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  Subjects -> HISTORY (Total: 1263 journals)
    - HISTORY (808 journals)
    - History (General) (50 journals)
    - HISTORY OF AFRICA (49 journals)
    - HISTORY OF ASIA (53 journals)
    - HISTORY OF AUSTRALASIA AND OTHER AREAS (8 journals)
    - HISTORY OF EUROPE (159 journals)
    - HISTORY OF THE AMERICAS (111 journals)
    - HISTORY OF THE NEAR EAST (25 journals)

HISTORY (808 journals)            First | 1 2 3 4 5 6 7 8 | Last

História (São Paulo)     Open Access   (Followers: 1)
Historia Constitucional     Open Access   (Followers: 1)
Historia Critica     Open Access  
Historia de la Educación. Anuario     Open Access  
História e Cultura     Open Access   (Followers: 1)
Historia i Polityka     Open Access  
Historia Magistra     Full-text available via subscription   (Followers: 1)
História Unisinos     Open Access  
Historia y Comunicación Social     Open Access  
História, Ciências, Saúde - Manguinhos     Open Access   (Followers: 1)
Historical Journal     Hybrid Journal   (Followers: 30)
Historical Methods: A Journal of Quantitative and Interdisciplinary History     Hybrid Journal   (Followers: 18)
Historical Reflections     Full-text available via subscription   (Followers: 3)
Historical Research     Hybrid Journal   (Followers: 21)
Historical Research Letter     Open Access   (Followers: 2)
Historical Review / La Revue Historique     Open Access   (Followers: 9)
Historical Studies in Education     Open Access   (Followers: 2)
Historical Studies in Industrial Relations     Hybrid Journal   (Followers: 3)
Historical Studies in the Natural Sciences     Full-text available via subscription   (Followers: 5)
Historically Speaking     Full-text available via subscription   (Followers: 3)
Histories of Anthropology Annual     Full-text available via subscription   (Followers: 5)
Historiographia Linguistica     Hybrid Journal  
Historiography East and West     Hybrid Journal   (Followers: 2)
Historische Zeitschrift     Hybrid Journal   (Followers: 8)
Historiæ     Open Access   (Followers: 1)
History & Memory     Full-text available via subscription   (Followers: 31)
History and Philosophy of the Life Sciences     Hybrid Journal   (Followers: 1)
History Australia     Full-text available via subscription   (Followers: 6)
History Compass     Hybrid Journal   (Followers: 14)
History in Africa     Full-text available via subscription   (Followers: 7)
History of CERN     Full-text available via subscription   (Followers: 2)
History of Education Quarterly     Hybrid Journal   (Followers: 8)
History of Education Review     Hybrid Journal   (Followers: 10)
History of Education: Journal of the History of Education Society     Hybrid Journal   (Followers: 26)
History of European Ideas     Hybrid Journal   (Followers: 28)
History of Neuroscience in Autobiography     Full-text available via subscription   (Followers: 1)
History of Political Thought     Full-text available via subscription   (Followers: 21)
History of Psychology     Full-text available via subscription   (Followers: 7)
History of Religions     Full-text available via subscription   (Followers: 28)
History of Science     Full-text available via subscription   (Followers: 17)
History Today     Full-text available via subscription   (Followers: 7)
Holocaust and Genocide Studies     Hybrid Journal   (Followers: 18)
Hortus Artium Medievalium     Full-text available via subscription   (Followers: 4)
HSE - Social and Education History     Open Access   (Followers: 2)
IEEE Annals of the History of Computing     Full-text available via subscription   (Followers: 13)
IKON     Full-text available via subscription   (Followers: 6)
Il Capitale Culturale. Studies on the Value of Cultural Heritage     Open Access   (Followers: 2)
ILCEA     Open Access  
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   (Followers: 2)
Imago Mundi: The International Journal for the History of Cartography     Hybrid Journal   (Followers: 8)
Immigrants & Minorities     Hybrid Journal   (Followers: 10)
Indian Economic & Social History Review     Hybrid Journal   (Followers: 6)
Índice Histórico Español     Open Access  
Indonesia and the Malay World     Hybrid Journal   (Followers: 4)
Indonesian Journal of History Education     Open Access  
Inner Asia     Hybrid Journal   (Followers: 2)
Intellectual History Review     Hybrid Journal   (Followers: 22)
Interaction     Full-text available via subscription   (Followers: 3)
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 Bibliography of Military History     Hybrid Journal   (Followers: 3)
International Journal of Asian Studies     Hybrid Journal   (Followers: 9)
International Journal of Culture and History     Open Access   (Followers: 2)
International Journal of Iberian Studies     Hybrid Journal   (Followers: 4)
International Journal of Middle East Studies     Hybrid Journal   (Followers: 60)
International Journal of Regional and Local History     Hybrid Journal  
International Journal of Society Systems Science     Hybrid Journal  
International Journal of Sustainable Society     Hybrid Journal   (Followers: 5)
International Politics     Partially Free   (Followers: 20)
International Review of Social History     Full-text available via subscription   (Followers: 21)
INTRECCI d'arte     Open Access   (Followers: 5)
Iran and the Caucasus     Hybrid Journal   (Followers: 8)
Irish Studies Review     Hybrid Journal   (Followers: 14)
Isis     Full-text available via subscription   (Followers: 17)
Israel Studies Forum     Full-text available via subscription   (Followers: 1)
Istituto Lombardo - Accademia di Scienze e Lettere - Rendiconti di Lettere     Open Access  
Itinerari di ricerca storica     Open Access  
Japanese Studies     Hybrid Journal   (Followers: 5)
Jewish Culture and History     Hybrid Journal   (Followers: 13)
Journal Asiatique     Full-text available via subscription   (Followers: 4)
Journal for Contemporary History     Full-text available via subscription   (Followers: 12)
Journal for Early Modern Cultural Studies     Full-text available via subscription   (Followers: 15)
Journal for Maritime Research     Hybrid Journal   (Followers: 6)
Journal for the Study of Judaism     Hybrid Journal   (Followers: 10)
Journal for the Study of Radicalism     Full-text available via subscription   (Followers: 4)
Journal of Aging, Humanities, and the Arts: Official Journal of the Gerontological Society of America     Hybrid Journal   (Followers: 5)
Journal of American History     Hybrid Journal   (Followers: 34)
Journal of American Studies     Hybrid Journal   (Followers: 13)
Journal of American-East Asian Relations     Hybrid Journal  
Journal of Ancient History and Archaeology     Open Access   (Followers: 6)
Journal of Arts Management, Law, and Society     Full-text available via subscription   (Followers: 7)
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: 30)
Journal of Canadian Studies/Revue d'études canadiennes     Full-text available via subscription   (Followers: 3)
Journal of Cognitive Historiography     Full-text available via subscription  
Journal of Colonialism and Colonial History     Full-text available via subscription   (Followers: 16)
Journal of Conflict Studies     Full-text available via subscription   (Followers: 16)
Journal of Contemporary Asia     Hybrid Journal   (Followers: 4)

  First | 1 2 3 4 5 6 7 8 | Last

Journal Cover Journal of the American Society of Hypertension
  [SJR: 1.15]   [H-I: 22]   [7 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 1933-1711
   Published by Elsevier Homepage  [2801 journals]
  • Sleep apnea, hypertension, and hemorrhagic stroke – Déjà
           vu all over again
    • Abstract: Publication date: Available online 30 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Naima Covassin, Virend K. Somers



      PubDate: 2016-01-30T21:20:54Z
       
  • Does This Patient Have Hypertensive Encephalopathy?
    • Abstract: Publication date: Available online 29 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Foteini Christopoulou, Evangelos C. Rizos, Paraskevi Kosta, Maria I. Argyropoulou, Moses Elisaf
      A 63 year old man was admitted to our hospital for further investigation and management of brain metastases. The patient was initially presented with a four-day history of confusion. On the day of admission the patient was confused, agitated, disorientated in place and time, and had visual disturbances. His blood pressure (BP) was repeatedly recorded high, with levels of systolic BP between 170-210 mmHg. A brain magnetic resonance imaging showed areas of high signal on T2 and FLAIR images, located bilaterally in the white matter of the occipital regions and unilateral in the left frontal lobe, suggestive of posterior reversible encephalopathy syndrome (PRES). Aggressive treatment of hypertension resulted in complete resolution of the clinical and radiologic features of the syndrome.


      PubDate: 2016-01-30T21:20:54Z
       
  • ARAs to the RESCUE
    • Abstract: Publication date: Available online 25 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Norman M. Kaplan



      PubDate: 2016-01-30T21:20:54Z
       
  • Recurrence of stroke caused by nocturnal hypoxia-induced blood pressure
           surge in a young adult male with severe obstructive sleep apnea syndrome
    • Abstract: Publication date: Available online 25 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Tetsuro Yoshida, Mitsuo Kuwabara, Satoshi Hoshide, Kazuomi Kario
      Obstructive sleep apnea syndrome (OSAS) causes resistant hypertension and a hypopnea-related nocturnal blood pressure (BP) surge. This could lead to an increase of not only the nocturnal BP level but also nocturnal BP variability, both of which increase an individual’s cardiovascular risk. We recently developed a trigger sleep BP monitoring (TSP) method that initiates BP measurement when an individual’s oxygen desaturation falls below a variable threshold, and we demonstrated that it can detect a BP surge during apnea episodes. We here report the case of a 36-year-old man with severe OSAS who experienced the recurrence of stroke due to nocturnal hypoxia and a nocturnal BP surge measured by this TSP device. A nocturnal BP surge during sleep in OSAS patients could be a strong trigger of cardiovascular events.


      PubDate: 2016-01-30T21:20:54Z
       
  • From the Editor
    • Abstract: Publication date: Available online 28 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Daniel Levy



      PubDate: 2016-01-30T21:20:54Z
       
  • The many benefits of exercise
    • Abstract: Publication date: Available online 28 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Norman M. Kaplan



      PubDate: 2016-01-30T21:20:54Z
       
  • Early atherosclerosis aggravates renal microvascular loss and fibrosis in
           swine renal artery stenosis
    • Abstract: Publication date: Available online 28 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Dong Sun, Alfonso Eirin, Behzad Ebrahimi, Stephen C. Textor, Amir Lerman, Lilach O. Lerman
      Background Renal function in patients with atherosclerosis and renal artery stenosis (ARAS) deteriorates more frequently than in non-atherosclerotic RAS. We hypothesized that ARAS aggravates stenotic kidney microvascular loss compared to RAS. Methods Domestic pigs were randomized to Normal, RAS, and ARAS (RAS fed a high-cholesterol diet) groups (n=7 each). Ten weeks later stenotic kidney oxygenation, renal blood flow (RBF), and glomerular filtration rate (GFR) were evaluated in-vivo, and microvascular density by Micro-CT. Results Blood pressure in both RAS and ARAS was elevated, and stenotic kidney RBF and GFR similarly decreased. RAS decreased the density of small-size cortical microvessels (<200 μm), while ARAS extended the decrease to medium-sized microvessels (200-300 μm). Cortical hypoxia and interstitial fibrosis increased in both RAS and ARAS, but correlated inversely with microvascular density only in RAS. Conclusions Atherosclerosis aggravates loss of stenotic-kidney microvessels, yet additional determinants likely contribute to cortical hypoxia and fibrosis in swine ARAS.


      PubDate: 2016-01-30T21:20:54Z
       
  • Renal Intramedullary Infusion of Tempol Normalizes the Blood Pressure
           Response to Intrarenal Blockade of Heme Oxygenase-1 in Angiotensin
           II-Dependent Hypertension
    • Abstract: Publication date: Available online 30 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): David E. Stec, Luis A. Juncos, Joey P. Granger
      Background Previous studies have demonstrated that intramedullary inhibition of heme oxygenase-1 (HO-1) increases the blood pressure and superoxide production response to angiotensin II (Ang II) infusion. The current study was designed to test the hypothesis that increased renal medullary superoxide production contributes to the increase in blood pressure in response to blockade of renal medullary HO-1 in Ang II-induced hypertension. Methods Male C57BL/6J mice (16-24 weeks of age) were implanted with chronic intrarenal medullary interstitial (IRMI) and infused with: saline, Tempol (6mM), the HO-1 inhibitor QC-13 (25 μM), or a combination of tempol + QC-13. Tempol treatment was started 2 days before infusion of QC-13. After 2 days, Ang II was infused subcutaneously at at a rate of 1 μg/kg/min for 10 days. Results Blood pressures on days 7-10 of Ang II infusion alone averaged 150 + 3 mmHg in mice receiving IRMI infusion of saline. IRMI infusion of QC-13 increased blood pressure in Ang II treated mice to 164 + 2 (p<0.05). Renal medullary superoxide production in Ang II treated mice was significantly increased by infusion of QC-13 alone. Ang II treated mice receiving IRMI infusion of tempol had a blood pressure of 136 + 3 mmHg. Ang II treated mice receiving IRMI infusion of tempol and QC-13 had a significantly lower blood pressure (142 + 2 mmHg ,p<0.05) than mice receiving QC-13 alone. The increase in renal medullary superoxide production was normalized by infusion of tempol alone or in combination with QC-13. Conclusion These results demonstrate that renal medullary interstitial blockade of HO-1 exacerbates Ang II-induced hypertension via a mechanism that is dependent on enhanced superoxide generation and highlight the important anti-oxidant function of HO-1 in the renal medulla.


      PubDate: 2016-01-30T21:20:54Z
       
  • Blood pressure effects of SGLT2 inhibitors make them an attractive option
           in diabetic patients with hypertension
    • Abstract: Publication date: Available online 22 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Michael J. Bloch



      PubDate: 2016-01-24T20:46:25Z
       
  • Cardiac structure and function, and ventricular-arterial interaction 11
           years following a pregnancy with preeclampsia
    • Abstract: Publication date: Available online 20 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Maha Al-Nashi, Maria J. Eriksson, Eva Östlund, Katarina Bremme, Thomas Kahan
      Preeclampsia (PE) is associated with acute left ventricular dysfunction. Whether these changes eventually resolve remains unclear. This study assessed left and right ventricular structure and function, and ventricular-arterial interaction in 15 women 11 years following a pregnancy with PE and 16 matched control subjects with a normal pregnancy. We found normal left and right ventricular dimensions, systolic function, and global left ventricular strain, with no differences between the groups. Also indices of diastolic function, left and right atrial size, and NT-pro-BNP were normal and did not differ between the groups. Women with a previous PE had impaired night/day ratios for systolic and diastolic ambulatory blood pressure. However, indices of aortic stiffness or ventricular-arterial coupling did no differ between the groups. In conclusion, we could not demonstrate remaining alterations in systolic or diastolic left or right ventricular function, or in ventricular-arterial interaction in women 11 years after PE.


      PubDate: 2016-01-20T20:23:28Z
       
  • The complexity of diagnosing postural orthostatic tachycardia syndrome:
           influence of the diurnal variability
    • Abstract: Publication date: Available online 19 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Jangsup Moon, Han Sang Lee, Jung-Ick Byun, Jun-Sang Sunwoo, Jung-Won Shin, Jung-Ah Lim, Tae-Joon Kim, Yong-Won Shin, Keon-Joo Lee, Daejong Jeon, Keun-Hwa Jung, Soon-Tae Lee, Ki-Young Jung, Kon Chu, Sang Kun Lee
      We investigated how the diagnosis of postural orthostatic tachycardia syndrome (POTS) would be changed due to diurnal variability in orthostatic tachycardia. The orthostatic vital sign (OVS) test was administered to each patient twice, in the afternoon of the day of admission and the next morning (n=113). Forty-six patients were diagnosed with POTS, and the remaining 67 patients were assigned to non-POTS group. Heart rate increments after standing were larger in the morning than in the afternoon in every group (all P < 0.001). Among the POTS patients, 82.6% fulfilled the diagnostic criteria for POTS in the morning, and 52.2% in the afternoon. The majority of the POTS group (65.2%) displayed normal result on single OVS test. Orthostatic intolerance symptoms were provoked in only 45.7% of the POTS patients, more frequently in the morning. In conclusion, diurnal variability in hemodynamic parameters and provoked symptoms significantly challenged the diagnosis of POTS.


      PubDate: 2016-01-20T20:23:28Z
       
  • Physician-Pharmacist Collaboration versus Usual Care for
           Treatment-Resistant Hypertension
    • Abstract: Publication date: Available online 18 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Steven M. Smith, Nicholas W. Carris, Eric Dietrich, John G. Gums, Liz Uribe, Christopher S. Coffey, Tyler H. Gums, Barry L. Carter
      Team-based care has been recommended for patients with treatment-resistant hypertension (TRH), but its efficacy in this setting is unknown. We compared a physician-pharmacist collaborative model (PPCM) to usual care in patients with TRH participating in the Collaboration Among Pharmacists and physicians To Improve Outcomes Now (CAPTION) study. At baseline, 169 patients (27% of CAPTION patients) had TRH: 111 received the PPCM intervention and 58 received usual care. Baseline characteristics were similar between treatment arms. After 9 months, adjusted mean systolic BP was reduced by 7 mmHg more with PPCM intervention than usual care (p=0.036). BP control was 34.2% with PPCM versus 25.9% with usual care (adjusted OR, 1.92; 95% CI, 0.33–11.2). These findings suggest that team-based care in the primary care setting may be effective for TRH. Additional research is needed regarding the long-term impact of these models and to identify patients most likely to benefit from team-based interventions.


      PubDate: 2016-01-20T20:23:28Z
       
  • Derivation of a measure of systolic blood pressure mutability: a novel
           information theory-based metric from ambulatory blood pressure tests
    • Abstract: Publication date: Available online 20 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): D.J. Contreras, E.E. Vogel, G. Saravia, B. Stockins
      We provide ambulatory blood pressure (BP) exams with tools based on information theory to quantify fluctuations thus increasing the capture of dynamic test components. Data from 515 ambulatory 24-hour BP exams were considered. Average age: 54 years, 54 % women, 53 % under BP treatment. The average systolic pressure (SP) was 127±8 mm Hg. A data compressor (wlzip) designed to recognize meaningful information is invoked to measure mutability which is a form of dynamical variability. For patients with the same average SP different mutability values are obtained which reflects the differences in dynamical variability. In unadjusted linear regression models, mutability had low association with the mean systolic blood pressure (R2=0.056; p<0.000001) but larger association with the SP deviation (R2=0.761; p<0.001) . Wlzip allows detecting levels of variability in SP that could be hazardous. This new indicator can be easily added to the 24-hour BP monitors improving information towards diagnosis.


      PubDate: 2016-01-20T20:23:28Z
       
  • Predicting home-clinic blood pressure differences
    • Abstract: Publication date: Available online 7 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Norman M. Kaplan



      PubDate: 2016-01-11T18:22:35Z
       
  • Differential Effects of Enalapril-Felodipine vs Enalapril-Lercanidipine
           Combination Drug Treatment on Sympathetic Nerve Traffic and Metabolic
           Profile in Obesity-Related Hypertension
    • Abstract: Publication date: Available online 11 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Gino Seravalle, Gianmaria Brambilla, Daniela Prata Pizzalla, Anna Casati, Marta Riva, Cesare Cuspidi, Michele Bombelli, Giuseppe Mancia, Guido Grassi
      Scanty information is available on the effects of combination drug treatment based on an ACE-inhibitor and a calcium channel blocker on the neurometabolic alterations characterizing obesity-related hypertension (OHT). After 2 weeks run-in with enalapril (E, 20 mg), 36 OHTs were randomized according to a double-blind crossover design to a combination therapy with either lercanidipine 10 mg (L) or felodipine extended release 5 mg (F), each lasting 8 weeks. Measurements included clinic and ambulatory blood pressure (BP) and heart rate, homeostasis model assessment (HOMA) index, plasma norepinephrine (NE) and muscle sympathetic nerve activity (MSNA). Patients with uncontrolled BP were then uptitrated to 20 mg/day (L) and 10 mg/day (F) combined with E 20 mg respectively, for further 8 weeks. For similar BP reductions, EL caused NE and MSNA increases significantly less pronounced than those seen with EF, the lesser sympathoexcitation observed with EL being coupled with a significant improvement in HOMA index. This was the case also when L and F were uptitrated in the combination. In OHT, at variance from EF, EL combination is almost entirely devoid of any major sympathoexcitatory effect and is associated with an improvement in insulin sensitivity.


      PubDate: 2016-01-11T18:22:35Z
       
  • Controversies in Hypertension: How Should BP be Measured in the
           Office?
    • Abstract: Publication date: Available online 11 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Sheldon W. Tobe, Joe L. Izzo
      There have always been substantial concerns among experts regarding the physical measurement of blood pressure. When the normally wide physiologic variation of BP is compounded by substantial measurement artifact and environmental interactions, the result is great uncertainty regarding the value of any single BP determination and a potentially skewed impression of how BP elevation affects us. The ensuing discussion and the opinions of Clarence Grim and Martin Myers in this installment highlight the need for greater attention to be paid to the conditions in which BP is measured and ask the question whether traditional sphygmomanometry should be replaced with newer automated techniques.


      PubDate: 2016-01-11T18:22:35Z
       
  • Reporting of Adherence to Healthy Lifestyle Behaviors among Hypertensive
           Adults in the 50 States and the District of Columbia, 2013
    • Abstract: Publication date: Available online 11 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Jing Fang, Latetia Moore, Fleetwood Loustalot, Quanhe Yang, Carma Ayala
      Achieving and maintaining a healthy lifestyle is an important part of hypertension management. The purpose of this study was to assess US state-level prevalence of adherence to healthy lifestyle behaviors among those with self-reported hypertension. Using 2013 data from the Behavioral Risk Factor Surveillance System, a state-based telephone survey, we examined the adherence to 5 healthy lifestyle behaviors related to hypertension management: having a “normal” weight, not smoking, avoiding or limiting alcohol intake, consuming the recommended amount of fruits and vegetables, and engaging in the recommended amount of physical activity. We estimated age-standardized percentages of each healthy lifestyle behavior overall and by state, as well as prevalence of all 5 healthy lifestyle behaviors. Overall, the prevalence of healthy lifestyle behaviors varied widely among those with self-reported hypertension: 20.5% had a normal weight, 82.3% did not smoke, 94.1% reported no or limited alcohol intake, 14.1% consumed the recommended amounts of fruits or vegetables, and 46.6% engaged in the recommended amount of physical activity. Overall, only 1.7% of adults with self-reported hypertension reported all 5 healthy lifestyle behaviors, with significant variation by state. Age-standardized prevalence of individuals reporting all 5 healthy lifestyle behaviors ranged from 0.3% in Louisiana to 3.8% in the District of Columbia. In conclusion, adherence to healthy lifestyle behaviors varied among those with hypertension; fewer than 2% reported meeting current recommendations and standards when assessed collectively. Disparities were observed by demographic and descriptive characteristics, including geography.


      PubDate: 2016-01-11T18:22:35Z
       
  • Importance of Inhibiting Sodium-Glucose Co-Transporter and its Compelling
           Indication in Type 2 Diabetes: Pathophysiological Hypothesis
    • Abstract: Publication date: Available online 11 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Genjiro Kimura
      Primarily the sodium-glucose co-transporter 2 (SGLT2) inhibitors suppress the co-transport of glucose and sodium from the tubular lumen of proximal tubules to the blood, and enhance the glucose excretion into urine. Therefore, glucose and caloric balances become negative, making the blood glucose level as well as insulin secretion both reduced. On the other hand, the proximal tubular fluid, constituting with low chloride concentration because of SGLT2 inhibition, is transferred to the loop of Henle. On the low chloride conditions, the reabsorption mechanisms in the loop of Henle do not work, as if loop diuretics are given. Finally, blood pressure is also lowered secondarily due to the loop diuretic action by SGLT2 inhibitions. Thus, the metabolic and hemodynamic combined systems synergistically interact further to suppress the risks leading to atherosclerosis and organs damage. Precise mechanisms for SGLT2 inhibitors to work in various aspects, especially in preventing organ damage and cardiovascular events must be clarified further.


      PubDate: 2016-01-11T18:22:35Z
       
  • Automated Office Blood Pressure – The Preferred Method for Recording
           Blood Pressure
    • Abstract: Publication date: Available online 11 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Martin G. Myers



      PubDate: 2016-01-11T18:22:35Z
       
  • Auscultatory BP: Still the Gold Standard
    • Abstract: Publication date: Available online 11 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Clarence E. Grim, Carlene M. Grim
      There is considerable debate about the use of auscultatory blood pressure (AusBP) versus oscillometric BP measurement (OBPM). We first present the evidence that AusBP is still the gold standard. Then we point out the serious errors of OBPM. While many are recommending AusBP be abandoned and replaced by OBPM arguing OBPM saves time and eliminates observer error, we posit these arguments are not valid on either point. First, we have shown that proper measurement using either method requires virtually the same amount of staff time. Second, the elimination of observer error augment is invalid as no OBPM device has been shown to insure that the steps needed to obtain an accurate pressure are followed. We suggest these can only be corrected by proven staff training programs and implementation of quality assurance methods. Third, and most bothersome to us and to our patient's health, is the demonstration that the oscillometric method reads BP unreliably in many individuals. These BP errors will seriously affect an individual's BP diagnosis and management. The only method to detect such serious errors is to compare OBPM readings to the AusBP in the individual. As this comparison must be carried out in every patient before relying on OBPM readings it is mandatory that the gold standard AusBP must be available in every office. Because of the time involved in doing these comparisons in every patient many offices may choose to continue using the gold standard AusBP until OBPM becomes more reliable.


      PubDate: 2016-01-11T18:22:35Z
       
  • Change in the prevalences of identifiable hypertension
    • Abstract: Publication date: Available online 4 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Norman M. Kaplan



      PubDate: 2016-01-07T17:46:02Z
       
  • Should Age Determine Hypertension Management? Recommendations from
           Current Guidelines
    • Abstract: Publication date: Available online 6 January 2016
      Source:Journal of the American Society of Hypertension
      Author(s): Joseph L. Izzo, Sheldon W. Tobe
      Age is the most powerful of risk factors and is related continuously to systolic BP. Yet many current guidelines have dichotomized age around a cutoff value of 55-60 years and suggest that age should affect treatment thresholds and drug choices. These opinions are contentious, not supported directly by reasonable scientific evidence, and simply represent the views of a small number of guideline writers. This initial topic of the new Controversies in Hypertension series highlights important differences among current North American and European practice guidelines.


      PubDate: 2016-01-07T17:46:02Z
       
  • Model of human cardiovascular system with a loop of autonomic regulation
           of the mean arterial pressure
    • Abstract: Publication date: Available online 31 December 2015
      Source:Journal of the American Society of Hypertension
      Author(s): A.S. Karavaev, J.M. Ishbulatov, V.I. Ponomarenko, M.D. Prokhorov, V.I. Gridnev, B.P. Bezruchko, A.R. Kiselev
      A model of human cardiovascular system is proposed which describes the main heart rhythm, the regulation of heart function and blood vessels by the autonomic nervous system, baroreflex, and the formation of arterial blood pressure. The model takes into account the impact of respiration on these processes. It is shown that taking into account nonlinearity and introducing the autonomous loop of mean arterial blood pressure in the form of self-oscillating time-delay system allow to obtain the model signals whose statistical and spectral characteristics are qualitatively and quantitatively similar to those for experimental signals. The proposed model demonstrates the phenomenon of synchronization of mean arterial pressure regulatory system by the signal of respiration with the basic period close to 10 s, which is observed in the physiological experiments.


      PubDate: 2016-01-02T16:13:47Z
       
  • Studies Comparing Ambulatory Blood Pressure and Home Blood Pressure on
           Cardiovascular Disease and Mortality Outcomes: A Systematic Review
    • Abstract: Publication date: Available online 23 December 2015
      Source:Journal of the American Society of Hypertension
      Author(s): Daichi Shimbo, Marwah Abdalla, Louise Falzon, Raymond R. Townsend, Paul Muntner
      Ambulatory blood pressure monitoring (ABPM) is more commonly recommended for assessing out-of-clinic blood pressure than home blood pressure monitoring (HBPM). We conducted a systematic review to examine whether ABPM or HBPM is more strongly associated with cardiovascular disease events and/or mortality. Of 1,007 abstracts published through July 20, 2015, nine articles, reporting results from seven cohorts, were identified. After adjustment for blood pressure on HBPM, blood pressure on ABPM was associated with an increased risk of outcomes in two of four cohorts for systolic blood pressure and two of three cohorts for diastolic blood pressure. After adjustment for blood pressure on ABPM, systolic blood pressure on HBPM was associated with outcomes in zero of three cohorts; an association was present in one of two cohorts for diastolic blood pressure on HBPM. There is a lack of strong empiric evidence supporting ABPM or HBPM over the other approach for predicting cardiovascular events or mortality.


      PubDate: 2015-12-25T13:47:30Z
       
  • Its not the doctor's fault
    • Abstract: Publication date: Available online 21 December 2015
      Source:Journal of the American Society of Hypertension
      Author(s): Norman M. Kaplan



      PubDate: 2015-12-25T13:47:30Z
       
  • BP variability—a patient perspective
    • Abstract: Publication date: Available online 24 December 2015
      Source:Journal of the American Society of Hypertension
      Author(s): Michael J. Bloch



      PubDate: 2015-12-25T13:47:30Z
       
  • Cardiometabolic Risks Related to Obesity Severity in Children and
           Adolescents: A Commentary
    • Abstract: Publication date: Available online 17 December 2015
      Source:Journal of the American Society of Hypertension
      Author(s): Bonita Falkner



      PubDate: 2015-12-21T12:59:33Z
       
  • Sustained high blood pressure reduction with etamicastat, a peripheral
           selective dopamine β-hydroxylase Inhibitor
    • Abstract: Publication date: Available online 19 December 2015
      Source:Journal of the American Society of Hypertension
      Author(s): Bruno Igreja, Lyndon C. Wright, Patricio Soares-da-Silva
      Background The aim of the present study was to evaluate the influence of chronic inhibition of dopamine-ß-hydroxylase (DBH) by etamicastat on the development of hypertension in the spontaneously hypertensive rat (SHR) and the sustainability of effects upon the systolic (SBP) and diastolic (DBP) blood pressure in the SHR and the normotensive Wistar-Kyoto rat (WKY). Methods WKY and SHR received etamicastat (10 mg/kg/day), from 5 weeks of age for 35 weeks in drinking water and cardiovascular assessments were performed on a weekly basis. Results Etamicastat reduced SBP and DBP when SHRs reached the age of 16 weeks with mean decreases of 37 and 32 mm Hg, respectively, for the subsequent for 24 weeks of treatment, but did not prevent the increase in BP between 5 to 11 weeks of age. The blood pressure lowering effect of etamicastat in SHR was reversible upon discontinuation and quickly resumed after reinstatement of therapy and was not accompanied by changes in heart rate. Etamicastat affected neither blood pressure nor heart rate in WKY during 36 weeks of treatment. Etamicastat reduced urinary excretion of norepinephrine to a similar extent in WKY and SHR, accompanied by significant increases in urinary dopamine in SHR. Chronic administration of etamicastat did not adversely affected development of animals. Conclusion Chronic DBH inhibition with etamicastat effectively decreases blood pressure, though does not prevent the development of hypertension in the SHR.


      PubDate: 2015-12-21T12:59:33Z
       
  • Dynamic Thiol/Disulphide Homeostasis inPatients with Newly Diagnosed
           Primary Hypertension
    • Abstract: Publication date: Available online 15 December 2015
      Source:Journal of the American Society of Hypertension
      Author(s): Ihsan Ates, Nihal Ozkayar, Bayram Inan, Fatma Meric Yilmaz, Canan Topcuoglu, Salim Neselioglu, Ozcan Erel, Fatih Dede, Nisbet Yilmaz
      We aimed to investigate the thiol/disulphide homeostasis in patients with newly diagnosed primary hypertension with a novel and automated method. Blood thiol/disulphide homeostasis, that consists of native thiol/disulphide exchanges, was investigated in 45 patients with primary hypertension and 45 healthy controls. The levels of native thiol, total thiol and native thiol/total thiol ratio were lower while the disulphide level and disulphide/native thiol and disulphide/total thiol ratios were higher in patients with primary hypertension when compared to those in the control group. Positive correlation was detected between 24-h systolic and diastolic blood pressure levels and disulphide/native thiol ratio. With reference to the stepwise multiple linear regression model; increase in disulphide/native thiol ratio and log(24-h urine microalbumin) and decrease in native thiol/total thiol ratio are independent predictors of 24-h systolic and diastolic blood pressure. This study demonstrated that thiol/disulphide homeostasis was shifted towards disulphide formation in patients with primary hypertension.


      PubDate: 2015-12-17T12:07:36Z
       
  • The Association of Renal Artery Calcification with Hypertension in
           Community-Living Individuals: The Multi-Ethnic Study of Atherosclerosis
    • Abstract: Publication date: Available online 13 December 2015
      Source:Journal of the American Society of Hypertension
      Author(s): Isac C. Thomas, Amanda R. Ratigan, Dena E. Rifkin, Joachim H. Ix, Michael H. Criqui, Matthew J. Budoff, Matthew A. Allison
      Hypertension (HTN) is a modifiable risk factor for cardiovascular disease (CVD). Renal artery calcium (RAC) may signal the presence of flow-limiting atherosclerotic disease that may contribute to changes in the kidney’s regulation of blood pressure. We hypothesized that RAC is independently associated with HTN. We examined a multi-ethnic cohort of 1,285 participants who underwent abdominal computed tomography (CT) scans in five US communities. After adjustment for age, gender, race/ethnicity, CVD risk factors, abdominal aortic calcium score and kidney function, the presence of RAC was associated with a 50% higher odds of HTN (OR: 1.54; 95% CI 1.11—2.13). Similarly, the presence of RAC was associated with a 8.5-mmHg higher systolic blood pressure (SBP), a 2.1 mmHg higher diastolic blood pressure (DBP), and a 7.4-mmHg higher pulse pressure (PP). In conclusion, independent of CVD risk factors, abdominal aortic calcium, and kidney function, the presence of RAC is associated with HTN prevalence.


      PubDate: 2015-12-17T12:07:36Z
       
  • Is one measurement enough to evaluate blood pressure among
           adolescents? A blood pressure screening experience in over 9,000
           
    • Abstract: Publication date: Available online 15 December 2015
      Source:Journal of the American Society of Hypertension
      Author(s): Xamayta Negroni-Balasquide, Cynthia Bell, Joyce Samuel, Joshua A. Samuels
      Evaluation of blood pressure is recommended in all children older than 3 years. Auscultatory devices are the recommended method to assess blood pressure in pediatrics but automated oscillometric devices are increasingly common. A retrospective analysis of our school-based blood pressure screening was performed to determine if multiple oscillometirc blood pressure measurements are needed to approach true blood pressure. All children had 4 oscillometric measurements of blood pressures and a random subset of 287 had an additional auscultatory measurement. Among 9,870 participants, we observed a non-linear decrease in blood pressure over time. The largest decrease in systolic blood pressure was between 1st and 2nd (-3.8mmHg) and in diastolic from 2nd to 3rd (-3.3mmHg) measurement. For systolic blood pressure, the 2nd oscillometric measurement, the average of 2nd-3rd and the average of 1st to 3rd were statistically similar to a single auscultatory measurement. We conclude that assessment of blood pressure using oscillometric devices should include at least 3 measurements in the same sitting to avoid inaccurate assessment.


      PubDate: 2015-12-17T12:07:36Z
       
  • Associations of anti-platelet therapy and beta-blockade with patient
           outcomes in atherosclerotic renovascular disease
    • Abstract: Publication date: Available online 15 December 2015
      Source:Journal of the American Society of Hypertension
      Author(s): James Ritchie, Darren Green, Helen V. Alderson, Contantina Chrysochou, Diana Vassallo, Smeeta Sinha, Philip A. Kalra
      Randomised trials have shown a neutral effect of percutaneous revascularisation compared to optimal medical therapy (OMT) in patients with atherosclerotic renovascular disease (ARVD). However, there are few data to define what constitutes OMT. We present a retrospective analysis of 529 ARVD patients. Separate analyses were performed comparing outcomes in patients prescribed / not prescribed beta-blocker and anti-platelet agents. Analyses were adjusted for effects of baseline co-variates on probability of treatment and on clinical outcome. Over a median follow-up period of 3.8 years, anti-platelet therapy was associated with a reduced risk for death (relative risk 0.52 [95% CI 0.31-0.89], p=0.02). Beta-blocker therapy was associated with a reduced for death (relative risk 0.45 [95% CI 0.21-0.97], p=0.04) and non-fatal cardiovascular events (relative risk 0.74 [95% CI 0.60-0.90], p=0.003). Although limited by small patient numbers, this study suggests that in ARVD, treatment with anti-platelet therapy and beta-blockade may associate with a prognostic benefit.


      PubDate: 2015-12-17T12:07:36Z
       
  • The endothelium as the common denominator in malignant hypertension and
           thrombotic microangiopathy.
    • Abstract: Publication date: Available online 15 December 2015
      Source:Journal of the American Society of Hypertension
      Author(s): Roy O. Mathew, Ali Nayer, Arif Asif
      The endothelium plays a pivotal role in vascular biology. The endothelium is the primary site of injury in thrombotic microangiopathies including malignant hypertension. Endothelial injury in thrombotic microangiopathies is the result of increased shear stress, toxins, and/or dysregulated complement activation. Endothelial injury can lead to microvascular thrombosis resulting in ischemia and organ dysfunction, the clinical hallmarks of thrombotic microangiopathies. Currently available therapies target the underlying mechanisms that lead to endothelial injury in these conditions. Ongoing investigations aim at identifying drugs that protect the endothelium.


      PubDate: 2015-12-17T12:07:36Z
       
  • Editorial Board
    • Abstract: Publication date: December 2015
      Source:Journal of the American Society of Hypertension, Volume 9, Issue 12




      PubDate: 2015-12-13T11:16:02Z
       
  • Gender differences in the association of hypertension with
           gamma–glutamyltransferase and alanine aminotransferase levels in
           Chinese adults in Qingdao, China
    • Abstract: Publication date: December 2015
      Source:Journal of the American Society of Hypertension, Volume 9, Issue 12
      Author(s): Jie Ren, Jianping Sun, Feng Ning, Zengchang Pang, Liangyi Qie, Qing Qiao
      The aim of the study was to study the associations of hypertension with gamma–glutamyltransferase (GGT) and alanine aminotransferase (ALT) levels. Data of 3575 men and 5504 women were analyzed. Multivariate logistic regression analysis was performed to estimate the odds ratio (OR) for hypertension with GGT and ALT. Compared with the lowest quartile, the multivariate adjusted ORs for hypertension were 0.97 (0.79, 1.19) in men and 0.88 (0.74, 1.04) in women for ALT and 2.29 (1.68, 3.14) and 1.52 (1.27, 1.83) for GGT in the highest quartile group. The ORs for hypertension in the low waist circumference category were 2.61 (1.56, 4.36) in men and 1.41 (0.94, 2.12) in women and in the high waist circumference category 4.01 (2.21, 7.29) and 2.26 (1.54, 3.32) for GGT. The elevated GGT, but not ALT, was associated with the presence of the hypertension in men and women. The association is stronger in obese men and women than in their lean counterparts.


      PubDate: 2015-12-13T11:16:02Z
       
  • The origin of Korotkoff sounds and the accuracy of auscultatory blood
           pressure measurements
    • Abstract: Publication date: December 2015
      Source:Journal of the American Society of Hypertension, Volume 9, Issue 12
      Author(s): Charles F. Babbs
      This study explores the hypothesis that the sharper, high frequency Korotkoff sounds come from resonant motion of the arterial wall, which begins after the artery transitions from a buckled state to an expanding state. The motions of one mass, two nonlinear springs, and one damper, driven by transmural pressure under the cuff, are used to model and compute the Korotkoff sounds according to principles of classical Newtonian physics. The natural resonance of this spring-mass-damper system provides a concise, yet rigorous, explanation for the origin of Korotkoff sounds. Fundamentally, wall stretching in expansion requires more force than wall bending in buckling. At cuff pressures between systolic and diastolic arterial pressure, audible vibrations (> 40 Hz) occur during early expansion of the artery wall beyond its zero pressure radius after the outward moving mass of tissue experiences sudden deceleration, caused by the discontinuity in stiffness between bucked and expanded states. The idealized spring-mass-damper model faithfully reproduces the time-domain waveforms of actual Korotkoff sounds in humans. Appearance of arterial sounds occurs at or just above the level of systolic pressure. Disappearance of arterial sounds occurs at or just above the level of diastolic pressure. Muffling of the sounds is explained by increased resistance of the artery to collapse, caused by downstream venous engorgement. A simple analytical model can define the physical origin of Korotkoff sounds, suggesting improved mechanical or electronic filters for their selective detection and confirming the disappearance of the Korotkoff sounds as the optimal diastolic end point.
      Graphical abstract image

      PubDate: 2015-12-13T11:16:02Z
       
  • Association of serum cotinine levels and the parameters of vascular
           structure and function in never-smoking adults
    • Abstract: Publication date: December 2015
      Source:Journal of the American Society of Hypertension, Volume 9, Issue 12
      Author(s): Jin-Wen Wang, Da-Yi Hu
      Passive smoking is now recognized to be associated with early arterial damage. The aim of this study was to assess the relationship between secondhand smoke (SHS) exposure, measured objectively by serum cotinine level, and the parameters used to assess vascular structure and function among never smokers in North China. From January 2008 to August 2008, 652 adults aged 20–70 years were enrolled. Brachial–ankle pulse wave velocity (baPWV), ankle–brachial index, and carotid intima-media thickness measurements were performed in all patients. All participants were required to respond to an interviewer-led questionnaire including medical histories and demographic data and to receive blood tests on biochemical indicators. We found that in nonsmokers, higher levels of serum cotinine were positively associated with higher baPWV and brachial pulse pressure after adjusting for heart rate, body mass index, and other confounders. Tests for linear trends for this association were statistically significant. In contrast, no association was present with ankle–brachial index and carotid intima-media thickness. In never smokers, higher SHS exposure measured objectively by serum cotinine levels was found to be associated with brachial pulse pressure and baPWV after adjusting for confounders.


      PubDate: 2015-12-13T11:16:02Z
       
  • Twenty-year dynamics of hypertension in Iranian adults: age, period, and
           cohort analysis
    • Abstract: Publication date: December 2015
      Source:Journal of the American Society of Hypertension, Volume 9, Issue 12
      Author(s): Mostafa Hosseini, Mahmoud Yousefifard, Masoud Baikpour, Ali Rafei, Mohammad Fayaz, Ramin Heshmat, Jalil Koohpayehzadeh, Fereshteh Asgari, Koorosh Etemad, Mohammad Mehdi Gouya, Kazem Mohammad
      Hypertension is a well-known health problem all over the world. Many studies have assessed its prevalence and associated risk factors, but all were cross-sectional and did not evaluate the trend of hypertension through all three different temporal dimensions including age, period, and cohort. So, we aimed to assess the 20-year dynamics of hypertension via the age–period–cohort model. Data from 74,155 subjects aged 25–60 years gathered through five national health surveys (1990–91, 1999, 2003, 2007, and 2011) were used in this study. The age–period–cohort effect on hypertension was analyzed using the intrinsic estimator model. The prevalence of hypertension increased with age for both genders except for males in 2003 and 2011 periods with drops of 3.5% for ages 55–60 and 8.1% for ages 50–60, respectively. As for the period effect, the prevalence of hypertension was almost constant in all age groups for both genders from 1990–1999. The cohort-based prevalence of hypertension showed a declining trend in all cohorts for females except for 2011 in birth cohort of 1950–1955 which remains stationary. The trend of prevalence for males also follows a decreasing trend except for periods of 2003, 2007, and 2011; birth cohorts of 1945–1949, 1975–1980, and 1950–1960 increase by 3.5%, 1.9%, and 8.1%, respectively. The age effect on the prevalence of hypertension showed an almost monotonic increasing trend. The period effect increased the total prevalence of hypertension from 1992 to 1997. The cohort effect also showed a monotonic decrease in hypertension prevalence except for a few discrepancies.


      PubDate: 2015-12-13T11:16:02Z
       
  • Table of Contents
    • Abstract: Publication date: December 2015
      Source:Journal of the American Society of Hypertension, Volume 9, Issue 12




      PubDate: 2015-12-13T11:16:02Z
       
  • Some good epidemiologic news
    • Abstract: Publication date: December 2015
      Source:Journal of the American Society of Hypertension, Volume 9, Issue 12
      Author(s): Norman M. Kaplan



      PubDate: 2015-12-13T11:16:02Z
       
  • Twenty–four hour ambulatory blood pressure monitoring to all?
           Comments to the US Preventive Services Task Force document
    • Abstract: Publication date: December 2015
      Source:Journal of the American Society of Hypertension, Volume 9, Issue 12
      Author(s): Paolo Verdecchia, Fabio Angeli, Claudia Bartolini, Gianpaolo Reboldi



      PubDate: 2015-12-13T11:16:02Z
       
  • Vitamin D for hypertension: should we continue the search?
    • Abstract: Publication date: December 2015
      Source:Journal of the American Society of Hypertension, Volume 9, Issue 12
      Author(s): Candice A. Sternberg, Barry J. Materson, Ali Nayer



      PubDate: 2015-12-13T11:16:02Z
       
  • Prevalence, Awareness, Treatment, and Control of Hypertension in the Older
           Population: Results from the Multiple National Studies on Ageing
    • Abstract: Publication date: Available online 8 December 2015
      Source:Journal of the American Society of Hypertension
      Author(s): Fan Yang, D. Qian, Dan Hu
      Background The international comparisons that provided useful epidemiological information of hypertension in the elderly people is still sparse, we aim to provide the latest international estimates on the burden of Hypertension. Methods These sampling methods of the selection of surveys mainly used multi-stage population registry, this cross-national study of 63,014 adults aged 50 years and over was from in 4 high-income countries (HICs), 4 upper–middle-income countries (UMICs) and 3 low–middle-income countries (LMICs). Results Overall, the age -standardized prevalence of hypertension among the adult population age 50 years and over was 53.2% (51.9% of men and 54.3% of women), The HICs and UMICs had more or less twice the prevalence of hypertension compare with LMICs. The rates of awareness, treatment and control of hypertension were 55.6%, 44.1% and 17.1%, respectively; and awareness, and control of hypertension was lowest in UMICs and treatment of hypertension was lowest in LMICs. Conclusion Among this multiple national study population, hypertension was very common among elderly population. Even more worrisome is that the rates of awareness, treatment, and control of hypertension were relatively low in UMICs and IMICs. These results indicate that improving the ability to control and prevention of hypertension in resource-limited settings is needed.


      PubDate: 2015-12-13T11:16:02Z
       
  • Sex never dies
    • Abstract: Publication date: Available online 16 October 2015
      Source:Journal of the American Society of Hypertension
      Author(s): Norman M. Kaplan



      PubDate: 2015-12-03T10:10:51Z
       
  • Giving pharmacists ability to prescribe antihypertension medications can
           improve blood pressure control rates
    • Abstract: Publication date: Available online 23 October 2015
      Source:Journal of the American Society of Hypertension
      Author(s): Michael J. Bloch



      PubDate: 2015-12-03T10:10:51Z
       
  • The growing problem of obesity
    • Abstract: Publication date: Available online 23 October 2015
      Source:Journal of the American Society of Hypertension
      Author(s): Norman M. Kaplan



      PubDate: 2015-12-03T10:10:51Z
       
  • The Septal Bulge - an Early Echocardiographic Sign in Hypertensive Heart
           Disease
    • Abstract: Publication date: Available online 2 December 2015
      Source:Journal of the American Society of Hypertension
      Author(s): Philipp Daniel Gaudron, Dan Liu, Friederike Scholz, Kai Hu, Christiane Florescu, Sebastian Herrmann, Bart Bijnens, Georg Ertl, Stefan Störk, Frank Weidemann
      Patients in the early stage of hypertensive heart disease tend to have normal echocardiographic findings. The aim of this study was to investigate whether pathology-specific echocardiographic morphological and functional parameters can help to detect subclinical hypertensive heart disease. One hundred and ten consecutive patients without a history and medication for arterial hypertension (AH) or other cardiac diseases were enrolled. Standard echocardiography and two-dimensional speckle-tracking-imaging analysis were performed. Resting blood pressure (BP) measurement, cycle ergometer-test (CET) and 24-hour ambulatory BP monitoring (ABPM) were conducted. Patients were referred to “septal bulge (SB)” group (basal-septal wall thickness ≥2 millimeters thicker than mid-septal wall thickness) or “no-SB” group. Echocardiographic SB was found in 48 (43.6%) out of 110 patients. In this SB group 38 (79.2%) patients showed AH either by CET or ABPM. In contrast, in the no-SB group (n=62), 59 (95.2%) patients had no positive test for AH by CET or ABPM. When AH was solely defined by resting BP, SB was a reasonable predictive sign for AH (sensitivity 73%, specificity 76%). However, when AH was confirmed by CET or ABPM the echocardiographic SB strongly predicted clinical AH (sensitivity 93%, specificity 86%). In addition, regional myocardial deformation of the basal-septum in SB group was significantly lower than in no-SB group (14±4% vs. 17±4%; P<0.001). In conclusion, septal bulge is a morphological echocardiographic sign for early hypertensive heart disease. Sophisticated BP evaluation including resting BP, ABPM and CET should be performed in all patients with an accidental finding of a septal bulge in echocardiography.


      PubDate: 2015-12-03T10:10:51Z
       
  • The path to prevention and treatment of resistant hypertension
    • Abstract: Publication date: Available online 27 October 2015
      Source:Journal of the American Society of Hypertension
      Author(s): Norman M. Kaplan



      PubDate: 2015-12-03T10:10:51Z
       
  • Assessment of Hypertension Control and Clinical Course of Patients
           Excluded from the SYMPLICITY-HTN 3 Trial
    • Abstract: Publication date: Available online 28 October 2015
      Source:Journal of the American Society of Hypertension
      Author(s): Charan Yerasi, Nevin C. Baker, Anil K. Jonnalagadda, Rebecca Torguson, Suman Singh, Judith Vies, Ron Waksman
      Background The screening of patients referred for the SYMPLICITY HTN-3 trial was rigorous, with many found not eligible to participate. We investigate patients who were not included in the trial, and evaluate their current hypertensive (HTN) therapy, control and clinical status. Methods A retrospective review and telephone interview was performed 8-10 months post screening on 45 patients and their referring providers who were ultimately not included. Patients were grouped into 4 categories: 1) Non-interest, 2) Excluded (not meeting inclusion criteria), 3) Screen failure (excluded during screening visits due to adequate blood pressure control guided by HTN specialist), or 4) referred after enrollment closure. Primary outcomes evaluated included current anti-hypertensive management and clinical outcomes. Results This population consisted of 42% males, mean age 65±5 years, 78% African American, 64% diabetic, and 21% chronic kidney disease. Primary referral basis included cardiology (44%), nephrology (30%), and primary care (26%). At time of follow-up, 20% had continued resistant HTN while the majority of patients had controlled HTN (60%); with highest success rates amongst the screen failure group (88%) who also had the lowest average systolic blood pressure (137±11 mm of Hg) when compared to other groups (p= 0.04). Average number of medications was lowest in the screen failure group (2.8±1.6, p= 0.07). Resistant and/or uncontrolled HTN was most prevalent in the non-interest or excluded groups, as were hospitalization for cardiovascular and HTN urgency/emergency. Conclusion This study highlights the disparity of HTN control and treatment in daily practice compared with clinical trials, and confirms a need for vigilant screening of those considered candidates for RDN.


      PubDate: 2015-12-03T10:10:51Z
       
  • Genetic predisposition in patients with hypertension and normal ejection
           fraction to oxidative stress
    • Abstract: Publication date: Available online 2 December 2015
      Source:Journal of the American Society of Hypertension
      Author(s): Ádám Fazakas, Zsuzsanna Szelényi, Gábor Szénási, Gábor Nyírő, Péter M. Szabó, Attila Patócs, Narcis Tegze, Bertalan C. Fekete, Attila Molvarec, Bálint Nagy, Judit Jakus, Ferenc Örsi, István Karádi, András Vereckei
      The role of oxidative stress (OXS) due to myocardial nitric oxide synthase (NOS) uncoupling related to oxidative depletion of its cofactor tetrahydrobiopterin (BH4) emerged in the pathogenesis of heart failure with preserved ejection fraction (HFPEF). We determined the prevalence of 6 single nucleotide polymorphisms (SNPs) of genes encoding enzymes related to OXS, BH4 metabolism and NOS function in >60-year-old 94 patients with hypertension and 18 age-matched controls with normal EF. Using echocardiography 56/94(60%) patients with hypertension had left ventricular (LV) diastolic dysfunction (HTDD+ group), 38/94(40%) patients had normal LV diastolic function (HTDD- group). Four SNPs (rs841, rs3783641, rs10483639, rs807267) of guanosine triphosphate cyclohydrolase-1, the rate limiting enzyme in BH4 synthesis, 1 (rs4880) of manganese superoxide dismutase, and 1 (rs1799983) of endothelial NOS genes were genotyped using real time PCR method and Taqman probes. Protein carbonylation (PC), BH4 and total biopterin levels were measured from plasma samples. No between-groups difference in minor allele frequency (MAF) of SNPs was found. We calculated a genetic score indicating risk for OXS based on the MAFs of the SNPs. A high genetic risk for OXS was significantly associated with HTDD+ even after adjustment for confounding variables [OR(95%CI):4.79(1.12-20.54); p=0.035]. In both patient groups PC (p<0.05 for both), plasma BH4 (p<0.01 for both) and in the HTDD+ group total biopterin (p<0.05) increased vs. controls. In conclusion, in patients with hypertension and normal EF, a potential precursor of HFPEF, a partly genetically determined increased OXS seems to be associated with the presence of LV diastolic dysfunction.


      PubDate: 2015-12-03T10:10:51Z
       
 
 
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