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  Subjects -> HISTORY (Total: 1075 journals)
    - HISTORY (738 journals)
    - History (General) (46 journals)
    - HISTORY OF AFRICA (39 journals)
    - HISTORY OF ASIA (35 journals)
    - HISTORY OF AUSTRALASIA AND OTHER AREAS (8 journals)
    - HISTORY OF EUROPE (106 journals)
    - HISTORY OF THE AMERICAS (90 journals)
    - HISTORY OF THE NEAR EAST (13 journals)

HISTORY (738 journals)            First | 1 2 3 4 5 6 7 8 | Last

History in Africa     Full-text available via subscription   (Followers: 6)
History of CERN     Full-text available via subscription   (Followers: 1)
History of Education Quarterly     Hybrid Journal   (Followers: 3)
History of Education Review     Hybrid Journal   (Followers: 2)
History of Education: Journal of the History of Education Society     Hybrid Journal   (Followers: 11)
History of European Ideas     Hybrid Journal   (Followers: 18)
History of Political Thought     Full-text available via subscription   (Followers: 14)
History of Psychology     Full-text available via subscription   (Followers: 5)
History of Religions     Full-text available via subscription   (Followers: 24)
History of Science     Full-text available via subscription   (Followers: 12)
Holocaust and Genocide Studies     Hybrid Journal   (Followers: 13)
Hortus Artium Medievalium     Full-text available via subscription   (Followers: 4)
HSE - Social and Education History     Open Access  
IEEE Annals of the History of Computing     Full-text available via subscription   (Followers: 9)
IKON     Full-text available via subscription   (Followers: 4)
Il Capitale Culturale. Studies on the Value of Cultural Heritage     Open Access   (Followers: 3)
ILCEA     Open Access   (Followers: 1)
Illawarra Unity - Journal of the Illawarra Branch of the Australian Society for the Study of Labour History     Open Access   (Followers: 2)
Images re-vues : histoire, anthropologie et théorie de l'art     Open Access  
Imago Mundi: The International Journal for the History of Cartography     Hybrid Journal   (Followers: 7)
Immigrants & Minorities     Hybrid Journal   (Followers: 7)
Indian Economic & Social History Review     Hybrid Journal   (Followers: 4)
Indonesia and the Malay World     Hybrid Journal   (Followers: 3)
Inner Asia     Full-text available via subscription   (Followers: 2)
Intellectual History Review     Hybrid Journal   (Followers: 14)
Interaction     Full-text available via subscription   (Followers: 2)
Intermédialités : histoire et théorie des arts, des lettres et des techniques / Intermedialities: History and Theory of the Arts, Literature and Techniques     Full-text available via subscription   (Followers: 2)
International Journal of Asian Studies     Hybrid Journal   (Followers: 7)
International Journal of Iberian Studies     Hybrid Journal   (Followers: 3)
International Journal of Middle East Studies     Hybrid Journal   (Followers: 126)
International Journal of Society Systems Science     Hybrid Journal  
International Journal of Sustainable Society     Hybrid Journal   (Followers: 7)
International Politics     Partially Free   (Followers: 14)
International Review of Social History     Full-text available via subscription   (Followers: 17)
INTRECCI d'arte     Open Access   (Followers: 5)
Iran and the Caucasus     Full-text available via subscription   (Followers: 6)
Irish Studies Review     Hybrid Journal   (Followers: 12)
Isis     Full-text available via subscription   (Followers: 10)
Israel Studies Forum     Full-text available via subscription  
Italianist, The     Hybrid Journal   (Followers: 1)
Itinerari di ricerca storica     Open Access  
Japanese Studies     Hybrid Journal   (Followers: 4)
Jewish Culture and History     Hybrid Journal   (Followers: 8)
Journal Asiatique     Full-text available via subscription   (Followers: 4)
Journal for Contemporary History     Full-text available via subscription   (Followers: 10)
Journal for Early Modern Cultural Studies     Full-text available via subscription   (Followers: 12)
Journal for Maritime Research     Hybrid Journal   (Followers: 7)
Journal for the Study of Judaism     Full-text available via subscription   (Followers: 9)
Journal for the Study of Radicalism     Full-text available via subscription   (Followers: 5)
Journal of Aging, Humanities, and the Arts: Official Journal of the Gerontological Society of America     Hybrid Journal   (Followers: 4)
Journal of American History     Hybrid Journal   (Followers: 19)
Journal of American Studies     Hybrid Journal   (Followers: 11)
Journal of American-East Asian Relations     Full-text available via subscription  
Journal of Arts Management, Law, and Society     Full-text available via subscription   (Followers: 6)
Journal of Australian Colonial History     Full-text available via subscription   (Followers: 6)
Journal of Australian Naval History, The     Full-text available via subscription   (Followers: 4)
Journal of Baltic Studies     Hybrid Journal   (Followers: 3)
Journal of British Studies     Full-text available via subscription   (Followers: 22)
Journal of Canadian Studies/Revue d'études canadiennes     Full-text available via subscription   (Followers: 2)
Journal of Cognitive Historiography     Full-text available via subscription  
Journal of Colonialism and Colonial History     Full-text available via subscription   (Followers: 7)
Journal of Conflict Studies     Full-text available via subscription   (Followers: 11)
Journal of Contemporary Asia     Hybrid Journal   (Followers: 1)
Journal of Contemporary China     Hybrid Journal   (Followers: 5)
Journal of Contemporary History     Hybrid Journal   (Followers: 16)
Journal of Coptic Studies     Full-text available via subscription   (Followers: 5)
Journal of Cuneiform Studies     Full-text available via subscription   (Followers: 4)
Journal of Early Modern History     Full-text available via subscription   (Followers: 20)
Journal of East Asian Linguistics     Hybrid Journal   (Followers: 3)
Journal of Ecclesiastical History     Hybrid Journal   (Followers: 16)
Journal of English and Germanic Philology (JEGP)     Full-text available via subscription   (Followers: 7)
Journal of European Studies     Hybrid Journal   (Followers: 18)
Journal of Family History     Hybrid Journal   (Followers: 13)
Journal of Global History     Full-text available via subscription   (Followers: 13)
Journal of Historical Geography     Hybrid Journal   (Followers: 14)
Journal of Historical Pragmatics     Full-text available via subscription   (Followers: 2)
Journal of Historical Research in Marketing     Hybrid Journal   (Followers: 3)
Journal of Iberian and Latin American Studies     Hybrid Journal   (Followers: 10)
Journal of Imperial and Commonwealth History     Hybrid Journal   (Followers: 10)
Journal of Indian Society of Pedodontics and Preventive Dentistry     Open Access   (Followers: 1)
Journal of Israeli History: Politics, Society, Culture     Hybrid Journal   (Followers: 5)
Journal of Jewish Identities     Full-text available via subscription   (Followers: 7)
Journal of Latin American Cultural Studies: Travesia     Hybrid Journal   (Followers: 6)
Journal of Latin American Studies     Hybrid Journal   (Followers: 11)
Journal of Legal History     Hybrid Journal   (Followers: 13)
Journal of Medieval History     Hybrid Journal   (Followers: 145)
Journal of Medieval Iberian Studies     Hybrid Journal   (Followers: 7)
Journal of Medieval Religious Cultures     Full-text available via subscription   (Followers: 12)
Journal of Military History     Full-text available via subscription   (Followers: 17)
Journal of Modern Chinese History     Hybrid Journal   (Followers: 3)
Journal of Modern Greek Studies     Full-text available via subscription   (Followers: 2)
Journal of Modern History, The     Full-text available via subscription   (Followers: 120)
Journal of Modern Italian Studies     Hybrid Journal   (Followers: 4)
Journal of Modern Russian History and Historiography     Full-text available via subscription   (Followers: 8)
Journal of Moravian History     Full-text available via subscription   (Followers: 3)
Journal of Natural History     Hybrid Journal   (Followers: 4)
Journal of New Zealand Studies     Full-text available via subscription   (Followers: 1)
Journal of North African Studies     Hybrid Journal   (Followers: 5)
Journal of Northern Territory History     Full-text available via subscription  
Journal of Pacific History     Hybrid Journal   (Followers: 4)

  First | 1 2 3 4 5 6 7 8 | Last

Journal Cover Journal of the American Society of Hypertension
   [5 followers]  Follow    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
     ISSN (Print) 1933-1711
     Published by Elsevier Homepage  [2563 journals]   [SJR: 0.803]   [H-I: 17]
  • Detection of early diastolic alterations by Tissue Doppler Imaging in
           untreated childhood-onset essential hypertension
    • Abstract: Publication date: Available online 24 February 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Ngozi C. Agu , Karen McNiece Redwine , Cynthia Bell , Kathleen Marie Garcia , David S. Martin , Tim S. Poffenbarger , John T. Bricker , Ronald J. Portman , Monesha Gupta-Malhotra
      The aim of the study was to determine the presence of preclinical diastolic dysfunction in hypertensive children relative to normotensive children by Tissue Doppler Imaging (TDI). We prospectively enrolled children with untreated essential hypertension in absence of any other disease and a matched healthy control group with normal blood pressure (BP); both groups confirmed by clinic BP and a 24-hour ambulatory BP monitoring. Echocardiographic diastolic parameters were determined using spectral transmitral inflow Doppler, flow propagation velocity, TDI, and systolic parameters were determined via midwall shortening fraction and ejection fraction. A total of 80 multiethnic children were prospectively enrolled for the study: 46 hypertensive (median age, 13 years; 72% males) and 34 control (median age, 14 years; 65% males). The only echocardiography parameters that had a statistically significant change compared with the control children, were regional mitral Ea, Aa, and the E/Ea ratio by TDI. In comparison with controls, hypertensive children had lower Ea and Aa velocities of anterior and posterior walls and higher lateral wall E/Ea ratio. The decrease in posterior wall Ea and Aa remained significant after adjustment for gender, age, body mass index, ethnicity, and left ventricular hypertrophy on multivariate analysis. The lateral and septal wall E/Ea ratios correlated significantly with fasting serum insulin levels on similar multivariate analysis. Decreased regional TDI velocities were seen with preserved left ventricular systolic function even when other measures of diastolic dysfunction remained unchanged in untreated hypertensive children. Hypertension and serum insulin levels had strong associations with preclinical diastolic alterations in children.


      PubDate: 2014-04-28T11:19:33Z
       
  • Telmisartan improves survival and ventricular function in SHR rats with
           extensive cardiovascular damage induced by dietary salt excess
    • Abstract: Publication date: Available online 25 February 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Dinko Susic , Edward D. Frohlich
      Excessive dietary salt intake induces extensive cardiovascular and renal damage in spontaneously hypertensive rats (SHR) that may be prevented by antihypertensive agents. This study examines whether salt-induced cardiac damage may be reversed by angiotensin II (type 1) receptor blockade (telmisartan). Eight-week-old male SHRs were divided into four groups; Group 1 (NS) was fed regular rat chow, and Group 2 (HS) received high-salt diet (HS; 8% NaCl). After 8 weeks on their respective diets, systemic hemodynamics and indices of left ventricular (LV) function were determined. Group 3 (HSnoT) was given HS for 8 weeks and then switched to a regular chow (0.6% NaCl) diet with no other treatment, and Group 4 (HSArb) received HS for 8 weeks and was then given regular diet plus telmisartan. Rats from these latter two groups were monitored for the ensuing 30 days. Compared with the NS group, rats in the HS group exhibited increased mean arterial pressure (161 ± 7 vs 184 ± 8 mm Hg) and LV diastolic dysfunction, as evidenced by a decreased rate of LV pressure decline (−8754 ± 747 vs −4234 ± 754 mmHg/sec) at the end of the 8 weeks of their respective treatment. After switching to regular chow, only one of 11 rats in the HSnoT group survived for the 30 days, whereas 10 died within 18 days; in the HSArb group only one of nine rats died; eight survived 30 days (P < .01). Telmisartan significantly improved LV function and survival in those SHR rats having extensive cardiovascular damage induced by dietary salt excess.


      PubDate: 2014-04-28T11:19:33Z
       
  • Blood pressure control and perceived health status in African Americans
           with subclinical hypertensive heart disease
    • Abstract: Publication date: Available online 25 February 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Michael J. Burla , Aaron M. Brody , Brian A. Ference , John M. Flack , James J. Mahn , Alexander L. Marinica , Justin A. Carroll , Samar A. Nasser , Shiling Zhang , Phillip D. Levy
      The role of antihypertensive therapy in reducing the risk of cardiovascular complications such as heart failure is well established, but the effects of different blood pressure goals on patient-perceived health status has not been well defined. We sought to determine if adverse effects on perceived health status will occur with lower blood pressure goals or more intensive antihypertensive therapy. Data were prospectively collected as a part of a single center, randomized controlled trial designed to evaluate standard (Seventh Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure-compliant) versus intense (<120/80 mm Hg) blood pressure goals for patients with uncontrolled hypertension and subclinical hypertensive heart disease. Blood pressure management was open label, and health status was measured at 3-month intervals over 1 year of follow-up using the short-form (SF)-36. Mixed linear models were constructed for each of the SF-36 summary scores. One hundred twenty-three (mean age 49.4 ± 8.2; 65% female; 95.1% African American) patients were randomized, 88 of whom completed the protocol. With the exception of a decrease in perceived health transition, health status did not change significantly on repeat measurement. Lower blood pressure goals and more intensive antihypertensive therapy appear to be well tolerated with limited effects on patients' perception of health status.


      PubDate: 2014-04-28T11:19:33Z
       
  • Editorial Board
    • Abstract: Publication date: March 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 3




      PubDate: 2014-04-28T11:19:33Z
       
  • Table of Contents
    • Abstract: Publication date: March 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 3




      PubDate: 2014-04-28T11:19:33Z
       
  • Clinical determinants and prognostic significance of the
           electrocardiographic strain pattern in chronic kidney disease patients
    • Abstract: Publication date: Available online 26 February 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Antonio C. Cordeiro , Aline A.I. Moraes , Virginia Cerutti , Faustino França , Borja Quiroga , Celso Amodeo , Juliano C. Picotti , Lucas V. Dutra , Gabriel D. Rodrigues , Fernanda C. Amparo , Bengt Lindholm , Juan Jesús Carrero
      The electrocardiographic (ECG) strain pattern (Strain) is a marker of left ventricular hypertrophy (LVH) severity that provides additional prognostic information beyond echocardiography (ECHO) in the community level. We sought to evaluate its clinical determinants and prognostic usefulness in chronic kidney disease (CKD) patients. We evaluated 284 non-dialysis-dependent patients with CKD stages 3 to 5 (mean age, 61 years [interquartile range, 53–67 years]; 62% men). Patients were followed for 23 months (range, 13–32 months) for cardiovascular (CV) events and/or death. Strain patients (n = 37; 13%) were using more antihypertensive drugs, had higher prevalence of peripheral vascular disease and smoking, and higher levels of C-reactive protein, cardiac troponin, and brain natriuretic peptide (BNP). The independent predictors of Strain were: left ventricular mass index (LVMI), BNP, and smoking. During follow-up, there were 44 cardiovascular events (fatal and non-fatal) and 22 non-CV deaths; and Strain was associated with a worse prognosis independently of LVMI. Adding Strain to a prognostic model of LVMI improved in 15% the risk discrimination for the composite endpoint and in 12% for the CV events. Strain associates with CV risk factors and adds prognostic information over and above that of ECHO-assessed LVMI. Its routine screening may allow early identification of high risk CKD patients.


      PubDate: 2014-04-28T11:19:33Z
       
  • Calcitonin gene-related peptide (CGRP) in autonomic cardiovascular
           regulation and vascular structure
    • Abstract: Publication date: Available online 13 March 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Tu H. Mai , Jing Wu , André Diedrich , Emily M. Garland , David Robertson
      Calcitonin gene-related peptide (CGRP) is reported to play important roles in cardiovascular regulation in human and animal models. In spite of this, its role remains controversial. We aim to clarify this by studying the autonomic cardiovascular function and vascular structure in CGRP knockout (CGRP−/−) mice. Blood pressure (BP) and heart rate (HR) were assessed by telemeters. Urine (24-hour) and blood were collected for catecholamines measurements. Baroreflex sensitivity was assessed using phenylephrine and sodium nitroprusside administered in an acute study. Daytime mean arterial pressure (MAP; 12-hour period) was significantly higher in the CGRP−/− mice than in the wild type (WT) mice (114.5 vs 104.5 mm Hg; P = .04). Norepinephrine was elevated in plasma and 24-hour urine in the knockouts (Urine, 956 vs 618 pg/mL; P = .004; Plasma, 2505 vs 1168 pg/mL; P = .04). Paradoxically, cardiovagal baroreflex sensitivity was higher in CGRP−/− mice (3.2 vs 1.4 ms/mm Hg; P = .03). To increase insight, we studied aortic stiffness in CGRP−/− mice and found it increased compared with age-matched WT mice, as evidenced by the depression of the compliance curve (P < .05). CGRP−/− mice have higher BP due to elevated sympathetic signals and abnormalities in blood vessel structure. Moreover, our data also showed that CGRP plays an important role in the regulation of the cardio-vagal tone.


      PubDate: 2014-04-28T11:19:33Z
       
  • Adiponectin is better predictor of subclinical atherosclerosis than liver
           function tests in patients with nonalcoholic fatty liver disease
    • Abstract: Publication date: Available online 13 March 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Elena Omelchenko , Dov Gavish , Marina Shargorodsky
      Background Adiponectin has recently been considered as a possible link between liver dysfunction and atherosclerosis in patients with nonalcoholic fatty liver disease (NAFLD). The present study was designed to evaluate the relation between circulating adiponectin and arterial stiffness parameters, such as pulse wave velocity (PWV) and aortic augmentation index (AI), in patients with hepatic steatosis. Methods The study group consisted of 52 subjects with NAFLD. PWV and AI were performed using SphygmoCor (version 7.1, AtCor Medical, Sydney, Australia). Metabolic parameters, HOMA-IR and adiponectin levels were determined. Results Adiponectin was significantly, positively associated with AI (r=0.467, p<0.0001) and with PWV (r=0.348, p=0.011). No association between arterial stiffness parameters and liver function tests was observed. In a multiple linear regression analysis, adiponectin remained a significant predictor of PWV even after controlling for age, sex and MAP. Conclusions Serum adiponectin levels were significantly associated with indices of subclinical atherosclerosis, such as PWV and AI in patients with NAFLD. This association was independent of age, sex and blood pressure level and suggests an active role of adiponectin in the pathophysiology of vascular disease in this particular population group.


      PubDate: 2014-04-28T11:19:33Z
       
  • Apparent treatment resistant hypertension and risk for stroke, coronary
           heart disease and all-cause mortality.
    • Abstract: Publication date: Available online 15 March 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Marguerite R. Irvin , John N. Booth III , Daichi Shimbo , Daniel T. Lackland , Suzanne Oparil , George Howard , Monika M. Safford , Paul Muntner , David A. Calhoun
      Background Apparent treatment resistant hypertension (aTRH) is defined as uncontrolled hypertension despite the use of ≥ 3 antihypertensive medication classes or controlled hypertension while treated with ≥ 4 antihypertensive medication classes. We evaluated the association of aTRH with incident stroke, coronary heart disease (CHD) and all-cause mortality. Methods Participants from the population-based REasons for Geographic And Racial Differences in Stroke (REGARDS) Study treated for hypertension with aTRH (n=2,043) and without aTRH (n=12,479) were included. aTRH was further categorized as controlled aTRH (≥ 4 medication classes and controlled hypertension) and uncontrolled aTRH (≥ 3 medication classes and uncontrolled hypertension). Results Over a median of 5.9, 4.4, and 6.0 years of follow-up the multivariable adjusted hazard ratio for stroke, CHD, and all-cause mortality associated with aTRH versus no aTRH was 1.25 (0.94 – 1.65), 1.69 (1.27 – 2.24), and 1.29 (1.14 – 1.46), respectively. Compared to controlled aTRH, uncontrolled aTRH was associated with CHD (HR=2.33; 95% CI 1.21 – 4.48), but not stroke or mortality. Comparing controlled aTRH to no aTRH, risk of stroke, CHD and all-cause mortality was not elevated. Conclusion aTRH was associated with an increased risk for coronary heart disease and all-cause mortality.


      PubDate: 2014-04-28T11:19:33Z
       
  • The Effect of Lower Body Weight Support on Arterial Wave Reflection in
           Healthy Adults
    • Abstract: Publication date: Available online 20 March 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Atif Afzal , Daniel Fung , Sean Galligan , Ellen M. Godwin , John G. Kral , Louis Salciccioli , Jason M. Lazar
      Background Body weight support (WS) during treadmill exercise is used to rehabilitate orthopedic/neurological patients. WS lowers musculoskeletal strain and load. It compresses the lower body and increases intrathoracic volume. Methods We studied short term effects of WS on wave reflection indices using applanation tonometry during progressive WS of 25%, 50%, and 75% of body weight in 25 healthy men. Results WS decreased mean heart rate from 79 to 69 beats/min (p<0.001). Peripheral and central mean arterial, systolic and pulse pressures (PP) remained unchanged. There was a trend towards lower peripheral and central diastolic pressure. PP amplification ratio decreased significantly (p=0.005). Reflected wave characteristics: Augmented pressure and index increased in a stepwise manner with WS (both p<0.001). Both ejection duration and systolic duration of the reflected pressure wave (Ätr) increased progressively (both p<0.001). The round-trip travel time (Δtp) was unchanged. Left ventricular workload and oxygen demand: Left ventricular wasted pressure energy increased (p<0.001) and the subendocardial viability ratio decreased (p=0.005), whereas the tension time index remained unchanged. Conclusion In normal men, WS acutely decreases the PP amplification ratio, increases the amplitude and duration of the reflected aortic pressure wave, and increases measures of wasted LV pressure energy and oxygen demand.


      PubDate: 2014-04-28T11:19:33Z
       
  • Lung age is related to carotid structural alterations in hypertensive
           subjects
    • Abstract: Publication date: Available online 22 March 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Tatiana A. Kiyota , Paulo R. Mendes , José A. Cipolli , Roberto Schreiber , Layde R. Paim , Vera R. Bellinazzi , José R. Matos-Souza , Andrei C. Sposito , Wilson Nadruz Jr.
      Background Hypertensive patients exhibit higher cardiovascular risk and reduced lung function compared to the general population. Whether this association stems from the coexistence of two highly prevalent diseases or from direct or indirect links of pathophysiological mechanisms is presently unclear. This study investigated the association between lung function and carotid features in non-smoking hypertensive subjects with supposed normal lung function. Methods and Results Hypertensive patients (n=67) were cross-sectionally evaluated by clinical, hemodynamic, laboratory and carotid ultrasound analysis. Forced vital capacity, forced expired volume in 1s and in 6s and lung age were estimated by spirometry. Subjects with ventilatory abnormalities according to current guidelines were excluded. Regression analysis adjusted for age and prior smoking history showed that lung age and the percentage of predicted spirometric parameters associated with common carotid intima-media thickness, diameter and stiffness. Further analyses, adjusted for additional potential confounders, revealed that lung age was the spirometric parameter exhibiting the most significant regression coefficients with carotid features. Conversely, plasma C-reactive protein and matrix-metalloproteinases-2/9 levels did not influence this relationship. Conclusions The present findings point toward lung age as a potential marker of vascular remodeling and indicate that lung and vascular remodeling might share common pathophysiological mechanisms in hypertensive subjects.


      PubDate: 2014-04-28T11:19:33Z
       
  • Diagnosis and treatment of stage 1 hypertension: Which guidelines should
           we follow'
    • Abstract: Publication date: Available online 21 February 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Sadi Gulec



      PubDate: 2014-04-28T11:19:33Z
       
  • Effects of amlodipine and other classes of antihypertensive drugs on
           long-term blood pressure variability: Evidence from randomized controlled
           trials
    • Abstract: Publication date: Available online 15 February 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Ji-Guang Wang , Ping Yan , Barrett W. Jeffers
      Blood pressure (BP) is monitored and managed to prevent cardiovascular complications of hypertension, but BP variability (BPV) has not been sufficiently studied. This analysis assessed whether patients receiving amlodipine vs other antihypertensive agents had lower BPV after ≥12 weeks of treatment. Studies were included if individual subject data were available, had ≥1 active comparator, and treatment duration was ≥12 weeks. BPV was assessed using standard deviation (SD) and coefficient of variation (CV) of systolic BP across visits from 12 weeks. Individual trial and meta-analyses were performed for SD- and CV-based methodology. Five studies (47,558 BPV-evaluable patients) were included. Patient characteristics were largely consistent across the studies, but BP measurements varied from ∼4 months to ∼6 years. BPV with amlodipine was significantly (P < .0001) lower vs atenolol and lisinopril; significantly (P < .0001) lower than enalapril in one study and numerically, but not significantly lower in another; and similar to chlorthalidone and losartan. Meta-analysis revealed a treatment difference (standard error) for amlodipine vs all active comparators of −1.23 (0.46; P = .008) mm Hg using SD and −0.86 (0.31; P = .005) using CV. These findings suggest that amlodipine is effective for minimizing BPV. Future studies need to confirm a causal link between BPV and cerebrovascular/cardiovascular outcomes.


      PubDate: 2014-04-28T11:19:33Z
       
  • MicroRNA-9 and microRNA-126 expression levels in patients with essential
           hypertension: potential markers of target organ damage
    • Abstract: Publication date: Available online 27 March 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Joanna E. Kontaraki , Maria E. Marketou , Evangelos A. Zacharis , Fragiskos I. Parthenakis , Panos E. Vardas
      Background MicroRNAs (miRs), as essential gene expression regulators, modulate cardiovascular development and disease and thus they are emerging as potential biomarkers and therapeutic targets in cardiovascular disease, including hypertension. Methods and Results We assessed the expression levels of the microRNAs miR-9 and miR-126 in 60 patients with untreated essential hypertension and 29 healthy individuals. All patients underwent two-dimensional echocardiography and 24-h ambulatory blood pressure monitoring. MicroRNA expression levels in peripheral blood mononuclear cells were quantified by real-time reverse transcription polymerase chain reaction. Hypertensive patients showed significantly lower miR-9 (9.69±1.56 versus 41.08±6.06, p<0.001) and miR-126 (3.88±0.47 versus 8.96±1.69, p<0.001) expression levels compared with healthy controls. In hypertensive patients, miR-9 expression levels showed a significant positive correlation (r=0.437, p<0.001) with left ventricular mass index. Furthermore, both miR-9 (r=0.312, p=0.015) and miR-126 (r=0.441, p<0.001) expression levels in hypertensive patients showed significant positive correlations with the 24-h mean pulse pressure. Conclusions Our data reveal that miR-9 and miR-126 are closely related to essential hypertension in humans, as they show a distinct expression profile in hypertensive patients relative to healthy individuals and they are associated with clinical prognostic indices of hypertensive target organ damage in hypertensive patients. Thus, they may possibly represent potential biomarkers and candidate therapeutic targets in essential hypertension.


      PubDate: 2014-04-28T11:19:33Z
       
  • Effects of sodium-glucose co-transporter 2 inhibitors on blood pressure: A
           systematic review and meta-analysis
    • Abstract: Publication date: April 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 4
      Author(s): William L. Baker , Lindsay R. Smyth , Daniel M. Riche , Emily M. Bourret , Kevin W. Chamberlin , William B. White
      Sodium-glucose co-transporter 2 (SGLT2) inhibitors represent a new class of antihyperglycemic agents that block renal sodium and glucose reabsorption and may reduce blood pressure (BP). We assessed the BP lowering ability of these agents using meta-analytic techniques. PubMed, SCOPUS, and Cochrane Central were searched through October 2013. We included fully published randomized controlled trials (RCTs) that evaluated SGLT2 inhibitors in patients with type-2 diabetes mellitus and reported change in systolic and/or diastolic BP. Subgroup analyses were performed for placebo-controlled trials and those with active controls. We also conducted meta-regression to assess for a dose-response effect, and whether baseline BP, changes in body weight, heart rate, and hematocrit were associated with the BP effects. Twenty-seven RCTs (n = 12,960 participants) were included. SGLT2 inhibitors significantly reduced both systolic BP (weighted mean difference, −4.0 mm Hg; 95% confidence interval, −4.4 to −3.5) and diastolic BP (weighted mean difference, −1.6 mm Hg; 95% confidence interval, −1.9 to −1.3) from baseline. Only canagliflozin had a significant dose-response relationship with SBP (P = .008). Significant reductions in body weight and hematocrit were seen with the SGLTs. SGLTs had no significant effect on the incidence of orthostatic hypotension (P > .05). SGLT2 inhibitors significantly reduce BP in patients with type 2 diabetes.


      PubDate: 2014-04-28T11:19:33Z
       
  • Rebuttal: Relationship of left ventricular hypertrophy, age, and renal
           artery stenosis
    • Abstract: Publication date: Available online 22 February 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Abdur Rahman Khan , Mujeeb A. Sheikh , Dinkar Kaw , Christopher J. Cooper , Samer J. Khouri



      PubDate: 2014-04-28T11:19:33Z
       
  • Relationship of left ventricular hypertrophy, age, and renal artery
           stenosis
    • Abstract: Publication date: Available online 22 February 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Natalia Ruggeri Barbaro , Vanessa Fontana , Heitor Moreno



      PubDate: 2014-04-28T11:19:33Z
       
  • Prevalence and factors associated with left ventricular remodeling in
           renal artery stenosis
    • Abstract: Publication date: April 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 4
      Author(s): Abdur Rahman Khan , Mujeeb Sheikh , Dinkar Kaw , Christopher J. Cooper , Samer J. Khouri
      The objective of this study is to evaluate the prevalence, geometric patterns, and factors associated with left ventricular remodeling in patients with renal artery stenosis (RAS). Demographic, clinical, and echocardiographic data were assessed in 77 patients with RAS prior to endovascular stenting. The left ventricular mass index (LVMI) and relative wall thickness were calculated using American Society of Echocardiography (ASE) recommendations. Patients were classified based on LVMI and relative wall thickness into four ventricular remodeling patterns: normal geometry, concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH). Logistic regression was done to investigate the determinants of the different ventricular remodeling patterns. Mean LVMI and relative wall thickness were 118 ± 40 g/m2 and 0.45 ± 0.1. Left ventricular hypertrophy was observed in 65%. CH was the most prevalent geometric pattern of remodeling (normal, 16.9%; CR, 18.2%; CH, 40%; EH, 24.6%). Thirty (39%) patients had an abnormal LV systolic function (ejection fraction <55%), with 14 (46%) of them having eccentric hypertrophy. Independent predictor of EH was glomerular filtration rate (odds ratio [OR], 0.943; confidence interval [CI], 0.899–0.989; P = .01). Systolic elevation of blood pressure (OR, 1.030; CI, 1.003–1.058; P = .03) was associated with CH, and elevated diastolic blood pressure was associated with CR (OR, 0.927; CI, 0.867–0.992; P = .02). Patients with RAS have a high prevalence of left ventricular remodeling and LVH. Even though CH was the most prevalent pattern of left ventricular remodeling, EH was commonplace and was associated with renal dysfunction and heart failure.


      PubDate: 2014-04-28T11:19:33Z
       
  • Elevated Ldl–Cholesterol Hyperlipidemia combined With Hypertension
           Worsens Subclinical Vascular Impairment and Cognitive Function
    • Abstract: Publication date: Available online 26 April 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Katalin Réka Kovács , Zoltán Bajkó , Csilla Cecília Szekeres , Krisztina Csapó , László Oláh , Mária Tünde Magyar , Sándor Molnár , Dániel Czuriga , László Kardos , Andrea Bojtor Burainé , Dániel Bereczki , Pál Soltész , László Csiba
      Background Hypertension and dyslipidemia belong to the most prevalent modifiable risk factors of for cerebro- and cardiovascular diseases. Hereby, we aimed to examine the combined effects of newly diagnosed hypertension and hyperlipidemia on the characteristics of the arterial wall and on cognitive function. Methods We examined 72 hypertensive and 85 apparently healthy individuals. Based on serum lipid levels, four subgroups were created ranging from normotensive--normolipidemic to hypertensive-hyperlipidemic subjects. Carotid intima-media thickness (IMT), arterial stiffness and cognitive function were assessed. Results IMT of controls was the lowest, while that of patients with both risk factors the highest. Stiffness parameters increased when both risk factors were present, while subjects with only one risk factor exhibited intermediate values. Hypertensive patients performed worse when memory, attention, reaction time and trait anxiety were assessed. Significant worsening of IMT, arterial stiffness and sum of neuropsychological scores was observed along with increasing mean arterial pressure. Generally, hyperlipidemia combining with hypertension resulted in further worsening of all examined parameters. Conclusions Subclinical changes of the vascular wall and cognitive performance are already present in recently diagnosed hypertensive patients. Combination of hyperlipidemia and hypertension results in more severe impairments, therefore early and intensive treatment may be crucial to prevent further deterioration.


      PubDate: 2014-04-28T11:19:33Z
       
  • Table of Contents
    • Abstract: Publication date: April 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 4




      PubDate: 2014-04-28T11:19:33Z
       
  • From the Editor
    • Abstract: Publication date: April 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 4
      Author(s): Myron H. Weinberger



      PubDate: 2014-04-28T11:19:33Z
       
  • Melatonin attenuates prenatal dexamethasone-induced blood pressure
           increase in a rat model
    • Abstract: Publication date: April 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 4
      Author(s): You-Lin Tain , Chih-Cheng Chen , Jiunn-Ming Sheen , Hong-Ren Yu , Mao-Meng Tiao , Ho-Chang Kuo , Li-Tung Huang
      Although antenatal corticosteroid is recommended to accelerate fetal lung maturation, prenatal dexamethasone exposure results in hypertension in the adult offspring. Since melatonin is a potent antioxidant and has been known to regulate blood pressure, we examined the beneficial effects of melatonin therapy in preventing prenatal dexamethasone-induced programmed hypertension. Male offspring of Sprague-Dawley rats were assigned to four groups (n = 12/group): control, dexamethasone (DEX), control + melatonin, and DEX + melatonin. Pregnant rats received intraperitoneal dexamethasone (0.1 mg/kg) from gestational day 16 to 22. In the melatonin-treatment groups, rats received 0.01% melatonin in drinking water during their entire pregnancy and lactation. Blood pressure was measured by an indirect tail-cuff method. Gene expression and protein levels were analyzed by real-time quantitative polymerase chain reaction and Western blotting, respectively. At 16 weeks of age, the DEX group developed hypertension, which was partly reversed by maternal melatonin therapy. Reduced nephron numbers due to prenatal dexamethasone exposure were prevented by melatonin therapy. Renal superoxide and NO levels were similar in all groups. Prenatal dexamethasone exposure led to increased mRNA expression of renin and prorenin receptor and up-regulated histone deacetylase (HDAC)-1 expression in the kidneys of 4-month-old offspring. Maternal melatonin therapy augmented renal Mas protein levels in DEX + melatonin group, and increased renal mRNA expression of HDAC-1, HDAC-2, and HDAC-8 in control and DEX offspring. Melatonin attenuated prenatal DEX-induced hypertension by restoring nephron numbers, altering RAS components, and modulating HDACs.


      PubDate: 2014-04-28T11:19:33Z
       
  • The Association between Ambulatory Systolic Blood Pressure and
           Cardiovascular Events in a Selected Population with Intensive Control of
           Cardiovascular Risk Factors
    • Abstract: Publication date: Available online 4 April 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Wasseem Rock , Moshe Leshno , Gadi Shlomai , Avshalom Leibowitz , Yehonatan Sharabi , Ehud Grossman
      Background Recent guidelines recommend a target clinic systolic blood pressure (BP) of >140 mmHg. These recommendations are based on the relationship of office BP measurements and cardiovascular (CV) events. We evaluated the association between 24H ambulatory BP measurements (ABPM) and CV events in a selected population with intensive control of CV risk factors. Patients and Methods We retrospectively followed all patients who had undergone 24H ABPM during 2005 at the Institute of Periodic Medical Examinations, Chaim Sheba Medical Center, Tel-Hashomer, Israel to monitor the development of CV events. These patients were followed closely and treated meticulously in order to control CV risk factors. Results The study population consisted of 317 patients (81% males, mean age 59.2 ±9.8 years) followed for a mean period of 6.38±2.15 years (median = 6 years). During follow-up, 22 patients had their first CV event. Patients who experienced CV events were significantly older, more likely diabetic, and had a history of previous CV disease. 24H ABPM systolic BP ≥140 mmHg was not associated with increased CV events, whereas 24H ABPM systolic BP ≥150 mmHg was. Logistic regression analysis showed that 24H ABPM systolic BP≥150 mmHg, a former smoker, old age, and a history of CV disease were associated with CV events during follow-up. Conclusions We found that in a population aggressively managed for CV risk factors, 24H ABPM systolic BP ≥150 mmHg is associated with increased CV events.


      PubDate: 2014-04-28T11:19:33Z
       
  • Leadership Message
    • Abstract: Publication date: Available online 3 April 2014
      Source:Journal of the American Society of Hypertension
      Author(s): William B. White



      PubDate: 2014-04-28T11:19:33Z
       
  • Editorial Board
    • Abstract: Publication date: April 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 4




      PubDate: 2014-04-28T11:19:33Z
       
  • Enalapril/lercanidipine combination on markers of cardiovascular risk: A
           randomized study
    • Abstract: Publication date: Available online 4 April 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Giuseppe Derosa , Aldo Bonaventura , Davide Romano , Lucio Bianchi , Elena Fogari , Angela D’Angelo , Pamela Maffioli
      Background the aim of this study was to evaluate enalapril/lercanidipine combination effects on markers of cardiovascular risk stratification of hypertensive patients. Methods 359 patients were randomized to enalapril 20 mg, or lercanidipine 10 mg, or enalapril/lercanidipine 20/10 mg fixed combination. We evaluated blood pressure, fasting plasma glucose (FPG), lipid profile, lipoprotein(a) (Lp[a]), soluble receptor for advanced glycation end products (sRAGE), soluble CD40 ligand (sCD40L), serum myeloperoxidase (MPO), high sensitivity C-reactive protein (Hs-CRP), and tumor necrosis factor-α (TNF-α). Results we recorded a decrease of blood pressure in all groups, with enalapril/lercanidipine combination being more effective in reducing blood pressure compared to single monotherapies. Lipid profile or FPG were not affected by various treatments. Lercanidipine, but not enalapril, improved Lp(a) levels compared to baseline, with enalapril/lercanidipine having a greater effect on Lp(a) reduction. All treatments increased sRAGE levels, and decreased sCD40L and MPO, even if enalapril/lercanidipine combination was more effective than single monotherapies. TNF-α and Hs-CRP were greater reduced by enalapril/lercanidipine combination compared to enalapril (p<0.05 for both). Conclusions enalapril/lercanidipine fixed combination was more effective than single monotherapies in decreasing blood pressure, but also in improving markers of cardiovascular risk stratification in hypertensive patients.


      PubDate: 2014-04-28T11:19:33Z
       
  • Arterial Stiffness is Associated with Increase in Blood Pressure Over Time
           in Treated Hypertensives
    • Abstract: Publication date: Available online 4 April 2014
      Source:Journal of the American Society of Hypertension
      Author(s): T. Coutinho , K.R. Bailey , S.T. Turner , I.J. Kullo
      Background Arterial stiffness is associated with incident hypertension. We hypothesized that arterial stiffness would predict increases in systolic (SBP), mean (MAP) and pulse pressure (PP) over time in treated hypertensives. Methods Blood pressure (BP) was measured a mean of 8.5±0.9 years apart in 414 non-Hispanic white hypertensives (mean age 60±8 years, 55% women). The average of 3 supine right brachial BPs was recorded. Measures of arterial stiffness including carotid-femoral pulse wave velocity (cfPWV), aortic augmentation index (AIx) and central pulse pressure (CPP) were obtained at baseline by applanation tonometry. We performed stepwise multivariable linear regression analyses adjusting for potential confounders to assess the associations of arterial stiffness parameters with BP changes over time. Results Systolic, mean and pulse pressure increased in 80% of participants. After adjustment for the covariates listed above, cfPWV was significantly associated with increases in SBP (β±SE: 0.71±0.31) and PP (β±SE: 1.09±0.27); AIx was associated with increases in SBP (β±SE: 0.23±0.10) and MAP (β±SE: 0.27±0.07); and CPP was associated with increases in SBP (β±SE: 0.44±0.07), MAP (β±SE: 0.24±0.05) and PP (β±SE: 0.42±0.06) over time (P≤0.02 for all). Conclusions Baseline arterial stiffness measures were associated with longitudinal increases in SBP, MAP and PP in treated hypertensives.


      PubDate: 2014-04-28T11:19:33Z
       
  • Attempts to Define the Risk of Elevated Blood Pressure
    • Abstract: Publication date: Available online 5 April 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Barry J. Materson



      PubDate: 2014-04-28T11:19:33Z
       
  • The effect of predonation hypotension on whole blood donor adverse
           reactions: a systematic review
    • Abstract: Publication date: Available online 5 April 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Nele S. Pauwels , Leila Cusack , Emmy De Buck , Veerle Compernolle , Philippe Vandekerckhove
      Background Blood services are reliant upon healthy blood donors to provide a safe and adequate supply of blood products. Inappropriate variables contained within blood donor exclusion criteria can defer potentially appropriate donors. The aim of this systematic review was to examine the effect of low predonation blood pressure as compared to normal blood pressure, on adverse events in allogeneic whole blood donors. Methods and Results A systematic review was performed using highly sensitive search strategies within five databases (Cochrane Central Register of Controlled Trials), CINAHL, Embase, MEDLINE and Web of Science) from inception date until April 12th 2013. Out of 8,305 records, ten observational studies were identified which addressed the question. Five of these studies (with a combined total of 1,482,020 donations and 2,903 donors) included either a statistical analysis or an appropriate study design which controlled for possible confounding factors. Based on the currently available evidence, hypotension has not been shown to be an independent predictive factor for donor complications. However, the overall quality of evidence was rather limited and rated ‘low’, using the GRADE approach. Conclusion There currently is no evidence that hypotensive blood donors have a greater risk for donor adverse events, compared to their normotensive counterparts.


      PubDate: 2014-04-28T11:19:33Z
       
  • From The Editor
    • Abstract: Publication date: Available online 12 April 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Myron H. Weinberger



      PubDate: 2014-04-28T11:19:33Z
       
  • Top 10 Landmark Studies in Hypertension
    • Abstract: Publication date: Available online 12 April 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Elizabeth W. Edwards , Donald J. DiPette , Raymond R. Townsend , Debbie L. Cohen
      The field of hypertension has evolved considerably over the last 70 years, from a belief that elevated blood pressure was an inevitable consequence of aging and beneficial to maintaining perfusion to overwhelming proof of the cardiovascular morbidity and mortality associated with elevated blood pressure. The authors reviewed the literature on hypertension and selected 10 studies pivotal in changing physicians’ attitudes regarding the management, treatment, and outcomes of hypertensive patients. Four studies cover treatment initiation and blood pressure goals, two studies compare pharmacologic antihypertensive agents, and the final four address the approach to blood pressure control in special populations (diabetes mellitus and chronic kidney disease). The authors readily acknowledge the many other contributions to the field of hypertension not profiled here.


      PubDate: 2014-04-28T11:19:33Z
       
  • From the Editor
    • Abstract: Publication date: Available online 13 April 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Myron H. Weinberger



      PubDate: 2014-04-28T11:19:33Z
       
  • The Impact of Hypertension on Cerebral Perfusion and Cortical Thickness in
           Older Adults
    • Abstract: Publication date: Available online 13 April 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Michael L. Alosco , John Gunstad , Xiaomeng Xu , Uraina S. Clark , Donald Labbe , Hannah Riskin-Jones , Gretel Torrero , Nicolette F. Schwarz , Edward Walsh , Athena Poppas , Ronald A. Cohen , Lawrence H. Sweet
      Background Hypertension may increase risk for dementia possibly because of its association with decreased cortical thickness. Disturbed cerebral autoregulation is one plausible mechanism by which hypertension impacts the cerebral structure, but the associations among hypertension, brain perfusion, and cortical thickness are poorly understood. Methods The current sample consisted of 58 older adults with varying levels of vascular disease. Diagnostic history of hypertension and antihypertensive medication status was ascertained through self-report and, and when available, confirmed by medical record review. All participants underwent arterial spin labeling and T1-weighted magnetic resonance imaging (MRI) to quantify total and regional cortical perfusion and thickness. Results Analysis of covariance adjusting for medical variables showed that participants with hypertension exhibited reduced temporal and occipital brain perfusion as well as total and regional cortical thickness relative to those without hypertension. The effects of hypertension on total brain perfusion remained unchanged even after adjustment for age, though no such pattern emerged for cortical thickness. Decreased total brain perfusion predicted reduced thickness of the total brain as well as of the frontal, temporal, and parietal lobe cortices. Antihypertensive treatment was not associated with total cerebral perfusion or cortical thickness. Discussion This study provides initial evidence for the adverse effects of a diagnostic history of hypertension on brain hypoperfusion and reduced cortical thickness. Longitudinal studies are needed to investigate the role of hypertension and its interaction with other contributing factors (e.g., age) in the manifestation of cerebral hypoperfusion and reduced cortical thickness.


      PubDate: 2014-04-28T11:19:33Z
       
  • Effect of Rg3-Enriched Korean Red Ginseng (Panax Ginseng) on Arterial
           Stiffness and Blood Pressure in Healthy Individuals: A Randomized
           Controlled Trial
    • Abstract: Publication date: Available online 16 April 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Elena Jovanovski , Emma A. Bateman , Jyoti Bhardwaj , Chris Fairgrieve , Iva Mucalo , Alexandra L. Jenkins , Vladimir Vuksan
      Background Ginsenoside Rg3, present in steamed ginseng (Panax Ginseng C.A. Meyer), is thought to be a potent modulator of vascular function. Our objective was to clinically evaluate acute effects of ginsenoside Rg3-enriched Korean red ginseng (Rg3-KRG) on measures of arterial stiffness and peripheral and central blood pressure (BP) parameters in healthy volunteers. Methods Using a double-blind, randomized, crossover design, 23 individuals (9M:14F; age:25±2; BMI:22±0.6kg/m2; SBP/DBP:113±3/70±2mmHg) were administered 400mg Rg3-KRG extract or 400mg wheat bran control on two separate visits with a 7-day washout period. Aortic augmentation index (AIx) and central BP were measured using applanation tonometry by radial pulse wave analysis and peripheral BP was evaluated oscillometrically. Measurements were taken at baseline and 1, 2 and 3h post-intervention. Results Compared to control, there were significant reductions in AIx (-4.3±8.9%, p=0.03), central (-4.8±6.8mmHg, p=0.01) and brachial mean arterial pressure (-4.4±6.6mmHg, p=0.01), central systolic (-5.0±7.9mmHg, p=0.01) and diastolic BP (-3.9±6.6mmHg, p=0.01), brachial systolic (-4.4±10.0mmHg, p=0.048) and diastolic BP (-3.6±6.4mmHg, p=0.01) at 3h post-intervention compared to control. Conclusions This study is the first to demonstrate Rg3-KRG extract acutely lowers central and peripheral arterial pressures in healthy adults. Further clinical evaluation is desired to quantify efficacy in higher-risk individuals and in long term settings.


      PubDate: 2014-04-28T11:19:33Z
       
  • Long Term Renin-Angiotensin Blocking Therapy in Hypertensive Patients with
           Normal Aorta may Attenuate the Formation of Abdominal Aortic Aneurysms
    • Abstract: Publication date: Available online 18 April 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Daniel Silverberg , Anan Younis , Naphtali Savion , Gil Harari , Dmitry Yakubovitch , Basheer Sheick Yousif , Moshe Halak , Ehud Grossman , Jacob Schneiderman
      Objective Renin Angiotensin System (RAS) has been implicated in the pathogenesis of abdominal aortic aneurysm (AAA). Angiotensin II (Ang II) type 1 receptor blocker (ARB), when given with Ang II prevents AAA formation in mice, but found ineffective in attenuating the progression of pre-existing AAA. This study was designed to evaluate the effect of chronic renin-angiotensin system (RAS) blockers on abdominal aortic diameter in hypertensive patients without known aortic aneurysm. Methods Consecutive hypertensive outpatients (n=122) were stratified according to antihypertensive therapy they received for 12 months or more, consisting of either ARB (n=45), angiotensin converting enzyme inhibitor (ACE-I) (n=45), or nonARB/nonACE-I (control therapy; n=32). Abdominal ultrasonography was performed to measure maximal subrenal aortic diameter. 84 patients were re-examined by ultrasonography 8 months later. The correlation between the different antihypertensive therapies and aortic diameter was examined. Results Aortic diameters were significantly smaller in ARB than in control patients in the baseline and follow up measurements (P = 0.004, P = 0.0004, respectively). Risk factor adjusted covariance analysis showed significant differences between ARB or ACE-I treated groups and controls (P = 0.006 or P = 0.046, respectively). Ultrasound that was performed 8 months later showed smaller increases in mean aortic diameters of the ARB and ACE-I groups than in controls. Conclusion Both ARB and ACE-I therapy attenuated expansion of non-aneurismal abdominal aorta in humans. These results indicate that RAS blockade given prior to advancement of aortic medial remodeling may slow down the development of AAA.


      PubDate: 2014-04-28T11:19:33Z
       
  • Accumulation of microvascular target organ damage in newly-diagnosed
           hypertensive patients
    • Abstract: Publication date: Available online 19 April 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Areti Triantafyllou , Panagiota Anyfanti , Xenophon Zabulis , Eleni Gavriilaki , Polykarpos Karamaounas , Eugenia Gkaliagkousi , Konstantinos Petidis , Athina Pyrpasopoulou , Chrysafios Girasis , Spyros Aslanidis , Stella Douma
      Background Early identification of hypertensive target organ damage (TOD) emerges as important for global cardiovascular risk assessment. Retinal vascular alterations, capillary rarefaction and microalbuminuria represent different forms of microvascular TOD. However, data regarding their concomitant presence in the early stages of hypertension, the association of the number of affected organs with cardiovascular risk, and aldosterone effect on multiple TOD are lacking. Methods We studied naïve, never-treated patients with recent duration of hypertension and healthy volunteers. Innovative software was developed to estimate retinal vascular diameters and capillary density. Biochemical parameters including microalbuminuria and serum aldosterone were derived. Framingham Risk Score was used to determine cardiovascular risk. Results In total 103 subjects, 66 hypertensives and 37 normotensives, were included. Hypertensive patients exhibited a greater number of affected target organs compared to normotensives (p=0.014), with retinopathy and capillary rarefaction (40.9%) representing the most common TOD among hypertensives. The number of affected organs was linearly correlated with increased Framingham score and serum aldosterone, analyzed with univariate (p<0.001 and p=0.002) and multivariate analysis (p=0.025 and p=0.004) respectively. Conclusions Physicians dealing with hypertensive patients should be aware of the possibility of diffuse microvascular impairment and seek multiple TOD even in the early stages of hypertension.


      PubDate: 2014-04-28T11:19:33Z
       
  • Antioxidant effect of imperatorin from Angelica Dahurica in hypertension
           via inhibiting NADPH oxidase activation and MAPK pathway
    • Abstract: Publication date: Available online 26 April 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Yan Jun Cao , Yan Min Zhang , Nan Wang , Lang Chong He
      Background Imperatorin (IMP) is an active furocoumarin in the traditional Chinese medicine Angelica Dahurica, and has been demonstrated to have vasodilatory activity. In the present study, we investigated the effect of IMP on blood pressure (BP) and antioxidant effects in Spontaneously Hypertensive Rats (SHR) and HEK293 cells. Methods and Results SHR were administered IMP (6.25, 12.5 and 25 mg/kg/day) or tempol (18 mg/kg/day) daily by gavage for 12 weeks. Thiobarbituric acid-reactive substances (TBARS), proteinuria levels and superoxide dismutase (SOD) activity were evaluated with commercial kits. Nicotinamide adenine dinucleotide phosphate (NADPH) oxidase subunits of the renal cortial tissues were determined by RT-PCR and Western blot. 24 h urinary 8-Iso-prostaglandin F2α (8-iso-PGF2α) was measured by ELISA. Systolic blood pressure and diastolic blood pressure were significantly reduced by treatment with IMP (6.25, 12.5 and 25 mg/kg/day) in SHR. Meanwhile, we found that renal cortical SOD activities were significantly increased in IMP-treated groups. Renal cortical and urinary TBARS levels, the 24 h urinary excretion of 8-iso-PGF2α and proteinuria in the IMP treated group were lower than SHR group. After that, we found the mRNA expressions and protein levels of NADPH oxidase subunits were markedly reduced after IMP treated in SHR. IMP also reduced the phosphorylation of Akt, ERK1/2, p38MAPK and JNK in renal cortical in SHR. In addition, H2O2-induced ROS production in HEK293 cells was markedly attenuated by IMP. H2O2-induced activation of MAPK, AKT and expression of NADPH oxidase were also attenuated by pretreatment of IMP. Conclusions In summary, IMP showed antihypertensive effect via preventing of renal injury not only by reducing NADPH oxidase but also by inhibiting of MAPK pathway.


      PubDate: 2014-04-28T11:19:33Z
       
  • Neutral Endopeptidase Inhibitor versus Angiotensin Converting Enzyme
           Inhibitor in a Rat Model of the Metabolic Syndrome
    • Abstract: Publication date: Available online 24 January 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Yoav Eizenberg , Ehud Grossman , Edna Peleg , Zehava Shabtai , Yehonatan Sharabi
      Background The antihypertensive treatment in patients with metabolic syndrome is unclear. We therefore used a rat model of the metabolic syndrome and compared the effects of enalapril, an angiotensin-converting-enzyme inhibitor, with candoxatril, a neutral endopeptidase inhibitor which inhibit degradation of atrial natriuretic peptide and in addition to lowering blood pressure exerts metabolically beneficial activity. Methods Ten male Sprague Dawley rats were fed regular rat chow for 5 weeks. Fifty male Sprague Dawley rats were fed a high-fructose diet for 3 weeks, followed by addition of enalapril, 10 mg/Kg/d, or candoxatril, 25, 50, or 100 mg/Kg/d, for 2 weeks. Systolic blood pressure, plasma triglyceride level, and insulin level were measured at baseline and after 3 weeks and 5 weeks. Results Three weeks of a high-fructose diet led to a significant increase in all metabolic parameters. Candoxatril and enalapril lowered systolic blood pressure significantly (candoxatril -10±1 to -22±1 mmHg and enalapril -27±2 mmHg). High-dose candoxatril and enalapril significantly decreased plasma triglyceride levels (by 17.8% and 32.8%, respectively), but only high-dose candoxatril decreased plasma insulin levels significantly (by 25.3%). Conclusion High-dose candoxatril is a metabolically favorable option for lowering blood pressure in a rat model of metabolic syndrome.


      PubDate: 2014-01-24T16:33:48Z
       
  • From The Editor
    • Abstract: Publication date: Available online 18 January 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Myron H. Weinberger



      PubDate: 2014-01-20T09:56:29Z
       
  • Characteristics of Hypertension Subtypes and Treatment Outcome among
           Elderly Korean Hypertensives
    • Abstract: Publication date: Available online 11 January 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Suk-Won Choi , Min-Kyu Kim , Seong-Woo Han , Sung Hea Kim , Hyun Joong Kim , Seok-Min Kang , Dae-Kyeong Kim , Byung Soo Kim , Won Ho Kim , Jang-Young Kim , Hee-Yeol Kim , Jay-Young Rhew , Keum-Soo Park , Kyoung-Im Cho , Myung Ho Jeong , Yong Suk Jeong , Kyu-Hyung Ryu
      There are limited data about characteristics of hypertension subtypes in Asian hypertensive patients and their impacts on treatment of hypertension. This prospective, multi-center, observational study evaluated 2,439 hypertensive patients. (≥ 60 years) Inadequately controlled and drug-naïve patients were categorized into three hypertension subtypes (isolated systolic hypertension [ISH], combined systolic/diastolic hypertension [SDH], and isolated diastolic hypertension [IDH]) and proportions of each hypertension subtype were evaluated. After six-month strict treatments, we compared the characteristics of patients who did not achieve target BP with those who did. In overall population, ISH was the most common subtype (53.2%, 1297/2439). However, in drug-naïve patients, SDH was predominant hypertension subtype (59.6%, 260/436). Notably, the proportion of ISH was substantially lower than previously known data. Predictors associated with failure of reaching target BP were old age (>70 years), hypertension awareness, and baseline systolic BP (≥160 mm Hg) for total patients. In drug naïve patients, hypertension awareness, ISH, and microalbuminuria were associated with treatment failure. These findings might have an impact on the evaluations and antihypertensive treatments of elderly Korean patients.


      PubDate: 2014-01-13T02:27:32Z
       
  • Gunfight at O.K. CORAL
    • Abstract: Publication date: Available online 11 January 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Friedrich C. Luft , Erdal Safak , Ralf Dechend



      PubDate: 2014-01-13T02:27:32Z
       
  • Aortic Dilatation in Children with Systemic Hypertension
    • Abstract: Publication date: Available online 9 January 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Monesha Gupta-Malhotra , Richard B. Devereux , Archana Dave , Cynthia Bell , Ronald Portman , Diana Milewicz
      Background The aim of the study was to determine presence of aortic dilatation in hypertensive children, the prevalence of which is 4-10% in hypertensive adults. Methods Prospectively enrolled multiethnic children untreated for their hypertension, underwent an echocardiogram to exclude congenital heart disease and evaluate for end-organ damage and aortic size. The aorta was measured in the parasternal long-axis view at 3 levels: the sinus of Valsalva, supra-tubular junction and the ascending aorta. Aortic dilatation was determined by z-score > 2 at any 1 of the levels measured. Hypertension was defined as blood pressure above the 95th percentile based on the Fourth Working Group criteria confirmed by 24-hour ambulatory blood pressure monitoring. Results Among 142 consecutive hypertensive children (median age 14 years, 45% females) aortic dilatation was detected in 2.8% (95% CI 1% to 7%, median age 16 years, 100% females). Children with aortic dilatation, when compared to those without, had significantly more aortic valve insufficiency (p = 0.005) and left ventricular hypertrophy (p = 0.018). Conclusions Prevalence of aortic dilatation was 2.8% and was associated with significantly more aortic insufficiency and left ventricular hypertrophy in comparison to those without aortic dilatation.


      PubDate: 2014-01-13T02:27:32Z
       
  • High potassium intake blunts the effect of elevated sodium intake on blood
           pressure levels
    • Abstract: Publication date: Available online 7 January 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Sérgio Lamêgo Rodrigues , Marcelo Perim Baldo , Rebeca Caldeira Machado , Ludimila Forechi , Maria del Carmem Bisi Molina , José Geraldo Mill
      Background To investigated the influence of dietary potassium on the sodium effect on BP in the general population and the adherence of current recommendations for sodium and potassium intake. Methods An overnight (12 h) urine sample was collected in a population-based study to investigate cardiovascular risk. A sub-sample of 1,285 subjects (25-64 years) free from any medication interfering with BP or potassium excretion was studied. Results 86.0% of participants consumed over 6 g of salt/day and 87.7% less than the recommended intake of potassium (4.7 g). Potassium excretion and the sodium to potassium ratio were significantly related to systolic and diastolic BP only in subjects consuming more than 6 g/day of salt. Subjects in the highest sodium to potassium ratio quartile (surrogate of unhealthy diet) presented 8 mmHg and 7 mmHg higher values of systolic and diastolic BP, respectively, when compared with the first quartile whilst individuals in the fourth quartile of urinary potassium excretion (healthier diet) showed 6 mmHg and 4 mmHg lower systolic and diastolic BP, respectively, compared with the first quartile. Conclusion Our data indicate that when people have an increased intake of potassium, high intake of sodium is not associated with higher BP.


      PubDate: 2014-01-09T00:25:12Z
       
  • Baseline Predictors of Central Aortic Blood Pressure: A PEAR Substudy
    • Abstract: Publication date: Available online 3 January 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Rebecca Rosenwasser , Niren K. Shah , Steven M. Smith , Xuerong Wen , Yan Gong , John G. Gums , Wilmer W. Nichols , Arlene B. Chapman , Eric Boerwinkle , Julie Johnson , Benjamin Epstein
      Background Elevated central systolic blood pressure (BP) increases the risk of cardiovascular events and appears superior to peripheral BP for long term risk prediction. The objective of this study was to identify demographic and clinical factors associated with central pressures in patients with uncomplicated hypertension. Methods and Results We prospectively examined peripheral BP, central aortic BP, and arterial wall properties and wave reflection in 57 subjects with uncomplicated essential hypertension in the Pharmacogenomic Evaluation of Antihypertensive Responses (PEAR) Study. Significant predictors of central SBP included height, smoking status, HR, and peripheral SBP, while central DBP was explained by peripheral DBP and HR. These variables accounted for nearly all of the variability in central SBP and central DBP (R2= 0.94 and R2= 0.98, respectively). Central pulse pressure variability was largely explained by gender, ex-smoking status, HR, peripheral SBP, and peripheral DBP (R2=0.94). Central augmented pressure had a direct relationship with smoking status, peripheral SBP, and duration of hypertension, whereas it was indirectly related to height, HR, peripheral DBP. Conclusions Easily obtainable demographic and clinical factors are associated with central pressures in essential hypertensive persons. These relationships should be considered in future studies to improve assessment of BP to reduce cardiovascular risk and mortality.


      PubDate: 2014-01-04T19:42:04Z
       
  • The Effect of Migration on Hypertension and Other Cardiovascular Risk
           Factors: A Review
    • Abstract: Publication date: Available online 2 January 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Talma Rosenthal
      This comprehensive review summarizes the effects of migration and immigration on the development of hypertension and cardiovascular risk factors the world over – Europe, Asia, Africa, North, South and Central America, China, Australia, the Middle East. The process of acculturation that populations undergo as they move from small, rural, agricultural economies to industrialized towns and cities takes a toll on health and well being. Surroundings change, a new culture has to be adapted to, a new language learned, lifestyles changed, physical activity often drastically reduced, and major changes made in eating habits as low-sodium low-fat diets are replaced by processed foods and high amounts of salt. Even populations that move from one westernized country to another undergo these traumas. The results: increased stress, hypertension, obesity and diabetes. These changes are more severe in the elderly than young people, who adapt to their new home more quickly. While such reactions to migration are seen worldwide, all populations do not respond the same, the result of constitutional differences and of the different cultures from whence they came. These dramatic changes put the onus on the governments and health services of the host countries to tailor prevention and treatment programs to these different populations – proactive programs that are sorely lacking in most countries. The literature documents these phenomena, and can serve as a wake-up call to what is becoming a major worldwide health issue as populations shift and peoples struggle to adapt.


      PubDate: 2014-01-04T19:42:04Z
       
  • Excessive pulse pressure response to standing in community population with
           orthostatic systolic hypertension
    • Abstract: Publication date: Available online 20 December 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Jingsong Xu , Yueying Zhou , Juxiang Li , Xuehua Tao , Zhihong Zhang , Xin Liu , Jiaqi Liu , Hai Su
      Background The postural change of pulse pressure (PP) in the persons with orthostatic hypertension (OHT) is unclear. Methods This study included 2849 (65.0 ± 9.3 y) community participants. Blood pressures (BP) in supine and standing positions were measured. The differences between upright and supine BP and PP were recorded as ΔBP and ΔPP. The criteria for OHT was ΔBP ≥ 10mmHg, for orthostatic hypotension (OH) was ≤-10 mmHg and for orthostatic normotension (ONT) was -9-9 mmHg. Fasting blood lipids and glucose were measured. Results The supine SBP of the sOHT group were similar to that of sONT group (140.9±20.2, vs 138.2±19.7mmHg), but significantly lower than that of sOH group (151.9±19.2mmHg, P<0.05). Their PPs were 65.3±15.9, 62.8±14.7 and 71.1±15.1 mmHg, respectively, and with the similar group difference like SBP. When the position from supine to standing, the sOHT group showed PP rise, while sOH and sONT groups showed PP reduction (3.8±7.1 vs -17.0±8.5 and -5.8±6.6mmHg, both P<0.05) . Thus, the standing PP in the sOHT group was significantly higher than in the sONT (69.1±18.0 vs 57.0±15.8 mmHg, P<0.05) and in the sOH (54.2±15.2 mmHg, P<0.05) groups. Conclusion The postural PP profile varies with the postural responses of SBP. The sOHT group has obviously increased PP and significantly higher standing PP compared with the sONT group.


      PubDate: 2013-12-24T13:31:07Z
       
  • Effect of Change in Systolic Blood Pressure Between Clinic Visits on
           Estimated 10-Year Cardiovascular Disease Risk
    • Abstract: Publication date: Available online 19 December 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Siqin Ye , Y. Claire Wang , Daichi Shimbo , Jonathan D. Newman , Emily B. Levitan , Paul Muntner
      Background Systolic blood pressure (SBP) often varies between clinic visits within individuals, which can affect estimation of cardiovascular disease (CVD) risk. Methods and Results We analyzed data from participants with two clinic visits separated by a median of 17 days in the Third National Health and Nutrition Examination Survey (n=808). Ten-year CVD risk was calculated with SBP obtained at each visit using the Pooled Cohort Equations. The mean age of participants was 46.1 years and 47.3% were male. The median SBP difference between the two visits was -1 mmHg (1st – 99th percentiles: -23 to 32 mmHg). The median estimated 10-year CVD risk was 2.5% and 2.4% at the first and second visit, respectively (1st – 99th percentiles -5.2% to +7.1%). Meaningful risk reclassification (i.e., across the guideline recommended 7.5% threshold for statin initiation) occurred in 12 (11.3%) of 106 participants whose estimated CVD risk was between 5% to 10%, but only in 2 (0.3%) of 702 participants who had a 10-year estimated CVD risk of <5% or >10%. Conclusions SBP variability can affect CVD risk estimation, and can influence statin eligibility for individuals with an estimated 10-year CVD risk between 5% and 10%.


      PubDate: 2013-12-19T19:13:01Z
       
  • Modulation of aldosterone levels by -344C/T CYP11B2 polymorphism and
           spironolactone use in resistant hypertension
    • Abstract: Publication date: Available online 4 December 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Vanessa Fontana , Ana Paula Cabral de Faria , Natália Ruggeri Barbaro , Andréa Rodrigues Sabbatini , Rodrigo Modolo , Riccardo Lacchini , Heitor Moreno
      Background Interindividual variability in plasma aldosterone levels comprises environmental and genetic sources. Increased aldosterone levels have been associated with higher risk of hypertension and target-organ damage related to hypertension. Aldosterone excess and intravascular volume expansion are implicated in pathophysiology of resistant hypertension (RH). Methods and Results We sought to investigate whether -344C/T polymorphism (rs1799998) in aldosterone synthase gene (CYP11B2) is associated with plasma aldosterone levels in patients with resistant hypertension. Sixty-two patients with resistant hypertension were enrolled in this cross-sectional study. Genotypes were obtained by allelic discrimination assay using Real Time PCR. Multivariable linear regression was used to identify whether TT genotype was predictor of aldosterone levels. No differences in clinical and laboratorial parameters were found among genotype groups. We found an additive effect of the T allele on plasma aldosterone concentration in RH. Also, there was higher aldosterone levels in TT homozygous under use of spironolactone compared to C carriers and compared to TT subjects who was not under use of spironolactone. TT genotype and the use of spironolactone were significant predictors of aldosterone levels in RH subjects. Conclusions Plasma aldosterone concentration is significantly associated with -344C/T CYP11B2 polymorphism and with the treatment with spironolactone in resistant hypertensive subjects.


      PubDate: 2013-12-08T03:04:03Z
       
  • Sodium surfeit and potassium deficit: Keys to the pathogenesis of
           hypertension
    • Abstract: Publication date: Available online 5 November 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Horacio J. Adrogué , Nicolaos E. Madias
      The pathogenic role of Na+ in primary hypertension is widely recognized but that of K+ remains unappreciated. Yet, extensive evidence indicates that together, the body's dominant cations constitute the chief environmental factor in the pathogenesis of hypertension and its cardiovascular sequelae. In this Review, we provide a synthesis of the determinants of Na+ retention and K+ loss developing in the body as the Na+-rich and K+-poor modern diet interacts with kidneys intrinsically poised to conserve Na+ and excrete K+; and the molecular pathways utilized by these disturbances in the central nervous system and the periphery to increase sympathetic tone and vascular resistance, and establish hypertension. These fresh insights point to new directions for targeted pharmacotherapy of hypertension. The interdependency of Na+ and K+ in the pathogenesis of hypertension indicates that Na+ restriction and increased K+ intake are important strategies for the primary prevention and treatment of hypertension and its cardiovascular consequences.


      PubDate: 2013-11-06T01:20:19Z
       
  • Early treatment of Hypertension in Acute Ischemic and Intracerebral
           Hemorrhagic Stroke. Progress Achieved, Challenges and Perspectives
    • Abstract: Publication date: Available online 4 October 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Carlos Feldstein
      Hypertension is the leading risk factor for ischemic and intracerebral hemorrhagic subtypes of stroke. Additionally, high BP in the acute cerebrovascular event is associated with poor outcome, and a high percentage of stroke survivors have inadequate control of hypertension. The present is a systematic review of prospective, randomised, and controlled trials carried out on safety and efficacy of antihypertensive treatment of both subtypes of acute stroke. Six trials involving 7512 patients were included. It is likely that persistent controversies on the speed and the goal of treatment could arise, at least in part, from analyzing the results of antihypertensive treatment in ischemic and intracerebral hemorrhagic subtypes of acute stroke together, and different prevalence of past-stroke in the randomised groups. It needs further research to establish whether the guideline standard antihypertensive treatment could provide greater benefit than simple observation in patients with ischemic acute stroke and Stage 2 hypertension of JNC 7, albeit they were not candidates for acute reperfusion. In that case, the target reduction in BP could be 10% to 15% within 24 hours. The recently published INTERACT 2 has provided evidence that patients with hemorrhagic stroke can receive intensive antihypertensive treatment safely with the goal of reducing the SBP to values no lower than 130 mm Hg. It is important to take into account that marked BP lowering in acute stroke increases the risk of poor outcome by worsening cerebral ischemia from deterioration of cerebral blood flow autoregulation.


      PubDate: 2013-10-05T08:00:59Z
       
 
 
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