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 ...

BACKGROUND: Cardiovascular diseases are the most common cause of mortality in Poland. To improve the situation in this area, a national cardiovascular preventive project is necessary, and it can be done by close cooperation between medical and political agencies. AIM: To present the current epidemiological situation in Poland to political ...

An elevated circulating homocysteine concentration is associated with the risk of cardiovascular disease. The mechanism by which an elevated homocysteine increases cardiovascular risk is unclear but may be mediated in part by elevating blood pressure. It is well established that supplements containing folate, vitamins B-12, and B-6 lower homocysteine concentrations. ...

OBJECTIVES: To evaluate the blood pressure-dependent and independent effects of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) on major cardiovascular events. METHODS: Using data from 26 large-scale trials comparing an ACEI or an ARB with placebo or another drug class, meta-regression analyses were conducted in which treatment-specific relative ...

Hypertensive heart disease (HHD) is a late complication of chronic high blood pressure. Each year HHD claims the lives of more than 20,000 people in the United States. Between 1979 and 2003, 8735 Wisconsin residents died as a direct result of the condition. While annual death rates were relatively stable ...

The benefit of blood pressure-lowering therapy in individuals with normal blood pressure who are at high cardiovascular risk creates a challenge in how best to advocate such therapy. Arguments based on a putative causal role for blood pressure and the need to reduce blood pressure may be less likely to ...

The hypothesis has been advanced that cardiovascular prognosis is related not only to 24-hour mean blood pressure but also to blood pressure variability. Data, however, are inconsistent, and no long-term prognostic study is available. In 2012 individuals randomly selected from the population of Monza (Milan), 24-hour ambulatory blood pressure (Spacelabs ...

The ability to assess and respond to predation risk is a strong selective force. Detection of predators is carried out by one or more sensory modalities, but the use of chemoreception has significant advantages. This study examines the chemosensorial assessment of snake predation risk and corresponding behaviours in different species ...

The Action to Control Cardiovascular Disease in Diabetes (ACCORD) blood pressure trial is an unmasked, open-label, randomized trial with a sample size of 4,733 participants. This report describes the rationale, design, and methods of the blood pressure interventions in ACCORD. Participants eligible for the blood pressure trial are randomized to ...

Data are sparse regarding the actual predictive utility of pulse pressure and other blood pressure measures for cardiovascular events. We included all of the participants from the Chicago Heart Association Detection Project in Industry who were free of cardiovascular disease and not receiving antihypertensive treatment at baseline (1967-1973). Baseline blood ...

To determine whether statin therapy improves survival in patients with heart failure (HF) secondary to nonischemic dilated cardiomyopathy (non-IDC), data from 1,024 patients with non-IDC (New York Heart Association functional class III and IV HF) and left ventricular ejection fraction < or =0.35 who were enrolled in the BEST were ...

There exists a growing body of evidence linking depression with cardiovascular events, although the mechanisms responsible remain unknown. We investigated the role of the autonomic nervous system and inflammation in the link between coronary heart disease and major depressive disorder (MDD), and examined the cardiac risk modification following pharmacological treatment ...

The Asklepios Study is a longitudinal population study focusing on the interplay between ageing, cardiovascular haemodynamics and inflammation in (preclinical) cardiovascular disease. The 2524 participants (1301 women) are a representative cohort of 35-55-year-old individuals, free from overt cardiovascular disease at study initiation, randomly sampled from the twinned Belgian communities of ...

(1) Elevated blood pressure is an independent and progressive cardiovascular risk factor. The risk starts to increase above a threshold of 115/75 mmHg. (2) The threshold values for blood pressure with practical implications for patients' health have been determined from clinical trial results. These are, for example, 160/95 mmHg in ...

AIMS: To determine cardiovascular risk of screen detected subjects with type 2 diabetes (T2DM), impaired glucose tolerance (IGT) and impaired fasting glucose (IFG). To examine whether BMI is an effect modifier regarding the relation between level of glucose regulation and cardiovascular risk factors. METHODS: From 2002 to 2003, 29,251 persons, ...

OBJECTIVE: The plasma amino-terminal-pro-B-type natriuretic peptide (NT-proBNP) level predicted congestive heart failure, myocardial infarction, and ischaemic stroke in participants of the Perindopril Protection Against Recurrent Stroke Study (PROGRESS), a placebo-controlled study of the effects of blood pressure lowering on cardiovascular events among individuals with cerebrovascular disease. Active treatment comprised a ...

This review describes the clinical profile and rationale for the development of a single-pill formulation of the calcium channel blocker amlodipine besylate, a blood-pressure--lowering agent, and atorvastatin calcium, a statin with lipid-lowering antiatherosclerotic properties. Amlodipine and atorvastatin have been demonstrated in numerous clinical trials to be highly effective in lowering ...

With the aging of the population, the incidence and prevalence of cognitive disorders are increasing. Blood pressure plays an important role in the pathogenesis or clinical progression of stroke, vascular dementia, and Alzheimer's disease. Data from different studies reveal that the uses of antihypertensive medications decrease the risk of dementia ...

Clinical and observational studies have recently reported that coffee consumption is associated with cardiac arrhythmia, with increased serum cholesterol, blood pressure and affected heart rate variability, leading to an increased cardiovascular risk. Analysis of these papers shows that these data are controversial and strongly depend on methodology. Recent reports demonstrate ...

BACKGROUND AND PURPOSE: The objective of this study was to estimate the high blood pressure values and the 10-year risk of stroke in the Spanish general population aged 60 years or older using the Framingham scale. METHODS: This was a multicenter, population-based, cross-sectional study performed in Spanish primary care centers. ...

Recently, much interest has focussed on the potential interaction between sympathetic nervous system and global cardiovascular risk. We investigated how baroreflex sensitivity (BRS), an index of autonomic function, interacts with central obesity (CO) in an essential hypertensive (EH) population. We selected 170 EHs and 43 normotensives (NT), (median age 47.3+/-11.3 ...

Hypertension has a range of effects on the eye. Hypertensive retinopathy refers to retinal microvascular signs that develop in response to raised blood pressure. Signs of hypertensive retinopathy are frequently seen in adults 40 years and older, and are predictive of incident stroke, congestive heart failure, and cardiovascular mortality--independently of ...

Hypertension is one of the leading causes of death in developed countries, and the number of prehypertensive patients is increasing. The beneficial effects of moderate wine consumption on cardiovascular diseases have been demonstrated, along with the healthy influence of a Mediterranean dietary pattern. The association of these 2 factors on ...

BACKGROUND: The prognostic value of blood pressure measured during hospitalization after acute myocardial infarction (MI) has not been investigated, particularly with regard to arrhythmic death. METHODS: A total of 3311 placebo patients (2612 men, median age 64 years; range 23-92) from the EMIAT, CAMIAT, SWORD, TRACE and DIAMOND-MI studies with ...

AIM: To investigate the influence of hypertension on morbidity and mortality during rate and rhythm control in patients with persistent atrial fibrillation (AF). METHODS AND RESULTS: In the RAte Control vs. Electrical cardioversion (RACE) study, 522 patients (256 with hypertension) were randomized to rate or rhythm control. The occurrence of ...

Isolated systolic hypertension, an elevation in systolic but not diastolic pressure, is the most prevalent type of hypertension in those aged 50 or over, occurring either de novo or as a development after a long period of systolic-diastolic hypertension with or without treatment. The increase in blood pressure with age ...

Menopause is accompanied by an increased prevalence of hypertension, which may partially explain the corresponding cardiovascular risk observed in postmenopausal women. The relationship between blood pressure and cardiovascular risk is continuous, consistent and independent of other risk factors. There are profound benefits of treating hypertension: antihypertensive therapy has been associated ...

PURPOSE: To analyze patient physiologic alterations (events) and multiple organ failure during intensive care unit (ICU) stay and examine their relationship with ICU mortality. MATERIAL AND METHODS: A total of 17598 consecutive patients were studied for 10 months (1997-1998) in 55 European ICUs (EURICUS-II). Hourly data were collected on critical ...

The present dyadic study examined social control in married couples (n=132) in which one partner had been diagnosed with type 2 diabetes. Social control is defined as a social interaction involving regulation or influence, often in matters of disease prevention and management. The study focused on two spousal control strategies ...

Several studies had assessed the rheological and haemostatic parameters in both sickle cell anaemia(HbSS) and haemoglobin AA(HbAA) subjects. The effect of the heterogeneous state on these parameters has not been fully determined. Our aim was to assess the haemorheological and haemostatic parameters and there relationship to body mass index in ...

BACKGROUND: Hyperuricemia is associated with hypertension, vascular disease and cardiovascular (CV) disease. However, the role of serum uric acid (SUA) level as an independent risk factor for CV and renal morbidity in hypertension remains controversial. Accordingly, we aimed to determine whether SUA levels are independently and specifically associated with coronary ...

It is generally accepted that the increased cardiovascular morbidity and mortality in hypertension are related to target organ damage. Classically, the target organs are heart, brain, and kidneys. This brief report examines whether high arterial pressure may also affect other organs, such as aorta and large arteries. An attempt was ...

Hypertension is a common chronic condition and can lead to an economic burden for society because of the costs of treatment for high blood pressure and most likely also because of disabilities related to hypertension and its co-morbidities. The aim of this study was to investigate to what extent moderate/severe ...

The physiologic link between vascular health and arterial pressure makes it difficult to separate the adverse effects of pressure and vascular functional and structural alterations in determining the adverse complications of hypertension. Since endothelial dysfunction and nitric oxide deficiency are characteristic features of hypertension and of other risk factors for ...

The authors' purpose in this study was to determine whether changes in weather conditions were associated with daily mortality among people aged 65 years and older diagnosed as having congestive heart failure in Montreal, Canada, and who died in the urban area between 1984 and 1993. The authors used a ...

OBJECTIVES: Impaired arterial baroreflex sensitivity (BRS) has been associated with cardiac mortality and non-fatal cardiac arrests after a myocardial infarction. Patients with chronic renal failure (CRF) have a poor prognosis because of cardiovascular diseases, and sudden death is common. The aim of this study was to assess whether BRS or ...

There is a large body of evidence indicating that inflammation plays a crucial role in all steps characterizing the atherosclerotic process. C-Reactive Protein is a circulating marker of inflammation which recently emerged as a powerful independent determinant of cardiovascular events. Hypertension is closely linked to inflammation. Experimental data and results ...

OBJECTIVE: Population blood pressure (PBP) is the average BP shared by all members of a population. In PBP research, the main focus is on the great majority of individuals who are healthy in respect to blood pressure. From previous studies, we know that PBP decreased 2 mmHg during 15 years ...

The development of drugs that selectively inhibit cyclooxygenase-2 (COX-2) demonstrates translational research from bench to bedside based on underlying knowledge of micro-cellular structure and function. However, theoretical concerns about potentially prothrombotic effects of selective COX-2 inhibitors coupled with observations of increased cardiovascular risk have produced significant consternation and lead to ...

INTRODUCTION: Isolated systolic hypertension (ISH) is an important risk factor for cardiovascular events (myocardial infarction and stroke) and premature mortality, particularly in the elderly population. Among this population, it is an even better predictor of morbidity and mortality than diastolic blood pressure (BP). This cooperative survey was promoted by the ...

Arterial stiffness and pulse pressure are important determinants of cardiovascular risk. Patients with hypercholesterolaemia have a higher central pulse pressure and stiffer blood vessels than matched controls, despite similar peripheral blood pressures. These haemodynamic changes may contribute to the increased risk of cardiovascular disease associated with hypercholesterolaemia and their assessment ...

Inflammatory processes are increasingly recognized as important participants in the pathophysiology of hypertension and cardiovascular disease. Angiotensin II may be to a large degree responsible for triggering vascular inflammation by inducing oxidative stress, resulting in up-regulation of inflammatory mediators. Inflammatory markers such as C-reactive protein are increased in the blood ...

Hypertension is a known risk factor for stroke, and thus for vascular dementia. However, recent large observational studies have suggested that high blood pressure may also play a role in Alzheimer's disease. The mechanisms linking hypertension to Alzheimer's disease remain to be elucidated, but white matter lesions seen on cerebral ...

Increased carotid artery intima-media thickness (IMT) is a non-invasive marker of systemic arterial disease. Increased IMT has been associated with atherosclerosis, abnormal arterial mechanics, myocardial infarction, and stroke. Given evidence of a relationship between cardiovascular health and attention-executive-psychomotor functioning, the purpose of this study was to examine IMT in relation ...

BACKGROUND AND PURPOSE: Statins have been shown conclusively to reduce the risk of cardiovascular events in subjects with clinical cardiovascular disease or diabetes aged 65 to 80 years of age. However, few data are available for primary prevention of cardiovascular disease in those aged > or =70 years. SUMMARY OF ...

OBJECTIVE: This systematic review evaluates the evidence on the association between lead exposure and cardiovascular end points in human populations. METHODS: We reviewed all observational studies from database searches and citations regarding lead and cardiovascular end points. RESULTS: A positive association of lead exposure with blood pressure has been identified ...