Our aim was to assess the prognostic significance of nighttime and daytime ambulatory blood pressure and their ratio for mortality and cause-specific cardiovascular events in hypertensive patients without major cardiovascular disease at baseline. We performed a meta-analysis on individual data of 3468 patients from 4 prospective studies performed in Europe. ...

The influence of blood pressure on outcomes after high-risk myocardial infarction is not well characterized. We studied the relationship between blood pressure and the risk of cardiovascular events in 14 703 patients with heart failure, left ventricular systolic dysfunction, or both after acute myocardial infarction in the Valsartan in Myocardial ...

The objective of this study was to investigate the association between blood pressure and disability in older adults. Stroke-free participants in the Charleston Heart Study (n=999, mean age=68.5+/- 0.2 years SE, 57% women, and 39% African Americans) were followed between 1960 and 1993. Functional measures including Nagi's Congruency in Medical ...

RATIONALE: Chronic obstructive pulmonary disease (COPD) is associated with a 2-3-fold increase in the risk of ischaemic heart disease, stroke and sudden death. The mechanisms responsible for this association are not clear and appear to be independent of smoking history. OBJECTIVE: We test the hypothesis that patients with COPD have ...

OBJECTIVE: To perform a meta-analysis on the incidence of cardiovascular events in white-coat hypertension (WCHT), masked and sustained hypertension in comparison with true normotension. METHODS: We searched for individual studies, in which the adjusted relative risk of incident cardiovascular events was assessed in patients with WCHT, masked and sustained hypertension ...

BACKGROUND: Blood pressure control is disappointingly suboptimal in populations. Whether metabolic abnormalities influence blood pressure control is unclear. We evaluated the relationship between metabolic risk factors and blood pressure control in a large population of patients with hypertension. METHODS: From our Hypertension Centre, 4551 subjects (43.4% women; age 51 +/- ...

BACKGROUND: Most blood pressure recordings end with a zero end-digit despite guidelines recommending measurement to the nearest 2 mmHg. The impact of rounding on management of cardiovascular disease (CVD) risk is unknown. AIM: To document the use of rounding to zero end-digit and assess its potential impact on eligibility for ...

BACKGROUND: Blood pressure predicts the risk of cardiovascular disease events in a linear, graded manner. Factors associated with significant short-term increases in blood pressure are not well established. We aimed to identify predictors of a significant increase in blood pressure over a 1-year period among nonhypertensive, community-dwelling adults. METHODS: From ...

BACKGROUND: An association between aircraft noise exposure and hypertension prevalence has been suggested but there are no longitudinal studies of this association. Our aim was to investigate the influence of aircraft noise on the incidence of hypertension. METHODS: A cohort of 2754 men in 4 municipalities around Stockholm Arlanda airport ...

Hypertension is a common condition associated with considerable morbidity and mortality. Antihypertensive drugs reduce the risk of cardiovascular and cerebrovascular events, and may also be associated with reductions in cognitive decline. Eprosartan is an angiotensin II type 1 receptor antagonist with a unique dual mechanism of action that is approved ...

Hypertension (HTN) is a traditional cardiovascular risk factor and is prevalent in end-stage renal disease (ESRD). There are no adequately powered prospective studies that explore the natural history and outcomes of HTN and blood pressure management in ESRD. Observational studies have not uniformly showed a relationship between HTN and mortality ...

Increased blood pressure is a consistent risk factor for the development of atherosclerotic diseases in humans, although the basis for this relationship is unknown. Genetically engineered mice are now commonly used to study mechanisms of atherosclerosis. More recently, blood pressure can be reliably measured in conscious mice using either tail ...

Arterial hypertension is one of the most important preventable causes of death worldwide; therefore, adequate treatment of high blood pressure should be mandatory in each hypertensive patient. Hypertension is now defined on the basis of systolic and diastolic blood pressure levels and classified into stages on the basis of the ...

Correlations between renal and cardiovascular (CV) pathologies in advanced kidney or heart disease are well characterised, but less clearly defined in the early stages. Microalbuminuria, in addition to being an early sign of kidney damage, is often found in patients with essential hypertension, suggesting that it may reflect early vascular ...

The aim of the present study was to investigate the prognostic value, in patients with community-acquired pneumonia (CAP), of procalcitonin (PCT) compared with the established inflammatory markers C-reactive protein (CRP) and leukocyte (WBC) count alone or in combination with the CRB-65 (confusion, respiratory rate >or=30 breaths x min(-1), low blood ...

Invasive species are increasingly becoming a policy priority. This has spurred researchers and managers to try to estimate the risk of invasion. Conceptually, invasions are dependent both on the receiving environment (invasibility) and on the ability to reach these new areas (propagule pressure). However, analyses of risk typically examine only ...

BACKGROUND: Few studies have formally compared the predictive value of the blood pressure at night over and beyond the daytime value. We investigated the prognostic significance of the ambulatory blood pressure during night and day and of the night-to-day blood pressure ratio. METHODS: We did 24-h blood pressure monitoring in ...

OBJECTIVES: To investigate the independent and combined effects of lifestyle changes and statin treatment on soluble markers of atherosclerotic activity. DESIGN: The study was a randomised, 2 x 2 factorial 1 year intervention trial. Participants (n=177) were sedentary, drug-treated, hypertensive men (aged 40-74 years). They were randomised to placebo, lifestyle ...

Prehypertension--blood pressure between 120-139/80-89 mmHg--is a major public health concern. The condition is very prevalent (especially in obese young people), is often associated with other cardiovascular risk factors and independently increases the risk of hypertension and subsequent cardiovascular events. In the general population, prehypertension can be lowered, but not often ...

OBJECTIVES: We tested the hypothesis that renal artery calcium (RAC), a marker of atherosclerotic plaque burden, is also significantly associated with higher blood pressure levels and a diagnosis of hypertension. BACKGROUND: In the nonrenal systemic vasculature, atherosclerotic plaque burden has been shown to be significantly associated with hypertension. METHODS: A ...

Higher blood pressure and body mass index (BMI) are risk factors for heart failure. It is unknown whether the presence of these risk factors in midadulthood affect the future development of heart failure. In the community-based Framingham Heart Study, we examined the associations of antecedent blood pressure and BMI with ...

BACKGROUND: Blood pressure is an important determinant of the risks of macrovascular and microvascular complications of type 2 diabetes, and guidelines recommend intensive lowering of blood pressure for diabetic patients with hypertension. We assessed the effects of the routine administration of an angiotensin converting enzyme (ACE) inhibitor-diuretic combination on serious ...

Cardiovascular risk factors such as hypertension and diabetes are known to initiate a chain of events that include oxidative stress, endothelial dysfunction, and vascular remodelling, and that if left to progress unchecked, will eventually culminate in end-stage cardiovascular disease. Perindopril is a long-acting lipophilic inhibitor of tissue angiotensin-converting enzyme (ACE) ...

BACKGROUND: The interpretation of serial electrocardiographic (ECG) changes in hypertensive subjects is uncertain. We tested the hypothesis that serial changes in repolarization and voltage are independent determinants of outcome. METHODS: The Hypertrophy at ECG And its Regression during Treatment (HEART) Survey was a prospective observational study performed at 61 centers. ...

BACKGROUND: There is significant evidence showing that microalbuminuria and arterial compliance are sensitive markers for early cardiovascular diseases. However, whether microalbuminuria is associated with reduced arterial compliance in Chinese metabolic syndrome (MS) patients remains unknown. METHODS: According to the definition of MS proposed by ATPIII in 2001, USA, subjects (n ...

Essential hypertension can be defined as a rise in blood pressure of unknown cause that increases risk for cerebral, cardiac, and renal events. In industrialised countries, the risk of becoming hypertensive (blood pressure >140/90 mm Hg) during a lifetime exceeds 90%. Essential hypertension usually clusters with other cardiovascular risk factors ...

Increased aortic stiffness and retinal arteriolar narrowing are subclinical vascular effects of chronic hypertension and predict future cardiovascular events. The relationship between these 2 vascular measures is uncertain and is examined in the Multi-Ethnic Study of Atherosclerosis. This cross-sectional analysis involves 3425 participants (aged 45 to 85 years) free of ...

BACKGROUND: Khush Dil was set up in Edinburgh in 2002 to manage cardiovascular risk factors in South Asians. We assessed its impact in an in-service evaluation. METHODS: Between June 2002 and July 2004, 304 South Asians attended health visitor led screening clinics. Measurements included self-report, anthropometry, blood pressure and blood ...

Hypertension is rare in the young, but its prevalence increases with aging. Currently, about 25% of the population has hypertension and this is expected to increase to up to about 29% in 2025. The overall risk of the hypertensive patient depends not only on blood pressure but also on the ...

OBJECTIVE: Although home blood pressure (HBP) is being used increasingly in clinical practice, the evidence on its prognostic value is still limited. This study in the general population investigated the value of HBP compared to office measurements (OBP) in predicting cardiovascular risk. SUBJECTS AND METHODS: In 1997 all adults of ...

Hypertension is associated with an increased risk of stroke and atherosclerosis. In addition to elevated blood pressure, hypertension is characterized by neuroendocrine and immune activation, including elevated levels of C-reactive protein, inflammatory cytokines, and soluble adhesion molecules, which are predictive of morbidity and mortality outcomes. Pharmacological treatment for hypertension reduces ...

The purpose of this study was to determine the relationship between hypertension and onset of cardiovascular disease in Japan. As part of an ongoing epidemiological survey of cardiovascular diseases in Hokkaido, Japan, 1,798 subjects (806 males and 992 females; mean age in the initial year of the survey, 58.6+/-11.8 years) ...

OBJECTIVE: To investigate the multivariate-adjusted predictive value of systolic and diastolic blood pressures on conventional (CBP) and daytime (10-20 h) ambulatory (ABP) measurement. METHODS: We randomly recruited 7,030 subjects (mean age 56.2 years; 44.8% women) from populations in Belgium, Denmark, Japan and Sweden. We constructed the International Database on Ambulatory ...

OBJECTIVE: Current hypertension guidelines stress the importance to assess total cardiovascular risk but do not describe precisely how to use ambulatory blood pressures in the cardiovascular risk stratification. METHOD: We calculated here global cardiovascular risk according to 2003 European Society of Hypertension/European Society of Cardiology guidelines in 127 patients in ...

OBJECTIVE: The risk of arterial hypertension and subsequent cardiovascular disease morbidity and mortality increases with low socio-economic status (SES). Even small differences in blood pressure, whether untreated or despite treatment, account for this substantial difference. Most of the increased risk in the low socio-economic group is due to traditional cardiovascular ...

In acute heart failure syndromes (AHFS), the prognostic value of left ventricular ejection fraction (LVEF), although widely accepted, has been recently challenged. In contrast, blood pressure is increasingly gaining ground over LVEF as predictor of mortality. Therefore, it is not clear whether both LVEF and mean arterial pressure (MAP) are ...

African American (AA) adolescents are twice as likely to develop high blood pressure in early adulthood as other groups. Continuous existence of risk factors in adolescents may be precursors to adult cardiovascular changes. The purpose of this study was to describe the prevalence of cardiovascular risk factors in a sample ...

The ultimate goal of antihypertensive therapy is cardiovascular risk reduction. As lowering blood pressure per se reduces risk for myocardial infarction only by 20% - 25%, it is obvious that a better protection is needed. An optimal strategy to reduce risk in hypertensives may include lifestyle modification, promotion of adherence ...

The Intensive/Initial Cardiovascular Examination Regarding Blood Pressure Levels: Evaluation of Risk Groups (ICEBERG) study focused on the impact of high-sensitivity C-reactive protein (hs-CRP) measurement on cardiovascular risk evaluation. The ICEBERG study comprised 2 subprotocols. Each subprotocol had 2 patient profiles: patients previously diagnosed with essential hypertension and under medical treatment ...

AIMS: The Sibutramine Cardiovascular OUTcomes (SCOUT) trial is a randomized, double-blind comparison of sibutramine vs. placebo, in addition to standard care for weight management, in overweight/obese subjects with an increased risk of cardiovascular disease. The study had an initial single-blind, 6-week lead-in period with sibutramine plus weight management. We report ...

BACKGROUND: Only limited data are available for risk factors for intracerebral haemorrhage (ICH) in subjects with established cerebrovascular disease. DESIGN: We performed a nested case-control study of participants of the Perindopril Protection Against Recurrent Stroke Study (PROGRESS). This was a randomized, placebo-controlled trial that established the beneficial effects of blood ...

Acute heart failure syndromes (AHFS) represent the most common discharge diagnosis in patients over age 65 years, with an exceptionally high mortality and readmission rates at 60-90 days. Recent surveys and registries have generated important information concerning the clinical characteristics of patients with AHFS and their prognosis. Most patients with ...

AIMS: The cardiac resynchronization therapy in heart failure trial (CARE-HF) demonstrated that cardiac resynchronization therapy (CRT) reduces morbidity and mortality in patients with heart failure and cardiac dyssynchrony. The aim of this study was to develop a prognostic model to evaluate the relationship between prospectively defined patient characteristics and treatment ...

There is a great need for antihypertensive agents that go beyond blood pressure lowering to treat the underlying pathophysiologic conditions that contribute to cardiovascular disease. However, the results of published outcome studies have been variable because they have investigated patients with complicated, high-risk hypertension. Although this ensures a sufficient number ...

Hypertension has not always been recognized as a harbinger of cardiovascular complications and premature death. Only 70 years ago, hypertension was considered the body's adaptation to sclerotic blood vessel disease and essential to maintain organ perfusion; thus, treatment was regarded as undesirable. Epidemiologic studies have since established a strong linear ...

OBJECTIVE: To provide updated, evidence-based recommendations for the diagnosis and assessment of adults with hypertension. OPTIONS AND OUTCOMES: The diagnosis of hypertension is dependent on the appropriate measurement of blood pressure, the timely assessment of serially elevated readings, the degree of blood pressure elevation, the method of measurement (office, ambulatory, ...

Raised blood pressure is the major cause of death in the world and the second major cause of disability next to childhood malnutrition. Furthermore, the risk of cardiovascular disease starts at as low as 115 mmHg of systolic or 75 mmHg of diastolic pressure, although the conventional cut-off point for hypertension is ...

Clinicians are taught to diagnose and manage disease starting with the question does this patient have disease or not—yes or no. As a consequence, cardiovascular risk factors were viewed historically as being dichotomous. However, over the past decade, there has been a shift towards the concept of total cardiovascular risk ...

Engaged patients with a good knowledge of their own disease are open to prevention and are also active in managing their own disease. However, high blood pressure and other cardiovascular risk factors are frequently viewed not as a disease but merely as one of the trappings of age. As there ...

High blood pressure (HBP) increases the risk for heart disease and stroke, the first and third leading causes of death in the United States, respectively. The association between HBP and cardiovascular disease is independent of other risk factors. Nearly 30% of the U.S. adult population had HBP during 2001-2004, according ...