OBJECTIVES: Although magnesium is now the drug of choice for the prevention of eclamptic seizures only few studies have evaluated whether magnesium may reduce blood pressure in pregnancies complicated with hypertension. METHODS: A total of 33 patients with pregnancy-induced hypertension were randomized to either magnesium or methyldopa treatment. Of these ...

OBJECTIVE: To examine whether baseline high blood pressure and antihypertensive treatment predicts cognitive decline in elderly individuals. METHODS: A longitudinal population-based study of elderly individuals (n = 1,373) in Nantes (western France) was undertaken. Individuals 59 to 71 years of age were selected from electoral rolls. High blood pressure at ...

Certain hydroxymethylglutaryl coenzyme A reductase inhibitors, ie, statins, may cause vasodilation by restoring the endothelial dysfunction that frequently accompanies hypertension and hypercholesterolemia. Several studies have found that a blood pressure reduction is associated with the use of statins, but conclusive evidence from controlled trials is lacking. After an 8-week placebo ...

The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure defines hypertension as systolic blood pressure > or =140 mm Hg or diastolic blood pressure (DBP) > or =90 mm Hg. Evidence shows that even slightly elevated blood pressure significantly increases the risk of morbidity and ...

Although diuretics are recommended for the treatment of hypertension, decreased diuretic use and increased calcium antagonist use necessitate a comparison of the efficacy of these drugs in preventing cardiovascular events. Patients >/=60 years of age with systolic blood pressure of 160 to 220 mm Hg and diastolic blood pressure <115 ...

OBJECTIVE: To determine whether anginal episodes might be related to extremes of hypotension in patients with ischaemic heart disease taking drugs to treat angina and heart failure. DESIGN AND SETTING: Observational study of patients with ischaemic heart disease attending an urban tertiary referral cardiology centre. INTERVENTIONS AND OUTCOME MEASURES: A ...

As men age, the incidence of both benign prostatic hyperplasia (BPH) and hypertension increases. Concomitant occurrence of these conditions also increases with age, and the 2 are frequently encountered together in primary care practice. In addition, many patients with hypertension require >1 antihypertensive agent to adequately control blood pressure. In ...

Hypertension is very common in adults >/=60 years of age. Isolated systolic hypertension (ISH) in particular is a good predictor of events associated with elevated blood pressure such as stroke, coronary heart disease, and congestive heart failure. Two large studies, the Systolic Hypertension in the Elderly Program (SHEP) and the ...

BACKGROUND: Individuals with systolic-diastolic hypertension (SDH, systolic blood pressure (SBP) >160 mm Hg and diastolic blood pressure (DBP) >90 mm Hg) are at increased risk of thrombotic complications, such as stroke and heart attacks, which may be related to a hypercoagulable state. Individuals with only isolated systolic hypertension (ISH; i.e. ...

The recommendations of several authoritative bodies that blood pressure be lowered to lower-than-traditional goals in patients with high-risk hypertension have recently been validated by data from several randomized clinical trials. In the Hypertension Optimal Treatment (HOT) trial, the best prognosis was in diabetic patients treated to a diastolic blood pressure ...

The Dietary Approaches to Stop Hypertension multicenter trial examined the impact of dietary patterns on blood pressure in 459 adults with blood pressure < 160 mm Hg systolic and 80 to 95 mm Hg diastolic. After a 3-week run-in period on a control diet low in fruits, vegetables, and dairy ...

In 1988, the Systolic Hypertension in China (Syst-China) Collaborative Group started to investigate whether active treatment could reduce the incidence of stroke and other cardiovascular complications of isolated systolic hypertension. After stratification for center, sex and previous cardiovascular complications, alternate patients (n = 1253) were assigned nitrendipine 10-40 mg daily, ...

We described the trends in the prevalence of isolated systolic hypertension during 1972 to 1992 in five independent population-based cross-sectional random samples in eastern Finland. A total of 15,155 men and 16,126 women aged 30-59 in 1972 and 30-64 years during 1977 to 1992 were included in this study. Standardised ...

The effect of different intensities of aerobic exercise on blood pressure remains uncertain. The goal of this trial was to compare the effect of two different levels of aerobic physical training on 24-hour ambulatory blood pressure. In this double-blind parallel-group trial, 28 sedentary hypertensive patients (mean diastolic blood pressure of ...

OBJECTIVES: To review and assess the cardiovascular safety of the alpha1-blocker terazosin when used to treat symptomatic benign prostatic hyperplasia (BPH) in patients taking concurrent antihypertensive medications. METHODS: This retrospective analysis focused on blood pressure changes and blood pressure-related side effects in 555 of 2084 patients randomized to either terazosin ...

Exercise training improves cardiovascular disease risk, but individual responses are highly variable. We hypothesized that common polymorphic gene variations would affect these responses. Sedentary obese hypertensive older men who had undergone exercise training were typed at the apolipoprotein (apo) E, angiotensin-converting enzyme (ACE), and lipoprotein lipase (LPL) loci. Individuals of ...

An open randomized hospital study conducted in 169 centers in France compared the blood pressure response to the first 36 h of treatment with perindopril (PER), 2 mg once daily, with that to captopril (CAP), 6.25 mg t.i.d., in 725 patients (mean age, 70 years; men, 67%) with echocardiographic left ...

OBJECTIVE: To examine whether initially low blood pressure is related to the incidence of dementia. DESIGN: A population-based prospective study. SETTING: The Kungsholmen district of Stockholm, Sweden PARTICIPANTS: Three hundred four nondemented subjects aged 75 to 96 years at baseline. MEASUREMENTS AND MAIN RESULTS: After an average of 3 years, ...

The determinants of diastolic dysfunction in patients with systemic hypertension are not completely known. To evaluate the possible role of age, arterial blood pressure, and baroreflex heart rate response impairment in causing diastolic dysfunction, we studied 61 patients (42 male; mean+/-SD age, 43.9+/-12 years) with newly recognized and therefore previously ...

BACKGROUND AND AIM: Acetate free biofiltration (AFB) provides a well-tolerated and efficient renal replacement therapy. Replacement of most of the acetate by bicarbonate in standard hemodialysis has resulted in a decrease in intradialytic hypotensive episodes. This has been attributed to a decrease in the acetate-induced impairment of myocardial contractility. The ...

BACKGROUND: Uncontrolled hypertension continues to be a common problem, particularly in noncompliant hemodialysis patients. Atenolol, a water soluble beta-blocker has a prolonged half-life in renal failure and may serve as a useful antihypertensive agent in these patients. METHODS: Hypertension was diagnosed by ambulatory blood pressure monitoring for 44 hours during ...

The relationship between atherosclerotic renal artery stenosis (ARAS) and blood pressure control remains poorly understood. Duplex ultrasonography is a noninvasive method for detecting and grading ARAS. The purpose of this study was to characterize the relationship between the degree of ARAS, levels of blood pressure, and control of blood pressure ...

CONTEXT: There is relatively little data available on the management of patients with severe, uncomplicated hypertension and severe hypertension with stable hypertensive complications. OBJECTIVE: To determine the incidence, clinical features, acute management, and clinical course of severe, uncomplicated hypertension and severe hypertension with stable hypertensive complications presenting for emergency department ...

BACKGROUND: Recent reports suggest that calcium-channel blockers may be harmful in patients with diabetes and hypertension. We previously reported that antihypertensive treatment with the calcium-channel blocker nitrendipine reduced the risk of cardiovascular events. In this post hoc analysis, we compared the outcome of treatment with nitrendipine in diabetic and nondiabetic ...

OBJECTIVE: To compare the effects on blood pressure of a 12-week moderate-intensity aerobic exercise program and a T'ai Chi program of light activity. DESIGN: A randomized clinical trial. SETTING: A suburban clinic in the Baltimore, MD, area. PARTICIPANTS: Sixty-two sedentary older adults (45% black, 79% women, aged > or = ...

PURPOSE: The aim of this study was to use the meta-analytic approach to examine the effects of aerobic exercise on resting systolic and diastolic blood pressure among adult women. METHODS: Studies were retrieved from computer searches (MEDLINE, Sport Discus, Current Contents) and bibliographies of retrieved articles were cross-referenced. Inclusion criteria ...

OBJECTIVE: To investigate the effects of modafinil, a central nonamphetamine awakening substance, on blood pressure and heart rate in hypersomnolent patients with obstructive sleep apnea. DESIGN: This double-blind, randomized, placebo-controlled crossover trial was performed over 2 days and 3 nights in a single-center study of hospitalized patients from a referred ...

Hypertension is common in hemodialysis patients and increases cardiovascular morbidity and mortality. We determined the prevalence of inadequate control of hypertension in 489 patients receiving hemodialysis and identified factors associated with uncontrolled hypertension. We interviewed the patients and abstracted demographic and clinical information from a computerized database. The prevalence of ...

OBJECTIVE: To determine the effects of dietary patterns on blood pressure in subgroups. METHODS: Dietary Approaches to Stop Hypertension (DASH) was a randomized controlled feeding study conducted at 4 academic medical centers. Participants were 459 adults with untreated systolic blood pressure less than 160 mm Hg and diastolic blood pressure ...

In this study the authors assessed the effectiveness and safety of isosorbide dinitrate aerosol administered through the oral mucosa in 30 adult patients who presented with a hypertensive crisis (mean arterial pressure > 130 mm Hg and evidence of target organ damage). The patients were given a first dose of ...

OBJECTIVES: The relation between blood lead concentration (PbB) and blood pressure was examined in a Taiwan nationwide population survey of PbB from July 1993 to June 1994. METHODS: After multistage sampling procedures, 2800 subjects (1471 males and 1329 females) with a mean (range) age of 44 (15-85) years were enrolled ...

We updated our previous systematic review of the effect of supplemental calcium on blood pressure. We extended our previous searches on MEDLINE and EMBASE to May 1997 and examined citations from relevant articles. We contacted the authors of eligible trials to ensure the accuracy and completeness of data, and to ...

A total of 254 elderly hypertensive patients (71 men and 183 women aged between 63 and 92 years, diastolic blood pressure (DBP) 95-115 mm Hg inclusive) were treated with the fixed combination of verapamil SR/trandolapril following a 4-week single-blind placebo run-in period. Treatment was started with a response dependent 3-step ...

-We have used the apolipoprotein E (apoE)-deficient mouse model to determine whether both the angiotensin II type 1 (AT1) and the alpha1-adrenergic receptors influence arteriosclerotic changes in this hyperlipidemic animal model. Mice were treated with antihypertensive drugs beginning at 9 weeks of age, and aortic atherosclerosis was measured after 12 ...

AIM: Elevating serum ionized calcium levels is known to stabilize blood pressure during and after a hemodialysis session. The data on lowering calcium levels is limited. SUBJECTS AND METHODS: This study examined the responses to an acute drop in ionized calcium during a four hour hemodialysis session in two subjects ...

The Hypertension Optimal Treatment (HOT) study showed that substantial reductions in blood pressure and a corresponding lowering of the risk of myocardial infarction could be achieved by intensive antihypertensive therapy. A cost-effectiveness analysis was performed to determine the possible economic consequences of three different targets of diastolic blood pressure lowering--< ...

BACKGROUND: Left ventricular hypertrophy (LVH) represents an independent risk factor in patients with essential hypertension. Because reversal of LVH may be associated with an improvement of prognosis, the influence of new antihypertensive compounds, such as angiotensin II AT1 receptor antagonists, on LVH should be determined. METHODS AND RESULTS: In a ...

BACKGROUND: Many factors contribute to the regulation of blood pressure. The role of climate has received relatively little attention. METHODS: During a four-year period, we determined the influence of climate on blood pressure in 53 patients with end-stage renal disease treated with hemodialysis. For each patient, blood pressure was measured ...

BACKGROUND: More frequent dialysis has been claimed to improve clinical outcome and quality of life. METHODS: Clinical status was optimized in 13 haemodialysis patients during a run-in period of 2 months with three dialysis sessions a week. Thereafter, daily home haemodialysis (DHHD, 6 sessions per week) was initiated. The total ...

Fatigue is an important symptom of a disturbed circadian rhythm. To date, no studies of circadian rhythms in patients with chronic fatigue syndrome (CFS) have been published. The objectives of the study were to study rhythms of heart rate and systolic and diastolic blood pressure in patients with chronic fatigue ...

BACKGROUND: Systolic hypertension increases the risk of dementia in elderly people. The vascular dementia project, set up in the framework of the double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial, investigated whether antihypertensive drug treatment could reduce the incidence of dementia. METHODS: Eligible patients had no dementia, were at least ...

alpha-Adrenergic blockers are potential alternative antihypertensive agents for diabetic patients. Data on their relative efficacy and their effect on kidney function and albuminuria are very limited however. 76 patients with diabetes type 2, hypertension (>/=140/90 mm Hg) and albuminuria (>/=30 mg/24 h) were randomized into three groups to receive cilazapril ...

There are currently over 150 patients receiving daily hemodialysis in over 12 centers worldwide. The experiences of over 200 daily hemodialysis patients spanning 30 years have been reviewed. The reports uniformly describe subjective and objective improvements. There are decreased symptoms during and after dialysis, improved functional status, and better quality-of-life ...

OBJECTIVE: To determine prevalence and severity of systemic arterial hypertension and proteinuria in dogs with naturally developing diabetes mellitus (DM) and to determine whether these abnormalities were related to age, sex, duration of DM, or degree of control of glycemia. DESIGN: Case series and cohort study. ANIMALS: Fifty dogs with ...

Hypertension is a major cause of heart failure, evolving from left ventricular hypertrophy to systolic and diastolic dysfunction. Although effective heart failure therapy has been associated with a lowering or no change in systemic arterial blood pressure in long-term follow-up, this study describes the symptomatic, clinical, and left ventricular functional ...

In the double-blind Systolic Hypertension in Europe (Syst-Eur) Trial, active treatment was initiated with nitrendipine (10 to 40 mg/d) with the possible addition of enalapril (5 to 20 mg/d) and/or hydrochlorothiazide (12.5 to 25 mg/d) titrated or combined to reduce sitting systolic blood pressure by at least 20 mm Hg ...

In this prospective study, the 24-h blood-pressure profile of 12 patients with type 2 diabetes was monitored before, at 6, and at 12 weeks after initiation of insulin therapy, to determine whether commencement of insulin therapy increases blood pressure in these patients. Insulin dosage adjustment was carried out by using ...

CONTEXT: Seasonal variation in arterial blood pressure has been reported in studies with hypertensive and normotensive subjects. However, the influence of seasonal change on blood pressure of hemodialysis patients has not been reported. OBJECTIVE: To investigate the seasonal variation of blood pressure in Brazil, a tropical country, in patients on ...

Management of tense ascites in cirrhotic patients on chronic hemodialysis is still a matter of speculation. A considerable problem with these patients is the frequent occurrence of hypotension during ultrafiltration. We describe a patient in whom ascitic fluid was reinfused on the arterial line and ultrafiltrated during standard treatment by ...

OBJECTIVE: To demonstrate that microvascular decompression of the left medulla oblongata is a safe and effective modality for treating elevated blood pressure in patients with severe medically refractory "essential" hypertension (HTN). METHODS: Twelve patients with medically intractable HTN with or without autonomic dysreflexia underwent microvascular decompression of the left rostral ...