-0.77; P= 0.006). The CG genotype and G allele carriers (CG/GG genotypes) were also observed to be associated with decreased risks of IPAH. Moreover, we found that individuals harboring -572GG or GC genotype showed significantly lower IL-6 levels than those harboring the -572CC genotype. No association between -6331T/C polymorphism and risk of IPAH or IL-6 levels was found. These results suggest that IL-6 promoter polymorphism -572C/G, but not -6331T/C, is associated with serum IL-6 levels and risk of IPAH.

      PubDate: 2017-02-05T23:48:06Z
      DOI: 10.1016/j.jash.2017.01.011
       
  • The importance of genetic counseling and genetic screening: A case report
           of a 16-year-old boy with resistant hypertension and severe hypokalemia
    • Authors: Ze-Min Kuang; Ying Wang; Jia-Jie Wang; Jing-Hua Liu; Rong Zeng; Qi Zhou; Zhen-Qiu Yu; Long Jiang
      Abstract: Publication date: Available online 3 February 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Ze-Min Kuang, Ying Wang, Jia-Jie Wang, Jing-Hua Liu, Rong Zeng, Qi Zhou, Zhen-Qiu Yu, Long Jiang
      Liddle's syndrome, an autosomal dominant form of monogenic hypertension, is characterized by salt-sensitive hypertension with early penetrance, hypokalemia, metabolic alkalosis, suppression of plasma rennin activity and aldosterone secretion, and a clear-cut response to epithelial sodium channel (ENaC) blockers but not spironolactone therapy. Here, we describe the case of a 16-year-old boy patient with resistant hypertension (maintain 170-180/100-110 mmHg after administration four kinds of antiypertensive drugs) and severe hypokalemia. After a series of checks we exclude primary aldosteronism and renal artery stenosis and other diseases. Finally, the liddle syndrome was diagnosed because of the DNA sequencing found that the proband's mother and himself had mutations P616L (c.1847 C>T) in the SCNN1B gene. Liddle syndrome should be considered as a cause of hypertension in children or adolescents particularly with suppressed renin activity. Early diagnosis and appropriately tailored treatment avoid complications of long-term unrecognized or inappropriately managed hypertension.Genetic testing has made it possible to make accurate diagnoses and develop tailored therapies for mutation carriers. The role of genetic testing and genetic counseling in establishing the early diagnosis of Liddle's syndrome is important.

      PubDate: 2017-02-05T23:48:06Z
      DOI: 10.1016/j.jash.2017.01.012
       
  • Primate Response to Angiotensin Infusion and High Sodium Intake Differ by
           Sodium Lithium Countertransport Phenotype
    • Authors: Kimberly D. Spradling-Reeves; Robert E. Shade; Joseph R. Haywood; Laura A. Cox
      Abstract: Publication date: Available online 3 February 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Kimberly D. Spradling-Reeves, Robert E. Shade, Joseph R. Haywood, Laura A. Cox
      An increased level of sodium-lithium countertransport (SLC) activity has been associated with salt-sensitive hypertension. Previous findings have suggested that dysregulation of the renin-angiotensin-aldosterone system (RAAS) may be involved in the mechanism linking elevated SLC activity and hypertension. Therefore, baboons with different levels of SLC activity were given two diets differing in sodium content, with and without an angiotensin II (ANG II) infusion, to investigate the relationship between SLC activity, the RAAS, and physiological regulation by sodium. Although we anticipated that high SLC (HSLC) activity would be associated with inappropriate function of the RAAS and greater arterial pressure sensitivity to dietary sodium and ANG II and that low SLC (LSLC) activity would be associated with the least BP sensitivity, we found that the LSLC phenotype correlated with BP sensitivity similar to the HSLC phenotype, and the normal SLC (NSLC) phenotype showed the least BP sensitivity to dietary sodium and ANG II.

      PubDate: 2017-02-05T23:48:06Z
      DOI: 10.1016/j.jash.2017.01.010
       
  • Metformin lowers blood pressure in obese and insulin-resistant individuals
           without diabetes
    • Authors: Brent M. Egan
      Abstract: Publication date: Available online 3 February 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Brent M. Egan


      PubDate: 2017-02-05T23:48:06Z
      DOI: 10.1016/j.jash.2017.01.002
       
  • Home, Automated Office and Conventional Office Blood Pressure as
           Predictors of Cardiovascular Risk
    • Authors: Emmanuel A. Andreadis; Vasilios Papademetriou; Charalampia V. Geladari; George N. Kolyvas; Epameinondas T. Angelopoulos; Konstantinos N. Aronis
      Abstract: Publication date: Available online 3 February 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Emmanuel A. Andreadis, Vasilios Papademetriou, Charalampia V. Geladari, George N. Kolyvas, Epameinondas T. Angelopoulos, Konstantinos N. Aronis
      Objective Automated office blood pressure (AOBP) has recently been shown to closely predict cardiovascular (CV) events in the elderly. Home blood pressure (HBP) has also been accepted as a valuable method in the prediction of CV disease. This study aimed to compare conventional office BP (OBP), HBP and AOBP in order to evaluate their value in predicting CV events and deaths in hypertensives. Methods We assessed 236 initially treatment naïve hypertensives, examined between 2009 and 2013. The end points were any CV and non-CV event including mortality, myocardial infarction (MI), coronary heart disease (CHD), hospitalization for heart failure (HF), severe arrhythmia, stroke, and intermittent claudication. We fitted proportional hazards models using the different modalities as predictors, and evaluated their predictive performance using three metrics: time-dependent Receiver Operating Characteristics curves, the Akaike’s Information Criterion, and Harrell’s C-index. Results After a mean follow-up of 7 years, 23 participants (39% women) had experienced ≥1 CV event. Conventional office systolic(HR per 1mm Hg increase in BP, 1.028; 95%CI, 1.009-1.048), automated office systolic (HR per 1mm Hg increase in BP, 1.031; 95%CI, 1.008-1.054) and home systolic (HR, 1.025; 95%CI, 1.003-1.047) were predictive of CV events. All systolic BP measurements were predictive after adjustment for other CV risk factors (P<0.05). The predictive performance of the different modalities was similar. Conclusion Conventional OBP was significantly higher than AOBP and average HBP. AOBP predicts equally well to OBP and HBP CV events. It appears to be comparable to HBP in the assessment of CV risk and therefore its introduction into guidelines and clinical practice as the reference method for assessing BP in the office seems reasonable after verification of these findings by randomized trials.

      PubDate: 2017-02-05T23:48:06Z
      DOI: 10.1016/j.jash.2017.01.009
       
  • From the Editor
    • Authors: Daniel Levy
      Abstract: Publication date: Available online 2 February 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Daniel Levy


      PubDate: 2017-02-05T23:48:06Z
       
  • What is the Association between Left Ventricular Diastolic Dysfunction and
           Six-Minute Walk Test in Hypertensive Patients?
    • Authors: El-Sayed M. Farag; Mohammad M. Al-Daydamony; Marwa M. Gad
      Abstract: Publication date: Available online 28 January 2017
      Source:Journal of the American Society of Hypertension
      Author(s): El-Sayed M. Farag, Mohammad M. Al-Daydamony, Marwa M. Gad
      Background Heart failure (HF) is a major health problem. Hypertension is an important cause of HF. Most hypertensive patients have some degree of left ventricular (LV) diastolic dysfunction. The six-minute walk test (6MWT) provides objective data about the exercise tolerance. Aims We aimed to find the association between the degree of LV diastolic dysfunction and the functional capacity assessed by 6MWT in hypertensive patients. Patients and Methods The study included 200 asymptomatic hypertensive patients. All patients had undergone full history taking, complete clinical examination, electrocardiography, echocardiography for assessment of LV dimensions, systolic, and diastolic dysfunction, and 6MWT. Patients were classified into two groups according to the presence or absence of LV diastolic dysfunction. Results Clinical and echocardiographic data were comparable between the two groups. Regarding 6MWT, at the end of the test patients with diastolic dysfunction had significantly higher systolic (p =0.0088) and diastolic (p =0.019) blood pressure and higher Borg score for dyspnea (p <0.00001). The distant walked and percentage of the distance to predicted value were significantly lower in patients with diastolic dysfunction (p =0.0322, and 0.0002 respectively). Incidence of abnormal 6MWT was significantly higher in patients with diastolic dysfunction (p =0.00041). Patients with grade III diastolic dysfunction had significantly higher Borg score (p =0.013), lower distance walked (p =0.039), lower percentage of distance to predicted vale (p =0.009). Independent predictors for abnormal 6MWT were: E/E' ≥15 (p =0.0022), E'/A' <1 (p =0.0081), and deceleration time of E-wave <160 (p =0.013). Conclusion The presence of LV diastolic dysfunction in hypertensive patients has a bad effect on 6MWT. The degree of LV diastolic dysfunction was correlated with 6MWT results. It may be important to investigate LV diastolic function in asymptomatic hypertensive patients.

      PubDate: 2017-01-29T22:26:09Z
      DOI: 10.1016/j.jash.2017.01.004
       
  • Genetic testing helps to confirm the diagnosis and initiate appropriate
           treatment, a case of Liddle syndrome.
    • Authors: Pavel Pichurin; Garry L. Schwartz
      Abstract: Publication date: Available online 25 January 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Pavel Pichurin, Garry L. Schwartz


      PubDate: 2017-01-29T22:26:09Z
      DOI: 10.1016/j.jash.2017.01.003
       
  • Sleep, Insomnia, and Hypertension: Current Findings and Future Directions
    • Authors: S. Justin Thomas; David Calhoun
      Abstract: Publication date: Available online 29 December 2016
      Source:Journal of the American Society of Hypertension
      Author(s): S. Justin Thomas, David Calhoun
      Blood pressure (BP) varies over 24 hours. During normal sleep, BP typically decreases by 10% or more. Research suggests that disordered sleep, particularly sleep deprivation and obstructive sleep apnea, is associated with increased BP and risk of hypertension. Less is known about the relationship between insomnia and hypertension. Population-based studies have reported an association between insomnia symptoms and both prevalent and incident hypertension, particularly in the context of short sleep duration. Furthermore, a number of mechanisms have been proposed to explain the relationship between insomnia and hypertension. However, few studies have examined these proposed mechanisms and even fewer clinical trials have been conducted to determine if improved sleep improves BP and/or reverses a non-dipping BP pattern. Methodological concerns, particularly with respect to the diagnosis of insomnia, no doubt impact the strength of any observed association. Additionally, a large majority of studies have only examined the association between insomnia symptoms and clinic BP. Therefore, future research needs to focus on careful consideration of the diagnostic criteria for insomnia, as well as inclusion of either home BP or ambulatory BP monitoring. Lastly, clinical trials aimed at improving the quality of sleep should be conducted to determine if improved sleep impacts 24-hour BP.

      PubDate: 2017-01-06T17:48:07Z
      DOI: 10.1016/j.jash.2016.11.008
       
  • Schisandrin B Displays a Protective Role against Primary Pulmonary
           Hypertension by Targeting Transforming Growth Factor-β1
    • Authors: Jianjun Wu; Jing Jia; Li Liu; Fan Yang; Yuhua Fan; Sen Zhang; Dongxia Yan; Rui Bu; Guangnan Li; Yanhui Gao; Yanjun Chen
      Abstract: Publication date: Available online 28 December 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Jianjun Wu, Jing Jia, Li Liu, Fan Yang, Yuhua Fan, Sen Zhang, Dongxia Yan, Rui Bu, Guangnan Li, Yanhui Gao, Yanjun Chen
      Aims Pulmonary arterial smooth muscle cells (PASMCs) in the medial layer of the vessel wall are involved in vessel homeostasis, but also for pathologic vascular remodelling in diverse diseases, such as pulmonary arterial hypertension (PAH). Pulmonary vascular remodelling in PAH results in vascular disorders, but its underlying molecular mechanisms are still not to be fully disclosed. In this study, we investigated the expression and function of the transforming growth factor TGF-β1 in human PASMC cultured under the condition of hypoxia and elucidated the effect of schisandra chinensis and its active ingredients on proliferation, migration and apoptosis in human PASMCs. Methods and Results We demonstrated that Sch.B alleviated the severity of pulmonary arterial hypertension in PASMCs cultured under the condition of hypoxia. Significant upregulation of TGF-β1 was observed in hypoxia-induced human PASMCs. Interestingly, administration of Sch.B substantially attenuated TGF-β1 level in these PASMCs. In order to elucidate Sch.B function, the hypoxia-induced human PASMC were stimulated with Sch.B, or co-treatment with TGF-β1 in vitro. In agreement with its TGF-β1-reducing effect, Sch B relieved human PASMCs migration and promoted the apoptosis of human PASMCs, by activation of TGF-β1 downstream signal pathways in PASMCs. In contrast, co-treatment with TGF-β1 promoted humanPASMC proliferation and migration and inhibited the apoptosis of human PASMC, which can attnuate the protective role of Sch.B in human PASMC. Conclusion Taken collectively, these findings suggest that the vascular relaxation evoked by Sch.B was mediated by direct effect on vascular smooth muscle cell via TGF-β1 downstream signal pathways.

      PubDate: 2017-01-06T17:48:07Z
      DOI: 10.1016/j.jash.2016.12.007
       
  • From the Editor
    • Authors: Daniel Levy
      Abstract: Publication date: Available online 24 December 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Daniel Levy


      PubDate: 2016-12-27T14:12:44Z
       
  • Assessment of vascular function in low socioeconomic status preschool
           children: A pilot study
    • Authors: Lama Ghazi; Tanja Dudenbostel; Daisy Xing; Deborah Ejem; Anne Turner-Henson; Cynthia Irwin Joiner; Olivia Affuso; Andres Azuero; Suzanne Oparil; David A. Calhoun; Marti Rice; Fadi G. Hage
      Abstract: Publication date: Available online 24 December 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Lama Ghazi, Tanja Dudenbostel, Daisy Xing, Deborah Ejem, Anne Turner-Henson, Cynthia Irwin Joiner, Olivia Affuso, Andres Azuero, Suzanne Oparil, David A. Calhoun, Marti Rice, Fadi G. Hage
      Objective Elevated brachial blood pressure (BP) in childhood tracks into adulthood. Central BP and measures of arterial stiffness, such as aortic augmentation index (AIx) and pulse wave velocity (PWV), have been associated with future cardiovascular disease (CVD). This pilot study assessed the feasibility of non-invasively measuring these parameters in preschool children and explored factors that may be associated with elevated BP in this age group.Methods: Brachial BP was measured using an electronic oscillometric unit (Dinamap PRO 100) and defined as elevated when systolic (SBP) and/or diastolic (DBP) BP was ≥ the 90th percentile for age, gender, and height. Central BP, AIx, and PWV were measured using applanation tonometry (SphygmoCor). C-reactive protein (CRP) was measured in serum samples.Results: Sixteen African American preschool children were recruited (4.4±0.8 years, 69% males), 6 (38%) of whom had an elevated brachial BP (110±10/69±4 vs. 96±8/55±6 mm Hg, Cohen’s d=2.2). Children with elevated brachial BP had higher central SBP (d=1.6) and DBP (d=1.96) (97±6/68±4 vs. 85±8/57±6 mm Hg), AIx (d=0.88) (31±8 vs.18±16%, standardized to heart rate) and CRP (3.1[2.3-6.3] vs. 0.1[0.1-0.3] mg/L, d=2). There was no significant difference in PWV between groups (d=0.26). CRP and SBP (Spearman r=0.70), DBP (r=0.68), central SBP (r=0.58), and central DBP (r=0.71) were positively correlated. Wide confidence intervals for the estimated effect sizes indicated a large degree of uncertainty about all estimates due to the small sample size. Conclusion Non-invasive assessment of central BP and arterial stiffness is feasible in preschool children. Vascular inflammation may be an important factor that influences BP at an early age. Further studies in preschool children are needed to elucidate mechanisms of early onset hypertension.

      PubDate: 2016-12-27T14:12:44Z
      DOI: 10.1016/j.jash.2016.12.006
       
  • A Cross-Sectional Study of Physical Activity and Arterial Compliance: The
           Effects of Age and Artery Size
    • Authors: A. Maleah Holland; Jeffrey S. Martin; Christopher D. Mattson; Keith R. Lohse; Peter R. Finn; Joel M. Stager
      Abstract: Publication date: Available online 22 December 2016
      Source:Journal of the American Society of Hypertension
      Author(s): A. Maleah Holland, Jeffrey S. Martin, Christopher D. Mattson, Keith R. Lohse, Peter R. Finn, Joel M. Stager
      Our study examined the relationship between habitual high levels of vigorous physical activity on large and small artery compliance via radial artery pulse wave analysis. Eighty-three healthy men (n=44) and women (n=39), aged 18-78 years, were recruited as habitually less active (light to moderate exercise ≤3 times/wk), or habitually highly active (vigorous exercise ≥5 times/wk). A multivariate ANOVA revealed a significant interaction of Age, and Activity level; habitual vigorous activity was associated with greater compliance in large and small arteries in older adults (40-78 years) and younger adults (18-22 years). In the large and small arteries, we observed an age-associated decrease in arterial compliance (aged > 40 years), though it appears to be less pronounced in the large artery amongst habitually highly active subjects. This study suggests that aging may be associated with declines in large and small artery compliance that can be attenuated by habitual vigorous activity.

      PubDate: 2016-12-27T14:12:44Z
      DOI: 10.1016/j.jash.2016.12.005
       
  • Olmesartan with azelnidipine versus with trichlormethiazide on home blood
           pressure variability in patients with type 2 diabetes mellitus
    • Authors: Emi Ushigome; Shinobu Matsumoto; Chikako Oyabu; Hidetaka Ushigome; Isao Yokota; Goji Hasegawa; Naoto Nakamura; Muhei Tanaka; Masahiro Yamazaki; Michiaki Fukui
      Abstract: Publication date: Available online 22 December 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Emi Ushigome, Shinobu Matsumoto, Chikako Oyabu, Hidetaka Ushigome, Isao Yokota, Goji Hasegawa, Naoto Nakamura, Muhei Tanaka, Masahiro Yamazaki, Michiaki Fukui
      The aim of the present study was to compare the effects of olmesartan combined with azelnidipine, versus olmesartan combined with trichlormethiazide, on home blood pressure and pressure variability in type 2 diabetes mellitus patients using home blood pressure telemonitoring system. We performed an open-label cross-over pilot study of 28 patients with type 2 diabetes mellitus. Patients received combination treatment with either olmesartan 20mg plus azelnidipine 16mg or olmesartan 20mg plus trichlormethiazide 1mg for more than 6 weeks each in a cross-over method. The coefficient of morning systolic blood pressure variability in the olmesartan plus azelnidipine group was significantly lower than that in the olmesartan plus trichlormethiazide group (6.4 ± 1.9 versus 7.5 ± 2.6, P = 0.004). There were no significant differences in mean morning systolic blood pressure between the two groups. Using home blood pressure telemonitoring for hypertensive patients with type 2 diabetes, this study revealed for the first time that the olmesartan with azelnidipine combination is superior to the olmesartan with trichlormethiazide combination in reducing home blood pressure variability.

      PubDate: 2016-12-27T14:12:44Z
      DOI: 10.1016/j.jash.2016.12.004
       
  • Does SPRINT support a change in blood pressure targets? The importance of
           two implicit assumptions and blood pressure measurement methods
    • Authors: Brent M. Egan
      Abstract: Publication date: Available online 18 December 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Brent M. Egan


      PubDate: 2016-12-19T13:15:02Z
      DOI: 10.1016/j.jash.2016.12.001
       
  • An Exploratory Propensity-Score Matched Comparison of Second-Generation
           and First-Generation Baroreflex Activation Therapy Systems
    • Authors: Rolf Wachter; Marcel Halbach; George L. Bakris; John D. Bisognano; Hermann Haller; Joachim Beige; Abraham A. Kroon; Mitra K. Nadim; Eric G. Lovett; Jill E. Schafer; Peter W. de Leeuw
      Abstract: Publication date: Available online 16 December 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Rolf Wachter, Marcel Halbach, George L. Bakris, John D. Bisognano, Hermann Haller, Joachim Beige, Abraham A. Kroon, Mitra K. Nadim, Eric G. Lovett, Jill E. Schafer, Peter W. de Leeuw
      Background Baroreflex activation therapy (BAT) is a device-based therapy for patients with treatment-resistant hypertension. In a randomized, controlled trial the first-generation system significantly reduced blood pressure (BP) versus sham. Although an open-label validation study of the second-generation system demonstrated similar BP reductions, controlled data are not presently available. Therefore, this investigation compares results of first- and second-generation BAT systems. Methods Two cohorts of first-generation BAT system patients were generated with propensity-matching to compare against the validation group of 30 second-generation subjects. The first cohort was drawn from the first-generation randomized trial sham group and the second cohort from the active therapy group. Safety and efficacy were compared for the second-generation group relative to the first-generation. Results At 6 months, second-generation BAT outperformed first-generation sham systolic BP reduction by 20 ± 28 mmHg (mean ± SD, p=0.008), while BP reduction in first and second-generation active groups were similar. At 12 months, efficacy was comparable between all three groups after the sham group had received 6 months of therapy. 47% of second-generation patients achieved goal systolic BP of 140 mmHg or less after 12 months, comparable to 50% of patients at goal in the first-generation group (p>0.999). Implant procedure time, system/procedural safety and pulse generator longevity improved with the second-generation system. Conclusions Propensity-matched cohort analysis of the first- and second-generation BAT systems suggest similar therapeutic benefit and superior BP reduction of the second-generation system relative to sham control. Implantation procedure duration and perioperative safety were improved with the second-generation device. These findings should be validated in a prospective randomized trial.

      PubDate: 2016-12-19T13:15:02Z
      DOI: 10.1016/j.jash.2016.12.003
       
  • icotinamide Nucleotide Transhydrogenase (Nnt) Activity Impacts
           Mitochondrial Redox Balance and the Development of Hypertension in mice.
    • Authors: Igor Leskov; Amber Neville; Xinggui Shen; Sibile Pardue; Christopher G. Kevil; D. Neil Granger; David M. Krzywanski
      Abstract: Publication date: Available online 16 December 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Igor Leskov, Amber Neville, Xinggui Shen, Sibile Pardue, Christopher G. Kevil, D. Neil Granger, David M. Krzywanski
      Oxidant stress contributes to the initiation and progression of hypertension (HTN) by enhancing endothelial dysfunction and/or causing perturbations in nitric oxide (•NO) homeostasis. Differences in mitochondrial function may augment this process and provide insight into why age of onset and clinical outcomes differ amongst individuals from distinct ethnic groups. We have previously demonstrated that variation in normal mitochondrial function and oxidant production exist in endothelial cells from individuals of Caucasian and African American ethnicity and that this variation contributes to endothelial dysfunction. To model these distinct mitochondrial redox phenotypes we used the C57Bl/6N (6N) and C57Bl/6J (6J) that also display unique mitochondrial functional properties due to the differential expression nicotinamide nucleotide transhydrogenase (NNT). We demonstrate that the absence of NNT in 6J cells led to distinct mitochondrial bioenergetic profiles and a pro-oxidative mitochondrial phenotype characterized by increased superoxide production and reduced glutathione peroxidase activity. Interestingly, we found that 6J animals have significantly higher systolic blood pressure compared to 6N animals and this difference is exacerbated by angiotensin II (Ang II) treatment. The changes in pressure were accompanied by both mitochondrial and vascular dysfunction revealed by impaired respiratory control ratios and endothelial dependent vessel dilation. All endpoints could be significantly ameliorated by treatment with the mitochondria targeted superoxide dismutase mimetic MitoTEMPO demonstrating a critical role for the production of mitochondrial reactive oxygen species in the development of hypertension in these animals. Taken together, these data indicate that the absence of NNT leads to variation in mitochondrial function and contributes to a unique mitochondrial redox phenotype that influences susceptibility to HTN by contributing to endothelial and vascular dysfunction.
      Graphical abstract image

      PubDate: 2016-12-19T13:15:02Z
      DOI: 10.1016/j.jash.2016.12.002
       
  • Medication adherence as a potential confounder in device trials of
           resistant hypertension
    • Authors: Michael J. Bloch
      Abstract: Publication date: Available online 12 December 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Michael J. Bloch


      PubDate: 2016-12-19T13:15:02Z
      DOI: 10.1016/j.jash.2016.11.006
       
  • Increased plasma RBP4 concentration in older hypertensives is related to
           the decreased kidney function and the number of antihypertensive drugs –
           results from the Polsenior substudy
    • Authors: Marcin Majerczyk; Piotr Choręza; Maria Bożentowicz-Wikarek; Aniceta Brzozowska; Habibullah Arabzada; Aleksander Owczarek; Małgorzata Mossakowska; Tomasz Grodzicki; Tomasz Zdrojewski; Andrzej Więcek; Magdalena Olszanecka-Glinianowicz; Jerzy Chudek
      Abstract: Publication date: Available online 7 December 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Marcin Majerczyk, Piotr Choręza, Maria Bożentowicz-Wikarek, Aniceta Brzozowska, Habibullah Arabzada, Aleksander Owczarek, Małgorzata Mossakowska, Tomasz Grodzicki, Tomasz Zdrojewski, Andrzej Więcek, Magdalena Olszanecka-Glinianowicz, Jerzy Chudek
      Background Increased plasma retinol-binding protein 4 (RBP4), a novel adipokine, has been associated in previous studies with obesity, type 2 diabetes, dyslipidemia, hypertension, atherosclerosis and coronary artery disease. This study aimed to analyze the relationship between hypertension occurrence and its treatment, and plasma RBP4 concentrations in the older polish population. Methods The study sample consisted of 1728 (890 men, 838 women) PolSenior study participants aged 65 years and older with available plasma samples and NT-proBNP values below 2000 pg/mL. The analysis included BMI, waist circumference, blood pressure, antihypertensive medication, estimated glomerular filtration rate (eGFR), serum glucose and insulin (and HOMA-IR), and plasma RBP4 levels. Results RBP4 plasma concentrations were higher in hypertensive (N=645) than normotensive (N=236) men [43.4 (30.4 – 64.8) vs.38.1 (27.1 – 54.4) ng/mL, respectively; p < 0.01] but not in women [44.6 (29.6 – 63.5) vs. 40.7 (29.1 – 58.1) ng/mL, respectively; p=0.21]. In the sub-analysis, higher plasma RBP4 levels were observed in women with treated than untreated hypertension, and in subjects taking 4 of more antihypertensive drugs. The linear regression shown that eGFR (β = -0.015), thiazide diuretics (β = 0.041) and α-blockers (β = 0.049) were explaining log10RBP4 plasma levels variability in the study group. Conclusions Older male Caucasians with hypertension are characterized by elevated plasma RBP4 levels. This increase is proportional to the number of antihypertensive drugs and decreased glomerular filtration rate. Among the antihypertensive drugs only thiazide diuretics and α-blockers had a significant influence on RBP4 levels.

      PubDate: 2016-12-12T12:21:05Z
      DOI: 10.1016/j.jash.2016.11.009
       
  • From the Editor
    • Authors: Daniel Levy
      Abstract: Publication date: December 2016
      Source:Journal of the American Society of Hypertension, Volume 10, Issue 12
      Author(s): Daniel Levy


      PubDate: 2016-12-12T12:21:05Z
       
  • Redefining beta-blocker use in hypertension: Selecting the right
           beta-blocker and the right patient
    • Authors: Samuel Mann
      Abstract: Publication date: Available online 5 December 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Samuel Mann
      Randomized controlled trials have concluded that the cardiovascular outcome of first-step treatment of hypertension with traditional vasoconstricting beta-blockers is inferior to treatment with other antihypertensive drug classes. Beta-blocker use is also associated with undesireable side effects. Consequently, some recent guidelines consider beta-blockers an inferior option for first-step treatment of hypertension. Despite this, beta-blockers are still widely prescribed, and likely overused, in the management of hypertension. It is the contention of this perspective that beta-blockers do have an important role in treating hypertension, but their use needs to be much better targeted, by better identification of both the right patient and the right beta-blocker. Identifying the right patient involves consideration of underlying mechanisms of hypertension. In the absence of co-morbidities for which a beta-blocker is indicated, beta-blockers would not seem to be the preferred treatment for patients with either sodium/volume-mediated hypertension, for which they are usually ineffective, or for those with renin-angiotensin system-mediated hypertension, for which angiotensin-converting enzyme inhibitors and angiotensin receptor blockers provide equal antihypertensive efficacy with evidence of better outcome and fewer adverse effects. Beta-blockers would instead appear to be best suited for patients with sympathetically-driven, i.e., neurogenic, hypertension, whether as a first-step drug, such as in patients with hypertension in the acute post-stroke period, in so-called “hyperkinetic” patients, and in patients with labile hypertension, or as an add-on drug in patients with resistant hypertension. In choosing among the beta-blockers, combined alpha/beta-blockade offers advantages over beta-blocker monotherapy, and merits greater clinical and research attention. Finally, unreliable bioavailability greatly interferes with the effectiveness of lipophilic, but not nonlipophilic, beta-blockers. Clinical effectiveness could be improved with greater focus on the beta-blockers with the more favorable pharmacokinetics.

      PubDate: 2016-12-05T11:36:04Z
      DOI: 10.1016/j.jash.2016.11.007
       
  • Extended Consensus on Blood Pressure Variability beyond Blood Pressure for
           Management of Hypertension
    • Authors: Ram B. Singh; Krasimira Hristova; Geir Bjørklund; Jan Fedacko; Salvatore Chirumbolo; Daniel Pella
      Abstract: Publication date: Available online 25 November 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Ram B. Singh, Krasimira Hristova, Geir Bjørklund, Jan Fedacko, Salvatore Chirumbolo, Daniel Pella


      PubDate: 2016-11-28T06:04:04Z
      DOI: 10.1016/j.jash.2016.11.005
       
  • Race-ethnicity on Blood Pressure Control after Ischemic Stroke: A
           Prospective Cohort Study
    • Authors: Mai N. Nguyen-Huynh; Nancy K. Hills; Stephen Sidney; Jeffrey Klingman; S. Claiborne Johnston
      Abstract: Publication date: Available online 17 November 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Mai N. Nguyen-Huynh, Nancy K. Hills, Stephen Sidney, Jeffrey Klingman, S. Claiborne Johnston
      Disparities in healthcare access and socio-economic status (SES) have been associated with racial-ethnic differences in blood pressure (BP) control. We examined post-ischemic stroke BP in a multi-ethnic cohort with good healthcare access. We included all hypertensive patients (n=2972) from a randomized quality improvement trial on secondary stroke prevention, conducted in 14 Kaiser Permanente hospitals in Northern California from 2004-2006 (QUISP). Average age 73.2 ±12.2 years; 52% female, 66% non-Hispanic white, 14% African-American, 11% Asian, 8% Hispanic, and 1% other. Demographics, diagnoses, health care utilization, BP measurements and medications were obtained as part of routine care. We used random effects logistic regression models to examine race as a predictor of blood pressure control (<140/90 mmHg) at 6 months post-discharge, adjusted for SES, age, gender, dementia, antihypertensive therapy, and attendance at follow-up visits. At 6 months, BP was controlled in 52.7% of blacks compared to 61.4% of whites (OR=0.63, 95% CI 0.48-0.82, p=0.001). Black race remained independently associated with poorer BP control in adjusted analysis, even though blacks were as likely to attend post-discharge visits, and more likely to be on any antihypertensive therapy, than whites. Greater difficulty in controlling BP and lifestyle differences may account for this difference.

      PubDate: 2016-11-21T03:45:33Z
      DOI: 10.1016/j.jash.2016.11.002
       
  • Sensitive detection of hemodynamic failure during orthostatic stress in
           patients with diabetic polyneuropathy using a mini laser Doppler blood
           flowmeter
    • Authors: Masaki Goma; Masahiro Kaneshige; Sayaka Ichijo; Masashi Ichijo; Hideo Shindo; Nobuyuki Terada; Hiroshi Yokomichi; Zentaro Yamagata; Kenichiro Kitamura; Hiroki Shimura; Tetsuro Kobayashi
      Abstract: Publication date: Available online 17 November 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Masaki Goma, Masahiro Kaneshige, Sayaka Ichijo, Masashi Ichijo, Hideo Shindo, Nobuyuki Terada, Hiroshi Yokomichi, Zentaro Yamagata, Kenichiro Kitamura, Hiroki Shimura, Tetsuro Kobayashi
      Autonomic dysfunction in diabetes is serious but often underestimated. The purpose of this study was to evaluate hemodynamics within the important initial phase just after standing, which cannot be evaluated by conventional instruments for orthostatic hypotension. Earlobe blood flow, which indirectly reflects the blood pressure response on standing, was evaluated using a mini laser Doppler flowmeter during standing from the sitting position in 58 healthy controls and 56 diabetic patients categorized as without (11), mild (27), and advanced diabetic polyneuropathy (18). The response-area of the earlobe blood flow waveform within 30 seconds after standing was calculated. An increased response-area indicates poor recovery of earlobe blood flow. Response-area increased significantly with the degree of neuropathy (P<0.001 for linear trend). Orthostatic hypotension was detected in two patients in the mild neuropathy group. The present approach may be sensitive and practical for detecting autonomic dysfunction not detected with the conventional orthostatic test.

      PubDate: 2016-11-21T03:45:33Z
      DOI: 10.1016/j.jash.2016.11.003
       
  • The risk of developing cardiovascular disease in Bangladesh: Does diabetes
           mellitus matter? Which socio-economic status does it impact? A cross
           sectional study
    • Authors: G.M. Rabiul Islam
      Abstract: Publication date: Available online 17 November 2016
      Source:Journal of the American Society of Hypertension
      Author(s): G.M. Rabiul Islam
      Objectives The elevation of blood pressure levels has been recognized as a determinant of the risk for several common cardiovascular diseases. This work explores the evidence of disparities in the form of association between hypertension and diabetes mellitus in different socio-economic statuses (SES) at household level. Methods A population sample of 7,561 individuals aged 35 years or older from the 2011 Bangladesh Demographic Health Survey (BDHS) was used for this study. A concentration indexes are used to measure the disparities of myocardial infarction and diabetes mellitus with SES. A two level hierarchical logit model was used to examine the effects of participants and household SES accompanied by other explanatory variables on having hypertension. Then, the analysis is stratified by SES groups to examine how the overall effect of diabetes mellitus on hypertension may vary with SES. Finally, predictive margins are determined to understand the predictive probability of diabetes and SES of having hypertension as a risk factor of developing cardiovascular disease. Results The descriptive summary measures of SES inequality indicate that prevalence of hypertension and diabetes were higher among high SES. The multivariate analysis covering all samples reveals that there is a strong association between diabetes and hypertension (p<0.01). Likewise, after stratifying, it is evident that in high SES there is a strong association between individuals with diabetes mellitus and hypertension development; they have around four-fold higher chance of being affected by hypertension in comparison to individuals with normal fasting plasma glucose (p<0.01). Moreover, there are strong associations between individuals in low and medium SES having diabetes and having hypertension (p<0.01): the likelihood of having hypertension is around double compared to individuals who have no diabetes. The result of this study also shed light on the chance of an increase in prevalence of hypertension in pre-diabetes individuals and in medium and high SES groups, though the association is statistically insignificant (p>0.05). Finally, the predictive analysis reveals that the predictive margin of having hypertension is high amongst individuals belonging to the high SES (23%; CI:20-23) and diabetic patients with high SES (37%; CI:33-47). Conclusions Contrary to other developed countries, hypertension in Bangladesh is prevalent among all SES, and the likelihood is high among diabetic patients in the medium and high SES. Hence, urgent preventive measures are needed to control the impending comorbidity of diabetes and developing cardiovascular disease risk.

      PubDate: 2016-11-21T03:45:33Z
      DOI: 10.1016/j.jash.2016.11.001
       
  • Electrocardiographic Measures of Left Ventricular Hypertrophy in the
           Antihypertensive and Lipid-Lowering to Prevent Heart Attack Trial
    • Authors: Michael E. Ernst; Barry R. Davis; Elsayed Z. Soliman; Ronald J. Prineas; Peter M. Okin; Alokananda Ghosh; William C. Cushman; Paula T. Einhorn; Suzanne Oparil; Richard H. Grimm
      Abstract: Publication date: Available online 9 November 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Michael E. Ernst, Barry R. Davis, Elsayed Z. Soliman, Ronald J. Prineas, Peter M. Okin, Alokananda Ghosh, William C. Cushman, Paula T. Einhorn, Suzanne Oparil, Richard H. Grimm
      Left ventricular hypertrophy (LVH) predicts cardiovascular risk in hypertensive patients. We analyzed baseline/follow-up ECGs in 26,376 ALLHAT participants randomized to amlodipine (A), lisinopril (L), or chlorthalidone (C). Prevalent/incident LVH were examined using continuous and categorical classifications of Cornell voltage. At 2- and 4-years, prevalence of LVH in the C-group (5.57%; 6.14%) was not statistically different from A-group (2-years: 5.47%; p=0.806, 4-years: 6.54%; p=0.857), or L-group (2-years: 5.64%; p=0.857, 4-years: 6.50%; p=0.430). Incident LVH followed similarly, with no difference at 2-years for C (2.99%) compared to A (2.57%; p=0.173) or L (3.16%; p=0.605), and at 4-years (C=3.52%, A=3.29%, L=3.71%; p=0.521 C vs A, p=0.618 C vs L). Mean Cornell voltage decreased comparably across treatment groups (Δ baseline, 2-years = +3 to -27 μV, ANOVA p=0.8612; 4-years = +10 to -17 μV, ANOVA p=0.9692). We conclude that risk reductions associated with C treatment in secondary endpoints of ALLHAT cannot be attributed to differential improvements in ECG LVH.

      PubDate: 2016-11-14T00:40:24Z
      DOI: 10.1016/j.jash.2016.10.010
       
  • Effect of Placebo groups on Blood Pressure in Hypertension: A
           Meta-Analysis of beta-blocker trials
    • Authors: Marcel Wilhelm; Alexander Winkler; Winfried Rief; Bettina K. Doering
      Abstract: Publication date: Available online 5 November 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Marcel Wilhelm, Alexander Winkler, Winfried Rief, Bettina K. Doering
      Hypertension is often treated pharmacologically. Since there is evidence that the cardiovascular system is sensitive to placebo mechanisms, our aim was to conduct an effect size analysis of placebo groups in double-blinded randomized controlled parallel-group drug trials using beta-blockers to treat hypertensive patients. A comprehensive literature search via PubMed, PsycINFO, PSYNDEX, PQDT OPEN, OpenGREY, ISI Web of Knowledge, and the WHO International Clinical Trials Registry Platform provided the basis of our meta-analysis. Effect sizes were estimated using a random effects model based on 23 studies covering a total of 11,067 participants. Main outcomes were systolic and diastolic blood pressure. Blood pressure was lowered in placebo groups with significant and robust effect sizes (Hedges’ g). The estimates for systolic blood pressure (-0.27, p <.001) and diastolic blood pressure (-0.49, p <.001) can be interpreted as small to moderate. The placebo response accounted for 34% of the drug response for systolic blood pressure, and 47% of the drug response for diastolic blood pressure. Our moderator analyses indicated that a higher study quality and more study site visits were marginally associated with a higher placebo response. In light of these strong placebo responses, placebo mechanisms need to be considered in order to improve antihypertensive treatment.

      PubDate: 2016-11-06T22:58:07Z
      DOI: 10.1016/j.jash.2016.10.009
       
  • Evaluating the risk of hypertension according to the metabolic health
           status stratified by degree of obesity
    • Authors: Jae-Hong Ryoo; Sung Keun Park; Chang-Mo Oh; Young-Jun Choi; Ju Youn Chung; Woo Taek Ham; Taegi Jung
      Abstract: Publication date: Available online 2 November 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Jae-Hong Ryoo, Sung Keun Park, Chang-Mo Oh, Young-Jun Choi, Ju Youn Chung, Woo Taek Ham, Taegi Jung
      Despite the accumulated evidence showing the significant association between hypertension and obesity, it remains unclear how metabolic healthy status of obesity have an impact on the development of hypertension. Thus, this study was to investigate the risk of hypertension according to the metabolic healthy status stratified by the degree of obesity. A cohort of 25,442 Korean men without hypertension at baseline was followed-up from 2005 to 2010. They were divided into the following 6 phenotypes according to their baseline metabolic health and obesity status: metabolically healthy normal weight (MH-NW), metabolically healthy overweight (MH-OW), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MU-NW), metabolically unhealthy overweight (MU-OW), and metabolically unhealthy obese (MUO). Cox proportional hazard model was used to evaluate the risk for hypertension according to the metabolically healthy status stratified by degree of obesity. During 91,256.4 person-years of follow-up, 4,633 participants (18.2%) developed hypertension. The adjusted hazard ratios (95% confidence intervals) for hypertension in MH-OW, MHO, MU-NW, MU-OW, and MUO phenotypes compared with MH-NW phenotype were 1.13 (1.04 – 1.23), 1.43 (1.15 – 1.69), 1.17 (1.02 – 1.34), 1.49 (1.27 – 1.72), and 1.54 (1.36 –1 .88), respectively. The interaction between metabolically healthy status and degree of obesity was not significant (P for interaction = 0.29). Compared with MH-NW, both the obese phenotype and metabolically unhealthy phenotype independently had an increased risk for hypertension. These results imply that both metabolic health status and obesity status play important roles independently in the risk of hypertension in Korean men.

      PubDate: 2016-11-06T22:58:07Z
      DOI: 10.1016/j.jash.2016.10.006
       
  • Total Antihypertensive Therapeutic intensity score and its relationship to
           Blood Pressure Reduction
    • Authors: Phillip Levy; Robina Josiah Willock; Michael Burla; Aaron Brody; James Mahn; Alexander Marinica; Samar A. Nasser; John Flack
      Abstract: Publication date: Available online 28 October 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Phillip Levy, Robina Josiah Willock, Michael Burla, Aaron Brody, James Mahn, Alexander Marinica, Samar A. Nasser, John Flack
      Predicting blood pressure (BP) response to antihypertensive therapy is challenging. The therapeutic intensity score (TIS) is a summary measure that accounts for the number of medications and the relative doses a patient received, but its relationship to BP change, and its utility as a method to project dosing equivalence has not been reported. We conducted a prospective, single center, randomized controlled trial to compare the effects of Joint National Committee (JNC) 7 compliant treatment with more intensive (< 120/80 mm Hg) BP goals, on left ventricular structure and function in hypertensive patients with echocardiographically determined subclinical heart disease who were treated over a 12-month period. For this preplanned subanalysis, we sought to compare changes in BP over time with changes in TIS. Antihypertensive therapy was open label. TIS and BP were determined at 3-month intervals with titration of medication doses as needed to achieve targeted BP. Mixed linear models defined antihypertensive medication TIS as an independent variable and change in systolic BP as an outcome measure, while controlling for gender, age, baseline BP, and treatment group. 123 patients (mean age 49.4 ± 8.2 years; 66% female; 95.1% African American) were enrolled and 88 completed the protocol. For each single point increase in total antihypertensive TIS, a 14.5 (95% CI 11.5, 17.4) mm Hg decrease in systolic BP was noted (15.5 [95% CI 13.0, 18.0] mm Hg for those who completed the trial). Total TIS is a viable indicator of the anticipated BP lowering effect associated with antihypertensive therapy.

      PubDate: 2016-10-30T21:13:11Z
      DOI: 10.1016/j.jash.2016.10.005
       
  • Unfounded Concerns about the Use of Automated Office Blood Pressure
           Measurement in SPRINT
    • Authors: Martin G. Myers; Norm R.C. Campbell
      Abstract: Publication date: Available online 21 October 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Martin G. Myers, Norm R.C. Campbell
      SPRINT reported significantly fewer cardiovascular events when patients with a higher cardiovascular risk were treated to a target systolic blood pressure (BP) of <120 versus <140 mmHg. In SPRINT, BP was recorded using the automated office BP method, with multiple readings being taken automatically with the patient resting alone. This technique for BP measurement eliminates the white coat effect and gives lower BP readings than conventional manual office BP. Critics have questioned if the readings were actually taken with the subject alone and have expressed concerns about the time taken to obtain the readings and the cost of automated sphygmomanometers. Others have suggested that the findings in SPRINT can be applied to current clinical practice if a correction factor is used to convert conventional BP readings to automated office BP. This article responds to these criticisms and explains why current methods for recording BP in clinical practice should be changed to automated office BP, the technique for BP measurement used in SPRINT.

      PubDate: 2016-10-30T21:13:11Z
      DOI: 10.1016/j.jash.2016.10.003
       
 
 
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