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  Subjects -> HISTORY (Total: 1077 journals)
    - HISTORY (739 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 (107 journals)
    - HISTORY OF THE AMERICAS (90 journals)
    - HISTORY OF THE NEAR EAST (13 journals)

HISTORY (739 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: 127)
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: 147)
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: 123)
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]
  • An Imbalance in Serum Concentrations of Inflammatory and Anti-inflammatory
           Cytokines in Hypertension
    • Abstract: Publication date: Available online 21 May 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Seyed Reza Mirhafez , Mohsen Mohebati , Mahboobeh Feiz Disfani , Maryam Saberi Karimian , Mahmoud Ebrahimi , Amir Avan , Saied Eslami , Alireza Pasdar , Hassan Rooki , Habibollah Esmaeili , Gordon A. Ferns , Majid Ghayour-Mobarhan
      Background Hypertension is an important risk factor for cardiovascular disease and there is increasing evidence that inflammation and abnormal immune responses are involved in the pathogenesis of hypertension. However, the data on the association between specific cytokine concentrations and hypertension is inconsistent. We have evaluated the association between 12 cytokines/growth factors and the presence of different degrees of hypertension, comparing these concentrations to values in a healthy group of subjects. Methods /Patients: The concentrations of interleukin-1α/-1β/-2/-4/-6/-8/-10, tumor necrosis factor (TNF-α), Interferon-γ (IFN-γ), monocyte chemoattractant protein (MCP-1), epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) were measured in 155 hypertensive patients and 148 healthy subjects, using EV-3513 cytokine biochip arrays, a competitive chemiluminescence immunoassay. Univariate and multivariate analyses were used to evaluate the association of specific cytokines/growth factors with systolic/diastolic blood pressure (SBP/DBP). Results Hypertensive subjects had higher serum concentrations of IL-1α/-2/-8, VEGF, IFN-γ, TNF-α, MCP-1 and EGF; and lower concentrations of anti-inflammatory cytokine, IL-10 (p<0.05), compared to the healthy individuals. The serum concentrations of IL-4/-6/-1β did not differ between the hypertensive subjects and control group. Univariate and multivariate analyses revealed that IL-1α and INFγ were independent predictors of a high SBP, while INF-γ, IL-1α, TNF-α and MCP-1 remained statistically significant for DBP after correction for age, gender, BMI, smoking, FBG and TG. Conclusions There was a significant association between the concentrations of several cytokines and hypertension. These associations may either be related to common underlying factors that cause hypertension, and may also be pro-inflammatory; or because these inflammatory cytokines might directly be involved in the etiology of hypertension.


      PubDate: 2014-07-24T20:29:45Z
       
  • Relationship between cardio-ankle vascular index and N-Terminal pro-brain
           natriuretic peptide in hypertension and coronary heart disease subjects
    • Abstract: Publication date: Available online 28 May 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Hongyu Wang , Jinbo Liu , Hongwei Zhao , Yingyan Zhou , Xujing Zhao , Yuejie Song , Lihong Li , Hongyan Shi
      Background Arterial stiffness is an independent predictor for vascular diseases. Cardio-ankle vascular index (CAVI) is a new index of arterial stiffness. N-Terminal pro-brain natriuretic peptide (NT-proBNP) is a strong prognostic marker in advanced stage of coronary heart disease (CHD). In the present study, we investigated the relationship between CAVI and NT-proBNP in hypertension and CHD subjects. Methods 501 subjects (M/F 209/292) from Vascular Medicine of Peking University Shougang Hospital were divided into four groups: healthy group (n=186), hypertension group (n=159), CHD group (n=45), hypertension with CHD group (n=111). CAVI was measured by VS-1000 apparatus. Results Our results showed that CAVI was significantly higher in hypertension subjects with CHD than in healthy and hypertension group, respectively (8.42±1.51 vs 7.77±1.19; 8.42±1.51 vs 7.92±1.11, both p<0.05). NT-proBNP was significantly higher in hypertension subjects with CHD than in healthy, hypertension, and CHD group, respectively (422.48±761.60 vs 174.29±415.48; 422.48±761.60 vs 196.14±299.16; 422.48±761.60 vs 209.66±242.66; all p<0.05). And after log transformation of NT-proBNP, this phenomenon also exists (2.32±0.47 vs 2.03±0.40; 2.32±0.47 vs 2.09±0.44; 2.32±0.47 vs 2.12±0.42; all p<0.05). There was positive correlation between Log NT-proBNP and CAVI in the entire study group, healthy group and non-healthy group (r=0.235, p<0.001; r=0.184, p=0.023; r=0.237, p<0.001; respectively). Multivariate analysis showed that NT-proBNP was an independent associating factor of CAVI in all subjects (beta=0.150, p=0.021). Conclusions Our present study showed that CAVI and NT-proBNP were significantly higher in hypertension subjects with CHD compared to healthy and hypertension groups. There was significant correlation between NT-proBNP and CAVI, which indicating the relationship between arterial stiffness and biomarkers in vascular-related diseases.


      PubDate: 2014-07-24T20:29:45Z
       
  • Population health: ASH and the American Health Care Revolution Leadership
           Message from the American Society of Hypertension
    • Abstract: Publication date: June 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 6
      Author(s): Robert A. Phillips



      PubDate: 2014-07-24T20:29:45Z
       
  • Diabetes and age-related demographic differences in risk factor control
    • Abstract: Publication date: June 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 6
      Author(s): Brent M. Egan , Jiexiang Li , Tamara E. Wolfman , Angelo Sinopoli
      Disparate vascular outcomes in diabetes by race and/or ethnicity may reflect differential risk factor control, especially pre-Medicare. Assess concurrent target attainment for glycohemoglobin <7%, non–high density lipoprotein-cholesterol <130 mg/dL, and blood pressure <140/<90 mm Hg in white, black, and Hispanic diabetics <65 years and ≥65 years of age. The National Health and Nutrition Examination Surveys 1999–2010 data were analyzed on diagnosed and undiagnosed diabetics ≥18 years old. Concurrent target attainment was higher in whites (18.7%) than blacks (13.4% [P = .02] and Hispanics [10.3%, P < .001] <65 years but not ≥65 years of age; 20.0% vs. 15.9% [P = .13], 19.5% [P = .88]). Disparities in health care insurance among younger whites, blacks, and Hispanics, respectively, (87.4% vs. 81.1%, P < .01; 68.0%, P < .001) and infrequent health care (0–1 visits/y; 14.3% vs. 15.0%, P = not significant; 32.0%, P < .001) declined with age. Cholesterol treatment predicted concurrent control in both age groups (multivariable odds ratio >2, P < .001). Risk factor awareness and treatment were lower in Hispanics than whites. When treated, diabetes and hypertension control were greater in whites than blacks or Hispanics. Concurrent risk factor control is low in all diabetics and could improve with greater statin use. Insuring younger adults, especially Hispanic, could raise risk factor awareness and treatment. Improving treatment effectiveness in younger black and Hispanic diabetics could promote equitable risk factor control.


      PubDate: 2014-07-24T20:29:45Z
       
  • Editorial Board
    • Abstract: Publication date: June 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 6




      PubDate: 2014-07-24T20:29:45Z
       
  • Table of Contents
    • Abstract: Publication date: June 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 6




      PubDate: 2014-07-24T20:29:45Z
       
  • Ginseng for Cardiovascular Disease. Not yet the Panacea
    • Abstract: Publication date: Available online 4 June 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Italo Biaggioni



      PubDate: 2014-07-24T20:29:45Z
       
  • Clinical Predictors and Impact of Ambulatory Blood Pressure Monitoring in
           Pediatric Hypertension Referrals
    • Abstract: Publication date: Available online 2 June 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Marguerite L. Davis , Michael A. Ferguson , Justin P. Zachariah
      Background Elevated blood pressure (BP) is rising in children. Significant proportions of children have reactive hypertension or masked hypertension, making ambulatory blood pressure monitoring (ABPM) a valuable tool, although with potential economic implications. In youth referred for elevated BP, we sought clinic BP combinations that obviated the need for ABPM and to specify the economic role of ABPM. Methods In a retrospective pediatric referral cohort (n=170), we examine clinic systolic BP (SBP) predictors of components of ABPM hypertension and their combination. In economic analyses, we compared effectiveness and charges of three diagnostic pathways: 1. Clinic BP alone; 2. Abnormal Clinic BP prompting ABPM; or 3. Universal ABPM. Results ABPM hypertension occurred in 55 (32.4%) and reactive hypertension in 37 (21.8%), Average automated (β=0.208 [95%CI 0.027, 0.389], P=0.03) and maximum auscultatory clinic SBP (β=0.160 [95%CI 0.022, 0.299], P=0.02) were associated with ABPM SBP mean, but none predicted SBP load. No clinic SBP combination was associated with ABPM hypertension. Universal ABPM accrued the lowest average charge per hypertensive youth identified ($10,948). Conclusions We did not identify a clinic SBP combination that predicted ABPM hypertension in youth referred for elevated BP. Universal ABPM in this context may be the most economically and clinically efficient diagnostic strategy.


      PubDate: 2014-07-24T20:29:45Z
       
  • Ventricular-arterial coupling in obstructive sleep apnoea
    • Abstract: Publication date: Available online 4 June 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Alena Shantsila , Eduard Shantsila , Mehmood Butt , Omer A. Khair , Girish Dwivedi , Gregory Y.H. Lip
      Objectives Arterial and systolic elastance are important parameters determining effective functional interaction of heart and vessels. The aims of this study were to (i) compare arterial [arterial elastance index (EaI)] and ventricular [End-systolic elastance (Ees) and End-diastolic elastance (Eed)] elastance in subjects with obstructive sleep apnoea (OSA) and patients with treated ‘high-risk’ hypertension (HHT), and (ii) test whether these parameters in OSA patients can be improved by continuous positive airway pressure (CPAP) therapy. Methods Echocardiographic parameters of cardiac and vascular stiffness (EaI, Ees and Eed) were quantified in 28 patients with OSA (mean [SD] age 51 [11] years, 79% male) and 28 treated subjects with HHT (mean [SD] age 48 [12] years, 61% male). Twenty three OSA patients were treated with CPAP for median of 26 weeks. Ea was calculated from stroke volume and systolic BP and adjusted by body area (EaI). Both study groups had preserved and comparable left ventricle (LV) contractility. Results There was no significant differences in arterial elastance index (EaI, p=0.94), end-systolic elastance (Ees, p=0.5), end-diastolic elastance (Eed, p=0.63) and arterial-ventricular interaction (Ees/Ea, p=0.62) between OSA and HHT groups. After CPAP therapy, there was a significant reduction in arterial elastance index (EaI; paired t-test, p=0.013), and arterial-ventricular interaction (Ees/Ea; paired t-test, p=0.004). End-systolic elastance (Ees, p=0.17), end-diastolic elastance (Eed, p=0.66) parameters did not change significantly. Conclusions OSA patients and HHT patients have similar parameters of elastance and ventricular-arterial coupling. CPAP treatment in OSA patients significantly improved ventricular-arterial coupling.
      Teaser There was no significant differences in arterial elastance index (EaI, p=0.94), end-systolic elastance (Ees, p=0.5), end-diastolic elastance (Eed, p=0.63) and arterial-ventricular interaction (Ees/Ea, p=0.62) between obstructive sleep apnoea and high risk hypertension groups. After continuous positive airway pressure therapy, there was a significant reduction in arterial elastance index (EaI), and arterial-ventricular interaction (Ees/Ea). End-systolic elastance (Ees), end-diastolic elastance (Eed) parameters did not change significantly. As a result patients with obstructive sleep apnoea and high risk hypertension have similar parameters of elastance and ventricular-arterial coupling. Continuous positive airway pressure treatment in patients with obstructive sleep apnoea significantly improves ventricular-arterial coupling.

      PubDate: 2014-07-24T20:29:45Z
       
  • Hemodynamic Effects of Angiotensin Inhibitors in Elderly Hypertensives
           Undergoing Total Knee Arthroplasty under Regional Anesthesia
    • Abstract: Publication date: Available online 12 June 2014
      Source:Journal of the American Society of Hypertension
      Author(s): J.J. Calloway , S. Memtsoudis , D. Krauser , Y. Ma , L.A. Russell , S.M. Goodman
      Background The aim was to investigate the association between continuing angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) with postinduction hypotension and vasoactive drug use in elderly orthopedic surgery patients under regional anesthesia. Methods Retrospective design. 114 patients (mean age 66) undergoing elective total knee arthroplasty (TKA), including 84 patients with chronic hypertension, were divided as: Group I (n=37): ACEI/ARB continued, Group II (n=23): ACEI/ARB withdrawn, Group III (n=24): Beta blocker/calcium channel blocker continued and Group IV (n=30): without hypertension/control. Primary endpoints: systolic (SBP) and mean arterial blood pressures (MAP) at 0, 30, 60 and 90 minutes postinduction, incidence of hypotension(SBP<85mmHg) and ephedrine requirements. Repeated measurements were analyzed using generalized estimating equations controlling for baseline characteristics and accounting for correlations. Logistic regression was used for remaining variables. Results Hypotension occurred more frequently (p=0.02) in Group I (30%) versus Groups II-IV (9%, 13%, 3%). Ephedrine use was increased (p<0.001) in Group I (51%) compared to Groups II-IV (26%, 17%, 7%). Group I had lower mean SBPs compared with Group II (110 versus 120; p=0.0045) and Group IV (110 versus 119; p=0.0013). Lower mean MAPs were found in Group I versus Group II (74 versus 81, p=0.001) and Group IV (74 versus 80; p=0.001). Group I had an increased odds of receiving ephedrine versus Group IV (odds ratio 16.27; 95% confidence interval 3.10-85.41; p=0.001). No adverse clinical events were recorded. Conclusion Day of surgery ACEI/ARB use is associated with a high incidence and severity of postinduction hypotension with associated high vasopressor requirements. Associated clinical outcomes merit further study.


      PubDate: 2014-07-24T20:29:45Z
       
  • From the Editor
    • Abstract: Publication date: Available online 13 June 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Myron H. Weinberger



      PubDate: 2014-07-24T20:29:45Z
       
  • Illusions of truths in the Symplicity HTN-3 trial: Generic design
           strengths but neuroscience failings
    • Abstract: Publication date: Available online 12 June 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Murray Esler
      The Achilles heel in catheter-based studies of renal denervation for severe hypertension is the almost universal failure to apply a confirmatory test for renal denervation. When renal denervation efficacy was assessed, using measurements of the spillover of norepinephrine from the renal sympathetic nerves to plasma, the only test validated to this point, denervation was found to be incomplete and non-uniform between patients. It is probable that the degree of denervation has typically been sub-optimal in renal denervation trials. This criticism applies with special force to the Symplicity HTN-3 trial, where the proceduralists, although expert interventional cardiologists, had no prior experience with the renal denervation technique. Their learning curve fell during the trial, a shortcoming accentuated by the fact that one third of operators performed one procedure only. Recently presented results from the Symplicity HTN-3 trialists confirms that renal denervation was not effectively or consistently achieved in the trial.


      PubDate: 2014-07-24T20:29:45Z
       
  • Physiology: hemodynamics, endothelial function,
           renin–angiotensin–aldosterone system, sympathetic nervous
           system
    • Abstract: Publication date: July 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 7
      Author(s): L. Gabriel Navar



      PubDate: 2014-07-24T20:29:45Z
       
  • Simvastatin but not Ezetimibe Reduces Sympathetic Activity Despite Similar
           Reductions in Cholesterol Levels
    • Abstract: Publication date: Available online 25 June 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Jacek Lewandowski , Maciej Siński , Liana Puchalska , Bartosz Symonides , Zbigniew Gaciong
      Background The relationship between the sympatholytic effects of statins and their lipid-lowering activity remains unclear. Ezetimibe lowers cholesterol, but its sympatholytic activity is unknown. The purpose of study was to compare the influence of equipotent doses of simvastatin and ezetimibe on sympathetic activity. Methods and Results This randomized, double-blinded study was performed in 22 hypertensive patients (age: 45.6±2.2 years, F/M: 2/20) with untreated hypercholesterolemia. The subjects were administered 20 mg/day of simvastatin (n=11) or 20 mg/day of ezetimibe (n=11) for 6 weeks. Pre- and post-treatment measurements of muscle sympathetic nerve activity (MSNA), baroreceptor control of heart rate (BRS) and impedance cardiography were recorded. Simvastatin and ezetimibe produced similar reductions of total (-58.0±23.4 vs -45.2±17.2 mg/dL, p=0.15, respectively) and LDL cholesterol (-52.6±20.9 vs -37.9±17.6 mg/dL, p=0.09, respectively). There was a significant difference in the effect of simvastatin and ezetimibe on MSNA (-8.5±5.1 vs -0.7±3.5 bursts/minute, p=0.0005). Simvastatin improved BRS as compared to ezetimibe (10.0±14.3 vs -2.8±6.1 ms/mmHg, p=0.01). There was no difference in the effect of both treatments on blood pressure, heart rate, cardiac output, stroke volume, total peripheral resistance, HDL and triglycerides. Conclusion Simvastatin reduced sympathetic activity via lipid-independent mechanisms, but ezetimibe exerts no sympatholytic effects.


      PubDate: 2014-07-24T20:29:45Z
       
  • ASH hypertension self-assessment program
    • Abstract: Publication date: July 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 7
      Author(s): Thomas D. Giles



      PubDate: 2014-07-24T20:29:45Z
       
  • Lowering blood pressure to prevent stroke recurrence: a systematic review
           of long-term randomized trials
    • Abstract: Publication date: July 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 7
      Author(s): Carlos A. Feldstein
      Albeit hypertension is a leading risk factor for an initial stroke, the role of blood pressure (BP) lowering to prevent a subsequent stroke is controversial. The present systematic review searched randomized trials published from January 1990 to January 2014 with the aim to assess antihypertensive treatment effects on recurrent stroke prevention. Seven randomized placebo-controlled trials enrolling 49,518 patients, two randomized trials not placebo controlled comparing antihypertensive drugs, and one randomized trial that compared the effects of intensive systolic BP lowering with a more conservative systolic BP management, were identified. The placebo-controlled trials had substantial methodological differences, explaining the difficulties to compare their results. An important obstacle arises from the large dispersion in the window's time between the qualifying stroke and randomization. Another barrier is the variation among studies in the recruited patient's stroke subtypes. Differences between trials could not be attributed to disparity in lowering BP or to different degrees of no adherence. The American Heart Association/American Stroke Association stated that although an absolute target of BP level has not been clearly defined, a reduction in recurrent stroke has been associated with an average lowering of 10/5 mm Hg. It should be taken into account that it is not advisable to reduce BP levels to <120/80 mm Hg. It should carry out an individualized selection, based on demographic characteristics and comorbidities (cardiovascular disease, diabetes mellitus, and chronic disease) among diuretics, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, or calcium channel blockers.


      PubDate: 2014-07-24T20:29:45Z
       
  • Is systolic blood pressure below 150 mm Hg an appropriate goal for
           
    • Abstract: Publication date: July 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 7
      Author(s): Reza Mohebi , Ali Mohebi , Arash Ghanbarian , Amirabbas Momenan , Fereidoun Azizi , Farzad Hadaegh
      Recently, Joint National Committee has changed the optimal therapeutic goal of systolic blood pressure (SBP) up to 150 mm Hg for elderly population. We aimed to investigate impact of different blood pressure (BP) categories on risk of developing cardiovascular disease (CVD) and mortality among elderly. The present study included 1845 participants, aged ≥60 years (mean age = 65 years), free of CVD at baseline, who had undergone health examinations between January 1999 and 2001, and were followed up until March 2010. Cox proportional hazard regression was performed to assess the hazard ratios (HRs) of BP categories for CVD and mortality events, considering those with optimal BP (SBP <120 mm Hg and diastolic BP [DBP] <80 mm Hg) as reference. During a median of 10 years follow-up, 380 cases of first CVD and 260 cases of mortality events occurred. In multivariable adjusted model, prehypertensive group (SBP between 120–129 mm Hg or DBP between 80–85 mm Hg) could not predict CVD (HR, 0.87 [0.61–1.24]) nor mortality events (HR, 0.86 [0.58–1.34]). Those with SBP between 140 mm Hg and 150 mm Hg (group 3) were at higher risk for developing CVD (HR, 1.79 [1.17–2.74]), but there were no significant risk for total mortality (HR, 1.13 [0.65–1.97]). Hypertensive group (SBP ≥150 mm Hg or DBP ≥90 mm Hg or taking antihypertensive drugs) was associated with increased risk of both CVD (HR, 1.73 [1.24–2.42]) and mortality events (HR, 1.49 [1.00–2.23]).However, Joint National Committee 8 suggested no more benefit with lowering SBP <150 mm Hg, but the results of this study imply that those with SBP between 150 mm Hg and 140 mm Hg are still at elevated risk for CVD/coronary heart disease events.


      PubDate: 2014-07-24T20:29:45Z
       
  • Are video sharing Web sites a useful source of information on
           hypertension'
    • Abstract: Publication date: July 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 7
      Author(s): Nilay Kumar , Ambarish Pandey , Anand Venkatraman , Neetika Garg
      Hypertension (HTN) is a prevalent and growing public health problem in the United States and worldwide. Video sharing Web sites such as YouTube could potentially influence patient behaviors via properties of interpersonal and mass media communication. We conducted this cross-sectional study to assess the accuracy and content of YouTube videos on HTN and understand how viewers interact with this online information. We analyzed 209 videos (31.57 hours) of which 63% were classified as useful, 33% as misleading, and 4% represented patient's personal experiences. Number of views per day and “likes” were significantly lower for useful videos. Approximately half the misleading videos contained product advertisements, 70% advocated unproven alternative treatments, and 91% targeted patients. Viewer engagement (number of views) was a poor predictor of usefulness and/or content whereas source of upload, and target audiences were good predictors of usefulness and/or content. Videos uploaded by university channels and/or professional organizations that targeted physicians had a 99.4% (P < .001) probability of being useful whereas videos uploaded by individuals with unknown credentials that targeted patients had a 21.2% (P < .001) probability of being useful. A majority of HTN-related videos on YouTube are useful. Viewer engagement is significantly higher with videos that contain misleading and/or erroneous information in comparison to videos that contain useful information.


      PubDate: 2014-07-24T20:29:45Z
       
  • Genetic variation in CYP4A11 and blood pressure response to
           mineralocorticoid receptor antagonism or ENaC inhibition: an exploratory
           pilot study in African Americans
    • Abstract: Publication date: July 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 7
      Author(s): Cheryl L. Laffer , Fernando Elijovich , George J. Eckert , Wanzhu Tu , J. Howard Pratt , Nancy J. Brown
      An rs3890011 variant of CYP4A11, which is in linkage disequilibrium with the loss-of-function variant rs1126742, is associated with hypertension in humans. In mice, Cyp4a deficiency results in salt-sensitive hypertension through activation of ENaC. We tested the hypothesis that the rs3890011 variant is associated with blood pressure response to drugs acting via the ENaC pathway. African Americans with volume-dependent, resistant hypertension were randomized to treatment with placebo, spironolactone, amiloride, or combination. Blood pressure responses were analyzed by CYP4A11 genotypes. Rs3890011 (GG:GC:CC = 20:35:28) and rs1126742 (TT:TC:CC = 45:31:7) were in linkage disequilibrium (D' = 1, r = 0.561). Expected small number of rs1126742 CC homozygotes precluded analysis of the effect of this genotype on treatment responses. Spironolactone reduced blood pressure in rs3890011 GG and GC individuals, but not in CC homozygotes (P = .002), whereas amiloride reduced blood pressure similarly in all rs3890011 genotypes. The antihypertensive effects of spironolactone and amiloride were comparable in GG and GC participants, but only amiloride reduced pressure in CC homozygotes (−6.3 ± 7.3/−3.2 ± 4.0 vs. +6.8 ± 7.9/+4.8 ± 8.6 mm Hg, P < .01/<.05). The aldosterone response to spironolactone was also blunted in the CC genotype. In individuals homozygous for the CYP4A11 rs3890011 C allele, blood pressure is resistant to mineralocorticoid receptor antagonism, but sensitive to ENaC inhibition, consistent with ENaC activation. Studies in a larger population are needed to replicate these findings.


      PubDate: 2014-07-24T20:29:45Z
       
  • Low plasma renalase concentration in hypertensive patients after surgical
           repair of coarctation of aorta
    • Abstract: Publication date: July 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 7
      Author(s): Maciej T. Wybraniec , Katarzyna Mizia-Stec , Olga Trojnarska , Jerzy Chudek , Beata Czerwieńska , Maria Wikarek , Andrzej Więcek
      The study aimed to evaluate plasma renalase level, a recently discovered kidney-derived catecholamine-metabolizing enzyme in patients after successful repair of aortic coarctation, with special consideration of arterial hypertension in the context of underlying process of arterial remodeling. This case–control study covered 50 consecutive patients after Dacron patch repair of aortic coarctation (31 men; median age 33 [26; 40]; age at surgery 10 [5; 16] years), matched in terms of age and gender with 50 controls. Both groups were stratified depending on the presence of hypertension and assessed in terms of renalase, C-reactive protein, and carotid intima-media thickness. Additionally ultrasound and tonometric markers of vascular remodeling were obtained in the study group. Hypertension was found in 21 patients (42%) in the study group and 29 (58%) in the control group (P = .11). Renalase level was significantly lower in patients in the study than control group (5825.1 vs. 6592.7 ng/mL; P = .041). Significant difference in terms of renalase concentration between hypertensive and normotensive patients was confirmed both in subjects with coarctation of aorta (P = .027) and in control group (P < .0001). Renalase level inversely correlated with serum creatinine (r = −0.36) and arterial blood pressure in the whole population, and with central systolic (r = −0.29) and diastolic pressure (r = −0.35) in study group. Multivariate regression revealed that serum creatinine and pulse pressure were independent predictors of renalase. Surgical intervention >7 years was linked to lower renalase (P = .018) and unfavorable vascular parameters. Renalase level <4958 ng/mL accurately predicted presence of hypertension in patients after coarctation of aorta repair (odds ratio, 3.8; P = .032). Renalase deficiency is associated with the presence of hypertension in both patients after surgical repair of aortic coarctation and the control group. In coarctation of aorta, its action is probably parallel to underlying arterial remodeling.


      PubDate: 2014-07-24T20:29:45Z
       
  • Editorial Board
    • Abstract: Publication date: July 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 7




      PubDate: 2014-07-24T20:29:45Z
       
  • Table of Contents
    • Abstract: Publication date: July 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 7




      PubDate: 2014-07-24T20:29:45Z
       
  • From the Editor
    • Abstract: Publication date: July 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 7
      Author(s): Myron H. Weinberger



      PubDate: 2014-07-24T20:29:45Z
       
  • Opportunities for multidisciplinary ASH clinical hypertension specialists
           in an era of population health and accountable care: ASH leadership
           message
    • Abstract: Publication date: July 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 7
      Author(s): Brent M. Egan



      PubDate: 2014-07-24T20:29:45Z
       
  • Cardiac myocyte sizes in right compared with left ventricle during
           overweight and hypertension
    • Abstract: Publication date: July 2014
      Source:Journal of the American Society of Hypertension, Volume 8, Issue 7
      Author(s): Richard E. Tracy
      Evidence is sparse concerning hypertrophy of cardiomyocytes in left and right ventricles (LV, RV). LV and RV from 105 forensic autopsies were weighed. Cross sectioned cardiac myocyte thicknesses were measured in hematoxylin and eosin–stained paraffin sections. Overweight (OW) is body weight >104.3 kg and hypertension (HT) is mean arterial pressure >106.7 mm Hg assessed from renal histology. Mean RV weights and cardiomyocyte thicknesses held nearly perfect proportionality to the LV values. Exceptions to these patterns were (1) myocytes were slightly thicker than expected in RV of the 27 specimens with the smallest myocyte thicknesses; (2) weights were slightly greater than expected in RV of hypertensives; and (3) myocytes were slightly smaller than expected in RV of OW subjects. Myocyte hypertrophy appears to affect LV and RV equally, preserving constant proportionality between them in a number of conditions which include OW, HT, and perhaps some cardiomyopathies. Ischemic, valvular, and right ventricular disorders determined at autopsy are specifically omitted from this provisional conclusion. The three exceptions from this principle were of small magnitude and unimpressive statistical significance which calls for cautious interpretation. Neither OW nor HT appears to act predictably upon the heart as exclusively volume or pressure overload.


      PubDate: 2014-07-24T20:29:45Z
       
  • Genomics reveals the pathogenesis of hypertension Preparation for
           hypertension specialists
    • Abstract: Publication date: Available online 5 July 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Friedrich C. Luft
      Genomics is a discipline in genetics that applies recombinant DNA, DNA sequencing methods, and bioinformatics to sequence, assemble, and analyze the function and structure of genomes, the complete set of DNA within a single cell of an organism. Research into the genetics of hypertension has now expanded to genomics. Two approaches have dominated this field. One relies on large populations in which the phenotype, hypertension versus no hypertension, or hypertension-relevant phenotypes are compared. Genome-wide association (GWAS) analyses of (>1 million) common variants identify relevant loci and possible genes exerting small effects. Detailed studies on APOL1 and SH2B3 are opening entire new fields of research. Family-based Mendelian studies have identified rare variants that exert very large effects on blood pressure. Mechanistically, these studies have been a bonanza of new information. The approaches are complementary.


      PubDate: 2014-07-24T20:29:45Z
       
  • Oxidative Stress
    • Abstract: Publication date: Available online 5 July 2014
      Source:Journal of the American Society of Hypertension
      Author(s): David G. Harrison



      PubDate: 2014-07-24T20:29:45Z
       
  • The CardioRenal Metabolic Syndrome
    • Abstract: Publication date: Available online 5 July 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Adam Whaley Connell , James R. Sowers



      PubDate: 2014-07-24T20:29:45Z
       
  • From the Editor
    • Abstract: Publication date: Available online 10 July 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Myron H. Weinberger



      PubDate: 2014-07-24T20:29:45Z
       
  • A Review of Blood Pressure Measurement Protocols among Hypertension
           Trials: Implications for “Evidence-Based” Clinical Practice
    • Abstract: Publication date: Available online 8 July 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Paolo Giorgini , Alan B. Weder , Elizabeth A. Jackson , Robert D. Brook
      Background Hypertension guidelines recommend following published standardized protocols to obtain accurate blood pressure (BP) readings in clinical practice. However, the various measurement techniques among clinical trials that provide the basis for evidence-based management have not been evaluted or compared to guideline recommendations. Methods We reviewed published information regarding BP measurement in clinical trials (n=64) from 1990-2014 by searching PubMed and Google Scholar databases. Results Every trial failed to provide published information regarding at least one of the 10 methodological aspects we evaluated. Details regarding the healthcare provider(s) performing measurement(s), temporal-relation to last medication dosage, number of readings, resting time before (and between recordings), and the device(s) employed varied amongst the trials and often differed from clinical recommendations. Most studies did evaluate ≥2 BP readings in a seated position, presumably from the upper arm (though explicit acknowledgement of this latter detail was rare). When indicated, “trough” BP levels were most commonly obtained (15/16 trials), while the usage of automated devices increased over time. Conclusions Numerous aspects of BP measurement varied considerably across trials and often from most recent guideline recommendations. The lack of uniform methodologies in outcome studies that form the foundation of evidence-based guidelines may have significant clinical implications.


      PubDate: 2014-07-24T20:29:45Z
       
  • Pediatric Ambulatory Blood Pressure Monitoring Grows Up
    • Abstract: Publication date: Available online 12 July 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Joseph T. Flynn



      PubDate: 2014-07-24T20:29:45Z
       
  • Initial Evaluation – Laboratory Testing
    • Abstract: Publication date: Available online 11 July 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Gary L. Schwartz , Lawrence R. Krakoff



      PubDate: 2014-07-24T20:29:45Z
       
  • Carotid-Radial Pulse Wave Velocity Responses Following Hyperemia in
           Patients with Congestive Heart Failure
    • Abstract: Publication date: Available online 11 July 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Yang Liu , Andrew Beck , Olawale Olaniyi , Sahib B. Singh , Fiona Shehaj , Ravi-Inder Mann , Syed R. Hassan , Haroon Kamran , Louis Salciccioli , John Carter , Jason M. Lazar
      Background Carotid-radial pulse wave velocity (PWV) normally decreases following hyperemia and is an indicator of vasodilator reserve. This response is impaired in patients with congestive heart failure (CHF). Methods To identify specific factors related to an impaired response, we studied 50 patients (60±14 years, 67% male) with chronic CHF. Baseline PWV was measured using applanation tonometry, and repeated 1 minute after release of upper arm occlusion for 5 minutes. Results Percentage changes (Δ) of PWV were normally distributed and mean ΔPWV was -2.2±15.3%. On univariate analyses, ΔPWV correlated with NYHA class, mean arterial pressure (MAP), log BNP levels and baseline PWV, but not with LVEF. Multivariate linear regression analysis demonstrated log BNP levels, MAP and baseline PWV (all p<0.05) as independent predictors of ΔPWV. Hyperemia increased PWV in 42% of patients. On logistic regression, higher BNP levels and lower baseline PWV were independent predictors of a PWV increase. Conclusions higher BNP levels and lower baseline PWV are independent predictors of an abnormal hyperemic PWV response in patients with CHF. Higher BNP levels may reflect abnormal vasodilator reserve. Forty-two percent of heart failure patients showed an increase in PWV following hyperemia, which may reflect more severe arterial vasodilator impairment.


      PubDate: 2014-07-24T20:29:45Z
       
  • Diagnostic Evaluation: Clinical Characteristics
    • Abstract: Publication date: Available online 16 July 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Barry J. Materson



      PubDate: 2014-07-24T20:29:45Z
       
  • Detection, Evaluation, and Treatment of Severe and Resistant Hypertension
           Proceedings from an American Society of Hypertension Interactive Forum
           held in Bethesda, Maryland, USA, October 10th2013
    • Abstract: Publication date: Available online 15 July 2014
      Source:Journal of the American Society of Hypertension
      Author(s): William B. White , J. Rick Turner , Dominic Sica , John D. Bisognano , David A. Calhoun , Raymond R. Townsend , Herbert D. Aronow , Deepak L. Bhatt , George L. Bakris
      The epidemiology, evaluation, and management of severe and resistant hypertension in the United States (US) are evolving. The American Society of Hypertension (ASH) held a multi-disciplinary forum in October 2013 to review the available evidence related to the management of resistant hypertension with both drug and device therapies. There is strong evidence that resistant hypertension is an important clinical problem in the US and many other regions of the world. Complex drug therapy is effective in the majority of patients with severe and resistant hypertension but there are certain individuals who may be refractory to multiple-drug regimens or have adverse effects that make adherence to the regimen difficult. When secondary forms of hypertension and pseudo-resistance, such as medication non-adherence, or white-coat hypertension based on marked differences between clinic and 24-h ambulatory blood pressure (BP) monitoring, have been excluded, the impact of device therapy is under evaluation through clinical trials in the US and from clinical practice registries in Europe and Australia. Clinical trial data have been obtained primarily in patients whose resistant hypertension is defined as systolic clinic BPs of ≥ 160 mmHg (or ≥ 150 mmHg in type 2 diabetes) despite pharmacologic treatment with at least 3 antihypertensive drugs (one of which is a thiazide or loop diuretic). Baroreceptor stimulation therapy has shown modest benefit in a moderately sized sham-controlled study in drug-resistant hypertension. Patients selected for renal denervation have typically been restricted to those with preserved kidney function (estimated GFR ≥ 45 ml/min/1.73m2). The first sham-controlled safety and efficacy trial for renal denervation (SYMPLICITY HTN-3) did not show benefit in this population when used in addition to an average of 5 antihypertensive medications. Analyses of controlled clinical trial data from future trials with novel designs will be of critical importance to determine the effectiveness of device therapy for patients with severe and resistant hypertension, and will allow for proper determination of patient selection and whether it will be acceptable for clinical practice. At present, the focus on the management of severe and resistant hypertension will be through careful evaluation for pseudo-resistance and secondary forms of hypertension, appropriate use of combination pharmacologic therapy, and greater utility of specialists in hypertension.


      PubDate: 2014-07-24T20:29:45Z
       
  • Cost estimation of hypertension management based on home blood pressure
           monitoring alone or combined office and ambulatory blood pressure
           measurements
    • Abstract: Publication date: Available online 16 July 2014
      Source:Journal of the American Society of Hypertension
      Author(s): N. Boubouchairopoulou , N. Karpettas , K. Athanasakis , A. Kollias , A.D. Protogerou , A. Achimastos , G.S. Stergiou
      Background This study aims at estimating the resources consumed and subsequent costs for hypertension management, using home blood pressure (BP) monitoring alone (HBPM) vs combined clinic measurements and ambulatory blood pressure monitoring (C/ABPM). Methods and Results 116 untreated hypertensive subjects were randomized to use HBPM or (C/ABPM) for antihypertensive treatment initiation and titration. Health resources utilized within 12-months follow-up, their respective costs and hypertension control, were assessed. The total cost of the first year of hypertension management was lower in HBPM than C/ABPM arm (1,336.0 vs 1,473.5€/subject, p<0.001). Laboratory tests' cost was identical in both arms. There was no difference in achieved BP control, and drug expenditure (HBPM:233.1€/subject, C/ABPM:247.6€/subject, p=NS), whereas the cost of BP measurements/visits was higher in C/ABPM arm (393.9 vs. 516.9€/patient, p<0.001). The cost for subsequent years (>1) was 348.9 and 440.2€/subject for HBPM and C/ABPM arm, and 2,731.4 vs 3,234.3€/subject (p<0.001) for a 5-year projection. Conclusions HBPM used alone for the first year of hypertension management presents lower cost than C/ABPM, and the same trend is observed in 5-year projection. The results on the resources consumption can be used to make cost estimates for other healthcare systems.


      PubDate: 2014-07-24T20:29:45Z
       
  • Diagnostic Evaluation: Classification of Hypertension
    • Abstract: Publication date: Available online 18 July 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Barry J. Materson



      PubDate: 2014-07-24T20:29:45Z
       
  • The variability of ankle-arm blood pressure difference and ankle-brachial
           index in treated hypertensive patients
    • Abstract: Publication date: Available online 21 July 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Kaiwu Cao , Jinsong Xu , Hanjun Sun , Ping Li , Juxiang Li , Xiaoshu Cheng , Hai Su
      Subject To investigate whether ankle-arm blood pressure (BP) difference (An-a) and ankle-brachial index (ABI) are consistent in treated hypertensive patients with obvious BP variation. Methods This study enrolled 414 hypertensive patients (200 males,61.3±13.3 y) admitted to our hospital. Simultaneous four-limb BP was measured using four automatic BP measurement devices in the day, 3 day and 6 day after admission. The ankle-arm differences on systolic and diastolic BP (SBP and DBP), mean artery pressure (MAP) and pulse pressure (PP) in both sides were calculated, respectively. The relative decrease amplitude of BP (RDA) was calculated using the formula: RDA = (BP1-BPn) / BP1. The ABI of right side was calculated. Results From the first to the third measurement, arm SBP and DBP levels of both arms significantly decreased (right arm: SBP: 163.7±18.4, 147.7±15.3 vs 135.4±11.7 mm Hg, P<0.05; DBP: 86.6±13.4, 79.9±11.6 vs 74.5±9.6 mm Hg, P<0.05 ), at the same times, the ankle SBP (right ankle: 182.1±22.1, 147.7±15.3 vs 153.4±16.6 mmHg P<0.05 ) and DBP (84.8±13.4, 79.9±11.6 vs 75.8±9.8 mmHg, P<0.05) of both sides also significantly decreased. The mean An-a of 3 measurements of the both sides was consistent at the levels of about 20 mmHg on SBP and PP, 7 mmHg on MAP and 0 mmHg on DBP. However, sABI gradually increased from the first to the third measurement. Conclusion In treated hypertensive patients the ankle-arm differences on SBP, DBP, PP and MAP are generally consistent, but sABI is associated with underlying SBP levels.


      PubDate: 2014-07-24T20:29:45Z
       
  • 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
       
  • 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
       
  • 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
       
  • 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
       
  • 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
       
 
 
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