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  Subjects -> HISTORY (Total: 1057 journals)
    - HISTORY (733 journals)
    - History (General) (45 journals)
    - HISTORY OF AFRICA (37 journals)
    - HISTORY OF ASIA (34 journals)
    - HISTORY OF AUSTRALASIA AND OTHER AREAS (8 journals)
    - HISTORY OF EUROPE (103 journals)
    - HISTORY OF THE AMERICAS (86 journals)
    - HISTORY OF THE NEAR EAST (11 journals)

HISTORY (733 journals)            First | 1 2 3 4 5 6 7 8 | Last

History Compass     Hybrid Journal   (6 followers)
History in Africa     Full-text available via subscription   (3 followers)
History of CERN     Full-text available via subscription   (1 follower)
History of Education Quarterly     Hybrid Journal   (3 followers)
History of Education Review     Hybrid Journal   (2 followers)
History of Education: Journal of the History of Education Society     Hybrid Journal   (10 followers)
History of European Ideas     Hybrid Journal   (16 followers)
History of Political Thought     Full-text available via subscription   (13 followers)
History of Psychology     Full-text available via subscription   (4 followers)
History of Religions     Full-text available via subscription   (24 followers)
History of Science     Full-text available via subscription   (12 followers)
Holocaust and Genocide Studies     Hybrid Journal   (13 followers)
Hortus Artium Medievalium     Full-text available via subscription   (4 followers)
HSE - Social and Education History     Open Access  
IEEE Annals of the History of Computing     Full-text available via subscription   (9 followers)
IKON     Full-text available via subscription   (4 followers)
Il Capitale Culturale. Studies on the Value of Cultural Heritage     Open Access   (3 followers)
ILCEA     Open Access   (1 follower)
Illawarra Unity - Journal of the Illawarra Branch of the Australian Society for the Study of Labour History     Open Access   (2 followers)
Images re-vues : histoire, anthropologie et théorie de l'art     Open Access  
Imago Mundi: The International Journal for the History of Cartography     Hybrid Journal   (6 followers)
Immigrants & Minorities     Hybrid Journal   (7 followers)
Indian Economic & Social History Review     Hybrid Journal   (4 followers)
Indonesia and the Malay World     Hybrid Journal   (3 followers)
Inner Asia     Full-text available via subscription   (2 followers)
Intellectual History Review     Hybrid Journal   (14 followers)
Interaction     Full-text available via subscription   (2 followers)
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   (2 followers)
International Journal of Asian Studies     Hybrid Journal   (7 followers)
International Journal of Iberian Studies     Hybrid Journal   (3 followers)
International Journal of Middle East Studies     Hybrid Journal   (93 followers)
International Journal of Society Systems Science     Hybrid Journal  
International Journal of Sustainable Society     Hybrid Journal   (7 followers)
International Politics     Partially Free   (14 followers)
International Review of Social History     Full-text available via subscription   (16 followers)
INTRECCI d'arte     Open Access   (5 followers)
Iran and the Caucasus     Full-text available via subscription   (6 followers)
Irish Studies Review     Hybrid Journal   (12 followers)
Isis     Full-text available via subscription   (9 followers)
Israel Studies Forum     Full-text available via subscription  
Italianist, The     Hybrid Journal   (1 follower)
Japanese Studies     Hybrid Journal   (4 followers)
Jewish Culture and History     Hybrid Journal   (8 followers)
Journal Asiatique     Full-text available via subscription   (4 followers)
Journal for Contemporary History     Full-text available via subscription   (10 followers)
Journal for Early Modern Cultural Studies     Full-text available via subscription   (11 followers)
Journal for Maritime Research     Hybrid Journal   (7 followers)
Journal for the Study of Judaism     Full-text available via subscription   (9 followers)
Journal for the Study of Radicalism     Full-text available via subscription   (5 followers)
Journal of Aging, Humanities, and the Arts: Official Journal of the Gerontological Society of America     Hybrid Journal   (4 followers)
Journal of American History     Hybrid Journal   (16 followers)
Journal of American Studies     Hybrid Journal   (11 followers)
Journal of American-East Asian Relations     Full-text available via subscription  
Journal of Arts Management, Law, and Society     Full-text available via subscription   (4 followers)
Journal of Australian Colonial History     Full-text available via subscription   (5 followers)
Journal of Australian Naval History, The     Full-text available via subscription   (4 followers)
Journal of Baltic Studies     Hybrid Journal   (3 followers)
Journal of British Studies     Full-text available via subscription   (19 followers)
Journal of Canadian Studies/Revue d'études canadiennes     Full-text available via subscription   (2 followers)
Journal of Colonialism and Colonial History     Full-text available via subscription   (7 followers)
Journal of Conflict Studies     Full-text available via subscription   (11 followers)
Journal of Contemporary Asia     Hybrid Journal   (1 follower)
Journal of Contemporary China     Hybrid Journal   (5 followers)
Journal of Contemporary History     Hybrid Journal   (16 followers)
Journal of Coptic Studies     Full-text available via subscription   (5 followers)
Journal of Cuneiform Studies     Full-text available via subscription   (4 followers)
Journal of Early Modern History     Full-text available via subscription   (16 followers)
Journal of East Asian Linguistics     Hybrid Journal   (3 followers)
Journal of Ecclesiastical History     Hybrid Journal   (15 followers)
Journal of English and Germanic Philology (JEGP)     Full-text available via subscription   (5 followers)
Journal of European Studies     Hybrid Journal   (17 followers)
Journal of Family History     Hybrid Journal   (12 followers)
Journal of Global History     Full-text available via subscription   (13 followers)
Journal of Historical Geography     Hybrid Journal   (13 followers)
Journal of Historical Pragmatics     Full-text available via subscription   (2 followers)
Journal of Historical Research in Marketing     Hybrid Journal   (3 followers)
Journal of Iberian and Latin American Studies     Hybrid Journal   (10 followers)
Journal of Imperial and Commonwealth History     Hybrid Journal   (10 followers)
Journal of Indian Society of Pedodontics and Preventive Dentistry     Open Access   (1 follower)
Journal of Israeli History: Politics, Society, Culture     Hybrid Journal   (5 followers)
Journal of Jewish Identities     Full-text available via subscription   (7 followers)
Journal of Latin American Cultural Studies: Travesia     Hybrid Journal   (6 followers)
Journal of Latin American Studies     Hybrid Journal   (11 followers)
Journal of Legal History     Hybrid Journal   (13 followers)
Journal of Medieval History     Hybrid Journal   (105 followers)
Journal of Medieval Iberian Studies     Hybrid Journal   (7 followers)
Journal of Medieval Religious Cultures     Full-text available via subscription   (12 followers)
Journal of Military History     Full-text available via subscription   (17 followers)
Journal of Modern Chinese History     Hybrid Journal   (3 followers)
Journal of Modern Greek Studies     Full-text available via subscription   (2 followers)
Journal of Modern History, The     Full-text available via subscription   (87 followers)
Journal of Modern Italian Studies     Hybrid Journal   (4 followers)
Journal of Modern Russian History and Historiography     Full-text available via subscription   (8 followers)
Journal of Moravian History     Full-text available via subscription   (3 followers)
Journal of Natural History     Hybrid Journal   (4 followers)
Journal of New Zealand Studies     Full-text available via subscription   (1 follower)
Journal of Northern Territory History     Full-text available via subscription  
Journal of Pacific History     Hybrid Journal   (4 followers)
Journal of Persianate Studies     Full-text available via subscription   (3 followers)
Journal of Policy History     Full-text available via subscription   (7 followers)

  First | 1 2 3 4 5 6 7 8 | Last

Journal of the American Society of Hypertension    [5 followers]  Follow    
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
     ISSN (Print) 1933-1711
     Published by Elsevier Homepage  [2556 journals]   [SJR: 0.803]   [H-I: 17]
  • Neutral Endopeptidase Inhibitor versus Angiotensin Converting Enzyme
           Inhibitor in a Rat Model of the Metabolic Syndrome
    • Abstract: Publication date: Available online 24 January 2014
      Source:Journal of the American Society of Hypertension
      Author(s): Yoav Eizenberg , Ehud Grossman , Edna Peleg , Zehava Shabtai , Yehonatan Sharabi
      Background The antihypertensive treatment in patients with metabolic syndrome is unclear. We therefore used a rat model of the metabolic syndrome and compared the effects of enalapril, an angiotensin-converting-enzyme inhibitor, with candoxatril, a neutral endopeptidase inhibitor which inhibit degradation of atrial natriuretic peptide and in addition to lowering blood pressure exerts metabolically beneficial activity. Methods Ten male Sprague Dawley rats were fed regular rat chow for 5 weeks. Fifty male Sprague Dawley rats were fed a high-fructose diet for 3 weeks, followed by addition of enalapril, 10 mg/Kg/d, or candoxatril, 25, 50, or 100 mg/Kg/d, for 2 weeks. Systolic blood pressure, plasma triglyceride level, and insulin level were measured at baseline and after 3 weeks and 5 weeks. Results Three weeks of a high-fructose diet led to a significant increase in all metabolic parameters. Candoxatril and enalapril lowered systolic blood pressure significantly (candoxatril -10±1 to -22±1 mmHg and enalapril -27±2 mmHg). High-dose candoxatril and enalapril significantly decreased plasma triglyceride levels (by 17.8% and 32.8%, respectively), but only high-dose candoxatril decreased plasma insulin levels significantly (by 25.3%). Conclusion High-dose candoxatril is a metabolically favorable option for lowering blood pressure in a rat model of metabolic syndrome.


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



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


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



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


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


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


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


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


      PubDate: 2013-12-24T13:31:07Z
       
  • Message from the President of the American Society of Hypertension The
           Journal of the American Society of Hypertension (JASH) will be the only
           official Journal of the Society in 2014
    • Abstract: Publication date: Available online 18 December 2013
      Source:Journal of the American Society of Hypertension
      Author(s): William B. White



      PubDate: 2013-12-19T19:13:01Z
       
  • Effect of Change in Systolic Blood Pressure Between Clinic Visits on
           Estimated 10-Year Cardiovascular Disease Risk
    • Abstract: Publication date: Available online 19 December 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Siqin Ye , Y. Claire Wang , Daichi Shimbo , Jonathan D. Newman , Emily B. Levitan , Paul Muntner
      Background Systolic blood pressure (SBP) often varies between clinic visits within individuals, which can affect estimation of cardiovascular disease (CVD) risk. Methods and Results We analyzed data from participants with two clinic visits separated by a median of 17 days in the Third National Health and Nutrition Examination Survey (n=808). Ten-year CVD risk was calculated with SBP obtained at each visit using the Pooled Cohort Equations. The mean age of participants was 46.1 years and 47.3% were male. The median SBP difference between the two visits was -1 mmHg (1st – 99th percentiles: -23 to 32 mmHg). The median estimated 10-year CVD risk was 2.5% and 2.4% at the first and second visit, respectively (1st – 99th percentiles -5.2% to +7.1%). Meaningful risk reclassification (i.e., across the guideline recommended 7.5% threshold for statin initiation) occurred in 12 (11.3%) of 106 participants whose estimated CVD risk was between 5% to 10%, but only in 2 (0.3%) of 702 participants who had a 10-year estimated CVD risk of <5% or >10%. Conclusions SBP variability can affect CVD risk estimation, and can influence statin eligibility for individuals with an estimated 10-year CVD risk between 5% and 10%.


      PubDate: 2013-12-19T19:13:01Z
       
  • From The Editor
    • Abstract: Publication date: Available online 11 December 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Myron H. Weinberger



      PubDate: 2013-12-16T13:17:48Z
       
  • From The Editor
    • Abstract: Publication date: Available online 11 December 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Myron H. Weinberger



      PubDate: 2013-12-16T13:17:48Z
       
  • Editorial Board
    • Abstract: Publication date: November–December 2013
      Source:Journal of the American Society of Hypertension, Volume 7, Issue 6




      PubDate: 2013-12-11T04:53:18Z
       
  • Table of Contents
    • Abstract: Publication date: November–December 2013
      Source:Journal of the American Society of Hypertension, Volume 7, Issue 6




      PubDate: 2013-12-11T04:53:18Z
       
  • Effects of low-dose thiazide diuretics on fasting plasma glucose and serum
           potassium–a meta-analysis
    • Abstract: Publication date: November–December 2013
      Source:Journal of the American Society of Hypertension, Volume 7, Issue 6
      Author(s): Bertrand N. Mukete , Clive Rosendorff
      This study is a meta-analysis of the metabolic profile (fasting plasma glucose and serum potassium) of low-dose thiazide and thiazide-like diuretics. The meta-analysis involved 10 randomized controlled clinical trials with a total sample size of 17,636 and 17,947 for the potassium and glucose arms respectively. The random effect model was used to calculate the odds ratio with 95 percent confidence interval. The cumulative mean change of fasting plasma glucose was +0.20 mmol/L (+3.6 mg/dL) for the diuretic arm versus +0.12 mmol/L (+2.2 mg/dL) for the comparator arm. The cumulative mean change of serum potassium was −0.22 mmol/L (−0.22 mEq/L) for the diuretic arm versus +0.05 mmol/L (+0.05 mEq/L) for the comparator arm. The aggregate odds ratio for having higher fasting plasma glucose in subjects on low-dose thiazide versus non-thiazide antihypertensive was 1.22 (1.11 to 1.33; P < .01). The odds ratio for having a lower serum potassium in subjects on low-dose thiazide versus non-thiazide antihypertensive was 0.36 (0.27 to 0.49; P < .01). The magnitude of the observed change in fasting plasma glucose associated with low-dose thiazide diuretic use, while statistically significant, does not appear to place patients at clinically significant risk. On the other hand, the observed change in serum potassium was also statistically significant, and may be clinically significant in patients whose baseline potassium concentration is low or low-normal, and could predispose at-risk patients, such as those with ischemic heart disease, to ventricular arrhythmias.


      PubDate: 2013-12-11T04:53:18Z
       
  • Subject Index
    • Abstract: Publication date: November–December 2013
      Source:Journal of the American Society of Hypertension, Volume 7, Issue 6




      PubDate: 2013-12-11T04:53:18Z
       
  • Thanks to Our Reviewers
    • Abstract: Publication date: November–December 2013
      Source:Journal of the American Society of Hypertension, Volume 7, Issue 6




      PubDate: 2013-12-11T04:53:18Z
       
  • Author Index
    • Abstract: Publication date: November–December 2013
      Source:Journal of the American Society of Hypertension, Volume 7, Issue 6




      PubDate: 2013-12-11T04:53:18Z
       
  • Modulation of aldosterone levels by -344C/T CYP11B2 polymorphism and
           spironolactone use in resistant hypertension
    • Abstract: Publication date: Available online 4 December 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Vanessa Fontana , Ana Paula Cabral de Faria , Natália Ruggeri Barbaro , Andréa Rodrigues Sabbatini , Rodrigo Modolo , Riccardo Lacchini , Heitor Moreno
      Background Interindividual variability in plasma aldosterone levels comprises environmental and genetic sources. Increased aldosterone levels have been associated with higher risk of hypertension and target-organ damage related to hypertension. Aldosterone excess and intravascular volume expansion are implicated in pathophysiology of resistant hypertension (RH). Methods and Results We sought to investigate whether -344C/T polymorphism (rs1799998) in aldosterone synthase gene (CYP11B2) is associated with plasma aldosterone levels in patients with resistant hypertension. Sixty-two patients with resistant hypertension were enrolled in this cross-sectional study. Genotypes were obtained by allelic discrimination assay using Real Time PCR. Multivariable linear regression was used to identify whether TT genotype was predictor of aldosterone levels. No differences in clinical and laboratorial parameters were found among genotype groups. We found an additive effect of the T allele on plasma aldosterone concentration in RH. Also, there was higher aldosterone levels in TT homozygous under use of spironolactone compared to C carriers and compared to TT subjects who was not under use of spironolactone. TT genotype and the use of spironolactone were significant predictors of aldosterone levels in RH subjects. Conclusions Plasma aldosterone concentration is significantly associated with -344C/T CYP11B2 polymorphism and with the treatment with spironolactone in resistant hypertensive subjects.


      PubDate: 2013-12-08T03:04:03Z
       
  • Review of blood pressure control rates and outcomes
    • Abstract: Publication date: Available online 3 December 2013
      Source:Journal of the American Society of Hypertension
      Author(s): George Bakris , Pantelis Sarafidis , Rajiv Agarwal , Luis Ruilope
      Despite the high prevalence of hypertension and documented benefits of blood pressure (BP) control, >40% of patients with hypertension are not controlled. A majority of uncontrolled hypertensive patients receive two or more antihypertensive drugs. The current review examined the relationship between antihypertensive combination drug therapy, achievement of goal BP, and cardiovascular (CV) outcomes. Articles were selected from a PubMed search using a prespecified search strategy. Randomized, controlled clinical trials of adult human subjects published in English between January 1991 and January 2013 were included. From 2319 identified articles, 28 met inclusion criteria and contained a total of 226,877 subjects. There were seven placebo-controlled studies and 21 treatment comparator and combination therapy studies. The studies included in this review reported a positive association between the degree of BP lowering, number of medications, and CV outcomes. As combination therapy became available, it was increasingly utilized in clinical trials and enabled an increased proportion of patients to achieve a prespecified BP target. Adverse events with monotherapy and combination therapy were as anticipated for the specific classes of antihypertensive therapy. Although many patients reach BP goal, combination antihypertensive therapy is often needed to reach BP goal. Effective BP lowering has been shown to result in improvements in CV outcomes.


      PubDate: 2013-12-04T00:07:30Z
       
  • Impact of anti-hypertensive therapy on cardiovascular disease burden in
           Asia: Renewed hope with immense scope
    • Abstract: Publication date: Available online 10 November 2013
      Source:Journal of the American Society of Hypertension
      Author(s): C.Venkata S. Ram , Anshu Kumari



      PubDate: 2013-11-13T08:21:57Z
       
  • Angiotensin (1-7) increases the potassium current and the resting
           potential of arterial myocytes from vascular resistance vessels of normal
           adult rats: Pathophysiological implications
    • Abstract: Publication date: Available online 9 November 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Walmor C. De Mello
      The influence of angiotensin (Ang) (1-7) on potassium current (Kv) and resting potential of smooth muscle cells isolated from mesenteric artery of Sprague Dawley rats was investigated. Measurements of potassium current were performed using the whole cell configuration of pCLAMP. The results indicated that Ang (1-7) (10−9 M) increased the potassium current by 120% ± 2.6% (P < .05) and the resting potential of smooth muscle cells by 8 ± 2.8 mV (n = 23; P < .05). Ang II (10−9 M) administered to the bath reduced the potassium current by 35% ± 3.6% (n = 23; P < .05) and depolarized the arterial myocytes by 7.8 ± 2.1 mV (n = 25; P < .05). The effect of the heptapeptide on potassium current was inhibited by a Mas receptor inhibitor (A779; 10−8 M) as well as by a protein kinase A (PKA) inhibitor (10−9 M) dialyzed into the cell. Intracellular dialysis of the catalytic subunit of PKA (5 × 10−8 M) enhanced the potassium current by 38% ± 3.4% (n = 14; P < .05) but did not abolish the effect of Ang (1-7). On the other hand, Bis-1 (10−9 M), which is a specific inhibitor of PKC, suppressed the effect of Ang (1-7) on potassium current. In conclusion, Ang (1-7) counteracts the effect of Ang II on potassium current and membrane potential of smooth muscle cells from mesenteric arteries, which are resistance vessels involved in the regulation of peripheral resistance and blood pressure. The activation of the cAMP/PKA cascade is essential for the effect of the heptapeptide. Pathophysiological implications are discussed.


      PubDate: 2013-11-13T08:21:57Z
       
  • The Relationship Between Magnesium and Ambulatory Blood Pressure,
           Augmentation Index, Pulse Wave Velocity, Total Peripheral Resistance and
           Cardiac Output in Essential Hypertensive Patients
    • Abstract: Publication date: Available online 12 November 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Baris Afsar , Rengin Elsurer
      Background Magnesium levels have been shown to be associated with elevated blood pressure (BP), endothelial dysfunction, insulin resistance, vascular calcification, inflammation and atherosclerosis. It was also demonstrated that patients with hypertension (HT) have increased inflammation, insulin resistance and endothelial dysfunction. However, the relationship between magnesium, ambulatory BPs and central hemodynamic parameters were not evaluated extensively. Methods Serum magnesium levels, ambulatory blood pressures, augmentation index (Aix), Pulse wave velocity (PWV), total peripheral resistances (TPR) and cardiac output were measured for all patients. Results In total 184 essential HT patients were enrolled. In univariate analysis, magnesium levels were correlated with hemoglobin (r: +0.155, p:0.037), albumin (+0.180, p:0.018), pulse pressure (daytime) (r:-0.170, p:0.021), pulse pressure (24-hours) (r:-0.156, p:0.035), Aix (daytime) (r:-0.223, p:0.002) Aix (nighttime) (r:-0.169, p:0.022) Aix (24-hours) (r:-0.247, p:0.001) In regression analysis magnesium levels were independently and conversely associated with daytime Aix (P < .0001), nighttime Aix (P: 0.019) and 24-hours Aix (P < .0001). Conlusions we suggest that magnesium levels were associated with Aix but not with TPR, PWV, CO and central BPs. The unique mechanisms related with magnesium and Aix but not shared by other central parameters needs to be determined.


      PubDate: 2013-11-13T08:21:57Z
       
  • Sodium surfeit and potassium deficit: Keys to the pathogenesis of
           hypertension
    • Abstract: Publication date: Available online 5 November 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Horacio J. Adrogué , Nicolaos E. Madias
      The pathogenic role of Na+ in primary hypertension is widely recognized but that of K+ remains unappreciated. Yet, extensive evidence indicates that together, the body's dominant cations constitute the chief environmental factor in the pathogenesis of hypertension and its cardiovascular sequelae. In this Review, we provide a synthesis of the determinants of Na+ retention and K+ loss developing in the body as the Na+-rich and K+-poor modern diet interacts with kidneys intrinsically poised to conserve Na+ and excrete K+; and the molecular pathways utilized by these disturbances in the central nervous system and the periphery to increase sympathetic tone and vascular resistance, and establish hypertension. These fresh insights point to new directions for targeted pharmacotherapy of hypertension. The interdependency of Na+ and K+ in the pathogenesis of hypertension indicates that Na+ restriction and increased K+ intake are important strategies for the primary prevention and treatment of hypertension and its cardiovascular consequences.


      PubDate: 2013-11-06T01:20:19Z
       
  • Effects of antihypertensive treatment in Asian populations: A
           meta-analysis of prospective randomized controlled studies (CARdiovascular
           protectioN group in Asia: CARNA)
    • Abstract: Publication date: Available online 21 October 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Yuichiro Yano , Alexandros Briasoulis , George L. Bakris , Satoshi Hoshide , Ji-Guang Wang , Kazuyuki Shimada , Kazuomi Kario
      To examine the effects of antihypertensive treatment on cardiovascular disease (CVD) in Asian populations, we systematically evaluated prospective randomized studies carried out in Asia (1991–2013). We identified 18 trials with 23,215 and 21,986 hypertensive patients in the intervention (ie, strict blood pressure [BP] lowering or add-on treatment) and reference groups, respectively (mean age, 65 years; follow-up duration, 3.2 years). Analysis was performed through 1) first subgroup: eight trials that compared active antihypertensive treatment with placebo or intensive with less intensive BP control and 2) second subgroup: 10 trials that compared different antihypertensive treatments. In the first subgroup analysis, BP was reduced from 160.3/87.3 mm Hg to 140.2/78.4 mm Hg in the intervention group with a −6.7/−2.2 mm Hg (P < .001) greater BP reduction than the reference group. Compared with the reference group, the intervention group had a lower risk of composite CVD events (odd ratio [OR], 0.73; 95% confidence interval [CI], 0.66–0.81), myocardial infarction (OR, 0.79; 95% CI, 0.63–1.0), stroke (OR, 0.71; 95% CI, 0.63–0.80), and CVD mortality (OR, 0.81; 95% CI, 0.68–0.97; all P ≤ .05). In the second subgroup analysis, no difference was found for any outcome between renin-angiotensin blockers and calcium-channel blockers or diuretics. The meta-regression line among the 18 trials indicated that a 10 mm Hg reduction in systolic BP was associated with a reduced risk for composite CVD events (−39.5%) and stroke (−30.0%). Our meta-analysis shows a benefit when a BP target of less than 140/80 mm Hg is achieved in Asian hypertensives. BP reduction itself, regardless of BP lowering agents, is important for achieving CVD risk reduction.


      PubDate: 2013-10-25T02:02:58Z
       
  • Temporal trends in management of hypertension among Israeli adults,
           2002–2010: Lesson from the Acute Coronary Syndromes Israeli Survey
           (ACSIS)
    • Abstract: Publication date: Available online 23 October 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Gadi Shlomai , Eran Kopel , Ilan Goldenberg , Ehud Grossman
      Our aim was to evaluate trends in blood pressure (BP) management and BP levels among patients admitted with acute coronary syndromes (ACS) over the past decade. The study population comprised 7658 ACS patients enrolled in the Acute Coronary Syndromes Israeli Survey (ACSIS) between 2002 and 2010. We compared patients' characteristics, admission systolic BP levels, and antihypertensive therapy between those hospitalized during the early (years: 2002–2004) and late (years: 2008–2010) periods. Among 7658 study participants, 4421 (58%) were hypertensive. Hypertensive patients presenting from 2008 to 2010 tended to exhibit lower BP levels (P < .001). The use of angiotensin converting enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARB) and beta-blockers has increased over the years (P < .001 for both), whereas the use of diuretics and calcium antagonists has remained stable (P = .77 for both). The use of diuretics tended to increase in hypertensive subjects without prior cardiovascular disease (P = .05). In addition, the late period was characterized by a significant increase in the use of two or more antihypertensive agents (combination therapy) compared with the early period (57% vs 50%; P < .001). BP levels decreased among Israeli hypertensive patients presenting with ACS between 2002 and 2010, possibly due to increased use of ACEi/ARB, and combination therapies during this time period.


      PubDate: 2013-10-25T02:02:58Z
       
  • Effects of renin-angiotensin-aldosterone system inhibitors and
           beta-blockers on markers of arterial stiffness
    • Abstract: Publication date: Available online 17 October 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Charalambos Koumaras , Konstantinos Tziomalos , Eirini Stavrinou , Niki Katsiki , Vasilios G. Athyros , Dimitri P. Mikhailidis , Asterios Karagiannis
      Antihypertensive agents may, even within the same class, exert variable effects on arterial stiffness variables. Nebivolol could have a better impact than atenolol on arterial stiffness, by increasing the bioavailability of endothelium-derived nitric oxide. Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) increase plasma renin activity (enhancing the production of angiotensin II via non-ACE-related pathways) whereas aliskiren does not, potentially affecting central hemodynamics differently. We compared the effects of two renin-angiotensin-aldosterone system (RAAS) inhibitors (quinapril and aliskiren) and 2 beta-blockers (atenolol and nebivolol) on arterial stiffness variables. Treatment-naïve patients (n = 72; 68.1% males; age, 47.6 ± 10.6 years) with uncomplicated stage I-II essential hypertension were randomly assigned to quinapril, aliskiren, atenolol, or nebivolol for 10 weeks. Central systolic and diastolic blood pressure (BP), central pulse pressure (PP), augmentation index (AIx), and pulse wave velocity (PWV) were measured at baseline, 2, and 10 weeks. The same measurements were performed in 20 normotensive subjects (65.0% males; age, 40.0 ± 8.9 years). Peripheral and central systolic and diastolic BP, peripheral PP, and PWV were significantly and similarly reduced by all agents. However, PWV continued to decline between the second and last visit in patients on quinapril and aliskiren but did not change in those on nebivolol or atenolol. Central PP and AIx decreased in patients on quinapril, aliskiren, and nebivolol but did not change in those taking atenolol. The decrease in central PP and AIx did not differ between patients on quinapril, aliskiren, and nebivolol. Despite similar reductions in peripheral BP, atenolol is less effective than nebivolol and RAAS inhibitors in improving central pulsatile hemodynamics. Aliskiren exerts similar effects on markers of arterial stiffness as quinapril. The clinical relevance of these differences remains to be established.


      PubDate: 2013-10-17T01:52:21Z
       
  • Contribution of obesity to left atrial and left ventricular dysfunction in
           asymptomatic patients with hypertension: a two-dimensional
           speckle-tracking echocardiographic study
    • Abstract: Publication date: Available online 13 October 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Hirokazu Miyoshi , Yoshifumi Oishi , Yukio Mizuguchi , Arata Iuchi , Norio Nagase , Nusrat Ara , Takashi Oki
      Hypertension and obesity each are well known to result in heart failure with preserved ejection fraction. Therefore, it is clinically important to clarify the mechanisms of further deterioration of left atrial (LA)-left ventricular (LV) interaction in asymptomatic patients with obesity in the presence of hypertension. Data on conventional and two-dimensional speckle-tracking echocardiography (2DSTE) were obtained from 134 asymptomatic hypertensive patients. The study sample was divided into two groups: non-obese (n = 80; body mass index [BMI] <25 kg/m2] and obese (n = 54; BMI ≥25 kg/m2). The end-diastolic LV diameter, ratio of early transmitral flow to mitral annular motion velocity (E/e’), peak systolic LV circumferential strain rate, and E/e’/peak systolic LA strain (S-LAs) were greater in the obese group. Among the significantly correlated variables with BMI and E/e’/S-LAs in univariate analyses, multivariate analyses revealed that BMI is independently associated with end-diastolic LV diameter and peak systolic LV radial strain in all hypertensive patients, and that age, systolic blood pressure, relative LV wall thickness, peak systolic mitral annular motion velocity (s’), peak systolic LV radial strain, and peak early diastolic LV longitudinal strain rate are identified as independent predictors related to E/e’/S-LAs in the obese patients, whereas only s’ contributes to the E/e’/S-LAs in the non-obese patients. Impaired LA-LV interaction was accelerated with obesity in the presence of hypertension. Assessment of the LA and LV function using 2DSTE provided additional information to the negative effects of cardiovascular risk factors on the LA and LV function in patients without clinical symptoms.


      PubDate: 2013-10-17T01:52:21Z
       
  • Influence of autoantibodies against AT1 receptor and AGTR1 polymorphisms
           on candesartan-based antihypertensive regimen Results from the Study of
           Optimal Treatment in Hypertensive Patients with Anti-AT1-Receptor
           Autoantibodies trial
    • Abstract: Publication date: Available online 13 October 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Yanxiang Sun , Yuhua Liao , Yong Yuan , Li Feng , Shihui Ma , Feng Wei , Min Wang , Feng Zhu
      The autoantibodies against angiotensin AT1 receptors (AT1-AAs) in patients with essential hypertension exhibited an agonistic action like angiotensin II and maintained high blood pressure (BP). Angiotensin II receptor gene (AGTR1) polymorphisms were associated with BP response to RAS inhibition in the hypertensive population. Furthermore, the BP response to AT1 receptor blockers varied significantly among individuals with hypertension. We hypothesized that the polymorphisms of the AGTR1 and AT1-AAs might affect antihypertensive response to AT1 receptor blockers based in patients with primary hypertension. Patients who received a candesartan-based regimen came from the SOT-AT1 study (Study of Optimal Treatment in Hypertensive Patients with Anti-AT1-Receptor Autoantibodies). The established enzyme-labeled immunosorbent assay was used to detect AT1-AAs in the sera of the patients. Genotype 3 single nucleotide polymorphisms in AGTR1 gene was used by DNA sequencing. The correlations among AT1-AAs, AGTR1 gene polymorphisms or haplotypes, and the antihypertensive effect candesartan-based were analyzed using SPSS. The percentage of systolic BP reduction that was candesartan-based was greater in AT1-AA positive groups than in AT1-AA negative ones (21 ± 8 vs. 18 ± 9; P = .001). Meanwhile, systolic BP reduction that was candesartan-based was more significant in the group of rs5186 AC genotypes than AA homozygotes after adjusting for other confounding factors (37.55 ± 13.7 vs. 32.47 ± 17.27 mm Hg; adjusted P = .028). Furthermore, haplotypes (GCC) and (AAC) had impacts on the antihypertensive effect of candesartan therapy. The AT1-AAs, AGTR1 gene polymorphisms and haplotypes solely or jointly have influences on candesartan-based antihypertensive response in patients with primary hypertension.


      PubDate: 2013-10-17T01:52:21Z
       
  • JASH VOLUME 7, ISSUE 6
    • Abstract: Publication date: Available online 16 October 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Myron H. Weinberger



      PubDate: 2013-10-17T01:52:21Z
       
  • Controlled hypertension induces cerebrovascular and gene alterations in
           Cyp1a1-Ren2 transgenic rats
    • Abstract: Publication date: Available online 8 October 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Mercede A. Pannozzo , Philip R. Holland , Gillian Scullion , Richard Talbot , John J. Mullins , Karen Horsburgh
      Hypertension is a major risk factor for small vessel disease and dementia, but the pathogenic mechanisms are not fully known. This study aimed to assess cerebrovascular alterations in response to different durations (4 or 6 months) of controlled hypertension in an inducible transgenic rat model of hypertension (Cyp1a1-Ren2) as compared with normotensive litter mate controls. After 6 months of hypertension as compared with controls, a significant reduction in vascular width was paralleled by an increase in the protein levels of claudin-5, an endothelial tight junction protein. Notably, vascular alterations were associated with increased microglia, and these changes were preceded by increased eNOS expression. Investigation of global gene expression by microarray analysis indicated alterations in predominantly growth factor related genes. Herein, we show that modest, sustained levels of hypertension are sufficient to cause cerebrovascular alterations accompanied by endothelial and inflammatory changes. These changes are paralleled by alterations in growth factor expression suggestive of a mechanistic role.


      PubDate: 2013-10-12T08:53:08Z
       
  • Comparison Between Oscillometric And Intra−Arterial Blood Pressure
           Measurements In Ill Preterm And Full−Term Neonates
    • Abstract: Publication date: Available online 11 October 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Shwetal Lalan , Douglas Blowey
      Background Conflicting data exists regarding the accuracy of oscillometric method of blood pressure (BP) measurement in neonates. There is limited data regarding intra-arterial BP trends in the neonates. We aimed to determine the accuracy of oscillometric BP and evaluate BP distribution in ill neonates. Methods and results 1492 simultaneously obtained oscillometric and intra-arterial (umbilical arterial (UAC) or radial arterial) BP measurements from 101 neonates were used for comparison. 125,580 5-minute averaged intra-arterial BP readings were used to evaluate BP distribution. There was statistically significant difference (P < 0.0001) between the oscillometric and radial mean arterial BP (MAP) 4.8 +/- 9.8 mm Hg, systolic BP 8.3 +/- 11.6 mm Hg, diastolic BP 4.3+/- 9.3 mm Hg and between oscillometric and UAC systolic BP 5.2 +/- 11.9 mm Hg and diastolic BP - 0.8 +/- 10.4 mm Hg. MAP increased with increase in weight (35.3 + 4.92 mm Hg /kg), post menstrual age (PMA) (- 0.29 + 1.41 mm Hg/week) and advanced gestational age (GA) at birth (13.12 + 0.90 mm Hg/week) Conclusion Oscillometric BP measurements are not equivalent to intra-arterial (UAC or radial arterial) BP in ill neonates. BP increases with increase in weight, GA at birth and PMA in ill neonates.


      PubDate: 2013-10-12T08:53:08Z
       
  • Sex and age differences in the effect of obesity on incidence of
           hypertension in the Japanese population: A large historical cohort study
    • Abstract: Publication date: Available online 8 October 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Misuzu Fujita , Akira Hata
      Elevated risk of death from any cause and stroke associated with high body mass index (BMI) values decline with aging. However, it is not clear whether the effect of obesity on the incidence of hypertension varies by sex or age. Cox regression analyses were performed using a large historical cohort composed of 6803 men and 22,800 women. In the final model, which included the main effect (sex, age, and BMI), all two-way interactions (sex*age, sex*BMI, and age*BMI), a three-way interaction (sex*age*BMI), and adjusted variables determined by backward elimination, the three-way interaction and two of the two-way interactions (age*sex and age*BMI) were not significant; the remaining two-way interaction between sex and BMI was significant (P = .016). In the next step, the effect of BMI on the incidence of hypertension stratified by sex was evaluated. Hazard ratios (HRs) were significantly higher for BMI 27.0 to <29.0 and ≥29.0 kg/m2 than for the HR for BMI 21.0 to <23.0 kg/m2 in women (HR, 1.45; 95% confidence interval [CI], 1.32–1.59 and HR, 1.46; 95% CI, 1.29–1.65, respectively), but not in men (HR, 1.14; 95% CI, 0.98–1.33 and HR, 1.01; 95% CI, 0.77–1.32, respectively). The effect of obesity on the incidence of hypertension is stronger in women than in men.


      PubDate: 2013-10-08T18:54:59Z
       
  • Retinal arteriole-to-venule ratio changes and target organ disease
           evolution in newly diagnosed hypertensive patients at one year follow-up
    • Abstract: Publication date: Available online 5 October 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Gabriel Coll-De-Tuero , Sonia González-Vazquez , Antonio Rodriguez-Poncelas , Antònia Barceló Maria , Joan Barrot-De-La Puente , Mg Penedo , Antonio Pose-Reino , Marta Pena-Seijo , Marc Saez
      Background There is no agreement on the systematic exploration of the fundus oculi (FO) in hypertensive patients, and it is unknown whether the evolution of retinal microcirculatory alterations has prognostic value or not. Aim To investigate whether the evolution of the arteriole-to-venule ratio (AVR) in newly-diagnosed hypertensive patients is associated with better or worse evolution of target organ damage (TOD) during one year. Methods A cohort of 133 patients with newly-diagnosed untreated hypertension, followed for one year. At baseline and follow-up all patients underwent a physical examination, self-blood pressure measurement, ambulatory blood pressure monitoring, blood and urine analysis, ECG and retinography. The endpoint was the favourable evolution of TOD and the total amount of TOD, according to the baseline AVR and the baseline and final difference of the AVR. Results A total of 133 patients were analyzed (57 years, SD 10.7; 59% men). No differences were found in the decrease in blood pressure or antihypertensive treatment between quartiles of baseline AVR or baseline-final AVR difference. Patients with a difference between baseline and final AVR in the highest quartile (>0.0817) had a favourable evolution of left ventricular hypertrophy (LVH) (OR 14.9; 95% CI 1.08-206.8) and the amount of TOD (OR 2.22; 95% CI 1.03-6.05). No favourable evolution was found of glomerular filtration rate. Conclusions There is an association between the evolution of the AVR and the favourable evolution of TOD. Patients with greater increase of AVR have significantly better evolution of LVH and amount of TOD.


      PubDate: 2013-10-08T18:54:59Z
       
  • Accumulated brisk walking reduces arterial stiffness in overweight adults:
           evidence from a randomised control trial
    • Abstract: Publication date: Available online 6 October 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Thérèse M. Kearney , Marie H. Murphy , Gareth W. Davison , Maurice J. O’Kane , Alison M. Gallagher
      Objective Arterial stiffness is a major contributor to the development of atherosclerosis and consequently cardiovascular disease. This study aimed to examine whether six months of accumulated (3x10min, 5days/week) brisk walking was sufficient to reduce arterial stiffness in sedentary, overweight individuals. Methods 77 individuals (19♂,58♀; age 30-55yr) were randomly allocated to one of three groups; two groups completed 30 minutes of accumulated walking with either monthly or weekly telephone support; the third group (control), performed stretching exercises. The walking groups were combined and telephone support included as a covariate. Anthropometry, blood pressure (BP), blood lipids, pulse wave velocity (PWV) and NOx (surrogate marker for nitric oxide) were measured at baseline, post-intervention and four months post-intervention. Results No changes were observed for anthropometry, BP, or lipids. However, at the end of the intervention there was a decrease in PWV (p < 0.001) accompanied by an increase in NOx (P<0.001), with changes maintained 4 months post intervention. A strong negative correlation between PWV and NOx was also observed (p < 0.001, r = -0.65). Conclusions A lifestyle approach to meeting current physical activity guidelines results in favourable alterations in arterial function in overweight individuals.


      PubDate: 2013-10-08T18:54:59Z
       
  • Early treatment of Hypertension in Acute Ischemic and Intracerebral
           Hemorrhagic Stroke. Progress Achieved, Challenges and Perspectives
    • Abstract: Publication date: Available online 4 October 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Carlos Feldstein
      Hypertension is the leading risk factor for ischemic and intracerebral hemorrhagic subtypes of stroke. Additionally, high BP in the acute cerebrovascular event is associated with poor outcome, and a high percentage of stroke survivors have inadequate control of hypertension. The present is a systematic review of prospective, randomised, and controlled trials carried out on safety and efficacy of antihypertensive treatment of both subtypes of acute stroke. Six trials involving 7512 patients were included. It is likely that persistent controversies on the speed and the goal of treatment could arise, at least in part, from analyzing the results of antihypertensive treatment in ischemic and intracerebral hemorrhagic subtypes of acute stroke together, and different prevalence of past-stroke in the randomised groups. It needs further research to establish whether the guideline standard antihypertensive treatment could provide greater benefit than simple observation in patients with ischemic acute stroke and Stage 2 hypertension of JNC 7, albeit they were not candidates for acute reperfusion. In that case, the target reduction in BP could be 10% to 15% within 24 hours. The recently published INTERACT 2 has provided evidence that patients with hemorrhagic stroke can receive intensive antihypertensive treatment safely with the goal of reducing the SBP to values no lower than 130 mm Hg. It is important to take into account that marked BP lowering in acute stroke increases the risk of poor outcome by worsening cerebral ischemia from deterioration of cerebral blood flow autoregulation.


      PubDate: 2013-10-05T08:00:59Z
       
  • Apparent and true resistant hypertension: Why not the same?
    • Abstract: Publication date: Available online 12 September 2013
      Source:Journal of the American Society of Hypertension
      Author(s): David A. Calhoun



      PubDate: 2013-09-12T23:04:53Z
       
  • RNA silencing targeting PIN (protein inhibitor of neuronal nitric oxide
           synthase) attenuates the development of hypertension in young
           spontaneously hypertensive rats
    • Abstract: Publication date: Available online 12 September 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Su-Chen Wang , Kuan-Miao Lin , Shao-Ju Chien , Li-Tung Huang , Chien-Ning Hsu , You-Lin Tain
      Nitric oxide (NO) deficiency contributes to hypertension. We previously showed that neuronal nitric oxide synthase (nNOS) was involved in hypertension and kidney damage in spontaneously hypertensive rats (SHRs). The protein inhibitor of nNOS (PIN) has been reported to inhibit activity of nNOS.Thus, we tested whether increased PIN in the kidney results in hypertension and whether small interfering RNA (siRNA) targeting PIN attenuates hypertension in SHRs. Four-week-old male SHRs were assigned into three groups (n = 6-7/group): SHR; SHR + PIN, SHR that received siRNA targeting PIN; and SHR + NC, SHR treated with random negative control siRNA. Rats were sacrificed at 12 weeks of age. PIN protein expression was inhibited considerably when PIN siRNA was transfected into NRK52E cells (90% siRNA at 1 nM). The increases of BP were attenuated by siRNA targeting PIN in12-week-old SHRs. Immunostaining of nNOS-α and total nNOS was greater in SHR + PIN group than SHR. Moreover, renal superoxide production and 8-hydroxydeoxyguanosine (8-OHdG) staining were more decreased in the SHR + PIN group than SHRs. We conclude that PIN siRNA reduced PIN expression in vitro and in vivo. PIN siRNA therapy attenuates hypertension in SHRs at 12 weeks of age. Our results suggest that PIN is involved in the development of hypertension.


      PubDate: 2013-09-12T23:04:53Z
       
  • Potential benefits of exercise on blood pressure and vascular function
    • Abstract: Publication date: Available online 27 August 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Sebely Pal , Simone Radavelli-Bagatini , Suleen Ho
      Physical activity seems to enhance cardiovascular fitness during the course of the lifecycle, improve blood pressure, and is associated with decreased prevalence of hypertension and coronary heart disease. It may also delay or prevent age-related increases in arterial stiffness. It is unclear if specific exercise types (aerobic, resistance, or combination) have a better effect on blood pressure and vascular function. This review was written based on previous original articles, systematic reviews, and meta-analyses indexed on PubMed from years 1975 to 2012 to identify studies on different types of exercise and the associations or effects on blood pressure and vascular function. In summary, aerobic exercise (30 to 40 minutes of training at 60% to 85% of predicted maximal heart rate, most days of the week) appears to significantly improve blood pressure and reduce augmentation index. Resistance training (three to four sets of eight to 12 repetitions at 10 repetition maximum, 3 days a week) appears to significantly improve blood pressure, whereas combination exercise training (15 minutes of aerobic and 15 minutes of resistance, 5 days a week) is beneficial to vascular function, but at a lower scale. Aerobic exercise seems to better benefit blood pressure and vascular function.


      PubDate: 2013-09-01T02:46:48Z
       
  • Impact of country of birth on progression of steady and pulsatile
           hemodynamic parameters in normotensive and hypertensive subjects
    • Abstract: Publication date: Available online 27 August 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Frédérique Thomas , Bruno Pannier , Michel E. Safar
      The impact of country of birth (Africa, Asia, or France) on variations of hemodynamic, clinical, and biological parameters of a French general population was evaluated. The study included 2743 subjects (1641 men, 1102 women; mean age 45.4 ± 13.5 years) with at least two health checkups at the Centre d'Investigations Préventives et Cliniques, Paris, between 2008 and 2011. The interval between the two visits (V1, V2) was 1.74 ± 0.66 years. Changes of hemodynamic, biological and clinical markers were calculated using the V2–V1 absolute difference or percent variation. African- and Asian-born were compared separately to French-born subjects using variance analysis and χ² tests. In men, country of birth was not associated with any significant mean hemodynamic parameter variation. In women, mean brachial and central pulse pressures, heart rate (HR), and central augmentation index (CAI) varied significantly more among African- than Asian-born women, when compared with French-born women. For each hemodynamic parameter, V1 values were the first predictive of this change. Country of birth was a significant predictor of HR and CAI changes. Evaluation of interactions showed that a gender × birth country interaction was significant with CAI variation and, to a lesser extent, HR. Finally, country of birth impacted changes in CAI differently in men and women, suggesting that wave reflections play an important role in cardiovascular risk mainly in women. Their effects act predominantly on pulse pressure level and its amplification, indicating an increasing contribution of CAI with age.


      PubDate: 2013-09-01T02:46:48Z
       
  • BpTRUth: Do automated blood pressure monitors outperform mercury?
    • Abstract: Publication date: Available online 19 August 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Cedric Edwards , Swapnil Hiremath , Ankur Gupta , Brendan B. McCormick , Marcel Ruzicka
      Manual measurement of blood pressure (BP) in the office (MOBP) is inferior in accuracy when compared with ambulatory BP measurements (ABPM) since it misses white coat and masked effects on BP. BpTRU, an automated office BP device (AOBP), has been reported to reduce white coat effect. We performed a retrospective review of the diagnostic accuracy of MOBP (taken by a trained nurse in clinical hypertension) and AOBP using the Bland-Altman method in hypertensive patients referred to a Renal Hypertension Clinic. In 329 hypertensive patients, the 95% limits of agreement between systolic AOBP and ABPM were −31 mm Hg to 33 mm Hg and for MOBP and ABPM were −27.8 mm Hg to 37.4 mm Hg. The bias between systolic MOBP and systolic ABPM was 4.9 mm Hg (95% confidence interval, 3.0–6.6 mm Hg) whereas the bias between the systolic AOBP and the systolic ABPM was −3.2 (95% confidence interval, −1.3 to −5.0). AOBP did not improve treatment relevant classification errors compared with MOBP (28% vs. 23%; P = .052). Our data support findings by others showing that AOBP improves, but does not eliminate, white coat effect. The increased detection of white coat effect appears related to systematic downward bias by BpTRU. As a result, detection of masked effect is undermined by BpTRU.


      PubDate: 2013-08-23T23:31:41Z
       
  • Perception of uncontrolled blood pressure and non-adherence to
           anti-hypertensive agents in diabetic hypertensive patients
    • Abstract: Publication date: Available online 19 August 2013
      Source:Journal of the American Society of Hypertension
      Author(s): P.S. Ledur , L.F. Leiria , M.D. Severo , D.T. Silveira , D. Massierer , A.D. Becker , F.M. Aguiar , M. Gus , B.D. Schaan
      We assessed the association between adherence to antihypertensive drug treatment and patient's perception of uncontrolled blood pressure (BP) in diabetic hypertensive subjects. This was a cross-sectional study that evaluated adherence to antihypertensives (Morisky questionnaire), patients' perception of abnormal BP, office BP, and ambulatory BP monitoring in diabetic hypertensive subjects. We evaluated 323 patients, 65.2% women, aged 56.5 ± 7 years, glycosylated hemoglobin (HbA1c) 8.0% (range, 6.9%–9.6%), diabetes duration of 10 years (range, 5–17 years). Adherence to drug treatment was 51.4%. Patients who reported hypertension-related symptoms (60.4%) had a lower level of adherence (P < .001). Non-adherence occurred four times more frequently in patients who reported hypertension-related symptoms (P < .001, adjusted for use of three or more anti-hypertensives, age, and duration of diabetes). Non-adherents had higher office diastolic BP (83.6 ± 11.9 vs. 79.8 ± 9.9; P = .003), but no difference between groups was observed considering systolic, diastolic, and mean BP evaluated by ambulatory BP monitoring. Low rates of adherence to antihypertensive drug treatment were observed in outpatient hypertensive diabetic subjects. Perception of uncontrolled BP levels was strongly and independently associated with non-adherence. Non-adherence determined repercussion on office BP that may have clinical implications in cardiovascular risk.


      PubDate: 2013-08-19T21:55:12Z
       
  • Review of the state of renal nerve ablation for patients with severe and
           resistant hypertension
    • Abstract: Publication date: Available online 15 August 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Vinay Gulati , William B. White
      Through modulation of renin secretion, glomerular filtration rate, and renal absorption of sodium, the sympathetic innervation of the kidneys plays an important role in the pathogenesis of hypertension. Renal nerve ablation technology is being developed for treatment of drug-treatment-resistant hypertension worldwide. Preliminary research with the use of radiofrequency-based renal denervation systems have demonstrated encouraging results with significant reduction of blood pressure in patients inadequately controlled despite nearly maximal drug therapy regimens. From work done thus far, the renal denervation procedure has not been associated with serious adverse effects. Long-term efficacy and safety still needs to be established for renal nerve ablation. This review focuses on the impact of the renal sympathetic system on blood pressure regulation, the clinical rationale for renal nerve ablation in severe and drug-treatment-resistant hypertension, and current evidence from the more advanced renal denervation devices.


      PubDate: 2013-08-19T21:55:12Z
       
  • Furosemide for your mother?
    • Abstract: Publication date: Available online 12 August 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Norman M. Kaplan



      PubDate: 2013-08-15T01:30:41Z
       
  • Sarcopenic obesity as an independent risk factor of hypertension
    • Abstract: Publication date: Available online 30 July 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Seung Ha Park , Jae Hee Park , Pil Sang Song , Dong Kie Kim , Ki Hun Kim , Sang Hoon Seol , Hyun Kuk Kim , Hang Jea Jang , Jung Goo Lee , Ha Young Park , Jinse Park , Kyong Jin Shin , Doo il Kim , Young Soo Moon
      Low muscle mass has been associated with arterial stiffness. The aim of the study was to determine whether sarcopenic obesity is associated with hypertension. Subjects consisted of 6832 adults who participated in the 2009 Korea National Health and Nutrition Examination Survey. Participants were classified as normal, sarcopenic, obese, or sarcopenic-obese based on the following measures: waist circumference and appendicular skeletal muscle mass divided by weight (ASM/Wt). The sarcopenic-obese group had systolic and diastolic blood pressure levels that were ≈12 mm Hg and 5 mm Hg higher, respectively, than those in the normal group. Compared with the normal group, the odds ratio (OR) of having hypertension for the sarcopenic, obese, and sarcopenic-obese groups were 2.48 (95% confidence interval [CI], 1.89–6.16), 3.15 (95% CI, 2.76–3.59), and 6.42 (95% CI, 4.85–8.48) times higher, respectively. When waist circumference and ASM/Wt were used as continuous variables in the same regression model, ASM/Wt was a significant predictor of hypertension (OR, 0.94; 95% CI, 0.89–0.98). Sarcopenic obesity is associated with hypertension, while low muscle mass is also correlated with hypertension, independent of abdominal obesity. Abdominal obesity and sarcopenia may potentiate each other to induce hypertension.


      PubDate: 2013-08-02T22:52:02Z
       
  • Characteristics, drug combinations and dosages of primary care patients
           
    • Abstract: Publication date: Available online 23 July 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Larissa Grigoryan , Valory N. Pavlik , David J. Hyman
      Most studies on the prevalence and determinants of resistant hypertension (RH) do not account for white coat hypertension, medication non-adherence, or use of suboptimal treatment dosages. We studied the characteristics, drug combinations, and dosages of patients on at least three antihypertensives of different classes who had uncontrolled blood pressure on 24-hour ambulatory blood pressure monitoring and high medication adherence measured by electronic monitoring. The data were collected as part of the baseline measures of a hypertension control trial. Of 140 monitored primary care patients, all with uncontrolled office blood pressure, 69 (49%) were on at least three antihypertensives of different classes. Of these 69, 15 (22%) were controlled on ambulatory blood pressure monitoring, 20 (29%) were uncontrolled and non-adherent, leaving only 34 (49%) adherent to their medications and having uncontrolled ambulatory hypertension (uncontrolled RH). Thirty-one (91%) of the 34 uncontrolled RH patients were prescribed a diuretic, of which 24 were on hydrochlorothiazide 25 mg. Less than half of the patients on angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, or calcium channel blocker were prescribed maximal doses of these agents. Half of the RH can be attributed to white coat effect and poor medication adherence, and all of the remaining patients were on apparently suboptimal drug combinations and/or dosages. Primary care physicians need to be educated regarding the optimal treatment of RH.


      PubDate: 2013-07-26T03:15:57Z
       
  • Arterial stiffness evaluation by cardio-ankle vascular index in
           hypertension and diabetes mellitus subjects
    • Abstract: Publication date: Available online 18 July 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Hongyu Wang , Jinbo Liu , Hongwei Zhao , Xiaobao Fu , Guangyun Shang , Yingyan Zhou , Xiaolan Yu , Xujing Zhao , Guang Wang , Hongyan Shi
      Arterial stiffness is an independent predictor for vascular diseases. Cardio-ankle vascular index (CAVI) is a new index of arterial stiffness. In the present study, we investigated the possible risk factors involving CAVI in hypertension and diabetes mellitus (DM) subjects. One thousand sixty-three subjects (M/F 533/530) from Shougang Corporation Examination Center were divided into four groups: healthy group (n = 639); hypertension group (n = 312); DM group (n = 58); and hypertension with DM group (n = 54). CAVI was measured by VS-1000 apparatus. Our results showed that CAVI was significantly higher in hypertension subjects with DM than in healthy and hypertension group, respectively (8.59 ± 1.08 vs 7.23 ± 1.10; 8.59 ± 1.08 vs 7.94 ± 1.33; both P < .05). CAVI was positively correlated with age, systolic blood pressure, diastolic blood pressure, pulse pressure, fasting plasma glucose, HbA1c, uric acid, total cholesterol, triglycerides in the entire group (r = 0.633, 0.280, 0.172, 0.269, 0.209, 0.254, 0.176, 0.129, 0.175; all P < .05, respectively). There was negatively correlation between CAVI and high-density lipoprotein cholesterol in the entire group (r = −0.167; P < .05). Multivariate analysis showed that age, body mass index, HbA1c, and high-density lipoprotein cholesterol were independent associating factors of CAVI in all subjects (β = 0.699; P < .001, β = −0.189; P = .001, β = 0.144; P = .015, β = −0.136; P = .019, respectively). Our present study suggested that CAVI was significantly higher in hypertension subjects with DM compared with healthy and hypertension groups.


      PubDate: 2013-07-22T08:48:16Z
       
  • Prevalence and characteristics of pseudohypertension in patients with
           “resistant hypertension”
    • Abstract: Publication date: Available online 10 July 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Mark Kleman , Susmitha Dhanyamraju , William DiFilippo
      Pseudohypertension has been described as a cause of resistant hypertension, due to medial hypertrophy of the artery from atherosclerosis. This phenomenon results in an elevated cuff pressure compared with intra-arterial measurements and is found primarily in populations with advanced age and atherosclerotic disease. The purpose of this review was to investigate the clinical picture and medical outcomes of patients with this phenomenon. We conducted a retrospective chart review between April 2009 and October 2011 of 244 patients seen in our Hypertension clinic. Baseline characteristics and outcomes of pharmacologic and lifestyle modifications were analyzed. There were 17/244 (7%) patients found to have pseudohypertension among patients enrolled. The mean number of antihypertensive medications decreased from 3.7 to 2.7, following a mean of 4.1 visits. All patients had a brachial artery bruit and triphasic blood pressure readings via Doppler. Our findings suggest that elderly patients with concomitant history of atherosclerotic disease, renal insufficiency, and diabetes mellitus have the highest risk of developing pseudohypertension. This condition should be considered in patients with resistant hypertension. Blood pressure measurement with Doppler can be considered as a noninvasive investigation. Recognition of this entity may result in potential cost reduction with fewer medications prescribed.


      PubDate: 2013-07-14T06:37:28Z
       
  • Reproducibility of blood pressure dipping: relation to day-to-day
           variability in sleep quality
    • Abstract: Publication date: Available online 12 July 2013
      Source:Journal of the American Society of Hypertension
      Author(s): Alan L. Hinderliter , Faye S. Routledge , James A. Blumenthal , Gary Koch , Michael A. Hussey , William K. Wohlgemuth , Andrew Sherwood
      Previous studies of the reproducibility of blood pressure (BP) dipping have yielded inconsistent results. Few have examined factors that may influence day-to-day differences in dipping. Ambulatory BP monitoring was performed on three occasions, approximately 1 week apart, in 115 untreated adult subjects with elevated clinic BPs. The mean ± standard deviation BP dip was 18 ± 7/15 ± 5 mm Hg (sleep/awake BP ratio = 0.87 ± 0.05/0.82 ± 0.06), with a median (interquartile range) day-to-day variation of 5.2 (3.1–8.1)/4.3 (2.8–5.6) mm Hg. There was no decrease in variability with successive measurements. The reproducibility coefficient (5.6 [95% confidence interval, 5.1–6.1] mm Hg) was greater and the intraclass correlation coefficient (0.53 [95% confidence interval, 0.42–0.63]) was smaller for the systolic dip than for 24-hour or awake systolic BPs, suggesting greater day-to-day variability in dipping. Variability in systolic dipping was greater in subjects with higher awake BP, but was not related to age, gender, race, or body mass index. Within individuals, day-to-day variations in dipping were related to variations in the fragmentation index (P < .001), a measure of sleep quality. Although mean 24-hour and awake BPs were relatively stable over repeated monitoring days, our study confirms substantial variability in BP dipping. Day-to-day differences in dipping are related to sleep quality.


      PubDate: 2013-07-14T06:37:28Z
       
 
 
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