Resistant hypertension is defined as failure to achieve goal blood pressure (BP) when a patient adheres to the maximum tolerated doses of 3 antihypertensive drugs including a diuretic. Although the exact prevalence of resistant hypertension is currently unknown, indirect evidence from population studies and clinical trials suggests that it is ...

The objective of the study was to evaluate the efficacy of device-guided breathing to lower blood pressure (BP) in hypertensive type II diabetic patients. A randomized controlled trial was carried out in four urban family practice clinics in Israel. Non-insulin-dependent diabetic, hypertensive patients with uncontrolled BP, receiving antihypertensive therapy or ...

OBJECTIVES: Indapamide (IND) and bendroflumethiazide (BDZ) are both widely used in patients with stroke. We compared their effects on arterial blood pressure (BP) and arterial stiffness in a group of patients with stroke. METHODS: In a prospective, randomized, double-blinded study we investigated the effect of 28-day treatment with BDZ (2.5 ...

Torasemide is a high-ceiling loop diuretic frequently used in the treatment of congestive heart failure, renal failure, and hypertension. Low doses of torasemide (2.5 to 5 mg/day) do not elevate 24 h natriuresis, and they constitute effective monotherapy for mild-to-moderate uncomplicated essential hypertension according to results based on clinic blood ...

OBJECTIVES: Despite recommendations from the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7), only 36.8% of patients were at target blood pressure (BP) in 2003 and 2004. The objective of this study was to assess improvements in BP control and treatment patterns ...

The evaluation in real-life settings of services for the follow-up and control of hypertensive patients is a complex intervention, which still needs analysis of the roles, tasks, and resources involved in the basic items: patient, healthcare professional, and the interaction between the two. To evaluate the impact of patient-general practitioner ...

Hypertension is an important modifiable risk factor for cardiovascular disease. Risk is reduced by reduction of blood pressure (BP). The present survey estimated the prevalence of hypertension, awareness, treatment, and BP control in Denmark. BP was measured three times on one occasion in a representative sample (n = 7,767) of ...

Hypertension is present in three of four patients with coronary artery disease (CAD) but remains largely uncontrolled in most patients. Treating hypertension in these patients is complicated by the concern of precipitating coronary ischemia when diastolic blood pressure (DBP) is reduced excessively. However, an emerging body of evidence from recent ...

Blood pressure (BP) control rates and number of antihypertensive medications were compared (average follow-up, 4.9 years) by randomized groups: chlorthalidone, 12.5-25 mg/d (n=15,255), amlodipine 2.5-10 mg/d (n=9048), or lisinopril 10-40 mg/d (n=9054) in a randomized double-blind hypertension trial. Participants were hypertensives aged 55 or older with additional cardiovascular risk factor(s), ...

A large proportion of patients with hypertension need a second drug to reach satisfactory control of blood pressure (BP), but there are few well-designed controlled trials comparing the efficacy of drugs added as a second option. In a double-blind randomized clinical trial, 82 patients with uncontrolled BP, receiving hydrochlorothiazide 25 ...

Insufficient awareness of hypertension guidelines by physicians may be an impediment to achieving adequate blood pressure (BP) control rates in clinical practice. We therefore conducted an open intervention survey among primary care physicians in 1596 centres from 16 countries in four different continents to prospectively assess what is the BP ...

BACKGROUND: A combination of antihypertensive agents of different drug classes in a fixed-dose combination (FDC) may offer advantages in terms of efficacy, tolerability, and treatment compliance. Combination of a calcium channel blocker with an angiotensin-converting enzyme inhibitor may act synergistically to reduce blood pressure (BP). OBJECTIVE: The aim of this ...

The aim of this placebo-controlled, double-blind randomized study was to evaluate the duration of the effect of once-daily administration of irbesartan in patients with essential hypertension. After a placebo run-in baseline period (of 2-4 weeks), 79 patients were randomized to either irbesartan (one 100 mg tablet per day) or placebo, ...

BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery is known to have a significant effect on obesity-related comorbidities such as hypertension curing it in some (50-70%) while improving control in others. Our aim was to observe the changes in blood pressure (BP) in a cohort of 100 patients followed prospectively for ...

The aim of this study was to assess whether the use of 24-h blood pressure (BP) measurement in the management of antihypertensive therapy improves BP in patients with sustained hypertension. Patients with sustained hypertension (office BP > or =140/90 mm Hg, and 24-h systolic BP > or =130/80 mm Hg) ...

To compare the antihypertensive effectiveness of sour tea (ST; Hibiscus sabdariffa) with black tea (BT) infusion in diabetic patients, this double-blind randomized controlled trial was carried out. Sixty diabetic patients with mild hypertension, without taking antihypertensive or antihyperlipidaemic medicines, were recruited in the study. The patients were randomly allocated to ...

Prehypertension, defined by Seventh Joint National Committee (JNC 7) as a blood pressure (BP) 120-139/80-89 mm Hg, was controversial. Approximately 31-37% of US adults are prehypertensive, and approximately 12-14% have BP of 130-139/85-89 mm Hg or ;Stage 2' prehypertension, is associated with approximately 3-fold greater likelihood of developing hypertension and ...

Although the term "prehypertension" has been challenged by some, its use to define people with systolic blood pressure (BP) between 120 and 139 mm Hg and/or diastolic pressures between 80 and 89 mm Hg has gained general acceptance. The category includes as many people as the number who have hypertension, ...

Hypertension frequently coexists with obesity, diabetes, hyperlipidemia, or the metabolic syndrome; their association with cardiovascular disease is well established. The identification and management of these risk factors is an important part of the overall management of hypertensive patients. Because patients in these special populations are more predisposed to target organ ...

The 52-week Therapeutic Arthritis Research and Gastrointestinal Event Trial (TARGET) investigated the gastrointestinal and cardiovascular safety profile of lumiracoxib 400 mg once daily compared with 2 traditional nonsteroidal anti-inflammatory drugs (NSAIDs): ibuprofen 800 mg 3 times daily and naproxen 500 mg twice daily. Data from TARGET were analyzed to examine ...

Resistant hypertension is defined as uncontrolled hypertension despite intensive treatment with at least three antihypertensive agents, one of which ideally should be a diuretic. To determine the efficacy and safety of the selective aldosterone antagonist eplerenone in this population, we studied patients with resistant hypertension (clinic blood pressure [BP] >140 ...

Moderate (grade 2) and severe (grade 3) hypertension are important public health problems associated with high cardiovascular risk. Blood pressure (BP) control becomes more difficult to achieve as hypertension progresses. Therefore, early and effective treatment is essential to prevent hypertensive urgencies and emergencies and reduce cardiovascular risk. Currently, less than ...

The prognostic value of a hypertensive blood pressure (BP) response is still unclear. Therefore, the prognostic value of a hypertensive BP response in patients during single-stage exercise testing for peripheral arterial disease (PAD) on long-term mortality and major adverse cerebrovascular and cardiac events (MACCEs) was investigated. In addition, effects of ...

Attenuation of 24-hour blood pressure (BP) fluctuation, and control of the early morning BP surge, may help to improve cardiovascular outcomes in hypertensive patients. However, studies show that early morning BP is generally poorly controlled even in patients with well-controlled clinic BP. Few antihypertensives are sufficiently long-acting to sustain adequate ...

OBJECTIVE: To compare the effect of ARB and ACE inhibitor on sympathetic activity in 32 hypertensives. DESIGN AND METHODS: After a four-week wash-out period, patients were randomized to four weeks of therapy with enalapril or telmisrtan, with crossover to another drug for another four weeks. Blood pressure (BP), NPY, and ...

BACKGROUND: Goal blood pressure (BP) was defined by the JNC VI and the World Health Organization-International Society of Hypertension (WHO/ISH) as <140 mm Hg systolic and <90 mm Hg diastolic for the general and <130 mm Hg systolic and <85 mm Hg diastolic for special high-risk populations. It is well ...

There are an overwhelming number of clinical trials that show that the main benefits of antihypertensive treatment are associated with blood pressure (BP)-lowering. Even small improvements in BP, or moving from a "prehypertensive" to a "normal" BP state, can have a dramatic effect on the progression of early-stage cardiovascular disease, ...

OBJECTIVE: Most patients with severe hypertension are at high risk for cardiovascular events and require prompt blood pressure (BP)-lowering and combination therapy to achieve BP goals. This study evaluated the therapeutic efficacy and tolerability of initial treatment with the combination of valsartan and hydrochlorothiazide (HCTZ) compared with valsartan monotherapy in ...

BACKGROUND: This study compared the effect of antihypertensive treatment with valsartan or ramipril on atrial fibrillation (AF) recurrence, on P-wave dispersion, (PWD) and on serum procollagen type I carboxy terminal peptide (PIP). METHODS: A total of 369 mild hypertensive (systolic blood pressure (SBP) >140 and/or 90 < diastolic blood pressure ...

BACKGROUND: The role of doxazosin in treatment of hypertension remains controversial. METHODS AND RESULTS: We evaluated the effects on blood pressure (BP) and biochemical parameters of doxazosin GITS (gastrointestinal therapeutic system) as a third-line antihypertensive agent among 10,069 participants in the Anglo-Scandinavian Cardiac Outcomes Trial--Blood Pressure Lowering Arm (ASCOT-BPLA) whose ...

Ambulatory monitoring of the blood pressure (BP) and heart rate allows for the assessment of the 24-hour rate-pressure product (RPP), a close correlate of myocardial oxygen demand, both in the untreated state and while on antihypertensive therapy. To evaluate the clinical effects of metoprolol succinate extended release (ER) tablets (100 ...

Blood pressure (BP) is known to vary by time of day and day of year. Studies differ substantially on the magnitude of the effect and there is doubt whether variation is clinically meaningful. We used more than 2 million BP measurements obtained between 1996 and 2004 from Geisinger Clinic primary ...

The Shiga Microalbuminuria Reduction Trial (SMART) showed the advantage of ARB over CCB beyond the blood pressure (BP)-lowering effect in reducing microalbuminuria. To further assess the impact of BP control or renin-angiotensin system inhibition on microalbuminuria, the SMART patients were re-analyzed. Hypertensive patients with type 2 diabetes and microalbuminuria were ...

The ideal therapy for patients with isolated systolic hypertension remains unclear; diuretics, calcium channel blockers, and angiotensin-converting enzyme (ACE) inhibitors are all used in clinical practice. The aim of this study was to determine whether a fixed-dose ACE inhibitor/diuretic combination would reduce ambulatory blood pressures (BP) and arterial stiffness in ...

The incidence of hypertension continues to increase worldwide and, according to recent estimates, its incidence is approximately 30% of the U.S. population. However, the control of blood pressure (BP) to recommended levels of < 140/90 mmHg for uncomplicated hypertension, recommended in the 7th Report of the Joint National Committee (JNC-7) ...

Intracerebral hemorrhage (ICH) remains the least treatable form of stroke. Despite ongoing attempts to find effective interventions based on the physiopathologic understanding of this disease, evidence-based medical therapies for ICH are limited to recommendations on blood pressure (BP) reduction, intracranial pressure monitoring, osmotherapy with adequate fluid resuscitation, fever and glycemic ...

The study compared valsartan/amlodipine combination with irbesartan/hydrochlorothiazide (HCTZ) combination in very elderly hypertensives. After a 4-week placebo period, 94 hypertensives, aged 75-89 years were randomized to valsartan 160mg/amlodipine 5mg or irbesartan 300mg/HCTZ 12.5mg for 24 weeks according to a prospective, parallel group study. After 4 weeks amlodipine or HCTZ was ...

INTRODUCTION: Admission blood pressure (BP) assessment is a central component of severity assessment for community acquired pneumonia. The aim of this study was to establish which readily available haemodynamic measure on admission is most useful for predicting severity in patients admitted with community acquired pneumonia. METHODS: A prospective observational study ...

Angiotensin-converting enzyme inhibitors combined with higher doses of hydrochlorothiazide (HCT), that is, 25 mg daily, have been recognized as an effective form of antihypertensive therapy. To evaluate the coadministration of 20 mg ramipril with 25 mg HCT, we carried out a randomized, double-blind, controlled trial with two dose schedules of ...

BACKGROUND: The prognostic impact of masked hypertension is not yet completely clear. The aim of this study was to evaluate the prognostic relevance of masked hypertension in subjects with prehypertension. METHODS: The occurrence of fatal and nonfatal cardiovascular events was evaluated in 591 subjects with prehypertension defined as clinic blood ...

BACKGROUND: The prevalence of hypertension in the Middle East is not well defined. We examined the prevalence, awareness, treatment, and control of hypertension in Iran. METHODS: The Survey of Risk Factors of Noncommunicable Diseases was conducted in 2005 and contains a representative sample of the Iranian adult population. Of 70,981 ...

Angiotensin II (Ang II) has been linked to vascular dysfunction and target-organ damage. Blockade of the angiotensin II type 1 receptor (AT(1)) with an angiotensin receptor blocker may reverse vascular pathology independent of blood pressure (BP) lowering. Stage I hypertensive, nondiabetic patients (61% male; age 38 to 67 years) were ...

BACKGROUND: Obstructive Sleep Apnea Syndrome (OSAS) is a risk factor for resistant hypertension. Overnight polysomnography and portable sleep monitors are not generally available and questionnaires may be useful for screening OSAS. In a case-control study, we investigate the association between resistant hypertension and sleep disorders evaluated by the Berlin Questionnaire ...

BACKGROUND: Combined regimen may be superior to monotherapy in blood pressure (BP) control. Since BP control is critically related to cardiovascular mortality and morbidity in hypertensive patients, this study aimed to evaluate the efficacy and safety of a low-dose combined regimen of preterax compared with cilazapril monotherapy for better BP ...

OBJECTIVES: To assess the efficacy of once daily dose generic Felodipine ER, Feloten in terms of BP lowering as assessed by office BP measurement (OBPM) and Home BP monitoring (HBPM) MATERIAL AND METHOD: Mild and moderate hypertensive patients (n = 60) were enrolled by primary care physicians. After a 2 ...

Few studies have examined predictors of poor blood pressure (BP) control. The aim of this study was to observe the relationship between the pulsatility of brachial artery pressure characterized as pulse pressure/diastolic pressure (PP/DP), suggesting aortic input impedance, and poor BP control. We obtained office BP measurements for 94 patients ...

Antihypertensive drugs that block the renin-angiotensin system (angiotensin-converting enzyme inhibitors [ACEIs] or angiotensin receptor blockers) are recommended for patients with chronic kidney disease (CKD). A low blood pressure (BP) goal (BP, <130/80 mm Hg) is also recommended. The objective of this study was to determine the long-term effects of currently ...

BACKGROUND: Some studies have suggested reductions in blood pressure (BP)with statin treatment, particularly in persons with hypertension. Randomized trial evidence is limited. METHODS: We performed a randomized, double-blind, placebo-controlled trial with equal allocation to simvastatin, 20 mg; pravastatin sodium,40 mg; or placebo for 6 months. Nine hundred seventy-three men and ...

Poor control of clinic and 24-h blood pressure (BP) is associated with enhanced risk of all cardiovascular disease events. Certain patient groups including the elderly, African-Americans, and those with hypertension and comorbid disease are difficult to control, as are patients with stage 2 hypertension (systolic BP>or=160 mmHg or diastolic BP>or=100 ...

The role of clinical inertia in the treatment of patients with hypertension was assessed by evaluating health care providers' knowledge, attitudes, and clinical practices regarding hypertension management. A cross-sectional survey was conducted at the Forsyth Medical Group in North Carolina. Participants were physicians (N = 18, 10 sites) and support ...