AIMS: To compare the autonomic, neuroendocrine and psychomotor effects of single doses of the 'atypical' antipsychotic clozapine and the 'classical' antipsychotic haloperidol, in healthy male volunteers. METHODS: Clozapine (50 mg), haloperidol (3 mg) and placebo were administered to 12 healthy male volunteers at weekly intervals, according to a balanced double-blind ...

Use of the DASH (Dietary Approaches to Stop Hypertension) diet, which is rich in fruits, vegetables, and low-fat dairy foods, significantly lowers blood pressure. Among the 459 participants in the DASH Trial, 72 had stage 1 isolated systolic hypertension (ISH) (systolic blood pressure, 140 to 159 mm Hg; diastolic blood ...

BACKGROUND: The purpose of this study was to examine the effects of walking on resting systolic and diastolic blood pressure in adults. METHODS: A total of 24 primary outcomes from 16 studies and 650 subjects (410 exercise, 240 control) met the criteria for inclusion: (1) randomized and nonrandomized controlled trials, ...

A cross-sectional analysis was performed to determine risk factors associated with hypertension in 1,238 chronic hemodialysis patients upon enrollment into the HEMO Study. The mean pre- and post-dialysis systolic blood pressure were 152.4 +/- 25.0 (mean +/- SD) and 137.8 +/- 24.6 mm Hg, respectively. The mean pre- and post-dialysis ...

Managing hypertension is a complex undertaking, where even the definition of the disorder is subject to discussion. Recently, there has been controversy concerning the most appropriate measure to determine health risks associated with hypertension. In the past, diastolic blood pressure (DBP) was the prime measure for defining hypertension, but currently ...

BACKGROUND: Technological advances in the distribution of information have opened new avenues for patient care. Few trials, however, have used telemedicine to improve blood pressure in patients with essential hypertension. OBJECTIVE: To determine the efficacy of a telecommunication service in reducing blood pressure. DESIGN: Randomized, controlled trial. SETTING: University-affiliated primary ...

BACKGROUND: Hypertension-related diseases are the leading cause of morbidity and mortality in industrially developed societies. Although antihypertensive drugs are extensively used, dietary and lifestyle modifications also are effective in the treatment of patients with hypertension. One such lifestyle intervention is the use of medically supervised, water-only fasting as a safe ...

A large-scale, 8-week, open-label, clinical experience trial evaluated the efficacy of the angiotensin II receptor (AT1 subtype) blocker candesartan cilexetil (16 to 32 mg once daily) either alone or as add-on therapy in 6465 hypertensive patients. The study population was 52% female and 16% African American with a mean age ...

OBJECTIVES: To examine the changes in blood pressure over time in a cohort of young adults attending university between 1948 and 1968. DESIGN: Cross sectional study. SETTING: Glasgow University. PARTICIPANTS: 12 414 students aged 16-25 years-9248 men (mean age 19.9 years) and 3164 women (19.2 years)-who participated in health screening ...

OBJECTIVES: This analysis assessed the association between blood pressure, meteorology, and air pollution in a random population sample. METHODS: Blood pressure measurements of 2607 men and women aged 25 to 64 years who participated in the Augsburg Monitoring of Trends and Determinants in Cardiovascular Disease survey were analyzed in association ...

The purpose of the present study was to examine patterns of systolic and diastolic hypertension by age in the nationally representative National Health and Nutrition Examination Survey (NHANES) III and to determine when treatment and control efforts should be recommended. Percentage distribution of 3 blood pressure subtypes (isolated systolic hypertension, ...

A large proportion, from 30% to 50%, of diabetic patients frequently manifests loss of the normal diurnal variation of blood pressure, i.e. their blood pressure does not show at least 10% fall at night (non-dippers). It has been demonstrated that non-dippers are at increased risk of end-organ damage, in particular, ...

Sixty patients with a hypertensive emergency (mean arterial pressure >130 mm Hg and evidence of target organ damage) were randomly divided into two groups of 30 patients each. Group A received 1.25 mg of isosorbide dinitrate aerosol upon arrival and a second dose 15 minutes later when the mean arterial ...

OBJECTIVE: To determine whether a vectored adjustment of the atlas in patients identified as demonstrating signs of upper cervical joint dysfunction would cause lowering of blood pressure in comparison with resting controls. DESIGN: Test 1: controlled clinical trial with a treatment (adjustment) group and a control (resting) group. Test 2: ...

Arterial blood pressure rises at apnea termination, and there is increasing evidence that the sleep apnea-hypopnea syndrome (SAHS) is associated with daytime hypertension but no randomized controlled trial evidence of whether SAHS treatment reduces blood pressure exists. We, therefore, conducted a randomized placebo-controlled cross-over study of the effects of 4 ...

Free radicals and oxidation are involved in several aspects of blood pressure physiology. We investigated the relationship between blood pressure and antioxidants, including plasma ascorbic acid (AscA), in a 17-week controlled-diet study. Study subjects included 68 men aged 30 to 59 years who had a mean diastolic blood pressure of ...

Treatment of intradialytic hypotension (IDH) in the end-stage renal disease population has been a difficult task for nephrologists caring for these patients. The presence of multiple pathogenic factors contributes to hemodynamic instability and explains why therapies that modulate only a specific aspect of the problem are only partially effective. Cool ...

OBJECTIVE: To study the differences in blood pressure readings between the auscultatory and oscillometric (Dinamap model 8100; Critikon, Tampa, Fla) methods. DESIGN: Survey of 2 blood pressure instruments. SETTING: Public schools. PARTICIPANTS: Seven thousand two hundred eight schoolchildren aged 5 through 17 years. MAIN OUTCOME MEASURE: Blood pressure levels. RESULTS: ...

In this study the authors used the meta-analytic approach to examine the effects of aerobic exercise on resting systolic and diastolic blood pressure in adults. Forty-seven clinical trials representing a total of 72 effect sizes in 2543 subjects (1653 exercise, 890 control) met the criteria for inclusion. Statistically significant exercise-minus-control ...

OBJECTIVE: To assess the effect of esmolol vs lidocaine to attenuate the detrimental rise in heart rate and blood pressure during intubation of patients with isolated head trauma. METHODS: This was a prospective, double-blind, randomized study, performed at an urban, county teaching emergency department. Participants were 30 patients with isolated ...

Nicardipine is the first intravenously administered dihydropyridine calcium channel blocker. Its primary physiologic action includes vasodilatation with limited effects on the inotropic and dromotropic function of the myocardium. Several previous reports document its use in adult patients for pharmacologic control of blood pressure. The current report describes the use of ...

This study compared the use of the original metric effect size with the standardized effect size for clinical data in meta-analysis. The example data set included 17 controlled clinical trials dealing with the effects of progressive resistance exercise on resting diastolic blood pressure in adults. Original metric effect size showed ...

The goal of treatment of hypertension in older persons is to lower the blood pressure to <140/90 mm Hg. Older persons with diastolic hypertension should have their diastolic blood pressure lowered to 80 to 85 mm Hg. The blood pressure should be lowered to 130/85 mm Hg in persons with ...

OBJECTIVES: To assess and compare the effects of candesartan or lisinopril, or both, on blood pressure and urinary albumin excretion in patients with microalbuminuria, hypertension, and type 2 diabetes. DESIGN: Prospective, randomised, parallel group, double blind study with four week placebo run in period and 12 weeks' monotherapy with candesartan ...

The relationship between blood pressure and health in old age is complex and influenced by socio-economic factors. The Healthy Old People in Edinburgh cohort were initially disease-free and untreated, providing a sample in which directionality in this relationship could be examined. Subjects' health status, medication use and blood pressure was ...

OBJECTIVES: Afferent nerve stimulation, such as acupuncture and transcutaneous electric nerve stimulation (TENS), has shown a blood pressure reduction in both animal and man. In the present open and non-controlled study we investigated the effect on 24-h ambulatory blood pressure of low frequency TENS in a group of hypertensive subjects ...

Data from the Third National Health and Nutrition Examination Survey, phase 2 (1991 to 1994), indicate that among hypertensive individuals in the United States, 53.6% are treated and only 27.4% are controlled to goal levels. We sought to determine whether poor hypertension control is due to lack of systolic or ...

BACKGROUND: Blockade of the renin-angiotensin-aldosterone system (RAAS) is the preferred mechanism of action for controlling hypertension in select groups of patients, including those with diabetic nephropathy and heart failure. Currently, 2 classes of drugs work by blocking the RAAS, albeit by differing mechanisms: angiotensin-converting enzyme (ACE) inhibitors and angiotensin II ...

OBJECTIVES: To describe the systolic and diastolic blood pressure criteria used by community physicians to: 1) establish a diagnosis of hypertension; and 2) increase dosage or change drug therapy in treated hypertensives. METHODS: A multiethnic population sample of adults at or above 40 years old was surveyed, by random digit ...

BACKGROUND: The goal of the present study was to assess the effect of antihypertensive therapy on clinic (CBP) and ambulatory (ABP) blood pressures, on ECG voltages, and on the incidence of stroke and cardiovascular events in older patients with sustained and nonsustained systolic hypertension. METHODS AND RESULTS: Patients who were ...

STUDY OBJECTIVE: To evaluate the effectiveness, safety, and costs associated with a formulary conversion from amlodipine to alternative calcium channel blockers. DESIGN: Retrospective study. SETTING: Veterans Affairs Medical Center. PATIENTS: One hundred patients with hypertension who were receiving amlodipine. INTERVENTION: Data from a random sample of 100 patients who were ...

Seasonal variation in blood pressure in patients undergoing hemodialysis in Europe has recently been described. If confirmed, this has important therapeutic, research, and epidemiological implications. All normotensive patients not administered antihypertensive drugs in our unit were studied. Predialysis blood pressures were measured before each dialysis treatment over two 2-month periods, ...

OBJECTIVE: This randomized, double-blind, placebo-controlled, parallel-group, multicenter trial investigated the effects of valsartan, an angiotensin II receptor blocker, on systolic blood pressure (SBP) in patients aged > or =65 years with systolic hypertension, with or without diastolic hypertension. BACKGROUND: Hypertension in older persons is a public health problem of epidemic ...

The Losartan Intervention For Endpoint (LIFE) reduction in hypertension study is a double-blind, prospective, parallel-group study comparing the effects of losartan with those of atenolol on the reduction of cardiovascular complications in patients (n = 9,194) with essential hypertension and with electrocardiographically (ECG) documented left ventricular hypertrophy (LVH). Baseline blood ...

BACKGROUND: The effects seen in clinical trials may not translate to actual practice situations. We examined the persistence of blood pressure effects 31 months after a clinical trial of treatment with hypotensive agents. METHODS: Nineteen previously untreated middle-aged men with hypertension had their office and ambulatory blood pressure recorded after ...

A 51-year-old female patient, with an adrenocorticotrophic hormone-secreting pituitary tumor, was scheduled for transphenoidal hypophysectomy. She had a history of recent onset diabetes mellitus and a 2-year history of arterial hypertension. Despite ongoing medical therapy, preoperative blood pressure was 150-160/90-120 mm Hg. During general anesthesia, in response to perinasal infiltration ...

A pilot study was conducted to examine the association between free medication and comprehensive care on blood pressure control for 60 adults with uncontrolled essential hypertension (mean blood pressure = 157/96 mm Hg) referred from a variety of primary care clinics at a public teaching hospital. Subjects received comprehensive care, ...

An 8-week, multicenter, open-label, clinical experience trial evaluated the efficacy of candesartan cilexetil either alone (34%) or as add-on therapy (66%) in 1014 patients with untreated or uncontrolled isolated systolic hypertension defined as systolic blood pressure 140-179 mm Hg/diastolic less than 90 mm Hg. Candesartan cilexetil 16 mg once daily ...

Systemic arterial blood pressures were measured in 30 dogs with acute babesiosis, 10 each with mild uncomplicated, severe uncomplicated and complicated disease. Ten healthy dogs were used as controls. Hypotension was defined as more than 3 standard deviations below the control mean. Normal mean pressures (+/-SD) were: systolic arterial pressure ...

Hypertension is a major public health problem affecting an estimated 43 million civilian, noninstitutionalized adults in the United States (24% of this population). The purpose of this study was to use the meta-analytic approach to examine the effects of progressive resistance exercise on resting systolic and diastolic blood pressure in ...

In this study, the authors' objective was to determine the influence of blood lead, meso 2,3-dimercaptosuccinic acid (DMSA)-chelatable lead, and tibial lead on systolic and diastolic blood pressures and on hypertension in 543 former organolead manufacturing workers. All workers had past exposure to inorganic and organic lead. The authors used ...

Awareness of and therapy for hypertension in the United States have been increasing in older patients. Despite this improvement, hypertension continues to be poorly controlled in this patient population. The control rate, defined as systolic blood pressure less than 140 mm Hg and diastolic blood pressure less than 90 mm ...

BACKGROUND: Water drinking increases blood pressure profoundly in patients with autonomic failure and substantially in older control subjects. The mechanism that mediates this response is not known. METHODS AND RESULTS: We studied the effect of drinking tap water on seated blood pressure in 47 patients with severe autonomic failure (28 ...

Hypertension is a common problem in patients undergoing chronic hemodialysis. The purpose of this study is to identify the clinical and demographic factors independently associated with blood pressure in this population. Data collected for the Dialysis Morbidity and Mortality Study Wave 1 by the US Renal Data System were analyzed. ...

OBJECTIVE: To assess the impact of calendar blister pack (CBP) use on glycemic and blood pressure control. RESEARCH DESIGN AND METHODS: We conducted an 8-month randomized controlled double-blind study among diabetic patients with poor glucose control (HbA1c >9.0%) in an urban area of South Auckland, New Zealand, with a high ...

The objective of this study was to evaluate the effectiveness of sublingual isosorbide dinitrate (ID) in the acute control of hypertension in patients with severe preeclampsia. A randomized, double-blind clinical trial with a preinclusion period of response to hydration and rest was performed in 60 patients with severe preeclampsia. The ...

We sought to determine whether reductions in blood pressure in hypertensives after acute exercise persist for more than the 2 to 3 h found in controlled laboratory settings. Subjects (n = 11) were obese (32 +/- 4% body fat), sedentary (VO2max 27 +/- 4 mL/kg/min) 60 +/- 6-year-old men with ...

To investigate the possible involvement of nitric oxide (NO) in haemodialysis hypotension, we measured plasma concentrations of nitrate anion (NO3-), a metabolite of NO, in 114 patients undergoing maintenance haemodialysis. Mean plasma NO3- concentrations before dialysis were greater in subjects with lower blood pressure (155 +/- 16 micromol L-1) than ...

OBJECTIVE: To determine whether riluzole is associated with blood pressure elevations in patients with amyotrophic lateral sclerosis (ALS). BACKGROUND: Though previously reported, hypertension is not considered a frequent adverse effect of riluzole. METHODS: We reviewed data from 35 consecutive ALS patients on riluzole, and 88 randomly selected controls without and ...

OBJECTIVE: To determine whether vasopressin could be effective in treating the hypotension associated with phosphodiesterase III inhibition. Phosphodiesterase III inhibitors are cardiotonic agents that increase myocardial contractility and decrease vascular smooth muscle tone. The vasodilatory effect can be profound, and the resulting hypotension frequently requires the administration of catecholamine pressors. ...