Stroke is the 4th leading cause of death in the US and a leading cause of disability among adults. Stroke is broadly classified into ischemic and hemorrhagic subtypes. Although the pathogenesis may differ between ischemic and hemorrhagic stroke subtypes, a unifying feature is that hypertension is a major risk factor ...

BACKGROUND: Inflammation is involved in the pathogenesis of hypertension. Hypertensive animals have an increased number of perivascular macrophages in cerebral arteries. Macrophages might be involved in remodeling of the cerebral vasculature. We hypothesized that peripheral macrophage depletion would improve middle cerebral artery (MCA) structure and function in hypertensive rats. METHODS: ...

BACKGROUND AND PURPOSE: On the basis of combined measurements of clinic blood pressure (CBP) and home blood pressure (HBP), blood pressure status can be divided into normotension, white-coat hypertension (WCHT), masked hypertension (MHT), and sustained hypertension (SHT). Despite the clear impact of MHT and SHT on clinical and subclinical arterial ...

Hypertension is thought to contribute to more than 7 million deaths worldwide each year and contributes to the development of atherosclerotic lesions that lead to myocardial infarction and stroke. While lifestyle modifications (diet, exercise, weight loss) and pharmacotherapy have been proven to be effective in the treatment of hypertension, as ...

OBJECTIVE: This study assessed the long-term effect of the eversion technique for carotid endarterectomy (e-CEA) on arterial baroreflex and peripheral chemoreflex function. METHODS: The study included 13 patients who underwent, between 2001 and 2006, bilateral e-CEA and 16 who underwent bilateral standard CEA (s-CEA) to eliminate the complicating effects of ...

BACKGROUND: Biomass fuels are used for cooking in the majority of rural households worldwide. While their use is associated with an increased risk of lung diseases and all-cause mortality, the effects on cardiovascular disease (CVD) are not well characterised. Exposure to biomass fuel smoke has been associated with lung-mediated inflammation ...

Only 20-30% out of the treated hypertensive patients in Europe are achieving blood pressure (BP) control. Among other recognized factors, these poor results could be attributable to the fact that for many doctors it is very difficult to detect which is the predominant hemodynamic cause of the hypertension (hypervolemia, hyperinotropy ...

INTRODUCTION: Patients with idiopathic normal pressure hydrocephalus often show neuropsychiatric symptoms besides the triad of 'classic' symptoms. Memantine has been reported to have positive effects on the neuropsychiatric symptoms of patients with Alzheimer's disease and patients with dementia with Lewy bodies. We administered memantine to a Japanese patient with probable ...

In Nigeria's megacity of Lagos, lifestyles resemble those of developed countries and hypertension is increasingly becoming a problem. Motunrayo Bello reports.

Idiopathic normal pressure hydrocephalus (iNPH) is characterized by gait disturbance, dementia and /or urinary incontinence, dilation of the ventricular system and normal opening cerebrospinal fluid pressure. Shunt surgery is the standard treatment of iNHP. Diversions with programmable valves are recommended, once drainage pressure can be changed. However, well-defined protocols still ...

A subset of hydrocephalic patients in whom shunts are placed at an early age will develop craniocerebral disproportion (CCD), an iatrogenic mismatch between the fixed intracranial volume and the growing brain. The lack of a reliable, reproducible method to diagnose this condition, however, has hampered attempts to treat it appropriately. ...

Carotid artery intima-media thickness (IMT) has emerged as a predictor of cardiovascular events. Home blood pressure (BP) is more closely associated with cardiovascular prognosis than clinic BP. The aim of this study was to compare the progression of carotid IMT with respect to strict and mild control of morning home ...

The importance of systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP), on the incidence of coronary heart disease (CHD) and stroke are known. However, the importance of blood pressure (BP)-age shifts regarding the stroke incidence is not clearly known. The BP changes with the advancement of ...

OBJECTIVE: To measure the carotid intima-media-thickness (cIMT) and to assess its determinant factors in healthy adolescents. METHODS: 319 adolescents aged 12.5-17.5 years (135 boys, 184 girls) were enrolled in this cross-sectional study. cIMT and carotid diameter were measured by high-resolution B-mode ultrasound. Anthropometric parameters, blood pressure, physical activity (PA), aerobic ...

BACKGROUND: The proceeding of blood pressure (BP) from normal level to the hypertension has been found to be associated with increased cardiovascular events and multiple vascular risk factors. However, whether the process is associated with increased carotid atherosclerotic plaque per se or not is still unclear. METHODS: Nine hundred and ...

BACKGROUND AND AIM: The hemodynamics of patients with portal hypertension within 4 hours after a single injection of terlipressin has been studied. However, the hemodynamics in a longer phase under different infusion styles is unknown. This study aims to compare the effects of bolus and continuous infusion of terlipressin on ...

OBJECTIVE: Right heart failure is a major cause of morbidity and mortality after left ventricular assist device (LVAD) implantation. This study evaluated the approach of a cavoaortic shunt included in the LVAD circuit, which would aim to relieve venous congestion and improve hemodynamics with preserved oxygen delivery during induced right ...

Resistant hypertension is highly prevalent, and is the form of arterial hypertension that is most difficult to treat. Many patients diagnosed with this disease do not have resistant hypertension, but rather have mismanaged primary hypertension. In many cases blood pressure can be controlled by directly addressing underlying causes such as ...

In the present historical review, we highlight several articles outlining contributions of the Framingham Heart Study over the span of nearly seven decades to our understanding of the epidemiology of blood pressure (BP), atrial fibrillation and genetic factors as they relate to cerebrovascular disease. In 1970, Framingham investigators led by ...

BACKGROUND AND OBJECTIVE:The prevalence of hypertension is increasing in children, and may persist into adulthood. This systematic review was conducted for the US Preventive Services Task Force recommendation on the effectiveness of screening asymptomatic children and adolescents for hypertension in order to prevent cardiovascular disease.METHODS:Eligible studies were identified from Medline ...

PURPOSE: Congenital portosystemic shunts (CPSS) with portal venous hypoplasia cause hyperammonemia. Acute shunt closure results in portal hypertension. A transcatheter method of staged shunt reduction to afford growth of portal vessels followed by shunt closure is reported. METHODS: Pressure measurements and angiography in the CPSS or superior mesenteric artery (SMA) ...

BACKGROUND: It is suggested that disturbed CSF dynamics are involved in the pathophysiology of idiopathic normal pressure hydrocephalus (INPH). The pulsatility curve describes the relationship between intracranial pressure (ICP) and the amplitude of cardiac related ICP pulsations. The position of baseline ICP on the curve provides information about the physiological ...

BACKGROUND: In treating idiopathic normal pressure hydrocephalus (INPH) with a shunt there is always a risk of underdrainage or overdrainage. The hypothesis is tested whether patients treated using an adjustable valve preset at the highest opening pressure leads to comparable good clinical results with less subdural effusions than in a ...

PURPOSE: A valved ventriculo-peritoneal shunt (V-P shunt) as a vesico-amniotic shunt (V-A shunt) preserves the filling/emptying cycle and normal bladder development in fetal lambs with bladder outlet obstruction. The optimal pressure for such shunts is unknown. MATERIALS AND METHODS: We created obstructive uropathy in 60-day gestation fetal lambs. A V-A ...

PURPOSE: The aim of this meta-analysis is to compare the ability of different types of brain monitoring systems vs clinical monitoring of the brain function to detect cerebral ischemia during cross-clamping of the carotid artery under regional anesthesia. METHODS: In May 2012, a search was conducted in PubMed, Cochrane Central ...

OBJECTIVES: Time rate of blood pressure (BP) variation is a measure of the speed of BP fluctuations derived from a computerized analysis of ambulatory BP monitoring. The aim of this study was to identify pathophysiological differences in the time rate of BP variation between stroke subtypes, on the basis of ...

Low-pressure hydrocephalus is a rare type of hydrocephalus characterized by negative intracranial pressure (ICP) and ventriculomegaly. Given the shortcomings of available methods to treat refractory low-pressure hydrocephalus, we set out to develop a new system for evacuation of cerebrospinal fluid (CSF) from the ventricular system where existing shunt systems do ...

OBJECTIVE: Carotid endarterectomy (CEA) is associated with a profound effect on blood pressure. The aim of this study was to evaluate 24 h ambulatory blood pressure measurement (ABPM) after eversion (E-CEA) and conventional (C-CEA) endarterectomy including a midterm follow-up. METHODS: Seventy-one patients were included in this prospective study [E-CEA (37)/C-CEA (34)]. ...

We present pressure-volume loops obtained from two patients with single-ventricle physiology, one with a modified Blalock-Taussig shunt and one with a right ventricle-to-pulmonary artery shunt. The dissimilarities in pressure-volume loop contour and related indices highlight potentially important differences in ventricular mechanics between the shunt types.

Background: MicroRNAs (miRNAs) are endogenous, non-coding, short, single-stranded RNAs and represent a new class of gene regulators. Recent evidence supports a role for miRNAs in cardiovascular pathophysiology and atherosclerosis development. We have previously demonstrated that miR-145 is widely expressed in human atherosclerotic lesions and its downregulation has been correlated with ...

OBJECTIVE:: Uncontrolled hypertension under antihypertensive multidrug regimen is not necessarily always true resistance. Incomplete adherence is one of several possible causes of uncontrolled hypertension. Nonadherence remains largely unrecognized and is falsely interpreted as treatment resistance, as it is difficult to confirm or exclude objectively. This is the first study assessing ...

BACKGROUND:: During mechanical ventilation (MV), pulmonary shunt is cardiac output (CO) dependent; however, whether this relationship is valid during unsupported spontaneous breathing (SB) is unknown. The CO dependency of the calculated venous admixture was investigated, with both minor and major shunt, during unsupported SB, MV, and SB with continuous positive ...

PURPOSE OF REVIEW: This review provides an evidence-based comparison of aqueous shunts in common use. RECENT FINDINGS: Aqueous shunts are being used with increasing frequency in the surgical management of glaucoma. Recent retrospective studies and prospective clinical trials have compared the outcomes of different shunt designs. Larger end-plate size is ...

Hypertensive encephalopathy typically presents with headache, confusion, and bilateral parietooccipital vasogenic edema. Brainstem edema in hypertensive encephalopathy usually occurs in association with typical supratentorial parieto-occipital changes and is usually asymptomatic. We report here a patient with hypertensive encephalopathy, with isolated brain stem involvement on magnetic resonance imaging (MRI). Rapid treatment ...

Chemoreceptors play an important role in the autonomic modulation of circulatory and ventilatory responses to changes in arterial O2 and/or CO2. However, studies evaluating hemodynamic responses to hypoxia and hypercapnia in rats have shown inconsistent results. Our aim was to evaluate hemodynamic and respiratory responses to different levels of hypoxia ...

Apart from the well-known role of hypertension in cerebrovascular disease, chronic kidney disease is emerging as an independent risk factor for stroke. Although the mechanism underlying the relationship between blood pressure variability, diurnal blood pressure variation disruption (e.g. nondipping) and kidney dysfunction is not fully understood, these factors are closely ...

Strokes remain the major complication among dialysis population as the number of diabetes and elderly is increasing. In chronic hemodialysis patients, prevalence and incidence of stroke is higher than that of the general population. According to the annual registry data of the Japanese Society for Dialysis Therapy, prevalence of stroke ...

Blood pressure is a strong risk factor for ischemic and atherosclerotic events such as stroke. Blood pressure is often elevated in patients with chronic kidney disease. Consequently, chronic kidney disease patients are at high risk of developing cardiovascular and cerebrovascular damage. Blood pressure reduction by means of inhibiting the renin-angiotensin-aldosterone ...

Only a limited proportion of patients needing pharmacological control of portal hypertension are hemodynamic responders to propranolol. Here we analyzed the effects of zolmitriptan on portal pressure and its potential interaction with propranolol. ZOLMITRIPTAN, PROPRANOLOL OR BOTH WERE TESTED IN TWO RAT MODELS OF PORTAL HYPERTENSION: common bile duct ligation ...

BACKGROUND Although tonometry-based devices have been applied in several population studies and clinical trials, the agreement between them remains unclear. METHODS Carotid systolic blood pressure (SBP) and augmentation index (AI) were randomly measured from 3 devices, SphygmoCor, PulsePen, and A-Pulse, in 66 consecutive patients from our ambulatory cardiovascular department. The ...

Recently, chronic kidney disease (CKD) has become a major public health problem and a risk factor for all-cause mortality, cardiovascular disease (CVD). To prevent cardiovascular disease as early as possible, subclinical studies for CKD are essential. Recently, carotid atherosclerosis has been evaluated by measurement of the intima-media thickness (IMT) of ...

: The role of hypertension in the incidence of postoperative hematoma has been well documented. A large number of patients who undergo aesthetic surgery consume a variety of herbal products, some of which may cause or exacerbate hypertension. The purpose of this study was to review the herbal products that ...

The Fontan procedure is employed as the final-stage palliation in single-ventricle congenital heart patients and results in diversion of venous blood directly to the pulmonary arteries. Fontan patients have been known to suffer from postoperative systemic venous hypertension, which in turn is associated with pleural effusions and protein losing enteropathy, ...

Subependymomas are rare, slow-growing benign neoplasms. Although most are asymptomatic, they can present with symptoms related to increased intracranial pressure and hydrocephalus. We describe a 47-year-old man with worsening headaches who was found to have a subependymoma, with a focus on the imaging findings, differential diagnoses, pathology, and treatment.

Introduction. Increased pressure in portal venous system is relatively a rare complication after chemoradiotherapy for Wilms' tumor (WT). In paediatric population, feasibility and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in portal hypertension nonresponsive to medical or endoscopic treatment have been recently advocated. We report a case of TIPS positioning ...

INTRODUCTION: Infusion tests are used to diagnose and select patients with idiopathic normal pressure hydrocephalus (INPH) for shunt surgery. The test characterizes cerebrospinal fluid dynamics and estimates parameters of the cerebrospinal fluid system, the pressure-volume index (PVI) and the outflow conductance (C(out) ). The Oscillating Pressure Infusion (OPI) method was ...

PURPOSE: A stroke is an uncommon but potentially devastating complication after surgery. Although hypoperfusion is often mentioned as a possible cause of a perioperative stroke, a thorough investigation is needed into the role of intraoperative and/or postoperative hypotension in the occurrence and development of perioperative cerebral ischemia. In this review ...

PURPOSE OF REVIEW: Hypertension has been recognized for decades as a major factor for stroke, with observational epidemiologic studies clearly identifying the increased stroke risks with blood pressure (BP) levels and randomized controlled clinical trials providing evidence of stroke risk reduction with lower BPs. Hypertension treatment and management guidelines, the ...

OBJECTIVES:: The aim of this study was to examine the utility of the generalized transfer function (GTF) and the late systolic shoulder of the radial pressure waveform (SBP2) for estimating seated central systolic blood pressure (c-SBP) and seated c-augmentation index (c-AIx). METHODS:: In 199 participants (182 cardiovascular disease patients and ...

Carotid to femoral pulse wave velocity (PWV) is associated with an increase in cardiovascular morbidity and all-cause mortality. Noninvasive approach has made this method applicable for the examination of larger populations. This study aimed to obtain reference values of PWV measured with the Vicorder device. PWV was obtained using the ...