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Aim: The study's main objective was to assess patients' adherence towards treatment and daily practices among Hypertension (HT), Diabetes Mellitus (DM) Type II and hypothyroid participants in South India before and after providing counseling and education based on WHO standards. Study Design: The present study is a prospective open-labeled observational study. Place and Duration of the Study: The present study was conducted in Vijayawada, South India for six months. Methodology: A total of 490 participants with Hypertension, Diabetes Mellitus (Type II) and Hypothyroidism were assessed for adherence based on the Morisky medication adherence scale containing 8 points at the starting of the study and 6 months after providing counseling and education. Results: At the initial point of study, only 12% of the Hypertensive group, 17% of Diabetes Mellitus (Type II) and 15% Hypothyroid group have high adherence. Towards the completion of the study, around 41% in the Hypertensive group, 50% of Diabetes Mellitus (Type II) and 60% Hypothyroid group had high adherence. Conclusion: The adherence was low at the initial point of the study among all the three groups. After counseling and education provided through the World Health Organization (WHO) specified criteria, we have seen a good increase in the adherence, measured with the MMAS-8 scale. Greater efforts should be made in educating and counseling the patients suffering from such chronic illnesses to improve their quality of life.

The objective of the study was to evaluate myocardial stiffness in hypertensive patients by measuring the intrinsic velocity propagation (IVP) of the myocardial stretch and to explore the correlation between IVP and cardiac systolic and diastolic functions. Eighty-one hypertensive patients and 53 healthy patients were prospectively enrolled in this study. IVP was measured using high-frame rate tissue Doppler (350-450 frames per second). IVP was significantly higher in hypertensive patients than in the control group (1.53 ± 0.39 m/s vs. 1.40 ± 0.19 m/s, p = 0.031). In the hypertensive group, IVP was significantly higher in patients with electrocardiogram (ECG) strain than in those without ECG strain (1.63 ± 0.46 m/s vs. 1.45 ± 0.32 m/s, p = 0.047). Moreover, IVP exhibited a good correlation with interventricular septal thickness at end-diastole (r = 0.434, p0.001), left ventricular posterior wall thickness at end-diastole (r = 0.439, p0.001), E/A ratio (r = 0.245, p = 0.004) and global longitudinal systolic strain (r = 0.405, p0.001). IVP was significantly higher in hypertensive patients, which indicates elevated myocardial stiffness in this cohort of patients. This novel measurement exhibited great potential for use in clinical practice to assess myocardial stiffness in patients with hypertension non-invasively.

Introduction: Wilms tumor (WT) is the most common form of childhood kidney cancer. Hypertension (HT) is noted in children with WT either at the time of initial presentation or in the post-operative follow-up period. Increased renin secretion could be the probable reason in most of the cases. Objective: The objective of this study was to assess the severity of HT and response to the treatment. Materials and Methods: We retrospectively reviewed all the children who had been treated for WT and presented with HT in the follow-up period. All the children below the age of 18 years with histologically confirmed WT, diagnosed between January 2000 and December 2018 at our hospital, were included in the study. Only patients with a documented diagnosis of HT that required treatment with antihypertensive therapy were included in the hypertensive group. Results: A total of 3 patients (8.57%) developed age-related HT in the follow-up period, needing medications. Amlodipine (calcium channel blocker) was a drug used in all children to control HT. Conclusion: HT is known to occur in children treated for WT at the time of initial diagnosis or during follow-up. Children can be properly managed with the use of medications.

Aim: The cardio-ankle vascular index (CAVI) represents the blood pressure-independent arterial stiffness from the origin of the aorta to the ankle. CAVI0 has been proposed as a variant index. We aimed to clarify the difference between CAVI and CAVI0 among large populations, and to explore reasons of the difference. Methods: The subjects were 5,293 Japanese healthy and 3,338 hypertensive people. Simple and multiple regression analyses were performed using age, sex, body mass index, systolic, and diastolic blood pressure (Pd) as variables. Sub-group analysis was performed by sex and age. The CAVI values with and without adjustment by reference pressure were also compared. Results: CAVI had a positive correlation with Pd, while CAVI0 had a negative correlation with Pd in the healthy population. The CAVI values of the hypertensive group were higher than those of healthy group in both men and women, but the CAVI0 values in women of the hypertensive group in the 30–39 age group was significantly lower than that of the corresponding healthy group. Differences of CAVI values with or without modification using the reference pressure were 1.09% ± 1.38% for the healthy group and 3.68% ± 1.66% for the hypertensive group. Conclusion: CAVI showed the expected values, but CAVI0 showed inexplicable results in the healthy and hypertensive populations. The differences were due to the strong dependency of CAVI0 on Pd. Differences of CAVI values with or without reference pressure were negligible. These results indicate that CAVI obtained by the VaSera system is appropriate, but CAVI0 is not.

The level of N Terminal – Pro Brain Natriuretic Peptide was independently associated with an increased risk of hypertension. This study aimed to determine the difference of NT-proBNP serum levels and the correlation between the levels of NT-proBNP in patients with hypertension stage 1 and stage 2. This research was conducted at RSUP dr. Wahidin Sudirohusodo in August -September 2018. The research was conducted at Dr. Wahidin Sudirohusodo RSUP from August through September 2018. The study used a cross-sectional design with a total of 72 hypertensive patients, who had met the inclusive criteria. NT-proBNP levels were measured using the ELISA (Enzyme-Linked Immunosorbent Assay) method. The collected data is processed using Mann Whitney Different Test and Spearman's rho Correlation Test. The study results indicated that the level of NT-proBNP in the hypertensive patients with stage 2 (172.85 + 316.26) was higher and significantly different (p = 6 years (247.83+361.01) than in the hypertensive group, Peningkatan kadar N Terminal-pro Brain Natriuretic Peptide (NT-proBNP) secara independen terkait dengan peningkatan risiko hipertensi. Penelitian ini bertujuan mengetahui perbedaan kadar NT-proBNP serum dan hubungan kadar NT-proBNP pada penderita Hipertensi Derajat 1 dan Derajat 2. Penelitian ini dilakukan di RSUP dr. Wahidin Sudirohusodo pada bulan Agustus -September 2018. Penelitian ini menggunakan desain cross sectional dengan jumlah pasien Hipertensi sebanyak 72 orang yang memenuhi kriteria inklusi.Kadar NT-proBNP diukur dengan menggunakan metoda ELISA (Enzyme Linked Immunosorbent Assay). Data yang terkumpul diolah dengan uji beda Mann Whithney, Spearman’s rho.Hasil penelitian menunjukan kadar NT-proBNP pada penderita hipertensi derajat 2 (172.85+316.26) lebih tinggi dan berbeda bermakna (p=6 tahun (247.83+361.01) dibandingkan kelompok penderita hipertensi

Objectives This cross-sectional study investigates associations between the FTO rs 17817449 genetic variant, liver enzymes, and hypertension in Slovak midlife women. Methods We assessed 576 Slovak women aged 39 to 65 years. The women were interviewed and examined during their medical examination at local Health Centers and then divided into subgroups according to their blood pressure status; 255 women with hypertension and 321 normotensive. The FTO genetic variant was detected by polymerase chain reaction-restriction fragment length polymorphism. Resultant data was analyzed by linear regression analysis and general linear models to adjust for risk factors associated with gamma-glutamyl transferase levels (GGT), including waist to hip ratio (WHR) and uric acid (UA). Results A significant association between the FTO variant and GGT levels was observed in the hypertensive group after control for confounding covariates, including WHR and UA (p = .004). The predicted GGT level for GT/TT hypertensive carriers is 0.158 μkat/L higher than for GG carriers. Moreover, the two-way analysis of covariance revealed significant interaction between FTO effects and hypertension on logGGT levels (p = .042). Finally, hypertensive women with the T-allele had the highest estimated marginal mean value of logGGT at -0.39 μkat/L while the GG-genotype in both hypertensive and normotensive women had the lowest value at -0.54 μkat/L. Conclusions This study suggests that the FTO (rs17817449) variant is associated with higher serum GGT levels in hypertensive midlife women.

The relationship between urinary dopamine levels and arterial blood pressure was studied in normal, unilaterally nephrectomized, and renal hypertensive male albino rats. Experimental hypertension was produced by a unilateral nephrectomy followed by compression of the contralateral renal artery. The two operations were spaced three weeks apart to allow for recovery. Nine weeks after-the-second operatton; mean systolic blood pressure of the renal hypertensive control group increased to 170 mm Hg. Mean systolic blood pressure of the diethyldithiocarbamate (DDC)-treated renal hypertensive group decreased abruptly after two weeks of treatment and remained at 105 mm Hg throughout the nine week period. Mean systolic blood pressures of the normal and unilaterally nephrectomized group of animals remained between 100-12 5 mm Hg throughout the study. However, in comparisons with control groups, the systolic blood pressures of the DDC-treated unilaterally nephrectomized and normal groups of animals were significantly lower after four or seven weeks of treatment respectively. Urinary dopamine was extracted by adsorption onto alumina, converted to its trihydroxyindole fluorophore and measured spectrofluorimetrically. In comparisons with control groups, urinary dopamine levels (μ.g/24 hr, μg/kg/24 hr) did not differ significantly in either the normal or DDC-treated renal hypertensive group of animals. Mean dopamine levels remained relatively constant throughout the nine week period and varied from 15 to 27 μg/24 hr and 13 to 21 μg/24 hr in the normal and renal hypertensive group of animals respectively. Mean dopamine levels varied from 35 to 45 μg/kg/24 hr and 23 to 26 μg/kg/24 hr in the normal and renal hypertensive groups respectively. After seven weeks of treatment, the mean urinary dopamine levels (μg/24 hr) of the DDC-treated unilaterally nephrectomized group of animals were significantly higher than controls. Mean dopamine levels of the DDCtreated group increased fro m 11 μg/24 hr to 23 μg/24 hr after the seventh week · of treatment. The control group remained relatively constant (15 μg/24 hr) within the same period. Mean body weights of the DDC-treated animals were significantly lower than controls after six, four, and two weeks of treatment in the normal, unilaterally nephrectomized, and renal hypertensive groups respectively. In all groups of drug-treated animals there was a correlation between decreased body weight, decreased amount of functional kidney tissue, and decreased arterial blood pressure. No correlation was found between art~rial blood pressure and urinary dopamine levels.

Background Glucocorticoid is among the most commonly prescribed medicine. Unfortunately, Excess glucocorticoid level leads hypertension in 80–90% patients. Garlic (Allium sativum) has been used since ancient times and even nowadays as a part of popular medicine for various ailments and physiological disorders. Hence this study was undertaken to investigate the antihypertensive activity of allicin in dexamethasone induced hypertension in wistar rats. Methods The animals were randomly divided into four groups comprising of six rats per group. Hypertension was induced by subcutaneous injection of dexamethasone (10 μg/rat/day) in hypertensive rats. Two hypertensive group animals were treated with nicorandil (6 mg/kg/day, po) and allicin (8 mg/kg/day, po) respectively for 8 weeks. While systolic blood pressure (SBP) was measured by the tail-cuff method weekly up to 8 weeks. Results Dexamethasone treatment resulted in significant increase in SBP while allicin treatment significantly decreases the SBP. Thus, this study confirmed that allicin treatment for 8 weeks partially reverse dexamethasone induced hypertension in rats. Allicin treatment also attenuated dexamethasone-induced anorexia and loss of total body weight. Conclusion This result suggests antihypertensive effects of allicin in dexamethasone induced hypertension. However, further studies are needed to explore the detailed mechanism of antihypertensive effect of allicin.

Background Hypertension is a major contributing factor to cardiovascular disease and is a leading cause of death in the world. The association between hepatic enzymes and hypertension has been reported in limited studies and the findings are inconsistent; data from Bangladeshi adults are not available yet. This study was conducted to estimate the prevalence of elevated liver enzymes and evaluate the association of elevated liver enzymes with hypertension in Bangladeshi adults. Methods In this cross-sectional study, 302 blood samples were collected from adult participants and analyzed the serum concentrations of alanine and aspartate aminotransferase (ALT, AST), alkaline phosphatase (ALP), and γ-glutamyltransferase (GGT) and other markers related to hypertension. Hypertension was defined as resting SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg. Associations between elevated liver enzymes and hypertension were evaluated by multinomial logistic regression. Results The mean concentrations of serum ALT, AST and GGT were significantly higher in the hypertensive group compared to the normotensive group (p p p p p p Conclusions The prevalence of elevated liver enzymes was higher in hypertensive individuals. Increased serum ALT and GGT activities were positively associated with hypertension in Bangladeshi adults.

Background Hypertension is the first cause of atrial fibrillation. Its onset is explained by intricate mechanisms such as atrial conduction impairment. The aim of our study was to evaluate atrial conduction by tissue Doppler imaging in hypertensive patients compared to a control group. Methods This is a comparative prospective study performed in the cardiology department of the FSI hospital enrolling 55 patients with hypertension and 55 controls. All of them underwent a complete echocardiography exam with Doppler tissue imaging. We measures inter-atrial and intra-atrial electromechanical delay by Pulsed Tissue Doppler. Results Left ventricular mass and septal thickness were more important in the hypertensive group. Mitral A wave was greater in hypertensive group compared to controls (7.1 cm/s vs. 5.6 cm/s; P Conclusion Atrial conduction time is significantly longer in hypertensive patients. Impairment of atrial conduction may be predictive of atrial fibrillation and should prompt closer follow-up to detect this arrhythmia in these patients.

Arterial hypertension is associated with greater risk of cardiovascular diseases and thrombotic complications, suggesting that hypertension is a prothrombotic state.To investigate the relationship between arterial hypertension and thrombin generation, and between blood pressure level and thrombin generation in hypertensive patients.A total of 165 hypertensive patients and 47 healthy adults controls were include in the study. Thrombin generation was assessed in both groups by the Calibrated Automated Thrombogram (CAT) method. Ambulatory blood pressure monitoring (ABPM) was also performed for all patients in the hypertensive group.Hypertensive patients had significantly higher levels of ETP and peak heights compared to healthy controls; means of ETP 1720.6 ± 267 and 1544.7 ± 302, respectively (P 0.001) and means of peak height were 297.26 ± 48 and, 273 ± 53, respectively (P 0.001). On multivariate linear regression analysis, hypertension remained independently associated with increased ETP (β = 0.185, P = 0.047). Analysis restricted to the hypertensive group with ABPM measurement showed statistically significant correlations between all measures of diastolic blood pressure (DBP) and ETP, and multivariate analysis showed that awake DBP was significantly associated with ETP (β = 0.194 for each 1-mm Hg increase in awake DBP, P = 0.012). Furthermore, hypertensive patients with cardiovascular complications had statistically elevated levels of peak height compared to hypertensive patients without cardiovascular complications.Hypertensive patients possess enhanced thrombin generation compared healthy controls. Diastolic blood pressure level is independently correlated with increased thrombin generation in hypertensive patients. These findings suggest that arterial hypertension is a prothrombotic state.

Dahan da Cunha Nascimento,1,2 Cristiane Rocha da Silva,1 Renato Valduga,1,3 Bruno Saraiva,1 Ivo Vieira de Sousa Neto,4 Amilton Vieira,4 Silvana Schwerz Funghetto,4 Alessandro Oliveira Silva,5 Samuel da Cunha Oliveira,1 Guilherme Borges Pereira,1 Jefrey M Willardson,6 Jonato Prestes11Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília, Brasília, Brazil; 2Centro Universitário do Distrito Federal (UDF), Brasília, Brazil; 3Centro Universitário Unieuro, Brasília, Brazil; 4Universidade de Brasília (UNB), Brasília, Brazil; 5Centro Universitário de Brasília (UNICEUB), Brasília, Brazil; 6Health and Human Performance Department, Rocky Mountain College, Billings, MT, USAPurpose: The purpose of the present study was to identify the variability of blood pressure response to a 10-week resistance training (RT) program in hypertensive and normotensive elderly women.Participants and methods: Twenty-seven untrained hypertensive and 12 normotensive elderly women participated in the present study. A whole-body RT program was performed on two nonconsecutive days per week for 10 weeks. The responsiveness of resting systolic blood pressure (SBP) was determined based on the percent decline between the pre- and post-training time points T1 and T4. The term responders were used to describe subjects who exhibited a percent SBP decline ≥−2.58% and the term nonresponders for subjects who exhibited a percent SBP decline

Background The percentage of undiagnosed prehypertensive and hypertensive women are high in the population of Kazakhstan. Aims Our study assessed biomarkers in prehypertension and hypertension in women. Methods 203 women were divided into 3 groups: “pre-hypertensive” group (n = 30, 46.6 ± 6.2 y.o.) with a systolic blood pressure from 120 to 139 mmHg or/and a diastolic blood pressure from 80 to 89 mm Hg. In the “hypertensive” group the blood pressure was > = 140/90 mmHg (n = 73, 46.6 ± 5.6 y.o.). In the normotensive group the blood pressure was Results The values of brain natriuretic peptide (BNP), creatine kinase-MB (CK MB), and leptin were statistically increased in women depending on their blood pressure. The BNP values in the hypertensive group (Me = 157.9 pg/ml, Q1 = 53.75 pg/ml and Q3 = 229.6 pg/ml) were statistically greater (p = 0.016) than in the normotensive group (Me = 85.14 pg/ml, Q1 = 18.55 pg/ml and Q3 = 113.9 pg/ml). The BNP values in the prehypertension group were greater than in the normotensive group and less than in the hypertensive group (Me = 73.00 pg/ml, Q1 = 35.52 pg/ml and Q3 = 139.4 pg/ml). The CK MB values in the hypertensive group (Me = 3693 pg/ml, Q1 = 3105 pg/ml and Q3 = 6178 pg/ml) were statistically higher (p = 0.022) than in the normotensive group (Me = 2688 pg/ml, Q1 = 1629 pg/ml and Q3 = 4532 pg/ml). The CK MB values in the prehypertension group were greater than in the normotensive group and less than in the hypertensive group (Me = 2722 pg/ml, Q1 = 1833 pg/ml and Q3 = 5266 pg/ml). In addition, the values of leptin in the hypertensive group (Me = 23910 pg/ml, Q1 = 14510 pg/ml and Q3 = 54824 pg/ml) were statistically greater (p = 0.001) than in the normotensive group (Me = 18256 pg/ml, Q1 = 9287 pg/ml and Q3 = 34843 pg/ml). The leptin values in the prehypertension group were: Me = 26424 pg/ml, Q1 = 10514 pg/ml and Q3 = 53060 pg/ml. Conclusion In hypertensive women, serum BNP, CK-MB and leptin levels were significantly different from the same parameters in control women. Pre-hypertensive patients were in-between the normotensive and the hypertensive groups. However, biomarkers were not statistically different in women with prehypertension and those from the two other groups. Thus, patients with pre-hypertension cannot longer be attributed to healthy individuals although, they have not yet pronounced clinical and laboratory signs of arterial hypertension, the mechanisms of arterial hypertension are already running. Our results showed that there is need to develop recommendations for the identification and monitoring of patients with pre-hypertension in order to prevent the development of irreversible cardiovascular alterations.

Though it is long known that irregular intake of antihypertensive may cause harm, but still there is much lack of awareness among the patients in this matter. This case controlled study was done in Dhaka Medical College Hospital, Dhaka, to determine the relationship between discontinuation of antihypertensive drugs and the risk of stroke among hypertensive patients. Number of cases was 72. Control group was selected via random sampling of stroke free treated hypertensive group, similar in age to stroke cases. Sampling technique was random systematic sampling. The relationship was determined employing statistical methods including Chi-square (?2) test using computer programs, and significant association between discontinuation of antihypertensive and development of stroke in hypertensive adult patients was found ?2(1,N= 103) = 32.637, p

Background: Exercise training may reduce blood pressure. Aim: To determine the effects of a high intensity interval training (HIIT) exercise protocol on systolic and diastolic blood pressure in hypertensive subjects. Material and methods: Eleven men and 27 women aged 46.4 ± 9.8 years old were divided in two groups according to their blood pressure. Sixteen were classified as normotensive and 22 as hypertensive. All attended an exercise program with 3 sessions per week for a total of 24 sessions. Each session consisted of one minute of intense exercise performed on a stationary bike, followed by an inactive pause lasting two minutes. This cycle was repeated 10 times and it was thus called 1 * 2 * 10. Blood pressure, weight (kg) and body fat were assessed. Results: In the hypertensive group, there was a significant reduction in systolic blood pressure from 145.4 ± 9.0 to 118.3 ± 15.6 mm Hg (p

This study aimed to compare within-subject blood pressure (BP) variabilities from different measurement techniques. Cuff pressures from three repeated BP measurements were obtained from 30 normotensive and 30 hypertensive subjects. Automatic BPs were determined from the pulses with normalised peak amplitude larger than a threshold (0.5 for SBP, 0.7 for DBP, and 1.0 for MAP). They were also determined from cuff pressures associated with the above thresholds on a fitted curve polynomial curve of the oscillometric pulse peaks. Finally, the standard deviation (SD) of three repeats and its coefficient of variability (CV) were compared between the two automatic techniques. For the normotensive group, polynomial curve fitting significantly reduced SD of repeats from 3.6 to 2.5 mmHg for SBP and from 3.7 to 2.1 mmHg for MAP and reduced CV from 3.0% to 2.2% for SBP and from 4.3% to 2.4% for MAP (all P<0.01). For the hypertensive group, SD of repeats decreased from 6.5 to 5.5 mmHg for SBP and from 6.7 to 4.2 mmHg for MAP, and CV decreased from 4.2% to 3.6% for SBP and from 5.8% to 3.8% for MAP (all P<0.05). In conclusion, polynomial curve fitting of oscillometric pulses had the ability to reduce automatic BP measurement variability.

Background Hypertension is the first cause of atrial fibrillation. Its onset is explained by intricate mechanisms such as atrial conduction impairment. The aim of our study was to evaluate atrial conduction by tissue Doppler imaging in hypertensive patients compared to a control group. Methods This is a comparative prospective study performed in the cardiology department of the FSI hospital enrolling 55 patients with hypertension and 55 controls. All of them underwent a complete echocardiography exam with Doppler tissue imaging. We measured inter-atrial and intra-atrial electromechanical delay by Pulsed Tissue Doppler. Results Left ventricular mass and septal thickness were more important in the hypertensive group. Mitral A wave was greater in hypertensive group compared to controls (7.1 cm/s vs. 5.6 cm/s; P Conclusion Atrial conduction time is significantly longer in hypertensive patients. Impairment of atrial conduction may be predictive of atrial fibrillation and should prompt closer follow-up to detect this arrhythmia in these patients.

The aim of this study was to evaluate the effect of two models of hypertension on serum ADMA concentrations and whether the changes of serum ADMA concentrations are reversible by removing the cause of hypertension. Materials and Methods. 48 male wistar rats were randomly assigned into four groups: control, deoxycorticosterone acetate salt (DOCA-Salt), sham, and two kidneys one clip (2K1C). After 12 weeks, in half of the animals (n=6 each group), serums were taken and direct blood pressure was measured. Then, DOCA injection was withdrawn and the animals received tap water and, in 2K1C group, renal clips were removed. After 12 weeks, direct blood pressure was measured and blood samples were taken. Results. Serum ADMA concentration in DOCA-Salt group was slightly higher than control, although it was not statistically significant. In 2K1C hypertensive group, serum ADMA concentration was significantly elevated compared to sham group (P<0.05). Unclipping and reversal of hypertension returned serum ADMA level to sham group. There was a weak positive correlation between systolic blood pressure and serum ADMA concentration. Conclusion. increased serum ADMA concentration during hypertension is dependent on the model of hypertension, and removing the cause of hypertension could reduce it

Summary Introduction The aim of this study was to evaluate the impact of different visceral fat (VF) and blood pressure (BP) levels on changes in blood flow velocity (BFV) among non-obese subjects, using a cross-sectional study approach. Methods A total of 110 putatively healthy and non-obese subjects were divided into three groups according to their level of VF and BP. Common carotid artery BFV was measured using a developed portable Doppler ultrasound measurement system. Results The most pronounced peak systolic velocity (S1) was lower (p < 0.05) in the hypertensive group and the peak diastolic velocity (D) was significantly lower in the pre-hypertensive group than in the normotensive group. There were differences in velocity reflection and resistive indices between the hypertensive and other two BP groups. The higher VF group had significantly lower S1 and D velocities and resistive and vascular elasticity indices. By contrast, the velocity reflection index was larger in the higher VF group. Conclusion We confirmed that there were significant differences in the BFV among non-obese subjects who differed in level of VF and BP. This study confirms that a putatively increasing VF and BP level is associated with the development of hypertension.

Whether there is any particular role of hypertension in remodeling process has not been completely understood yet. The aim of this study was to assess the association between hypertension and remodeling patterns in normal or minimally atherosclerotic coronary arteries. Seventy-nine patients who were free of significant coronary atherosclerosis were divided into two groups according to the absence (n = 39) or presence (n = 40) of hypertension; and standard intravascular ultrasound examination was performed in 145 segments. To determine the remodeling pattern in early atherosclerotic process, patients were also analyzed according to the level of plaque burden at the lesion site after the analysis of remodeling patterns. Positive remodeling was more prevalent in the hypertensive group (52.5% vs. 12.8%; P.001) whereas negative remodeling was more common in diabetic patients (53.6% vs. 27.4%; P = .03). Mean remodeling index was 1.04 for hypertensives and 0.96 for normotensives (P = .03). There were no correlations between remodeling patterns and other risk factors such as age, family history, and hypercholesterolemia. Early atherosclerotic lesions (30%) exhibited more negative remodeling characteristics while intermediate pattern was observed more frequently in patients with high plaque burden (P = .006 and .02, respectively). Positive remodeling showed no association in this context (P = .07). This study demonstrated that minimal atherosclerotic lesions in hypertensives had a tendency for compensatory arterial enlargement. Positive remodeling may result from local adaptive processes within vessel wall or hemodynamic effects of blood pressure itself.

Understanding the mechanical behavior of proximal pulmonary arteries (PAs) is crucial to evaluating pulmonary vascular function and right ventricular afterload. Early and current efforts focus on these arteries’ histological changes, in vivo pressure–diameter behavior and mechanical properties under in vitro mechanical testing. However, the in vivo stretch and stress states remain poorly characterized. To further understand the mechanical behavior of the proximal PAs under physiological conditions, this study computed the residual stretch and the in vivo circumferential stretch state in the main pulmonary arteries in both control and hypertensive calves by using in vitro and in vivo artery geometry data, and modeled the impact of residual stretch and arterial remodeling on the in vivo circumferential stretch distribution and collagen engagement in the main pulmonary artery. We found that the in vivo circumferential stretch distribution in both groups was nonuniform across the vessel wall with the largest stretch at the outer wall, suggesting that collagen at the outer wall would engage first. It was also found that the circumferential stretch was more uniform in the hypertensive group, partially due to arterial remodeling that occurred during their hypoxic treatment, and that their onset of collagen engagement occurred at a higher pressure. It is concluded that the residual stretch and arterial remodeling have strong impact on the in vivo stretch state and the collagen engagement and thus the mechanical behavior of the main pulmonary artery in calves.

Epicardial fat has been proposed as a new cardiometabolic risk factor. Although epicardial fat thickness (EFT) is associated with hypertension, the relationship between diurnal blood pressure profiles and EFT is still unknown. The purpose of this study is to investigate the association between the echocardiographic EFT and diurnal blood pressure profiles in hypertensive patients.After the ambulatory blood pressures of 123 patients were monitored, they were divided into three groups according to the clinical diagnoses: 41 patients (33.3%) were in the normotensive group, 40 patients (32.5%) were in the dipper hypertensive group and 42 patients (34.1%) were in the non-dipper hypertensive group. All participants underwent transthoracic echocardiography and ambulatory blood pressure monitoring to measure the EFT and blood pressure responses.The mean EFT measurements of the dipper group were significantly higher than the normotensive group (6.5 ± 0.6 vs 5.8 ± 0.6; p0.0001). On the other hand, the mean EFTs of the non-dipper group were also significantly higher than the dipper group (7.4 ± 0.7 vs 6.5 ± 0.6, p0.0001). An EFT of ≥ 7 mm predicted the non-dipper profile in hypertensive patients with 74% sensitivity and 71% specificity (receiving operator characteristic area under the curve: 0.826, 95% CI 0.738-0.913; p0.0001). EFT was associated with both dipper (OR 8.9, 95% CI 3.03-26.3; p0.0001) and non-dipper blood pressure profiles (OR 12.3, 95% CI 1.75-86.31; p0.0001), and this relationship was also independent from all the risk factors.Echocardiographic EFT assessment is independently associated with impaired diurnal blood pressure profiles in the hypertensive individuals. Thus, the echocardiographic assessment of the EFT may be helpful in cardiometabolic risk stratification and therapeutic interventions.

The study reveals the possibility of dividing the patients with cardiovascular diseases in two groups regarding the psychological background. We have studied one group of 104 patients with hypertension and one group of 80 patients with myocardial infarction.They were given two questionnaires to complete:1. The Jenkins questionnaire (for A behavioral type)2. The Anger-in questionnaire (for anger-in behavioral type)By analyzing all the 184 questionnaires we have noticed that the percentage of the A behavioural type for hypertensive patients is 65,5% and for patients with myocardial infarction is 34,5%. It has been confirmed that the cases with myocardial infarction show major tendencies towards internalization in a percentage of 97,1% (anger-in behavioral type), unlike the hypertensive group (2,9%).

The aim of the study was to analyze changes of systolic and diastolic blood pressure values over five and ten years separately boys and girls and to estimate correlation between them. Three age groups from 8 centers in Serbia were evaluated: Group 1: 10 year old patients, Group 2: 15 year old and Group 3: 20 year old. Group with normal blood pressure values, prehypertensive and hypertensive group were analyzed. Regarding the period of follow-up we analyzed: 10/15 years period-children between 10 and 15 years, 15/20 years period-children between 15 and 20 years, and 10/20 years period-children between 10 and 20 years. Significant increase of diastolic blood pressure was noticed for both genders in 10/15 years period of prehypertensive population, while in hypertensive children, boys showed decline in frequency for systolic and diastolic blood pressure and girls only for diastolic. In 15/20 years period there was significant decrease of prehypertensive and significant increase of hypertensive diastolic blood pressure frequency. In 10/20 years period significant reduction in frequency of prehypertensive systolic blood pressure was noticed, while only hypertensive group of boys showed significant reduction regarding systolic blood pressure frequency. Prehypertensive diastolic and hypertensive systolic blood pressure fluctuations are more related to age.

Objective To determine whether reduction in brain grey matter volume associated with hypertension persisted or was remediated among hypertensive patients newly treated over the course of a year. Methods Forty-one hypertensive patients were assessed over the course of a one-year successful anti-hypertensive treatment. Brain areas identified previously in cross-sectional studies as differing in volume between hypertensive and normotensive individuals were examined with a semi-automated measurement technique (ALP, automated labeling pathway). Volumes of grey matter regions were computed at baseline and after a year of treatment and compared to archival data from normotensive individuals. Results Reductions in regional grey matter volume over the follow-up period were observed despite successful treatment of blood pressure. The comparison group of older, but normotensive individuals showed no significant changes over a year in the regions tested in the treated hypertensive group. Conclusions These novel results suggest that essential hypertension is associated with regional grey matter shrinkage and successful reduction of blood pressure may not completely counter that trend.

Pulse wave velocity (PWV) is an accepted surrogate marker of arterial stiffness and may be a useful tool for assessing cardiovascular risk in hypertensive patients. The authors sought to compare a novel polyvinylidene fluoride (PVDF) piezoelectric-based sensing device for measuring PWV in the arm with a validated SphygmoCor device (AtCor Medical, West Ryde, Australia) in normal and hypertensive patients. They also sought to compare measured PWV in the forearm (brachial-radial PWV [BRPWV]) with values obtained in the carotid-radial segment (carotid-radial PWV [CRPWV]). Under standardized conditions, CRPWV in 108 normotensive patients with both devices was measured. BRPWV was measured with the PVDF device. Identical measurements were made in a group of 82 hypertensive patients before and after optimization of blood pressure control. Mean CRPWV was 8.7 m/s in the normotensive group and 9.4 m/s in the hypertensive group. Mean BRPWV was 9.2 m/s in the normotensive group and 10.3 m/s in the hypertensive group. There was excellent correlation between the 2 devices when comparing individual CRPWV values (normotensive group, R(2) = 0.92; mean bias 0.04 m/s; hypertensive group, R(2) = 0.89, mean bias 0.08 m/s). Correlation was also favorable when measuring changes in CRPWV in hypertensive patients undergoing pharmacotherapy (PVDF -0.52 ± 0.90 m/s vs SphygmoCor -0.53 ± 1.01 m/s; R(2) = 0.81). Measured values for BRPWV were significantly higher than CRPWV values, and this discrepancy was more marked in the hypertensive group. The PVDF piezoelectric device has excellent correlation with the validated SphygmoCor device when measuring PWV. This novel device may have an important role in patients with conditions such as hypertension.

OBJECTIVES By altering JNC-7 definition of hypertension as per our modified definition, we tried to find out the difference in prevalence of hypertension. Our modified definition is 1 mmHg less than JNC-7 criteria. METHODS We did the analysis of data collected in Belgaum Hypertension Prevalence Study conducted by KLE University Belgaum; to know the difference between the JNC-7 classified group and modified classification what we thought can change the hypertension statistics. RESULTS According to JNC-7, only 16.3% population in our study were in normal group while 41.1% had come in pre-hypertension group and 42.6% were in hypertensive group. According to our proposed modified definition, nearly double the populations i.e. 37.4% were in normal group, 40.2% remained in pre-hypertension group and only 22.4% were in hypertension group. CONCLUSION This statistics significantly altered prevalence of hypertension from 42.6% to 22.4% indicating that by making 1 mmHg alteration in number, the prevalence could be brought down by 20.2%. This simple alteration of figure by 1 mmHg can put more than 20% of people in normal group as compared to pre-hypertensive group of JNC-7, thereby reducing the agony and psychological torture.

We sought to compare left ventricular deformation in subjects with white-coat hypertension to normotensive and sustained hypertensive patients. This cross-sectional study included 139 untreated subjects who underwent 24-hour ambulatory blood pressure monitoring and completed 2- and 3-dimensional examination. Two-dimensional left ventricular multilayer strain analysis was also performed. White-coat hypertension was diagnosed if clinical blood pressure was elevated and 24-hour blood pressure was normal. Our results showed that left ventricular longitudinal and circumferential strains gradually decreased from normotensive controls across subjects with white-coat hypertension to sustained hypertensive group. Two- and 3-dimensional left ventricular radial strain, as well as 3-dimensional area strain, was not different between groups. Two-dimensional left ventricular longitudinal and circumferential strains of subendocardial and mid-myocardial layers gradually decreased from normotensive control to sustained hypertensive group. Longitudinal and circumferential strains of subepicardial layer did not differ between the observed groups. We concluded that white-coat hypertension significantly affects left ventricular deformation assessed by 2-dimensional traditional strain, multilayer strain, and 3-dimensional strain.

BACKGROUND The aim of this study was to determine the plasmatic levels matrix metalloproteinases (MMPs): MMP-2, MMP-3, MMP-9, and their inhibitors (TIMPs): TIMP-1 and TIMP-2 in hypertensive patients and healthy subjects. METHODS The study involved 60 hypertensive patients and 61 adult healthy controls. Pro-MMP-9 and pro-MMP-2 activity was determined by the gelatin zymography method and MMP-3, TIMP-1, and TIMP-2 levels were determined by ELISA method. RESULTS The mean plasma activity of pro-MMP-9 in the hypertensive group and the control group were significantly different (153.33 ± 129.33 vs. 90.38 ± 97.49 x 10(3) densitometric units/μL; p < 0.01). MMP-3 plasmatic level was significantly higher in hypertensive subjects than healthy subjects (20.24 ± 8.63 vs. 16.41 ± 6.8 ng/mL; p < 0.05), whereas the plasma concentration of TIMP-1 in the hypertensive group was lower than the control group 88.96 ± 26.9 vs. 93.96 ± 27.28 ng/mL. The MMP-3/ TIMP-1 and the MMP-3/TMP-2 ratios were higher in hypertensive subjects than healthy subjects. Also, we have found a significant positive correlation between systolic blood pressure and pro-MMP-9 (r = 0.311, p < 0.001). CONCLUSIONS The present study identified the existence of abnormalities in plasma markers for extracellular matrix metabolism in hypertensive patients.

The aim of this paper is to analyze the autonomic behavior mediated by the baroreceptor response to an orthostatic maneuver (OM) in hypertensive and non-hypertensive subjects. The heart rate (HR) was obtained in 65 subjects (32 hypertensive and 33 non-hypertensive) using a frequency meter polar watch, before and after an OM (sudden standing). The R-R intervals were transformed into a heart rate, temporal series, and interpolation was applied due to a lack of heart rate periodicity. Sampling at 10Hz was performed, and a band-pass filter was applied followed by 1 Hz subsampling. The results showed an increase in sympathetic activity in the hypertensive group that did not occur in the non-hypertensive group after the OM (∆%=59.84%, P

Despite normal indices of left-ventricular (LV) chamber function, patients with hypertension are thought to have depressed LV midwall systolic shortening. This study was designed to investigate effects of short-term therapy with cilnidipine on LV midwall fractional shortening (mFS) in Chinese patients with hypertension. Thirty-seven patients with mild to moderate essential hypertension underwent a 2 week placebo run-in period, then received 5-10 mg/day of cilnidipine orally for 8 weeks. At the end of the placebo period and treatment, patients were examined by echocardiogram, measuring and calculating LV ejection fraction (EF), LV endocardial fraction shortening (eFS), and LV mFS. Compared with the normotensive group, the hypertensive group had a significantly higher eFS (P0.05) and EF (P0.01), both at the end of the placebo period and at 8 weeks; mFS of patients with hypertension was lower at the end of the placebo period (P0.05), but at the end of 8 weeks mFS was not different than that of the control group (P = 0.963). After cilnidipine treatment, EF and eFS did not change (P0.05); however, absolute mFS and corrected mFS were increased significantly (P0.01). Moreover, changes of mFS showed no correlation with changes of blood pressure (P0.05). Midwall fractional shortening is more reliable and sensitive than conventional systolic function measures in assessment of systolic function; cilnidipine can improve left-ventricular systolic function (mFS) independently of blood pressure changes in Chinese patients who have hypertension.

Background: Scientific data about the effects of positive airwaypressure (PAP) treatment on blood pressure (BP) control are continuously increasing; however they are controversial. Aims: We aimed to determine the long term effects of compliance with PAP therapy on BP in both hypertensive and normotensive patientswith OSAHS. Methods: One thousand one hundred sixty eight consecutive patients with newly diagnosed OSAHS, who have been recommended PAP therapy, were followed up for a minimum of 2 years. Patients with previous cardiovascular disease were excluded. BP was measured at baseline and after 2 years of PAP treatment. In addition, the correlation between the changes in BP with different levels of PAP compliance was assessed. Results: At the end ofthe follow-up period, in the hypertensive group of patients (n=586), a significant decrease was shown in systolic (-11.2 mm Hg, p r =0.14, p=0.002 and r=0.1, p=0.025, respectively) was observed in the whole group of patients. Conclusions: Long-term use of PAP treatment as well as increased hours of PAP use showed significant reductions in BP not only in patients with OSAHS and hypertension, but also in normotensive patients. Therefore a significant potential reduction in cardiovascular mortality and morbidity should be expected in these patients.

Objectives: To evaluate the influences of coronary artery by-pass surgery(CABS) on sexual function(SF) and the comorbidities on the impact of CABS on SF. Methods: The data of 112 patients who underwent CABS and interviewed by full form of IIEF questionnaire before and 6 months after CABS were retrospectively evaluated. We specifically analyzed and compared the preoperative and postoperative(PAP) IIEF questionnaire(IQ) results to determine the influences of CABS on SF. Furthermore, we separately analyzed the same PAP data in diabetic, hypertensive and both diabetic and hypertensive subgroups and compared the data in each group to find possible influences of the comorbidities on the impact of CABS on SF. Results: The mean age was 61,7±9,1. The number of patients without erectile dysfunction(ED) increased from 3(%2.6) to 7(%6.2), with severe and moderate ED decreased from 85(%75.9) to 33(%29.4), with mild ED increased from 24(%21.4) to 72(%64.2) after CABS, which revealed the severity of ED declined in overall and ED completely improved in some patients after CABS. The total IIEF, erectile function(EF), intercourse satisfaction, orgasmic function and sexual desire scores significantly increased after CABS(P=0,000). Although OS(Overall Satisfaction) had an increase, no statistically significant alteration was found(P= 0,04). The SF most improved in both diabetic and hypertensive group, it was least affected in diabetic group. Conclusions: CABS had positive impacts on EF and almost all domains of SF. While the lonely presence of diabetes did not significantly affect the impact of CABS on SF, the SF most improved in both diabetic and hypertensive cases after CABS.

OBJECTIVES The nondipper pattern in hypertension is associated with worse cardiovascular outcomes. In this study, we hypothesized that high copeptin levels could predict nondippers among hypertensive patients and investigated the associations between copeptin levels and nondipper pattern in newly diagnosed hypertensive patients. METHODS Ambulatory blood pressure measurements were obtained and the patients were divided into two groups according to ambulatory blood pressure measurement as nondippers and dippers. Serum copeptin levels were measured in addition to routine laboratory investigations. A total of 76 patients were included in the study. RESULTS The clinical and laboratory characteristics of the two groups were similar. The mean copeptin values were found to be significantly higher in the nondipper hypertensive group [1.66 (1.19-4.01) and 1.35 (1.12-2.09) IU/ml, respectively, P=0.026]. In the correlation analysis, no correlation was found between copeptin levels and daytime diastolic blood pressure, but there were weak positive correlations with daytime systolic, 24 h systolic, and diastolic blood pressure values (r=0.335, P=0.034, r=0.350, P=0.027, r=0.372, P=0.018, respectively). However, there were significant positive correlations between serum copeptin levels and nocturnal systolic and diastolic blood pressure values (r=0.593, P

Central hemodynamics were determined in 202 men including 101 normotensive and 101 permanent essential hypertensive patients of the same age. Cardiac output was identical in the two groups while blood pressure and total peripheral resistance were significantly different. Strong differences between the two groups are revealed by a systematic correlation study: (i) correlations of blood pressure (with respectively heart rate and total blood volume) were significant in the normotensive group but not in the hypertensive group; (ii) correlations of cardiac output (with respectively heart rate and total blood volume) were significant in both groups; (iii) correlations of renal blood flow (with respectively cardiac output and blood pressure) were significant in the hypertensive group but not in the normo tensive group. This study provided evidence that the volume and neural pressure controls are impaired in hypertensive patients while the cardiac output control is maintained and, suggested the existence of adaptive mechanisms involving the kidney in the maintenance of normal cardiac output in permanent essential hypertensive patients.

Background Conflict still exists over whether patients with white-coat hypertension are at increased risk of developing target organ damage compared with normotensive individuals. Methods We studied vascular distensibility in 117 young-to-middle age patients with white-coat hypertension, 174 patients with sustained hypertension, and 51 normotensive controls. To obtain a measure of compliance, a model was used that divides the total systemic compliance into large artery (C 1 ) and small artery (C 2 ) compliance. With this aim, radial arterial pulse waves were recorded with a tonometer sensor array by means of an HDI CR2000 device (Eagan, Minnesota, USA). Moreover, pulse wave velocity and the augmentation index were measured using the Specaway DAT system (St Pauls, Sydney, Australia). Results Patients with sustained hypertension had a greater body mass index than patients with white-coat hypertension (P=0.04) or the normotensive individuals (P=0.01). C 1 and C 2 were decreased in the two hypertensive groups as compared with those in the normotensive group (P=0.0002 and 0.03, respectively, versus sustained hypertension; P=0.00007 and 0.0004, respectively, versus white-coat hypertension). Pulse wave velocity and aortic augmentation index were increased in the white-coat hypertension patients compared with the normotensive individuals (P= 0.02 and 0.004, respectively). Aortic augmentation index (P= 0.008) but not pulse wave velocity was increased in the sustained hypertensive patients compared with that in the normotensive individuals. All indexes of arterial distensibility were similar in the two hypertensive groups. Conclusions Indexes of arterial distensibility are impaired in the white-coat hypertensive group and similar to those in the sustained hypertensive group, indicating that early changes in the arterial wall can occur in white-coat hypertension. This may account for the higher risk of stroke that has been described in this condition.

Aim: To investigate the relationship between breast arterial calcifications (BACs) and systemic hypertension (HT) and diabetes mellitus (DM). Methods: Mammograms and patient records of 2406 women who were screened for breast cancer or had undergone diagnostic mammography were reviewed retrospectively. Mammograms were evaluated for the presence of arterial calcification and results were coded. Patients who had been using insulin or oral hypoglycemic agents were included in the diabetic group; patients who had been using antihypertensive agents were included in the hypertensive group. Diabetes was defined as use of oral hypoglycemic agents or insulin and hypertension was defined as use of anti hypertensive agents. Results: The prevalence of BACs among diabetics (25.4) was higher than among hypertensives (17.6%). The prevalence in the nondiabetic, nonhypertensive (NDNH) group was lowest (7.3%). The prevalence increased with age. BAC was seen almost four times more in diabetic patients and three times more in hypertensive patients than in NDNH controls. Conclusion: BACs are associated with diabetes and hypertension. BAC on a mammogram may indicate unsuspected diabetes or hypertension, especially after 59 years of age. (C) 2004 Elsevier Inc. All rights reserved.

The neural crest origin of the aortopulmonary septum has led us to investigate the septum for a special function, and we designed the present study to assess the alteration, if any, in the dimensions of the aortopulmonary septum in hypertension. The dimensions of the aortopulmonary septum were measured by echocardiography in 36 hypertensive and 36 age- and sex-matched normotensive subjects. Echocardiographic examination included measurement of the cross-sectional area of the aortopulmonary septum with standard two-dimensional views from the parasternal windows. Standardization of this dimension with appropriate cardiac measurements such as aortic and internal left ventricular diameters was also performed to provide growth-independent estimates of septal size. The average area of the septum in the hypertensive group was 2.183±0.391 cm2, significantly lower than that in the normotensive group (2.370±0.415 cm2). There were also significant differences in the area of the aortopulmonary septum between the groups when the values were standardized with internal left ventricular diameters. In conclusion, these data confirm that the aortopulmonary septum is smaller in hypertensive than in normotensive humans. This difference might be the result of a possible function of the aortopulmonary septum in blood pressure regulation. (Hypertens Res 2003; 26: 783-787)

The objective of this study was to determine the normal values and characteristics of 24-h ambulatory blood pressure (ABP) and to describe the ABP level of treated hypertensive subjects in an older Finnish population. ABP was measured in 502 randomly selected subjects aged 64 years or over living in a Finnish municipality (mean age 70 years, range 64-87 years). A total of 211 subjects did not have blood pressure (BP) affecting medication. ABP measurements were taken every 30 min for 24 h, and the day- and night-time periods were diary-based. The results were that in untreated subjects, the average office BP was 134/82 +/- 16/9 (s.d.) mm Hg for men and 140/81 +/- 18/8 mm Hg for women. The 24-h average BP was 120/75 +/- 14/8 mm Hg (95th percentile upper limit 145/93 mm Hg) for men and 125/75 +/- 15/7 (95th = 154/89 mm Hg) for women. The daytime averages were 127/78 +/- 12/7 mm Hg (95th = 154/99 mm Hg) and 131/78 +/- 15/7 mm Hg (95th = 158/91 mm Hg) for men and women, respectively. The ABP daytime value of 130/83 mm Hg corresponded best to the office BP value of 140/90 mm Hg. All BP values were significantly higher in the treated hypertensive group compared to the normotensive group. Night-time BP was markedly lower than daytime BP, and no difference in circadian variability was found between the normotensive and hypertensive subjects. Both office and ambulatory BPs were significantly higher in women than in men. This study provides sex-specific normal values for ABP in a 64 to 87-year-old age group. The normal values of ABP were markedly lower than the office BP values. Hypertensives, even when treated, tended to have elevated values.

Plasma endothelin-1 activity was measured by radioimmunoassay in 24 normotensive non-pregnant women and in 24 normotensive pregnant, 24-aproteinuric hypertensive and 24 pre-eclamptic women. Endothelin-1 activity was increased in the pre-eclamptic group (2.7 +/- 06 pg/ml) compared to the normotensive non-pregnant (1.0 +/- 0.8 pg/ml; P0.0001), normotensive pregnant (1.2 +/- 0.4 pg/ml; P0.0001) group and the aproteinuric hypertensive group (1.4 +/- 0.7 pg/ml; P0.0001). There was no difference in endothelin-1 activity between the normotensive non-pregnant and normotensive pregnant group (1.0 +/- 0.8 vs. 1.2 +/- 0.4 pg/ml; P = 0.3). However, there was a difference between the aproteinuric hypertensive group (1.4 +/- 0.7 pg/ml) and both the normotensive nonpregnant (1.0 +/- 0.8 pg/ml; P0.01) and the normotensive pregnant group (1.2 +/- 0.4 pg/ml; P0.06). The birth weight in the pre-eclamptic group (2.48 +/- 0.61 kg) was significantly lower than that of the normotensive pregnant group (2.85 +/- 0.33 kg; P0.001) and the aproteinuric hypertensive group (2.99 +/- 0.46 kg; P0.001). In addition, there was no difference in birth weight between the normotensive pregnant group and aproteinuric hypertensive group (2.85 +/- 0.33 vs. 2.99 +/- 0.46 kg; P = 0.3). A significant Pearson's correlation of plasma endothelin-l versus birth weight in the pre-eclamptic group was obtained (r = 0.64; P0.0001). Endothelin-1 activity is increased with pre-eclampsia in black African women with pre-eclampsia. The results of our study also suggests an ethnic difference in plasma endothelin-1 activity when compared to result of studies carried out in Caucasian women with hypertensive disorders of pregnancy.

The Pandora Project is a longitudinal database--implemented by general practitioners since June 1997 in the Ravenna area (Italy)--providing information on patients with hypertension. Data from 1,651 patients were followed up for I year in order to investigate the cost of hypertension. Only direct medical costs were considered in the perspective of the National Healthcare System.At enrollment, 552 patients were classified as normotensive, 1,099 as hypertensive. After 1 year, among normotensive group, 352 patients remained normotensive and 200 became hypertensive; among hypertensive group, 323 patients became normotensive and 776 remained hypertensive. The average total cost per patient at follow-up was 779.59 Euros. About 46% of total cost was due to anti-hypertensive therapy, irrespective of the evolution of blood pressure levels registered, whilst other direct costs represented 54% of total patient cost in all cohorts. It is possible that co-morbidities play a significant role in this situation. Patient aged 80-89 years generate higher costs. Even if further investigation is needed on the burden of comorbidity on a per-patient cost of hypertension, this work provides evidence that the average total cost per patient is likely to increase with age and co-morbidities. Key words: cost-of-illness, costs, economics, hypertension.

The effect of preexisting hypertension on living donor nephron number has not been established. In this study, we determined the association between preexisting donor hypertension and glomerular number and volume and assessed the effect of predonation hypertension on postdonation BP, adaptive hyperfiltration, and compensatory glomerular hypertrophy. We enrolled 51 living donors to undergo physiologic, morphometric, and radiologic evaluations before and after kidney donation. To estimate the number of functioning glomeruli (NFG), we divided the whole-kidney ultrafiltration coefficient (Kf) by the single-nephron ultrafiltration coefficient (SNKf). Ten donors were hypertensive before donation. We found that, in donors ages >50 years old, preexisting hypertension was associated with a reduction in NFG. In a comparison of 10 age- and sex-matched hypertensive and normotensive donors, we observed more marked glomerulopenia in hypertensive donors (NFG per kidney, 359,499±128,929 versus 558,239±205,152; P=0.02). Glomerulopenia was associated with a nonsignificant reduction in GFR in the hypertensive group (89±12 versus 95±16 ml/min per 1.73 m(2)). We observed no difference in the corresponding magnitude of postdonation BP, hyperfiltration capacity, or compensatory renocortical hypertrophy between hypertensive and normotensive donors. Nevertheless, we propose that the greater magnitude of glomerulopenia in living kidney donors with preexisting hypertension justifies the need for long-term follow-up studies.

The authors sought to investigate left ventricular (LV) mechanics and heart rate variability (HRV), and their relationship, in untreated hypertensive patients. A total of 63 untreated hypertensive patients and 45 healthy patients were included. All patients underwent 24-hour Holter monitoring and echocardiographic examination (two- and three-dimensional). All parameters of time and frequency domain of HRV were decreased in the hypertensive patients. Two-dimensional LV longitudinal and circumferential deformation was significantly reduced in hypertensive patients. Three-dimensional LV strain in all three directions as well as area strain were reduced in the hypertensive group. In two different models of multivariate regression, two-dimensional LV longitudinal and circumferential strain, as well as three-dimensional LV area strain, remained associated with HRV parameters independently of LV structural and functional parameters. This study showed that LV mechanics and HRV were significantly impaired in untreated hypertensive patients. Two- and three-dimensional echocardiographic LV deformation were independently associated with HRV parameters in the whole study population.

Objective: We sought to compare the end-tidal carbon monoxide breath levels in pregnant women with and without pregnancy-induced hypertension and preeclampsia. Study Design: We prospectively performed end-tidal carbon monoxide measurements corrected for ambient carbon monoxide in nonsmoking women during late gestation (>31 weeks). The study group included 22 women with pregnancy-induced hypertension or symptoms of preeclampsia and a control group of 20 normotensive pregnant women. Results: The carbon monoxide measurements corrected for ambient carbon monoxide (mean ± SD) were significantly lower (P < .01) in the hypertensive group than in the control group (1.17 ± 0.35 vs 1.70 ± 0.54 ppm). The study group had a significantly higher number of low (

Summary Objective The purpose of the present study was to compare the effects of resistance exercise (RE) leading to failure versus not to failure on 24-h blood pressure (BP) and rate-pressure product (RPP) responses in normotensive and hypertensive trained elderly women. Methodology Seven normotensive women and seven women with medically documented hypertension randomly performed three experimental sessions: (i) a non-exercise control session that involved 30 min of seated rest, (ii) whole body RE leading to failure that involved three sets with an eight repetitions maximum (8RM) load and (iii) whole body RE not to failure that involved three sets with 70% of an 8RM load. Systolic BP (SBP), diastolic BP (DBP) and mean BP (MBP) responses during each hour of sleep and awake states were measured. Results Results of all subjects revealed that the RPP was higher (P≤0·05) during afternoon and night hours after the RE session leading to failure versus not to failure and the non-exercise control session. For the hypertensive group during the night hours, SBP remained higher after the RE session not to failure (P = 0·047) versus non-exercise control session. For the normotensive group, DBP remained higher after the RE session leading to failure over the 24-h period (approximately 8 mmHg h−1, P = 0·044) and the period upon awaking (approximately 5 mmHg h−1, P = 0·044) versus the hypertensive group. Conclusions The normotensive elderly women of this pilot study presented a greater cardiovascular response to RE leading to failure, as a consequence of the higher training intensity.

In this study, we examined the sensitivity of two recently developed noninvasive baroreflex measurement techniques to assess baroreflex control in hypertension. We assessed baroreflex sensitivity noninvasively from covariations of systolic pressure and RR interval using spectral analysis and sequence detection. The noninvasive estimates of baroreflex control were compared with estimates derived from phenylephrine-induced increases in systolic pressure and RR interval in normotensive subjects (n=27) and borderline hypertensive subjects (n=15). Baroreflex sensitivity was significantly reduced in the borderline hypertensive group relative to the normotensive group when assessed with the use of either the noninvasive or invasive methods to index baroreflex control. In addition, estimates obtained from the noninvasive methods were significantly correlated with baroreflex sensitivity assessed with the phenylephrine method (spectral: r =.48, P r =.50, P

We investigated the relationship between clinic blood pressure (BP) and ambulatory blood pressure (ABP) in 297 elderly patients who underwent 24 hour ABP monitoring as a non-academic clinical references. Among 107 cases who were normotensive in office BP measurements, 33 cases (30.8%) proved to be hypertensive with more than 140 mmHg in ambulatory systolic BP. Those patients should be referred to as home hypertension or white coat normotension. On the other hand, among 187 patients who were hypertensive in the clinic, 78 cases (41.7%) turned out to be white coat hypertension with an ambulatory daytime systolic BP of less than 140 mmHg. Ambulatory systolic BP in white coat hypertension was comparable with that in the non-hypertensive group although their BP in the clinic was significantly higher than the latter (p < 0.02). Ambulatory systolic BP in the home hypertension group was significantly higher than that in the normotension but was comparable with that in true hypertension. The number of the antihypertensive drugs prescribed in the white coat hypertensive group tended to be greater than that in other groups although that in the home hypertensive group was similar to the other groups. The incidence of cerebro vascular disease in each group was similar.

Previous studies revealed that low calcium intake is related to high prevalence of cardiovascular diseases such as hypertension. However, the relationship between serum calcium and blood pressure was unclear. The prevalence of hypertension is high in China. Thus, the aim of this study was to evaluate the serum calcium level between hypertensive and normotensive groups and to investigate the correlation between serum calcium, blood pressure, and blood lipid parameters. A total of 1,135 adult subjects participated in this study and were divide into two study groups: a hypertensive group (n = 316) who had 140 mmHg or higher in systolic blood pressure (SBP) or 90 mmHg or higher in diastolic blood pressure (DBP) and an age- and sex-matched normotensive group (n = 819, 120 mmHg or less SBP and 80 mmHg or less DBP). Our results indicate a significant trend for men (60 years old or older) in the direction of decreasing blood pressure with increasing serum calcium level, but no trend for women was indicated. In the normotensive group, a significant positive correlation was found between DBP and total cholesterol (P < 0.01) and triglyceride (P < 0.01), Likewise, triglyceride was positively correlated with SBP (P < 0.01). Overall, these data suggest that serum calcium may have an influence in the blood pressure of older male subjects with hypertension and in blood lipid profiles of normotensive subjects.

Elevated percentage of lipid profile in both hypertensive and nonhypertensive groups indicate that there should be active screening for lipid profile in the community. Lower HDL levels and higher LDL levels confirm that subjects should pay more attention on physical activities and food habits. Although other lipid parameters were not significantly higher in hypertensive subjects compared to non-hypertensive subjects, in hypertensive group 60% or more subjects had a higher level of LDL and TC/HDL ratio as mentioned in the table below. Further 60% or more non-hypertensive subjects had higher LDL levels and lower HDL levels.