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A 3-arm, parallel group, randomized clinical trial examines the effect of aromatherapy through inhalation and foot massage on blood pressure and stress response in patients with essential hypertension. Lavender oil reduced blood pressure, heart rate, serum cortisol, and subjective anxiety in hypertensive patients. [ABSTRACT FROM AUTHOR]

A total of 91 people including 47 in the intervention group and 44 in the placebo group were included to a randomized controlled study. It can be asserted that acupressure, applied to the Neiguan (PC 6) acupuncture point in individuals with essential hypertension, provides blood pressure regulation and is effective for management of numerous hypertension-related symptoms. [ABSTRACT FROM AUTHOR]

Objective: The study aims to determine the daily workload and to analyze the content of workload, to describe the service profile of FPs working in primary care in Turkey. Methods: The study design is descriptive and cross-sectional. A total of 28 FPs from 17 different cities were enrolled into the study. Two surveys, one inquiring the demographic properties of FPs participated and a second encounter form with 43 items inquiring all aspects of FPs' workload were filled by the participants. Results: A total of 1,215 visits were reported. The average daily workload of FPs participating was 45.7 ± 16.8 visits. 92.5% of all patients were family physicians' own registered patients while 7.5% of them were guests. A total of 1,610 RFEs were reported. We categorized them as prescription requests (451, 28%), clinical complaints (447, 27.8%), preventive medicine services (436, 27%), administrative reasons (161, %10) and other reasons (115, 7.2%). Essential hypertension and diseases of musculoskeletal system were the most common diagnoses in prescription requests. Sore throat and cough were the top two clinical complaints. Conclusions: FPs are under severe pressure in terms of workload in Turkey. Prescription requests account for an important percentage of this workload. Measures should be taken to lessen this burden. [ABSTRACT FROM AUTHOR]

Background: It is well known that arterial stiffness is associated with hypertension. Recent studies have shown that adiponectin +276 G/T, ACE I/D, AGTR1 A1166C, and eNOS E298D polymorphisms are likely to be risk factors for arterial stiffness. In this study, we aimed to investigate possible associations between these single-nucleotide polymorphisms (SNPs) and essential hypertension in a Turkish population.Methods: The study population consisted of 170 patients who were diagnosed with essential hypertension and 170 sex- and age-matched controls. Genotyping of adiponectin +276 G/T, ACE I/D, AGTR1 A1166C, and eNOS E298D SNPs were performed using real-time polymerase chain reaction and commercially produced kits.Results: The percentage of the adiponectin +276 T allele carriers was significantly higher in the patients with hypertension (33%) than in the controls (25%,p< 0.011). Through multiple logistic regression analysis, the adiponectin +276 T allele carrier was found to be associated with an increased risk of hypertension (TT vs. GG and TG: odds ratio = 3.318,p= 0.014, 95% confidence interval: 1.269–8.678). The genotype distributions or allelic frequencies of ACE I/D, AGTR1 A1166C, and eNOS E298D SNPs did not significantly differ between the patients with hypertension and the controls.Conclusion: The present study demonstrated that the adiponectin +276 G/T SNP is likely to be a risk factor for essential hypertension in a Turkish population. [ABSTRACT FROM AUTHOR]

Objective: To determine the correlation between left ventricular mass index and calcium metabolism in patients with essential hypertension. Study Design: Cross sectional case-control study. Material and Methods: Twenty-seven patients with essential hypertension and 20 healthy individuals were compared with respect to calciotropic hormones, left ventricular mass index (LVMI), and urinary and serum biochemical parameters. The correlations between parathormone, vitamin D, and calcitonin levels and LVMI and blood pressure elevation were determined. Results: The parathormone level was significantly higher (p=0.006) and vitamin D level was significantly lower (p=0.01) in the patient group compared with the control group. However, the two groups were similar in terms of albumin-corrected calcium levels, which were within the normal range (p=0.988). The serum sodium (p=0.014) and urinary calcium (p=0.003) levels and LVMI (p<0.01) were also significantly higher in the patient group. No significant correlations were determined between ambulatory blood pressure and parathormone and vitamin D levels, but a significant correlation was found between LVMI and parathormone level (p=0.06) in hypertensive patients. Conclusion: Essential hypertension alters calcium metabolism, causing calciuresis by hypernatremia. Parathormone release increases to compensate for this, and leads to protein synthesis, which in turn provokes the development of myocardial hypertrophy. [ABSTRACT FROM AUTHOR]

Aim: Nitric oxide (NO) plays a major role in the regulation of vascular tone. Production of NO can be influenced by polymorphisms of the endothelial NO synthase (eNOS) gene, which may be associated with the pathogenesis of essential hypertension (EHT). Therefore, eNOS gene intron 4 a/b variable number of tandem repeats (VNTR) and intron 23 polymorphisms were investigated in patients with EHT living in a central area of Turkey. Materials and methods: The study was performed in 91 patients (34 M, 57 F) with EHT, aged 38-76 years, and 75 age-and sex-matched healthy controls (35 M, 40 F). eNOS gene polymorphisms were detected by polymerase chain reaction method. Results: There was no significant difference between the G-allele frequency of the G10-T polymorphism in intron 23 and intron 4 a/b VNTR polymorphism of the eNOS gene in EHT patients and in the controls. Conclusion: eNOS gene intron 4 a/b VNTR and intron 23 gene polymorphisms were not associated with EHT patients living in a central area of Turkey. Further studies are needed to investigate whether these 2 polymorphisms of the eNOS gene could represent useful genetic markers for indentifying individuals at risk of developing EHT. [ABSTRACT FROM AUTHOR]

G proteins and hypertension: An alternative candidate gene approach. Hypertension affects approximately 20 to 30% of individuals in industrialized countries, and is commonly believed to develop on the basis of both genetic and environmental factors. The identification of genes susceptibile to the most frequent form of hypertension, commonly referred to as “essential” hypertension, is hampered by the fact that blood pressure is a poorly defined phenotype that is modulated by multiple factors, such as gender, race, body mass etc., and that the definition of hypertension depends on a rather arbitrarily chosen cut-off value. Hence, more progress has been made in the identification of genes responsible for rare autosomal dominant forms of hypertension, such as Liddle's disease. This review focuses on an experimental approach that attempts to define candidate genes for essential hypertension using immortalized cells from well characterized normotensive and hypertensive subjects. From the presently available results, one attractive speculation is that an increased intracellular signal transduction caused by an enhanced reactivity of Gi -type G proteins represents a genetically fixed trait that renders affected individuals susceptible to essential hypertension.*. [ABSTRACT FROM AUTHOR]

We aimed to investigate the thiol/disulphide homeostasis in patients with newly diagnosed primary hypertension with a novel and automated method. Blood thiol/disulphide homeostasis, which consists of native thiol/disulphide exchanges, was investigated in 45 patients with primary hypertension and 45 healthy controls. The levels of native thiol, total thiol, and native thiol/total thiol ratio were lower while the disulphide level and disulphide/native thiol and disulphide/total thiol ratios were higher in patients with primary hypertension when compared with those in the control group. Positive correlation was detected between 24-hour systolic and diastolic blood pressure levels and disulphide/native thiol ratio. With reference to the stepwise multiple linear regression model; increase in disulphide/native thiol ratio and log(24-hour urine microalbumin) and decrease in native thiol/total thiol ratio are independent predictors of 24-hour systolic and diastolic blood pressure. This study demonstrated that thiol/disulphide homeostasis was shifted toward disulphide formation in patients with primary hypertension., (Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.)

Human serum paraoxonase 1 (PON1) is carried by high-density lipoprotein in blood circulation and is shown to be effective in preventing oxidized phospholipids carried by low-density lipoprotein particles, thus it acts as an antioxidant. Polymorphism in this gene has been investigated for many metabolic diseases, but it is not thought to be a genetic risk factor for essential hypertension. The aim of this study was to determine whether there was an association between PON1 gene polymorphisms and concentration with essential hypertension. The study population was comprised of 100 patients with essential hypertension and 100 healthy controls. One promoter region [C(-108)T] and two coding region (Q192R and L55M) polymorphisms in the PON1 gene were genotyped in individuals by using the TaqMan assay. Plasma PON1 concentration in all volunteers was also measured spectrophotometrically by the enzyme-linked immunosorbent assay method. The genotype and allele frequencies of the PON1 C(-108)T polymorphism showed significant differences between the essential hypertensive and control groups (CT vs. CC: p<0.001; T allele vs. C allele: p<0.001). There was no significant difference for the PON1 L55M polymorphism between the groups, while the heterozygote genotype of the PON1 Q192R polymorphism showed significant difference (p = 0.03). The PON1 concentration was also found to be significantly lower in hypertensive patients (p < 0.001). Decline in the level of PON1 gene may be one of the main factors in the development of essential hypertension, and the PON1 C(-108)T polymorphism may have a prognostic value in the patients with essential hypertension.

Background: Endothelial dysfunction, which is characterized by an imbalance between relaxing and contracting factors, procoagulant and anticoagulant substances, and between pro-inflammatory mediators, may play a particularly significant role in the pathogenesis of atherosclerosis. Numerous experimental and clinical reports suggest that a high von Willebrand factor (vWF) level reflects endothelial damage or dysfunction. Hypertensive retinopathy (HR) is a condition characterized by a spectrum of retinal vascular signs in people with elevated blood pressure. The pathophysiological mechanism of HR is not completely understood. Elevated blood pressure alone does not fully account for the extent of retinopathy. Endothelial dysfunction and mechanisms known to be involved in vascular lesions may be involved in the pathophysiological mechanism of HR. Therefore, this study was designed to answer the following questions: (i) Do vWf levels change in HR? and (ii) Is there any relation between degree of HR and vWf levels?, Material and Methods: This study included 80 hypertensive patients with HR. Group 1 comprised 40 patients with grade I HR, and group 2 comprised 40 patients with grade II HR. We selected 40 healthy subjects for the control group., Results: Level of vWf in group 2 was significantly higher than in group 1 (p=0.017) and the control group (p<0.001), and it was also higher in group 1 than in the control group (p<0.005). Also, vWf showed positive correlation with degree of HR in the hypertensive group (r=0.284, p=0.009)., Conclusions: Our study suggests that endothelial dysfunction, which is a mechanism known to be involved in vascular lesions, may promote the development of HR.

Introduction: Hypertension is an independent risk factor for cardiovascular disease. It is known that essential hypertension begins at a very early age. Recently, there have been reports of an increase in childhood hypertension, which has been attributed to an increase in the prevalence of childhood obesity. Obesity-dependent or independent asymptomatic hypertension can only be determined by random blood pressure measurements in children., Objective: In this study, we aimed to investigate the prevalence of obesity and asymptomatic hypertension among children living in Bursa, Turkey., Methods: One thousand children living in Nilüfer district and being served by the Fethiye Bulvar Family Health Care Center were enrolled in this study. All seven family physicians working at the centre participated in the study., Results: Eighty-five children (8.5%) were determined to be hypertensive. One hundred and twelve children (11.2%) were obese. Blood pressure and body mass index (BMI) increased with age, with peak prevalence of hypertension at age 12 and of obesity at age 10., Conclusions: The prevalence of obesity and hypertension is high among school-age children in Turkey. Family physicians should consistently perform blood pressure and BMI measurements as a part of well child visits through late childhood.

Aims: Our aim was to evaluate the effects of endothelial nitric oxide synthase (eNOS) E298D polymorphism in obesity variables and essential hypertension (eHT) development risk. The genotype frequencies of E298D polymorphism in eHT patients and non-hypertensive (non-HT) controls (proven to have normal coronaries angiographically) were analyzed for their association with demographic and obesity related data of the eHT patients and controls., Materials and Methods: eNOS gene E298D genotypes were determined with qPCR., Results: The eNOS E298D polymorphism frequencies for 298E/E, 298E/D and 298D/D genotypes were respectively as 41.1%, 44.6%, 14.3% in subjects eHT and 52.8%, 38.9%, 8.3% in the non-HT groups. The combined E298D homozygous polymorphic and heterozygous genotypes were found to have a decreasing effect on serum total-cholesterol levels in comparison to wild-type genotypes in eHT patients but not controls., Conclusions: Our results support the idea that, the eNOS E298D polymorphism, which is not associated with hypertension, may increase the risk of hypertension when associated with high serum total-cholesterol levels., (Copyright © 2013 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Background and Objectives: Increased evidence suggests that apart from patients with increased albumin excretion and decreased glomerular filtration rate (GFR); there are also patients with type 2 diabetes with decreased GFR but without albuminuria. The exact pathophysiologic mechanisms regarding these clinical conditions are not known. We suggest that different blood pressure (BP) levels may be one the factors for these different clinical conditions. However, before labeling BP as a causative factor; one must show whether BP levels are different in these patients. Thus the current study was performed to analyze the relationship between creatinine clearance, microalbuminuria and circadian blood pressure levels in newly diagnosed essential hypertensive and type 2 diabetic patients., Methods: Medical history, physical examination, laboratory analysis and ambulatory blood pressure measurements (ABPMs) were analyzed. 24-h urine specimens were collected to measure creatinine clearance and albumin excretion, Results: In total 216 patients were included which were divided into 4 groups: group 1 composed of 90 patients with normal GFR and without microalbuminuria (MA), group 2 composed of 50 patients with normal GFR and with MA, group 3 composed of 36 patients with decreased GFR and without MA and group 4 composed of 40 patients with both decreased GFR and MA. The ratio of dippers vs. non dippers was not different between group 1, group 2 and group 3 patients. However ratio of dippers was higher in group 1 when compared to group 4 (P: 0.003) and group 4 patients have an odds of 7.678 (CI: 1.657-35.576, P: 0.009) for non-dapping status when compared to patients in group 1., Conclusion: In conclusion, ABPM measurements were highest in patients with both decreased GFR and MA, whereas they are lowest in patients with normal GFR and normal UAE., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Previous studies have shown that the presence of simple renal cysts was related to hypertension. However, the relationship between simple renal cysts and circadian blood pressure was not studied before. Our study population comprised of newly diagnosed patients with essential hypertension. Medical history, physical examination and office blood pressure measurements, laboratory analysis, ambulatory blood pressure measurements, renal ultrasonography, and 24-h urine specimens were collected. In total, the study included 190 patients (male/female ratio 77/113; mean age 50.3 ± 11.3). Overall, 127 (66.8%) patients were dippers and 92 (48.4%) had at least one simple renal cyst. Thirty-five patients had solitary cysts and 57 patients had multiple cysts. Cysts were bilateral in 47 of patients. Most of ambulatory blood pressure recordings were higher in patients with at least one simple cyst when compared to patients without cysts. In multivariate logistic regression analysis, serum uric acid (P: 0.047, OR: 1.287, CI: 1.011-1.658), lower creatinine clearance (P: 0.001, OR: 1.030, CI: 1.012-1.049), presence of diabetes (P: 0.029, OR: 2.451, CI: 1.094-5.491), and presence of at least one cyst in each kidney (P: 0.002, OR: 3.087, CI: 1.533-6.212) were found to be independently related to nocturnal non-dipping. In conclusion, the presence of simple renal cysts is related to higher ambulatory BP and is associated with non-dipping phenomenon in patients with essential hypertension.