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  Subjects -> HISTORY (Total: 1286 journals)
    - HISTORY (808 journals)
    - History (General) (51 journals)
    - HISTORY OF AFRICA (48 journals)
    - HISTORY OF ASIA (54 journals)
    - HISTORY OF EUROPE (167 journals)
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HISTORY (808 journals)            First | 1 2 3 4 5     

Showing 601 - 452 of 452 Journals sorted alphabetically
Proceedings of the Aristotelian Society (hardback)     Hybrid Journal   (Followers: 4)
Proceedings of the Institution of Civil Engineers - Engineering History and Heritage     Hybrid Journal   (Followers: 3)
Proceedings of the Linnean Society of New South Wales     Full-text available via subscription   (Followers: 1)
Proceedings of the Royal Society of Queensland, The     Full-text available via subscription   (Followers: 1)
Proceedings of the Zoological Society     Hybrid Journal   (Followers: 2)
Procesos Historicos     Open Access  
Prose Studies: History, Theory, Criticism     Hybrid Journal   (Followers: 3)
Psychoanalysis and History     Hybrid Journal   (Followers: 3)
Psychoanalysis Culture & Society     Hybrid Journal   (Followers: 8)
Publications du Centre Européen d'Etudes Bourguignonnes     Full-text available via subscription  
Purdue Historian     Open Access  
Quaderns d’Història de l’Enginyeria     Open Access  
Quaker History     Full-text available via subscription   (Followers: 6)
Queensland Naturalist     Full-text available via subscription  
Questes : Revue pluridisciplinaire d'études médiévales     Open Access  
Quintana. Revista de Estudos do Departamento de Historia da Arte     Open Access  
Radical History Review     Full-text available via subscription   (Followers: 24)
Rasenna : Journal of the Center for Etruscan Studies     Open Access   (Followers: 1)
Rationality and Society     Hybrid Journal   (Followers: 6)
Raven : A Journal of Vexillology     Hybrid Journal  
Reinardus     Hybrid Journal  
Relaciones. Estudios de historia y sociedad     Open Access  
Renaissance Drama     Full-text available via subscription   (Followers: 6)
Renaissance Quarterly     Full-text available via subscription   (Followers: 40)
Renaissance Studies     Hybrid Journal   (Followers: 19)
Rethinking History: The Journal of Theory and Practice     Hybrid Journal   (Followers: 27)
Reti Medievali Rivista     Open Access   (Followers: 2)
Review of Central and East European Law     Hybrid Journal   (Followers: 8)
Reviews in American History     Full-text available via subscription   (Followers: 15)
Revista Alétheia     Open Access  
Revista Análisis Internacional     Open Access  
Revista Brasileira de Historia     Open Access   (Followers: 3)
Revista Brasileira de História das Religiões     Open Access   (Followers: 1)
Revista Chilena de Historia del Derecho     Open Access  
Revista de Divulgação Interdisciplinar     Open Access  
Revista de Estudios Historico-Juridicos     Open Access   (Followers: 1)
Revista de História     Open Access  
Revista de História Bilros. História(s), Sociedade(s) e Cultura(s)     Open Access  
Revista de História da UEG     Open Access  
Revista do Instituto Histórico e Geográfico do Rio Grande do Sul     Open Access  
Revista Historia Autónoma     Open Access  
Revista História da Educação - History of Education Journal     Open Access  
Revista Maracanan     Open Access  
Revista Memória em Rede     Open Access  
Revista Mosaico     Open Access  
Revista Paginas     Open Access  
Revolutionary Russia     Hybrid Journal   (Followers: 8)
Revue archéologique de l'Est     Open Access   (Followers: 3)
Revue archéologique du Centre de la France     Open Access   (Followers: 2)
Revue d'histoire de l'Amérique française     Full-text available via subscription   (Followers: 1)
Revue d'Histoire de l'Eglise de France     Full-text available via subscription   (Followers: 3)
Revue d'histoire de l'enfance     Open Access  
Revue d'Histoire des Textes     Full-text available via subscription  
Revue d'histoire du XIXe siècle     Open Access   (Followers: 7)
Revue d'Histoire Ecclésiastique     Full-text available via subscription  
Revue de l’Histoire des Religions     Open Access   (Followers: 12)
Revue des Études Arméniennes     Full-text available via subscription   (Followers: 2)
Revue historique des armées     Open Access   (Followers: 3)
Revue Mabillon     Full-text available via subscription   (Followers: 6)
Rhetoric Society Quarterly     Hybrid Journal   (Followers: 15)
RIHA Journal     Open Access   (Followers: 5)
RIMA: Review of Indonesian and Malaysian Affairs     Full-text available via subscription   (Followers: 1)
Romanticism     Hybrid Journal   (Followers: 5)
Romanticism and Victorianism on the Net     Open Access   (Followers: 6)
Royal Studies Journal     Open Access   (Followers: 1)
Rúbrica Contemporánea     Open Access  
Russian Education & Society     Full-text available via subscription   (Followers: 5)
Russian History     Hybrid Journal   (Followers: 14)
Russian Review     Hybrid Journal   (Followers: 18)
Sacris Erudiri     Full-text available via subscription   (Followers: 6)
Saeculum : Jahrbuch für Universalgeschichte     Hybrid Journal  
Safundi : The Journal of South African and American Studies     Hybrid Journal   (Followers: 1)
Scandinavian Journal of History     Hybrid Journal   (Followers: 13)
Scando-Slavica     Hybrid Journal   (Followers: 4)
Science & Society     Full-text available via subscription   (Followers: 5)
Science Journal of Volgograd State University. History. Area Studies. International Relations     Open Access  
Scientia Canadensis: Canadian Journal of the History of Science, Technology and Medicine / Scientia Canadensis : revue canadienne d'histoire des sciences, des techniques et de la médecine     Full-text available via subscription   (Followers: 5)
Scientia Militaria : South African Journal of Military Studies     Open Access   (Followers: 5)
Scientiae Studia     Open Access  
Scottish Historical Review     Hybrid Journal   (Followers: 15)
Scrineum Rivista     Open Access  
Scrutiny2: Issues in English Studies in Southern Africa     Hybrid Journal   (Followers: 1)
Senses and Society     Hybrid Journal   (Followers: 4)
SHARE : Studies in History, Archaeology, Religion and Conservation     Open Access  
Sibirica     Full-text available via subscription  
Siècles     Open Access   (Followers: 1)
Signals     Full-text available via subscription   (Followers: 2)
Signos Historicos     Open Access  
Slagmark - Tidsskrift for idéhistorie     Open Access   (Followers: 4)
Slavery & Abolition: A Journal of Slave and Post-Slave Studies     Hybrid Journal   (Followers: 11)
Slavonica     Hybrid Journal   (Followers: 3)
Social History     Hybrid Journal   (Followers: 46)
Social History of Medicine     Hybrid Journal   (Followers: 19)
Social Sciences and Missions     Hybrid Journal   (Followers: 4)
Società e Storia     Full-text available via subscription   (Followers: 1)
Society     Hybrid Journal   (Followers: 5)
Society and Economy     Full-text available via subscription   (Followers: 2)
SourceOECD National Accounts & Historical Statistics     Full-text available via subscription  
South African Historical Journal     Hybrid Journal   (Followers: 6)
South African Journal of Art History     Full-text available via subscription   (Followers: 2)
South African Journal of Cultural History     Full-text available via subscription   (Followers: 1)
South African Journal of Economic History     Full-text available via subscription   (Followers: 3)
South Asia Research     Hybrid Journal   (Followers: 8)
South Asia: Journal of South Asian Studies     Hybrid Journal   (Followers: 14)
South Asian History and Culture     Hybrid Journal   (Followers: 3)
South Asian Popular Culture     Hybrid Journal   (Followers: 2)
South Asian Survey     Hybrid Journal   (Followers: 5)
South Australian Naturalist, The     Full-text available via subscription  
South Central Review     Full-text available via subscription  
South European Society and Politics     Hybrid Journal   (Followers: 9)
Southeast European and Black Sea Studies     Hybrid Journal   (Followers: 5)
Southwestern Historical Quarterly     Full-text available via subscription   (Followers: 5)
Soviet and Post-Soviet Review     Hybrid Journal   (Followers: 9)
Spontaneous Generations : A Journal for the History and Philosophy of Science     Open Access   (Followers: 2)
Sport in History     Hybrid Journal   (Followers: 10)
Studia Aurea : Revista de Literatura Española y Teoría Literaria del Renacimiento y Siglo de Oro     Open Access   (Followers: 1)
Studia Historiae Ecclesiasticae     Open Access   (Followers: 2)
Studia Historiae Oeconomicae     Open Access  
Studia Iranica     Full-text available via subscription   (Followers: 4)
Studia Litteraria et Historica     Open Access  
Studia z Historii Filozofii     Open Access  
Studies in East European Thought     Hybrid Journal   (Followers: 6)
Studies in Eighteenth Century Culture     Full-text available via subscription   (Followers: 20)
Studies in History     Hybrid Journal   (Followers: 24)
Studies in History and Philosophy of Science Part A     Hybrid Journal   (Followers: 7)
Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences     Hybrid Journal   (Followers: 12)
Studies in People’s History     Hybrid Journal  
Studies in the History of Gardens & Designed Landscapes: An International Quarterly     Hybrid Journal   (Followers: 7)
Studies in Western Australian History     Full-text available via subscription   (Followers: 3)
Studium : Tijdschrift voor Wetenschaps- en Universiteits-geschiedenis / Revue d'Histoire des Sciences et des Universités     Open Access   (Followers: 1)
Suomen Sukututkimusseuran Vuosikirja     Open Access  
Sydney Institute Quarterly     Full-text available via subscription  
T'oung Pao     Hybrid Journal   (Followers: 11)
Tangence     Full-text available via subscription  
Tartu Ülikooli ajaloo küsimusi     Open Access  
Tasmanian Historical Studies     Full-text available via subscription   (Followers: 1)
Teaching History     Full-text available via subscription   (Followers: 7)
Technology and Culture     Full-text available via subscription   (Followers: 24)
temp - tidsskrift for historie     Full-text available via subscription  
Tempo     Open Access   (Followers: 2)
Tempo e Argumento     Open Access  
The Corvette     Open Access  
The Court Historian : The International Journal of Court Studies     Full-text available via subscription   (Followers: 1)
The Eighteenth Century     Full-text available via subscription   (Followers: 27)
The European Legacy: Toward New Paradigms     Hybrid Journal   (Followers: 2)
The Hilltop Review : A Journal of Western Michigan University Graduate Student Research     Open Access  
The Historian     Hybrid Journal   (Followers: 33)
The International History Review     Hybrid Journal   (Followers: 21)
The Irish Review     Full-text available via subscription   (Followers: 14)
The Italianist     Hybrid Journal   (Followers: 5)
The Journal of the Historical Society     Hybrid Journal   (Followers: 12)
The Public Historian     Full-text available via subscription   (Followers: 10)
The Seventeenth Century     Hybrid Journal   (Followers: 16)
The Sixties: A Journal of History, Politics and Culture     Hybrid Journal   (Followers: 11)
The South African Journal of Economics     Hybrid Journal   (Followers: 4)
Theatre History Studies     Full-text available via subscription   (Followers: 4)
Theoria et Historia Scientiarum     Open Access  
Tiempo devorado     Open Access  
Tiempo y Espacio     Open Access  
Tijdschrift voor Geschiedenis     Full-text available via subscription   (Followers: 2)
Tijdschrift voor Rechtsgeschiedenis / Revue d'Histoire du Droit / The Legal History Review     Hybrid Journal   (Followers: 21)
Time & Society     Hybrid Journal   (Followers: 10)
Trabajos y Comunicaciones     Open Access   (Followers: 1)
Traditio     Full-text available via subscription   (Followers: 1)
Trans-pasando Fronteras     Open Access  
Transactions of the Philological Society     Hybrid Journal   (Followers: 2)
Transactions of the Royal Society of South Africa     Hybrid Journal   (Followers: 2)
Transfers     Full-text available via subscription  
Transition     Full-text available via subscription   (Followers: 1)
Transmodernity : Journal of Peripheral Cultural Production of the Luso-Hispanic World     Open Access   (Followers: 3)
Trocadero     Open Access  
Troianalexandrina     Full-text available via subscription   (Followers: 1)
Turcica     Full-text available via subscription   (Followers: 9)
Turkish Historical Review     Hybrid Journal   (Followers: 6)
Turkish Studies     Hybrid Journal   (Followers: 10)
Twentieth Century British History     Hybrid Journal   (Followers: 18)
U.S. Catholic Historian     Full-text available via subscription   (Followers: 2)
UCLA Historical Journal     Open Access  
Ufahamu : A Journal of African Studies     Open Access   (Followers: 2)
United Service     Full-text available via subscription   (Followers: 2)
Urban History Review / Revue d'histoire urbaine     Full-text available via subscription   (Followers: 6)
Varia Historia     Open Access   (Followers: 2)
Vegueta : Anuario de la Facultad de Geografía e Historia     Open Access  
Vestiges : Traces of Record     Full-text available via subscription  
Viator     Full-text available via subscription   (Followers: 12)
Victorian Naturalist, The     Full-text available via subscription   (Followers: 3)
Victorian Periodicals Review     Full-text available via subscription   (Followers: 9)
Vigiliae Christianae     Hybrid Journal   (Followers: 12)
Viking and Medieval Scandinavia     Full-text available via subscription   (Followers: 14)
Vínculos de Historia. Revista del Departamento de Historia de la Universidad de Castilla-La Mancha     Open Access  
Visual Resources: An International Journal of Documentation     Hybrid Journal   (Followers: 2)
Vivarium     Hybrid Journal   (Followers: 2)
Vulcan     Hybrid Journal  
War & Society     Hybrid Journal   (Followers: 25)
Water History     Hybrid Journal   (Followers: 11)
Welsh History Review     Full-text available via subscription   (Followers: 12)
West 86th     Full-text available via subscription   (Followers: 5)
West Virginia History: A Journal of Regional Studies     Full-text available via subscription   (Followers: 3)
Whispering Wind     Full-text available via subscription   (Followers: 1)
Wicazo Sa Review     Full-text available via subscription  

  First | 1 2 3 4 5     

Journal Cover Journal of the American Society of Hypertension
  [SJR: 1.039]   [H-I: 31]   [8 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1933-1711
   Published by Elsevier Homepage  [3034 journals]
  • “Incremental Prognostic Value of a Complex Left Ventricular Remodelling
    • Authors: Nicola Riccardo Pugliese; Iacopo Fabiani; Salvatore La Carrubba; Lorenzo Conte; Francesco Antonini-Canterin; Paolo Colonna; Pio Caso; Frank Benedetto; Veronica Santini; Scipione Carerj; Maria Francesca Romano; Rodolfo Citro; Vitantonio Di Bello
      Pages: 71 - 77
      Abstract: Publication date: Available online 25 May 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Iacopo Fabiani, Nicola Riccardo Pugliese, Salvatore La Carrubba, Lorenzo Conte, Francesco Antonini-Canterin, Paolo Colonna, Frank Benedetto, Valentina Barletta, Enrico Calogero, Scipione Carerj, Simona Buralli, Stefano Taddei, Maria Francesca Romano, Vitantonio Di Bello
      Introduction We evaluated the prognostic impact of a complex remodeling classification (CRC) in asymptomatic patients with Arterial Hypertension (AH). Methods We retrospectively included 749 hypertensive patients (Female 325, 43.4%; Age 62±11.3 years) in stage A and B of heart failure (HF). CRC was evaluated including indexed left ventricular mass, end-diastolic volume, and relative wall thickness. After 45-month follow-up we considered a composite end-point: total mortality, myocardial infarction, myocardial revascularization, cerebrovascular events and acute pulmonary edema. Results Blood pressure was controlled in 265 patients (35.4%), 317 (42.3%) were in Grade 1 of AH, 123 (16.4%) in Grade 2 and 44 (5.9%) in Grade 3. Considering CRC, 292 patients (38%) presented normal/physiologic hypertrophy, 102 (13.6%) concentric remodeling, 29 (3.9%) eccentric remodeling, 157 (21%) concentric hypertrophy, 11 (1.5%) mixed hypertrophy, 52 (6.9%) dilated hypertrophy and 36 (4.8%) eccentric hypertrophy. We observed a total of 73 (9.7%) events. Kaplan-Meier method demonstrated a significant different survival in CRC-derived classes (p<0.001). Cox-regression demonstrated CRC as independent predictor (p=0.01), after adjusting for age, gender, diabetes mellitus, Grade of Hypertension, anti-hypertensive therapy, stable ischemic heart disease, obesity, systolic and diastolic dysfunction, classic remodeling classification. Conclusion In asymptomatic patients with AH, CRC is an independent predictor of poor outcome.

      PubDate: 2017-05-28T05:03:01Z
      DOI: 10.1016/j.amjcard.2016.09.018
      Issue No: Vol. 119, No. 1 (2017)
  • White coat effect in hypertensive patients: the role of hospital
           environment or physician presence
    • Authors: Xi-xing Wang; Wei Shuai; Qiang Peng; Ju-xiang Li; Ping Li; Xiao-shu Cheng; Hai Su
      Abstract: Publication date: Available online 21 June 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Xi-xing Wang, Wei Shuai, Qiang Peng, Ju-xiang Li, Ping Li, Xiao-shu Cheng, Hai Su
      Subject This study was to evaluate the role of hospital environment or physician presence for white coat effect (WCE) in hypertensive patients. Methods At first, 54 hypertensive outpatients diagnosed on office blood pressure (BP) were included for 2-week placebo run in. During the second week of the run in period, home BP (HBP) was measured using electronic BP monitors for 5-7 days. Finally, 26 sustained hypertensive patients with home SBP/DBP over 135/85 (but less than 180/110) mmHg were enrolled for 8-week treatment of nifedipine controlled-release tablet. In the visit day, BP was measured by patient-self (OBP-p) or by doctor (OBP-d) according to order determined with randomization method. The self BP measurement was performed in a reception room of hospital. The differences between HBP and OBP-d or OBP-p were calculated as WCE-d or WCE-p, respectively. The home and office BP were measured with the same BP device for each patient during the study period. Results In the total 54 outpatients received placebo, the WCE-d was similar to the WCE-p (for SBP 6.6±14.4 vs 6.8±15.8 mmHg, NS; for DBP 3.3±8.8 vs 2.9±9.2 mmHg, NS). Meanwhile, the 26 sustained hypertensive patients had similar systolic WCE-d and WCE-p (4.8±10.3 vs 5.0±12.2 mmHg, NS) at placebo stage. Similarly, these values were comparable (3.0±14.0 vs 2.2±14.4mmHg, NS) in treatment stage. Conclusion Hospital environment plays a main role for the white coat effect in hypertensive patients.

      PubDate: 2017-06-22T08:07:42Z
      DOI: 10.1016/j.jash.2017.06.006
  • Visit-to-Visit Variability of Blood Pressure
    • Authors: John B. Kostis
      Abstract: Publication date: Available online 20 June 2017
      Source:Journal of the American Society of Hypertension
      Author(s): John B. Kostis

      PubDate: 2017-06-22T08:07:42Z
      DOI: 10.1016/j.jash.2017.06.005
  • Instructions for Authors
    • Abstract: Publication date: June 2017
      Source:Journal of the American Society of Hypertension, Volume 11, Issue 6

      PubDate: 2017-06-22T08:07:42Z
  • Systemic and tissue-specific effects of aliskiren on the RAAS and
           carbohydrate/lipid metabolism in obese patients with hypertension
    • Authors: Stefan Engeli; Marcus May; Juerg Nussberger; A. H. Jan Danser; William P. Dole; Margaret F. Prescott; Marion Dahlke; Sylvie Stitah; Parasar Pal; Michael Boschmann; Jens Jordan
      Abstract: Publication date: Available online 12 June 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Stefan Engeli, Marcus May, Juerg Nussberger, A. H. Jan Danser, William P. Dole, Margaret F. Prescott, Marion Dahlke, Sylvie Stitah, Parasar Pal, Michael Boschmann, Jens Jordan
      Aliskiren penetrates adipose and skeletal muscle in hypertensive patients with abdominal obesity and reduces renin-angiotensin-aldosterone system activity. After discontinuation, blood-pressure–lowering effects are observed possibly through drug–tissue binding. We performed microdialysis evaluation of adipose tissue and skeletal muscle before and during an insulin-modified frequently sampled intravenous glucose tolerance test (IM-FSIGT). Aliskiren 300 mg (n=8) or amlodipine 5 mg (n=8) once daily were administered during a 12-week randomized treatment period. Aliskiren elicited variable changes in median interstitial angiotensin II in adipose (2.60 to 1.30 fmol/mL) and skeletal muscle (2.23 to 0.68 fmol/mL); amlodipine tended to increase adipose and skeletal muscle angiotensin II (p=0.066 for skeletal muscle treatment difference). Glucose/insulin increased median plasma angiotensin II 1 hour after glucose injection (1.04 to 2.50 fmol/mL; p=0.001), which was markedly attenuated by aliskiren but not amlodipine. Aliskiren increased glucose disposition index (p=0.012) and tended to increase acute insulin response to glucose (p=0.067). Fasting adipose glycerol (−17%; p=0.064) and fasting muscle glucose dialysate (−17%; p=0.025) were decreased by aliskiren but not amlodipine. In summary, aliskiren decreased angiotensin II production in response to glucose/insulin stimulus and elicited metabolic effects in adipose and skeletal muscle suggestive of increased whole-body glucose utilization.

      PubDate: 2017-06-16T07:37:07Z
      DOI: 10.1016/j.jash.2017.06.002
  • The Effect of Circadian Blood Pressure Pattern on Presence of Fragmented
           QRS Complexes in Hypertensive Subjects
    • Authors: Mehmet Eyuboglu; Yavuz Karabag; Suleyman Karakoyun; Bahri Akdeniz
      Abstract: Publication date: Available online 12 June 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Mehmet Eyuboglu, Yavuz Karabag, Suleyman Karakoyun, Bahri Akdeniz
      The association of deteriorated circadian blood pressure (BP) variability with presence of fragmented QRS (fQRS) on electrocardiography (ECG) is not clear. The present study aims to evaluate the relationship of BP patterns with presence of fQRS on ECG. 338 consecutive newly diagnosed and never treated hypertensive patients who are without left ventricular hypertrophy (LVH) and underwent 24-h ambulatory blood pressure monitoring (ABPM) were enrolled. Patients were classified as dippers, nondippers and reverse dippers according to ABPM results. The groups were compared regarding frequency of fQRS on ECG. The frequency of fQRS was significantly higher in reverse dippers compared to dippers (%37,7 vs %20,6, p=0,013). In multivariate logistic regression analysis, nighttime systolic BP was found to be an independent predictor of fQRS on ECG (p<0,001, 95% CI=0,901-0,955). Other predictors of fQRS were daytime diastolic BP and age. Furthermore, fQRS was found to be an independent predictor of reverse dipping BP pattern in hypertensive patients (p=0,004, OR: 2,416, 95% CI=1,327-4,396). In conclusion, as a marker of fibrosis and higher fibrotic burden within myocardium, fQRS may be useful to determine the high risk hypertensive patients in the absence of LVH.

      PubDate: 2017-06-16T07:37:07Z
      DOI: 10.1016/j.jash.2017.06.001
  • Large geographic disparity in life expectancy may be driven by rates of
           hypertension and related metabolic and behavioral parameters
    • Authors: Michael J. Bloch
      Abstract: Publication date: Available online 8 June 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Michael J. Bloch

      PubDate: 2017-06-12T07:11:50Z
      DOI: 10.1016/j.jash.2017.05.004
  • From the Editor
    • Authors: Daniel Levy
      Abstract: Publication date: May 2017
      Source:Journal of the American Society of Hypertension, Volume 11, Issue 5
      Author(s): Daniel Levy

      PubDate: 2017-06-07T06:25:27Z
  • Instructions for Authors
    • Abstract: Publication date: May 2017
      Source:Journal of the American Society of Hypertension, Volume 11, Issue 5

      PubDate: 2017-06-07T06:25:27Z
  • Severe and Resistant Hypertension in an Older Woman with Claudication
    • Authors: Puneet Gupta; Robert Hagberg; Electra Kaloudis; Anika Lucas; Parth Shah; William B. White
      Abstract: Publication date: Available online 1 June 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Puneet Gupta, Robert Hagberg, Electra Kaloudis, Anika Lucas, Parth Shah, William B. White
      Coarctation of the aorta is an uncommon cause of treatment resistant hypertension in adults. It is typically detected and treated in infancy or childhood with surgical or endovascular procedures. Most cases of recurrence of coarctation after repair occur in childhood or early adulthood; recurrence in older persons (> 70 years) has rarely been reported. A 73 year old woman was referred to us for the management of treatment resistant hypertension accompanied by symptoms of claudication and headaches, which had resulted in multiple emergency room visits. Of note, 58 years earlier, a graft from the left subclavian artery had been used to bypass an aortic coarctation. During a hospitalization for severe hypertension accompanied by acute kidney injury and heart failure, diagnostic angiography revealed a complete thrombotic occlusion of the left subclavian artery-to-descending aorta bypass graft and a tight coarctation in the descending thoracic aorta. Balloon angioplasty and stenting across the coarctation was only transiently effective; subsequently an ascending-to-descending graft was placed distal to the coarctation and within a few days, the blood pressure levels and claudication improved markedly. This case demonstrates that hypertension specialists should suspect the possibility of recurrence of a coarctation in older patients who present with resistant hypertension and have a remote history of coarctation repair. Although such late recurrences are not common, as illustrated in our patient, surgical intervention may contribute to significant improvement in blood pressure control and prevent future complications.

      PubDate: 2017-06-02T05:37:49Z
      DOI: 10.1016/j.jash.2017.05.007
  • Predictors of visit-to-visit blood pressure variability in patients with
           hypertension: an analysis of trials with an amlodipine treatment arm
    • Authors: Ji-Guang Wang; Duo Zhou; Barrett W. Jeffers
      Abstract: Publication date: Available online 29 May 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Ji-Guang Wang, Duo Zhou, Barrett W. Jeffers
      We conducted a post hoc analysis of blood pressure (BP) data from long-term antihypertensive trials in order to identify predictors of visit-to-visit blood pressure variability (BPV). BPV was defined as the within-subject coefficient of variation in systolic BP (SBP) from week 12 onwards. BP data from the ASCOT-BPLA, ALLHAT, CAMELOT, NY92011, and R-0510 trials were pooled and dichotomized into top 25th and bottom 75th percentiles due to positive skew. Significant (P<0.001) predictors of BPV within the top 25th percentile were identified using logistic regression. The baseline characteristics of the pooled cohort (n=47,558) were similar between patients who received amlodipine (n=17,499) versus other antihypertensive drugs (n=29,491). BPV in the top 25th percentile was lower with amlodipine versus other treatments (13.7±3.2 versus 14.3±3.5), with single-study analyses of ASCOT-BPLA, ALLHAT, and CAMELOT all showing BPV was lowest with amlodipine. Baseline diastolic blood pressure (DBP), eGFR, and smoking were predictors of BPV, with significant two-way interactions between smoking and both age and body mass index, and between SBP or DBP and being randomized to treatment other than amlodipine. In conclusion, analysis of BPV required transformation of BP data. Following transformation, a number of baseline variables and combinations of variables were predictors of BPV.

      PubDate: 2017-06-02T05:37:49Z
      DOI: 10.1016/j.jash.2017.05.006
  • Pharmacokinetic, Pharmacodynamic, and Antihypertensive Effects of the
           Neprilysin Inhibitor LCZ-696: Sacubitril/Valsartan
    • Authors: Steven G. Chrysant
      Abstract: Publication date: Available online 25 May 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Steven G. Chrysant
      LCZ-696: sacubitril/Valsartan is a dual-acting molecule consisting of the angiotensin II (Ang II) receptor blocker (ARB) valsartan and the neprisylin (neutral endopeptidase, NEP) inhibitor AHU-377 with significant beneficial effects in patients with hypertension and heart failure (HF). Several recent studies have demonstrated a higher effectiveness of LCZ-696 compared to valsartan in the treatment of hypertension and HF. The rationale for the development and the Food and Drug Administration (FDA) approval of LCZ-696 was based on the concept of an additive effect of the angiotensin II receptor blocker valsartan and the NEP (neprilysin) inhibitor AHU-377 for the treatment of hypertension and HF. The synergism from these drugs arises from the vasodilating effects of valsartan through its blockade of Ang II AT1 receptor and the action of natriuretic peptides ANP and BNP by preventing their catabolism with neprilysin resulting in increase of cyclic GMP. This action of neprilysin is associated with increased natriuresis, diuresis and systemic vasodilation, since these peptides have been shown to have potent diuretic, natriuretic and vasodilating effects. In addition, it reduces the levels of NT-Pro BNP. Therefore, administration of LCZ-696 results in significant reduction of wall stress from pressure and volume overload of the left ventricle as demonstrated by the reduction of NT-ProBNP, both significant constituents of hypertension and HF, and it is safe, well tolerated and is almost free of cough and angioedema

      PubDate: 2017-05-28T05:03:01Z
      DOI: 10.1016/j.jash.2017.04.012
  • Race and Sex Differences in Ambulatory Blood Pressure Measures among HIV+
    • Authors: Shia T. Kent; Joseph E. Schwartz; Daichi Shimbo; Edgar T. Overton; Greer A. Burkholder; Suzanne Oparil; Michael J. Mugavero; Paul Muntner
      Abstract: Publication date: Available online 25 May 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Shia T. Kent, Joseph E. Schwartz, Daichi Shimbo, Edgar T. Overton, Greer A. Burkholder, Suzanne Oparil, Michael J. Mugavero, Paul Muntner
      Ambulatory blood pressure monitoring (ABPM) can identify phenotypes that cannot be measured in the clinic. Determining race and sex disparities in ABPM measures among HIV+ individuals may improve strategies to diagnose and treat hypertension in this high risk population. We compared ABPM measures between 24 African American and 25 white HIV+ adults (36 men and 13 women). Awake systolic BP (SBP) and diastolic BP (DBP) were similar in African Americans and whites. After multivariable adjustment, sleep SBP and DBP were 9.7 (95%confidence interval [95%CI]: 4.7, 14.8) mmHg and 8.4 (95%CI: 4.3, 12.5) mmHg higher, respectively, among African Americans compared with whites. After multivariable adjustment, SBP and DBP dipping ratios were 5.2% (95%CI: 1.7%, 8.7%) and 6.1% (95%CI 2.0%, 10.3%) smaller among African Americans compared with whites. After multivariable adjustment, awake and sleep SBP and DBP were higher in men compared to women. There was no difference in SBP or DBP dipping ratios comparing men and women. The prevalence of awake masked hypertension was 42% in men versus 17% in women, and the prevalence of sleep masked hypertension was 57% among African Americans versus 18% among whites. These data suggest that ABPM measures differ by race and sex in HIV+ adults.

      PubDate: 2017-05-28T05:03:01Z
      DOI: 10.1016/j.jash.2017.05.002
  • Serum metabolomic response to exercise training in spontaneously
           hypertensive rats
    • Authors: Xiangyang Liu; Yanjun Wang; Rui Gao; Ying Xing; Xiaomiao Li; Zhengjun Wang
      Abstract: Publication date: Available online 20 May 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Xiangyang Liu, Yanjun Wang, Rui Gao, Ying Xing, Xiaomiao Li, Zhengjun Wang
      Chronic aerobic exercise training exhibits blood pressure protective effects, but the mechanism in metabolic level remains largely unclear. This study aims to investigate the effect of exercise training from serum metabolic profiles on the development of hypertension in spontaneously hypertensive rats (SHR). Exercise training was performed, and the serum metabolites were measured by integrating gas chromatography-mass spectrometer and correlation-based network analysis. After a period of 6 weeks of chronic aerobic exercise training, systolic blood pressure was significant lower in the exercise training group (SHR+EX) rats than the control group (SHR). Principal component analysis indicated a clearly separation of metabolomic profiles between SHR+EX and SHR. Nineteen of 63 metabolites in serum were identified (p < 0.05, variable importance in projections > 1, false discovery rate < 0.1), including fatty acids, amino acids and others. Lower levels of 6 fatty acids were observed in SHR+EX. Besides, pathway analysis indicated a significant alteration of fatty acid metabolism. The correlation-based (Pearson correlation coefficient > 0.83) network of serum metabolites revealed a decreased correlation linkage of SHR+EX than SHR rats. Higher activities of hexokinase, citrate synthase, aspartate aminotransferase and alanine aminotransferase were detected in liver, left ventricle, and skeletal muscle of SHR+EX groups. In summary, these findings provided essential biochemistry information about the metabolic alteration to exercise training in SHR, which may in part explained the protective effect of exercise in hypertensive individuals.

      PubDate: 2017-05-23T04:13:43Z
      DOI: 10.1016/j.jash.2017.05.003
  • The Dietary Approaches to Stop Hypertension (DASH) diet—Promise
    • Authors: Michael J. Bloch
      Abstract: Publication date: Available online 20 May 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Michael J. Bloch

      PubDate: 2017-05-23T04:13:43Z
      DOI: 10.1016/j.jash.2017.04.011
  • Prevalence, Awareness, Treatment and Control of Hypertension in Older
           People in Central Africa: The Epidemca Study
    • Authors: Sophie Pilleron; Victor Aboyans; Pascal Mbelesso; Bébène Ndamba-Bandzouzi; Ileana Desormais; Philippe Lacroix; Pierre-Marie Preux; Maëlenn Guerchet; Maëlenn Guerchet; Bébène Ndamba-Bandzouzi; Pascal Mbelesso; Sophie Pilleron; Iléana Desormais; Philippe Lacroix; Victor Aboyans; Jean-Claude Desport; Pierre Jésus; Achille E. Tchalla; Benoît Marin; Jean-Pierre Clément; Jean-Charles Lambert; Jean-François Dartigues; Pierre-Marie Preux
      Abstract: Publication date: Available online 9 May 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Sophie Pilleron, Victor Aboyans, Pascal Mbelesso, Bébène Ndamba-Bandzouzi, Ileana Desormais, Philippe Lacroix, Pierre-Marie Preux, Maëlenn Guerchet
      Hypertension represents a major global health burden. While older individuals of African descent are at higher risk of hypertension in western countries, epidemiological data on hypertension in older native Africans are scarce. We assessed the prevalence and the level of awareness and control of hypertension among older adults in Central Africa. A total of 1990 individuals 65 years of age and older from the Republic of Congo and the Central African Republic participated into a cross-sectional population-based survey. Hypertension was defined by self-reporting of on-going treatment and/or systolic (SBP)/diastolic (DBP) blood pressures at rest being ≥140 and/or 90 mmHg. Controlled hypertension was defined as treated hypertension with SBP <140 mmHg and DBP <90 mmHg. The overall prevalence of hypertension was 61.1%. Among hypertensive people, 46.7% were aware of their condition and 17.3% were treated. Among the latter 23.8% had their hypertension controlled. Correlates of hypertension were increasing age and body mass index, living in the Republic of Congo, occupation other than employee, no tobacco use, sedentary lifestyle and ≥ 3 meals a day. Our findings indicate a need for the implementation of public health policies to reduce hypertension in older Africans, and to prevent the subsequent burden of cardiovascular diseases.

      PubDate: 2017-05-13T02:32:06Z
      DOI: 10.1016/j.jash.2017.04.013
  • Speckle tracking echocardiography and tissue Doppler imaging reveal
           beneficial effect of pharmacotherapy in hypertensives with asymptomatic
           left ventricular dysfunction
    • Authors: Beata Uziębło-Życzkowska; Paweł Krzesiński; Grzegorz Gielerak; Andrzej Skrobowski
      Abstract: Publication date: Available online 8 May 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Beata Uziębło-Życzkowska, Paweł Krzesiński, Grzegorz Gielerak, Andrzej Skrobowski
      Global longitudinal strain (GLS), assessed by speckle tracking echocardiography (STE), is a sensitive marker of myocardial systolic function and an independent predictor of cardiovascular outcomes. The aim of this study was to investigate the effect of hypotensive treatment on GLS and evaluate the relation between change in GLS and left ventricular (LV) diastolic function. Methods In a group of 125 hypertensive subjects, without any symptoms of heart failure, the detailed echocardiographic assessment of LV systolic and diastolic function was performed prior to and after 12 months of hypotensive treatment. Results The mean GLS improved from -18.1±2.6% to -19.3±2.3% (p=0.004). Positive change was also observed within parameters of LV diastolic function (E/A: 1.05±0.32 vs 1.15±0.34; p=0,008; e': 9.54±2.60cm/s vs 10.59±2.39cm/s; p=0.003; E/e': 7.35±1.85 vs 6.69±1.61; p=0.044). The greatest benefit from hypotensive treatment was noticed within the patients with the lowest baseline absolute values of GLS. The significant correlations between change in GLS and e' (r=-0.51; p<0.001) as well as GLS and E/e' ratio (0.23; p=0.022) were also observed. Conclusions Mild systolic and diastolic LV alterations are interdependent and partially reversible. The effects of hypotensive therapy are differentiated in particular individuals and those with more impaired LV function seem to benefit most.

      PubDate: 2017-05-13T02:32:06Z
      DOI: 10.1016/j.jash.2017.03.009
  • The Relation of Digital Vascular Function to Cardiovascular Risk Factors
           in African Americans Using Digital Tonometry: the Jackson Heart Study
    • Authors: Eric E. McClendon; Solomon K. Musani; Tandaw E. Samdarshi; Sushant Khaire; Donny Stokes; Naomi M. Hamburg; Koby Sheffy; Gary F. Mitchell; Herman R. Taylor; Emelia J. Benjamin; Ervin R. Fox
      Abstract: Publication date: Available online 4 May 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Eric E. McClendon, Solomon K. Musani, Tandaw E. Samdarshi, Sushant Khaire, Donny Stokes, Naomi M. Hamburg, Koby Sheffy, Gary F. Mitchell, Herman R. Taylor, Emelia J. Benjamin, Ervin R. Fox
      Digital vascular tone and function, as measured by peripheral arterial tonometry (PAT), are associated with cardiovascular risk and events in non-Hispanics whites. There are limited data on relations between PAT and cardiovascular risk in African Americans. PAT was performed on a subset of Jackson Heart Study participants using a fingertip tonometry device. Resting digital vascular tone was assessed as baseline pulse amplitude. Hyperemic vascular response to 5-minutes of ischemia was expressed as the PAT ratio (hyperemic/baseline amplitude ratio). Peripheral augmentation index, a measure of relative wave reflection, also was estimated. The association of baseline PA, PAT ratio and augmentation index to risk factors was assessed using stepwise multivariable models. The study sample consisted of 837 participants from the Jackson Heart Study (mean age, 54±11 years, 61% women). In stepwise multivariable regression models, baseline pulse amplitude was related to male sex, body mass index and diastolic BP, accounting for 16% of the total variability of the baseline pulse amplitude. Age, male sex, systolic BP, diastolic BP, antihypertensive medication, and prevalent CVD contributed to 11% of the total variability of the PAT ratio. Risk factors (primarily age, sex and heart rate) explained 47% of the total variability of the augmentation index. We confirmed in our cohort of African Americans, a significant relation between digital vascular tone and function measured by PAT and multiple traditional cardiovascular risk factors. Further studies are warranted to investigate the utility of these measurements in predicting clinical outcomes in African Americans.

      PubDate: 2017-05-08T01:09:17Z
      DOI: 10.1016/j.jash.2017.04.008
  • Elastin microfibril interface located protein (EMILIN)1, Transforming
           growth factor beta (TGFβ), and Implications on Cardiovascular
    • Authors: Amy Randell; Noriko Daneshtalab
      Abstract: Publication date: Available online 3 May 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Amy Randell, Noriko Daneshtalab
      Elastin microfibril interface located protein (EMILIN), a glycoprotein, is associated with elastin in the extracellular matrix (ECM) of arteries, lymph vasculature and other tissues. EMILIN1 particularly has a niche role in elastin fiber biogenesis (elastogenesis) by aiding with the fusion of elastin fibers, rendering them more ordered. In addition to elastogenesis, EMILIN1 has been shown to have roles in maintenance of vascular cell morphology, smooth muscle cell (SMC) adhesion to elastic fibers, and transforming growth factor (TGFβ) regulation, by inhibiting TGFβ activation via blocking the proteolytic production of the latency associated peptide/active TGFβ complex. The increased TGFβ signaling induced during EMILIN1 deficiency alters TGFβ activity, resulting in vascular SMC growth and vascular remodeling. The increasing systemic blood pressure associated with TGFβ signaling may be closely linked to the activity of other mediators that affect cardiovascular homeostasis, such as angiotensin II. The increase in prevalence of hypertension and other cardiovascular diseases in other disease states likely involve a complex activation of TGFβ signaling, and ECM dysfunction. Thus, the interaction of TGFβ and ECM components appears to be integrative involving both structural alterations to vessels through EMILIN1 and changes in TGFβ signaling processes. This review summarizes the current knowledge on the EMILIN1 –TGFβ relationship; the specific roles of EMILIN1 and TGFβ in blood pressure regulation, their synergistic interaction, and in particular the role of TGFβ (in conjunction with ECM proteins) in other disease states altering cardiovascular homeostasis.

      PubDate: 2017-05-08T01:09:17Z
      DOI: 10.1016/j.jash.2017.04.010
  • Relationship among Age, Insulin Resistance, and Blood Pressure
    • Authors: Chan-Hee Jung; Sang Hee Jung; Bora Lee; Melanie Rosenberg; Gerald M. Reaven; Sun H. Kim
      Abstract: Publication date: Available online 14 April 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Chan-Hee Jung, Sang Hee Jung, Bora Lee, Melanie Rosenberg, Gerald M. Reaven, Sun H. Kim
      The effect of age to modify the relationship between insulin resistance and hypertension are unclear. In this retrospective, cross-sectional study, median age was used to create two age groups (<52 vs. ≥52 years), and comparisons were made of metabolic characteristics, including steady-state plasma glucose (SSPG) concentrations measured during the insulin suppression test to quantify insulin resistance. Individuals were stratified into SSPG tertiles and categorized as having normal BP, prehypertension, or hypertension. SSPG concentrations were similar in the two age groups (161 vs. 164 mg/dL). In the most insulin resistant tertile, distribution of normal BP, prehypertension, and hypertension was equal in those <52 years, whereas in those ≥52 years, prevalence of hypertension was increased approximately five-fold as compared to those with normal BP. Multivariate regression analysis demonstrated significant interaction between age and SSPG in predicting systolic BP (p=0.023). In stratified analysis, SSPG, but not age, was an independent predictor of systolic BP and diastolic BP in ≥52 year group, whereas the reverse was true in the younger group. The adverse impact of insulin resistance on blood pressure was accentuated in older individuals and may have a greater impact than further aging.

      PubDate: 2017-04-18T22:01:34Z
      DOI: 10.1016/j.jash.2017.04.005
  • Smoking before isometric exercise amplifies myocardial stress and
           dysregulates baroreceptor sensitivity and cerebral oxygenation
    • Authors: Panagiota Anyfanti; Eleftheria Triantafyllidou; Stavros Papadopoulos; Areti Triantafyllou; Michalis G. Nikolaidis; Antonis Kyparos; Ioannis S. Vrabas; Stella Douma; Andreas Zafeiridis; Konstantina Dipla
      Abstract: Publication date: Available online 14 April 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Panagiota Anyfanti, Eleftheria Triantafyllidou, Stavros Papadopoulos, Areti Triantafyllou, Michalis G. Nikolaidis, Antonis Kyparos, Ioannis S. Vrabas, Stella Douma, Andreas Zafeiridis, Konstantina Dipla
      This cross-over study examined whether acute cardiovascular responses, baroreceptor sensitivity (BRS), and brain oxygenation during isometric exercise are altered following cigarette smoking. Twelve young, habitual smokers randomly performed a smoking and a control protocol, during which participants smoked one cigarette (0.9mg nicotine) or a sham-cigarette, prior to exercise. Testing involved baseline, a 5-min smoking, a 10-min post-smoking rest, 3 min handgrip-exercise (30% maximum voluntary-contraction), and recovery. Beat-to-beat blood pressure (BP), heart rate (HR), and cerebral oxygenation (Near-Infrared-Spectroscopy, NIRS) were continuously monitored. Double-product, stroke volume (SV), cardiac output, systemic vascular resistance (SVR) and BRS were assessed. During post-smoking rest, systolic/diastolic BP (140.8±12.1/87.0±6.9 vs. 125.9±7.1/77.3±5.5mmHg), HR, and double-product were higher in the smoking vs. the control protocol, whereas BRS was lower (p<0.05). During handgrip-exercise, smoking resulted in greater HR and double-product (17240±3893 vs. 15424±3173mmHg·bpm) and lower BRS vs. the control protocol (p<0.05), without significant differences in SV and SVR between protocols. During recovery, smoking elicited a delayed return of brain-oxygenation indices, lower BRS, and higher double-product. Smoking a cigarette shortly before the exercise session, amplifies myocardial stress and dysregulates autonomic function and cerebral oxygenation during exercise and recovery, even in young habitual smokers, perceived as free from long-term cardiovascular effects of smoking.
      Graphical abstract image

      PubDate: 2017-04-18T22:01:34Z
      DOI: 10.1016/j.jash.2017.04.004
  • Salt and Essential Hypertension: Pathophysiology and Implications for
    • Authors: Michael A. Garfinkle
      Abstract: Publication date: Available online 14 April 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Michael A. Garfinkle
      Essential hypertension is common and is associated with significant morbidity and mortality. However, questions remain as to the exact physiologic mechanisms underlying this disease. First, we discuss how essential hypertension may be largely a result of a maladaptation to a high salt diet and that high blood pressure, rather than being an inactive side effect of high salt intake, may be an adaptive mechanism to improve salt secretion. Next we explain how any physiologic state that reduces urinary sodium concentrating ability may increase an individual’s risk for salt-induced hypertension. Finally, we conclude that natriuresis is a crucial criterion for effective long-term pharmacologic treatment of essential hypertension.

      PubDate: 2017-04-18T22:01:34Z
      DOI: 10.1016/j.jash.2017.04.006
  • The Number of Visits and Blood Pressure Measurements Influence the
           Prevalence of High Blood Pressure in Adolescents
    • Authors: Luciano Machado Ferreira Tenório de Oliveira; Alison Oliveira da Silva; Paula Rejane Beserra Diniz; Breno Quintella Farah; André Luiz Torres Pirauá; Antônio José de Lima Neto; Wallacy Milton do Nascimento Feitosa; Rafael Miranda Tassitano; Raphael M. Ritti-Dias
      Abstract: Publication date: Available online 13 April 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Luciano Machado Ferreira Tenório de Oliveira, Alison Oliveira da Silva, Paula Rejane Beserra Diniz, Breno Quintella Farah, André Luiz Torres Pirauá, Antônio José de Lima Neto, Wallacy Milton do Nascimento Feitosa, Rafael Miranda Tassitano, Raphael M. Ritti-Dias
      Background The aim of this study was to analyze the influence of the number of visits and the number of blood pressure (BP) measurements on the prevalence of high blood pressure (HBP) in adolescents. Methods A cross-sectional epidemiological study with 481 adolescents (14 to 19 years old) selected using a random cluster sampling strategy. We measured the BP three times in a first visit. Adolescents with HBP performed subsequent visits. The final calculation of BP followed four strategies: the 1st measure, mean of 1st and 2nd measurements, mean of all three measurements and averaging the 2nd and 3rd measurement. Results The prevalence of HBP in the first and second visits were 6.4%, 1.9% and the prevalence of hypertension (after three visits) was 1.7%. The prevalence of HBP varied from 8.6% to 18.6% for boys and 4.6% to 9.2% for girls, using the average 2nd and 3rd measurements and the 1st measurement, respectively. In all strategies, HBP and hypertension were more prevalent in boys and students attending the nocturnal shift. Conclusion The number of visits and number of measurements affects the prevalence of HBP and hypertension in adolescents. Thus, clinicians and researchers should consider these aspects when assessing BP in adolescents aged 14 to 19 years old.

      PubDate: 2017-04-18T22:01:34Z
      DOI: 10.1016/j.jash.2017.04.002
  • Aortic Backward Waves Rather Than Stiffness Account for Independent
           Associations Between Pulse Pressure Amplification and Left Ventricular
           Mass in a Young-to-Middle Aged Sample
    • Authors: Moekanyi J. Sibiya; Gavin R. Norton; Hendrik L. Booysen; Grace Tade; Carlos D. Libhaber; Imraan Ballim; Pinhas Sareli; Angela J. Woodiwiss
      Abstract: Publication date: Available online 13 April 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Moekanyi J. Sibiya, Gavin R. Norton, Hendrik L. Booysen, Grace Tade, Carlos D. Libhaber, Imraan Ballim, Pinhas Sareli, Angela J. Woodiwiss
      A decreased aortic-to-brachial pulse pressure amplification (PP amplification), which is independently associated with cardiovascular outcomes, may index several aortic functional changes. However that aortic functional change most likely to account for this effect is uncertain. In 706 randomly selected community participants of African ancestry with a mean age of 44.4±18.2 years we assessed aortic function using radial applanation tonometry and SphygmoCor software (including forward [Pf] and backward [Pb] wave separation analysis assuming a triangular flow waveform) and left ventricular mass index (LVMI)(echocardiography). In multivariate models with the inclusion of brachial PP, 1/PP amplification (partial r=0.12, p<0.005), reflected wave pressures (partial r=0,09, p<0.05), and aortic pulse wave velocity (PWV) (partial r=0.09, p<0.05) were independently associated with LVMI. Similarly, in multivariate models with the inclusion of brachial PP, 1/PP amplification (p<0.005), the reflected wave pressure (p<0.01), and aortic PWV (p<0.01) were independently associated with LVH. With adjustments for reflected wave pressures, the brachial PP-independent relationships between 1/PP amplification and LVMI or LVH were abolished (p>0.08 for both). However, adjustments for PWV failed to modify brachial PP-independent relations between 1/PP amplification and LVMI or LVH. Similar results were noted when brachial SBP rather than PP was included in regression models and in sensitivity analysis conducted in participants not receiving antihypertensive therapy. In conclusion, the independent relations between the reciprocal of aortic-to-brachial PP amplification and LVMI or LVH in a largely young-to-middle-aged sample are accounted for by variations in backward wave pressures rather than aortic stiffness.

      PubDate: 2017-04-18T22:01:34Z
      DOI: 10.1016/j.jash.2017.04.003
  • Fibroblast Growth Factor-23 is Independently Associated with Cardiac Mass
           in African American Adolescent Males
    • Authors: Bonita Falkner; Scott W. Keith; Samuel S. Gidding; Craig B. Langman
      Abstract: Publication date: Available online 12 April 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Bonita Falkner, Scott W. Keith, Samuel S. Gidding, Craig B. Langman
      Left ventricular hypertrophy (LVH) has been documented in hypertensive adolescents and among some with prehypertension. Obesity also appears to be associated with cardiac mass, independent of blood pressure (BP). Fibroblast growth factor-23(FGF23) is a novel biomarker positively associated with LVH in adults with and without kidney disease. The aim of this study was to determine if there was a significant and independent association of FGF23 with cardiac mass in a Black American adolescent cohort including both normotensive and prehypertensive (PH) participants with and without obesity. Measurements of BP, body mass index (BMI), plasma c-terminal FGF23, and echocardiographic measures of left ventricular mass index (LVMI) were obtained in 236 adolescents, aged 13-18 years, stratified by BMI as normal, overweight, or obese. LVMI differed significantly between normal, overweight, and obese groups (30.42+6.75 vs 33.49 +8.65 vs 37.26+6.99 gm/m2.7; P<0.01). FGF23 was significantly higher in both overweight (53.03 RU/ml) and obese (54.40 RU/ml) compared to the normal weight (32.83 RU/ml) group; both P<0.01). In multiple linear regression analysis, variables significantly related to LVMI in males were BMI (P<0.0001), and FGF23 (P=0.005), but not BP, hsCRP or insulin. The only significant variable associated with LVMI in females was BMI (P<0.0001). In males, the contribution of FGF23 to predicting LVMI was independent of and in addition to obesity. These results suggest that FGF23 is an integral part of a complex pathway, associated with higher cardiac mass in African Americans males with excess adiposity.

      PubDate: 2017-04-18T22:01:34Z
      DOI: 10.1016/j.jash.2017.04.001
  • Achieving the BpTRUth: Emergency Department Hypertension Screening and the
           Centers for Medicare & Medicaid Services Quality Measure
    • Authors: Elizabeth M. Goldberg; Taneisha Wilson; Cory Saucier; Aaron M. Brody; Phillip D. Levy; Charles B. Eaton; Roland C. Merchant
      Abstract: Publication date: Available online 30 March 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Elizabeth M. Goldberg, Taneisha Wilson, Cory Saucier, Aaron M. Brody, Phillip D. Levy, Charles B. Eaton, Roland C. Merchant
      Background In 2012, the Centers for Medicare & Medicaid Services (CMS) instituted a Physician Quality Reporting System measure for screening and referring patients with elevated blood pressure (BP). Objectives To (1) assess the reliability of ED triage BP as a metric to establish when the CMS threshold (≥120/80 mm Hg), and other clinically relevant BP thresholds (≥140/90 and ≥160/100 mm Hg) have been met, using BP measured with a highly accurate device (BpTRU) in the ED as the gold standard; and (2) determine whether correct identification varies by gender, race, or triage acuity. Methods Using the BpTRU, we calculated the proportion of patients whose triage BP accurately indicated a need for further referral and treatment for hypertension according to three suggested BP thresholds (≥120/80, ≥140/90, and ≥160/100 mm Hg). Results Of 354 patients, the median age was 39 years, 48.9% were women, and 66.4% were white. At the three suggested BP thresholds (≥120/80, ≥140/90, and ≥160/100 mm Hg), 66.1%, 74.0%, and 88.8% of patients were confirmed to meet the CMS threshold, respectively. There were no differences by gender, race, or triage acuity. Conclusions ED triage BP would reliably identify elevated BP using the CMS threshold in up to two-thirds of those without known hypertension.

      PubDate: 2017-04-04T20:58:18Z
      DOI: 10.1016/j.jash.2017.03.003
  • The Influence of Hypertension on Daytime Sleepiness in Obstructive Sleep
    • Authors: Helena Martynowicz; Robert Skomro; Paweł Gać; Grzegorz Mazur; Irena Porębska; Agnieszka Brylka; Wojciech Nowak; Michał Zieliński; Anna Wojakowska; Rafał Poręba
      Abstract: Publication date: Available online 27 March 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Helena Martynowicz, Robert Skomro, Paweł Gać, Grzegorz Mazur, Irena Porębska, Agnieszka Brylka, Wojciech Nowak, Michał Zieliński, Anna Wojakowska, Rafał Poręba
      Daytime sleepiness is a common symptom among hypertensive patients. The aim of this study was to determine subjective sleepiness assessed by Epworth Sleepiness Scale (ESS) and to asses sleep architecture in 304 patients with arterial hypertension. All patients underwent a standardized diagnostic overnight, polysomnography. The control group consisted of 67 normotensives. The hypertensive patients had a decreased sleep efficiency, mean and minimum oxygen saturation levels, increased apnea / hypopnea index and oxygen desaturation index compared with normotensive patients. The lower ratio of N3 sleep, higher of N2 sleep and decreased sleep efficiency was observed in hypertensives without obstructive sleep apnea (OSA). In the moderate to severe OSA groups the total ESS score was significantly lower in hypertensives compared to normotensives. The ESS scores decreased with age in hypertensives, but not in normotensives. The study showed that ESS total score is lower in hypertensives than in normotensives with OSA, making the OSA more difficult to suspect. Thus the low ESS score in hypertensives should not discourage further evaluation.

      PubDate: 2017-03-28T20:19:05Z
      DOI: 10.1016/j.jash.2017.03.004
  • Arterial stiffness and elevated left ventricular filling pressure in
           patients at risk for the development or a previous diagnosis of HF – a
           subgroup analysis from the DIAST-CHF study
    • Authors: Claus Lüers; Tobias Daniel Trippel; Sebastian Seeländer; Rolf Wachter; Gerd Hasenfuss; Ruhdja Lindhorst; Anna Bobenko; Kathleen Nolte; Burkert Pieske; Frank Edelmann
      Abstract: Publication date: Available online 27 March 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Claus Lüers, Tobias Daniel Trippel, Sebastian Seeländer, Rolf Wachter, Gerd Hasenfuss, Ruhdja Lindhorst, Anna Bobenko, Kathleen Nolte, Burkert Pieske, Frank Edelmann
      Background Left ventricular filling pressure (LVFP) is a marker for diastolic dysfunction and heart failure (HF) with preserved ejection fraction (pEF; HFpEF). The interaction between arterial stiffness (AS) and elevated LVFP has not been sufficiently investigated. Methods In 257 patients with preserved left ventricular ejection fraction (LVEF; mean age 66 years, 53% female, mean LVEF 61%) and at least one cardiovascular risk factor (e.g. hypertension, diabetes) for the development of HF or a previous diagnosis of HF, LVFP was estimated in accordance with the recommendations of the American Society of Echocardiography (elevated when E/e´ ≥ 13, left atrial volume index ≥ 34 ml/m2). LVFP was correlated with radial pulse wave analysis [augmentationindex normalised by 75 b/min (AIx@75)], and carotid-femoral pulse wave velocity (cfPWV)]. Results 38% of patients demonstrated an elevated LVFP. These patients were significantly older (68.3±7.4 vs. 63.5±7.6 years, p<0.001), demonstrated a higher body-mass-index (29.8±4.6 vs 28.0±5.0; p<0.01), presented more often with hypertension (89.7% vs. 73.1%, p<0.01), hypercholesterolemia (32.0% vs. 21.3%, p<0.05), dyspnea on exertion (28.4% vs. 16.6%, p<0.05) and peripheral edema (25.3% vs. 10.2%, p<0.01). cfPWV and AIx@75 and were significantly elevated in patients with elevated LVFP (12.2±2.7 m/s vs. 10.5±2.6 m/s, p<0.001, an 29.2±6.7% vs. 27.4±6.7%, p<0.05 respectively). cfPWV and AIx@75 were correlated with echocardiographic parameters, i.e. posterior wall thickness (r=0.292, p<0.001; r=0.167, p<0.01), left ventricular mass index (r=0.255, p<0.001; r=-0.192, p<0.01), e´ (r=-0.508, p<0.001; r=-0.159, p<0.05) and E/e´ (r=0.380, p<0.001; r=0.200, p<0.01). cfPWV correlated with left atrial volume index (r=0.189, p<0.05) and increasing E/A ratio (r=-0.334, p<0.001). Multivariate linear regression analysis demonstrated age and PWV as most important and independent predictors LVFP elevation in the entire cohort. Conclusions Increased AS measured by cfPWV was associated with an elevated LVFP in patients with preserved systolic function. Whether targeting AS as a major component of diastolic dysfunction and HFpEF needs to be further investigated.

      PubDate: 2017-03-28T20:19:05Z
      DOI: 10.1016/j.jash.2017.03.006
  • Response to Letter to editor “Lessons learned from the recent history of
           technologies for non-invasive estimation of aortic blood pressure using
           transfer functions and pulse wave analysis “ by Papaioannou et al.
    • Authors: Lama Ghazi; Fadi G. Hage
      Abstract: Publication date: Available online 27 March 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Lama Ghazi, Fadi G. Hage

      PubDate: 2017-03-28T20:19:05Z
      DOI: 10.1016/j.jash.2017.03.007
  • Galectin-3 mediates the pulmonary arterial hypertension-induced right
           ventricular remodeling through interacting with NADPH oxidase 4
    • Authors: Jingni He; Xiaohui Li; Hui Luo; Tangzhiming Li; Lin Zhao; Qiangqiang Qi; Yuwei Liu; Zaixin Yu
      Abstract: Publication date: Available online 27 March 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Jingni He, Xiaohui Li, Hui Luo, Tangzhiming Li, Lin Zhao, Qiangqiang Qi, Yuwei Liu, Zaixin Yu
      Objective Pulmonary arterial hypertension (PAH) is a progressive disorder that affects both pulmonary vasculature and the heart. The response of the right ventricle (RV) to the increased afterload is an important determinant of the PAH final outcome. Galectin-3 (Gal-3), a novel biomarker in left cardiac remodeling, takes part in multiple pathophysiological processes including the inflammation, fibrosis, immunity and oxidative stress. The levels of Gal-3 are elevated in PAH patients, though the exact mechanisms underlie the PAH-induced right ventricular structural changes remain unclear. Results Serum Gal-3 and Nox4 levels were significantly elevated and correlated in 26 human PAH patients when compared to 14 age- and sex-matched healthy controls. In the MCT-induced PAH rat models of RV hypertrophy and fibrosis, the Gal-3 and Nox4 expressions were both significantly up-regulated compared to the controls. The exogenous Gal-3 recombinant protein stimulated the proliferation, differentiation, collagen deposition and Nox4 expression of CFs. These simulations were blocked by the Gal-3 knockdown. The pro-fibrotic effects of TGF-β1 on the CFs were partially mediated by the Gal-3. Subsequently, our results showed that Gal-3 mediated the TGF-β1-induced cardiac fibrotic process by interacting with the Nox4 and Nox4- derived oxidative stress. Conclusions Gal-3 plays an important role in the PAH-induced RV remodeling by interacting with Nox4 and Nox4-derived oxidative stress. Gal-3 may become a RV-specific diagnostic and therapeutic target for clinics.

      PubDate: 2017-03-28T20:19:05Z
      DOI: 10.1016/j.jash.2017.03.008
  • Contributions of Aortic Pulse Wave Velocity and Backward Wave Pressure to
           Variations in Left Ventricular Mass are Independent of Each Other
    • Authors: Hamza Bello; Gavin R. Norton; Imraan Ballim; Carlos D. Libhaber; Pinhas Sareli; Angela J. Woodiwiss
      Abstract: Publication date: Available online 14 March 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Hamza Bello, Gavin R. Norton, Imraan Ballim, Carlos D. Libhaber, Pinhas Sareli, Angela J. Woodiwiss
      Aortic pulse wave velocity (PWV) and backward waves, as determined from wave separation analysis, predict cardiovascular events beyond brachial blood pressure (BP). However, the extent to which these aortic hemodynamic variables contribute independent of each other is uncertain. In 749 randomly selected participants of African ancestry we therefore assessed the extent to which relationships between aortic PWV or backward wave pressures (Pb)(and hence central aortic pulse pressure [PPc]) and left ventricular mass index (LVMI) occur independent of each other. Aortic PWV, PPc, forward wave pressure (Pf) and Pb were determined using radial applanation tonometry and SphygmoCor software and LVMI using echocardiography. 44.5% of participants had an increased LVMI-ht1.7. With adjustments for age, brachial systolic BP or PP and additional confounders, PPc and Pb, but not Pf was independently related to LVMI and LV hypertrophy (LVH) in both men and women. However, PWV was independently associated with LVMI in women (partial r=0.16, p<0.001), but not in men (partial r=0.03) and PWV was independently associated with LVH in women (p<0.05), but not in men (p=0.07). With PWV and Pb included in the same multivariate regression models, PWV (partial r=0.14, p<0.005) and Pb (partial r=0.10, p<0.05) contributed to a similar extent to variations in LVMI in women. In addition, with PWV and Pb included in the same multivariate regression models, PWV (p<0.05) and Pb (p<0.02) contributed to LVH in women. In conclusion, aortic PWV and backward wave pressure (and hence pulse pressure) although both associated with LVMI and LVH, produce effects which are independent of each other.

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

      PubDate: 2017-03-17T15:26:03Z
      DOI: 10.1016/j.jash.2017.03.002
  • Low dose sustained-release deoxycorticosterone acetate induced
           hypertension in Bama miniature pigs for renal sympathetic nerve
    • Authors: Wenzheng Han; Weiyi Fang; Qian Gan; Shaofeng Guan; Yanjie Li; Ming Wang; Kaizheng Gong; Xinkai Qu
      Abstract: Publication date: Available online 2 March 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Wenzheng Han, Weiyi Fang, Qian Gan, Shaofeng Guan, Yanjie Li, Ming Wang, Kaizheng Gong, Xinkai Qu
      Background Recently, the effectiveness of renal sympathetic nerve denervation for treatment of hypertension has been doubted after SYMPLICITY HTN-3 trial. An ideal animal model is still unavailable for pre-clinical study about catheter-based renal sympathetic nerve denervation (RDN) for treatment of hypertension. Traditional high dose deoxycorticosterone acetate (DOCA) induced hypertension pig model has some problems due to extensive end-organ damage. Based on the similarity in the anatomic characteristics of renal artery between pigs and humans, this study was undertaken to establish a low dose sustained-release DOCA-induced hypertension model in pigs. Methods A total of 14 pigs were subcutaneously implanted with low dose DOCA in the abdomen and cannulated from the femoral artery for the measurement of blood pressure (BP). Plasma angiotensin-I (Ang-I), angiotensin-II (Ang-II), plasma renin activity (PRA), aldosterone (Ald), creatinine (CREA), epinephrine (E) and norepinephrine (NE) were determined before and after treatments. The kidneys were collected and processed for haematoxylin & eosin staining, Masson–Goldner trichromic and periodic acid Schiff (PAS) staining. Results 10 pigs survived for one month. Mean BP significantly increased after 2-week treatment (P<0.001). The plasma Ang I, Ang II, PRA and Ald significantly decreased (Ang I: 6.92±6.06 vs 2.22±3.08, P=0.002; Ang II: 768.85±525.8 vs 213.76±148.63, P=0.003; PRA: 1.68±1.67 vs 0.29±0.39, P=0.008; Ald: 0.37±0.12 vs 0.25±0.09, P<0.001), but NE significantly increased (7.59±4.57 vs 16.96±10.38, P=0.021). Plasma CREA remained unchanged. Hisotological examination showed mild damage to the kidney. Conclusion: Low dose sustained-release DOCA is able to induce hypertension in pigs. A femoral catheter is not only helpful for monitoring BP, but can be used to quickly exchange the RDN equipment.

      PubDate: 2017-03-04T14:11:49Z
      DOI: 10.1016/j.jash.2017.02.006
  • From the Editor
    • Authors: Daniel Levy
      Abstract: Publication date: Available online 24 February 2017
      Source:Journal of the American Society of Hypertension
      Author(s): Daniel Levy

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

      PubDate: 2017-02-25T11:12:13Z
      DOI: 10.1016/j.jash.2017.02.003
  • Clinic and Ambulatory Blood Pressure in a Population-Based Sample of
           African Americans: the Jackson Heart Study
    • Authors: S. Justin Thomas; John N. Booth; Samantha G. Bromfield; Samantha R. Seals; Tanya M. Spruill; Gbenga Ogedegbe; Srividya Kidambi; Daichi Shimbo; David Calhoun; Paul Muntner
      Abstract: Publication date: Available online 16 February 2017
      Source:Journal of the American Society of Hypertension
      Author(s): S. Justin Thomas, John N. Booth, Samantha G. Bromfield, Samantha R. Seals, Tanya M. Spruill, Gbenga Ogedegbe, Srividya Kidambi, Daichi Shimbo, David Calhoun, Paul Muntner
      Blood pressure (BP) can differ substantially when measured in the clinic versus outside of the clinic setting. Few population-based studies with ambulatory blood pressure monitoring (ABPM) include African Americans. We calculated the prevalence of clinic hypertension and ABPM phenotypes among 1,016 participants in the population-based Jackson Heart Study, an exclusively African-American cohort. Mean daytime systolic BP was higher than mean clinic systolic BP among participants not taking antihypertensive medication (127.1[standard deviation 12.8] versus 124.5[15.7] mmHg, respectively) and taking antihypertensive medication (131.2[13.6] versus 130.0[15.6] mmHg, respectively). Mean daytime diastolic BP was higher than clinic diastolic BP among participants not taking antihypertensive medication (78.2[standard deviation 8.9] versus 74.6[8.4] mmHg, respectively) and taking antihypertensive medication (77.6[9.4] versus 74.3[8.5] mmHg, respectively). The prevalence of daytime hypertension was higher than clinic hypertension for participants not taking antihypertensive medication (31.8% versus 14.3%) and taking antihypertensive medication (43.0% versus 23.1%). A high percentage of participants not taking and taking antihypertensive medication had nocturnal hypertension (49.4% and 61.7%, respectively), white coat hypertension (30.2% and 29.3%, respectively), masked hypertension (25.4% and 34.6%, respectively), and a non-dipping BP pattern (62.4% and 69.6%, respectively). In conclusion, these data suggest hypertension may be misdiagnosed among African Americans without using ABPM.

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

      PubDate: 2017-02-12T00:42:00Z
      DOI: 10.1016/j.jash.2017.01.008
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