Hypertension: Planet Earth

Scroop R, Eskridge J, Britz GW. · Department of Neuroradiology, Flinders Medical Center, Flinders Drive, Bedford Park, SA, Australia. · AJNR Am J Neuroradiol. · Pubmed #12006295 links to  free full text

Abstract: Paradoxical cerebral embolism of cement occurred in a 78-year-old woman after cement-assisted transpedicular spinal fixation surgery. Multiple pulmonary emboli of polymethylmethacrylate precipitated pulmonary hypertension and right-to-left shunting into the systemic circulation through a patent foramen ovale. This rare complication occurred because of failure to recognize venous migration of cement during the procedure and the injection of multiple levels in one setting. Although this was an open procedure, the technical aspects were the same as for vertebroplasty and the precautions should be applied to percutaneous vertebroplasty.

Anonymous78333. · No affiliation provided · Hypertension. · Pubmed #12364364 links to  free full text

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Anonymous90183. · No affiliation provided · Hypertension. · Pubmed #14718349 links to  free full text

This publication has no abstract.

Rachmani R, Slavachevsky I, Amit M, Levi Z, Kedar Y, Berla M, Ravid M. · Department of Medicine, Meir-Hospital Kfar-Sava and the Sackler Faculty of Medicine, Tel Aviv University, Israel. · Diabet Med. · Pubmed #15089793 No free full text.

Abstract: OBJECTIVE: The effect of spironolactone, cilazapril and their combination on albuminuria was examined in a randomized prospective study in female patients with diabetes and hypertension. PATIENTS AND METHODS: Sixty female diabetic patients aged 45-70 years with blood pressure (BP) 140-180/90-110 mmHg, serum creatinine (sCr) < or = 160 micro mol/l, HbA(1c) < or = 10%, and albuminuria were treated by atenolol 12.5-75 mg/d and hydrochlorothiazide 6.25-25 mg/d. Titration-to-target helped to reach BP values < or = 135/85 mmHg in 46 patients after 12 weeks. These patients were randomized to spironolactone 100 mg/d or cilazapril 5 mg/d for 24 weeks. Then both groups received spironolactone 50 mg/d and cilazapril 2.5 mg/d for 24 weeks. BP was stabilized by tapering the dose of the initial agents. Urinary albumin/creatinine ratio (ACR), BP, K(+). sCr and HbA(1c) were assessed at baseline and at weeks 12, 16, 36 and 60. RESULTS: The average BP at week 12 was 128 +/- 4/81 +/- 3 mmHg and remained constant, in both groups, throughout the study. ACR declined on spironolactone from a median value (range) of 452 (124-1571) to 216 (64-875) mg/g (P = 0.001), and on cilazapril to 302 (90-975) mg/g (P = 0.001). The difference between spironolactone and cilazapril was significant (P = 0.002). Combined treatment resulted in a further modest decline in ACR. Serum creatinine was unaltered by spironolactone and rose slightly (121 to 126 micro mol/l, P = 0.02) on cilazapril. CONCLUSION: At the doses tested, spironolactone was superior to cilazapril in reducing albuminuria. Combined administration was more effective than either drug alone. These effects were independent of BP values. Hyperkalaemia was the main side-effect.

Anonymous95826. · No affiliation provided · Proc Natl Acad Sci U S A. · Pubmed #15517657 links to  free full text

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Panagiotakos DB, Kromhout D, Menotti A, Chrysohoou C, Dontas A, Pitsavos C, Adachi H, Blackburn H, Nedeljkovic S, Nissinen A. · Department of Dietetics and Nutrition, Harokopio University, Athens, Greece. · Arch Intern Med. · Pubmed #16217005 links to  free full text

Abstract: BACKGROUND: Hypertension is a dominant characteristic in the prediction of cardiovascular diseases (CVDs). We aimed to evaluate the association of blood pressure measurements with CVD mortality among different populations of the world. METHODS: A total of 12 763 men, aged 40 to 59 years, from 7 countries (United States, Japan, Italy, Greece, former Yugoslavia, Finland, and the Netherlands) were surveyed from 1958 to 1964. Follow-up for vital status and causes of death was carried out over 25 years. RESULTS: All baseline blood pressure measurements were the best predictors of CVD mortality, compared with age, physical activity, total serum cholesterol level, body mass index or height, and smoking. Moreover, pulse pressure and diastolic and systolic blood pressures were the best predictors for CVD death, followed by mean and mid blood pressures. The age-adjusted hazard ratio per 10-mm Hg increase in pulse pressure varied among cohorts from 1.19 in the United States (P = .04) to 1.29 in southern Europe (P = .01). Differences among cohorts were not significant. In the pooled cohorts, pulse pressure measurements were also a significant predictor for coronary heart disease (hazard ratio per 10-mm Hg increase, 1.15; P = .04) as well as stroke death (hazard ratio per 10-mm Hg increase, 1.32; P = .01). CONCLUSIONS: Pulse pressure followed by diastolic and systolic blood pressures were the best predictors for CVD mortality among other blood pressures, as well as age, physical activity, total serum cholesterol level, anthropometric indexes, and smoking habits. No significant differences were observed among the different populations studied.

Papageorgiou C, Pitsavos C, Panagiotakos DB, Kontoangelos K, Chrysohoou C, Papadimitriou GN, Rabavilas AD. · Psychiatric Clinic, Eginition Hospital, and University Mental Health Research Institute, Athens, Greece. · Neuropsychobiology. · Pubmed #16319506 No free full text.

Abstract: OBJECTIVE: The present study focuses on testing the association of hostility with plasma homocysteine levels in a general population sample. METHOD: Four hundred and ten healthy adults (200 men and 210 women), participating in a health survey in Greece, had blood samples taken for homocysteine concentrations and also completed a multidimensional hostility questionnaire, assessing direction of hostility ('extra- and intropunitive') as well as total hostility and its ingredients, i.e. urge to act out hostility, criticism of others, delusional hostility, self-criticism and delusional guilt. Multivariate relationship was tested between hostility components and homocysteine, after statistically controlling for potential confounders such as age, gender, educational status, smoking and body mass index. RESULTS: Total hostility, delusional guilt as well as extrapunitive direction of hostility were positively related to homocysteine levels. Self-criticism was negatively related to homocysteine. CONCLUSION: The study provides further evidence that particular dimensions of hostility are associated with increased plasma homocysteine levels, thus deserving a place within the spectrum of the coronary heart disease risk factors.

Anonymous109960. · No affiliation provided · Diabet Med. · Pubmed #16842490 No free full text.

This publication has no abstract.

Pins JJ, Keenan JM. · Department of Family Medicine and Community Health, University of Minnesota Medical School, Hypertension and Cholesterol Research Center, Minneapolis, MN 5545, USA. · J Clin Hypertens (Greenwich). · Pubmed #17086017 No free full text.

Abstract: Previous studies have shown that peptides derived from milk proteins can improve blood pressure. Therefore, the authors tested the blood pressure-lowering effects of a hydrolyzed whey protein supplement rich in bioactive peptides. In a 6-week controlled study, 30 prehypertensive or stage 1 hypertensive subjects (blood pressure >or=120/80 mm Hg and <or=155/95 mm Hg) were randomized to receive 20 g/d of either a hydrolyzed whey protein (active treatment) or an unmodified whey protein (control treatment). Blood pressure, blood lipids, safety measures, side effects, and diet were evaluated throughout the trial. After completion of treatment, a 4-week follow-up was conducted. There was a mean reduction of 8.0+/-3.2 mm Hg in systolic blood pressure (P<.05) and of 5.5+/-2.1 mm Hg in diastolic blood pressure (P<.05) in the treatment group compared with the control group. Low-density lipoprotein cholesterol and high-sensitivity C-reactive protein were significantly improved by treatment. Whey-derived peptides might be a viable treatment option for prehypertensive and/or stage 1 hypertensive populations.

Suzuki N, Kozuma K, Ueno Y, Nagaoka K, Kyono H, Ishikawa S, Watanabe H, Yokoyama N, Takeshita S, Isshiki T. · Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan. · Ann Thorac Surg. · Pubmed #18222257 No free full text.

Abstract: BACKGROUND: A paucity of data exists with respect to changes in whole saphenous vein grafts (SVGs) despite accelerated atherosclerosis within grafted saphenous vein conduits. In the present study, we evaluated the one-year change in SVGs by means of quantitative coronary analysis. METHODS: This study enrolled consecutive 52 patients with 109 SVGs, who underwent coronary artery bypass graft surgery successfully. A follow-up study was performed in 33 patients with 65 SVGs after one year because 16 SVGs were obstructed (baseline, 8; follow-up period, 8), and 15 patients with 28 SVGs dropped out within one year. RESULTS: Both minimal and mean lumen diameters decreased significantly (3.17 +/- 0.64 mm vs 2.41 +/- 0.57 mm, p < 0.001; 3.70 +/- 0.69 mm vs 2.92 +/- 0.70 mm, p < 0.001; respectively). Graft length also decreased significantly (107.1 +/- 25.8 vs 100.6 +/- 25.2 mm, p < 0.001). The graft shortening rate (graft shortening length/baseline graft length x 100) was greater than 5% in 33 vessels (51%) and greater than 10% in 23 vessels (35%). Coronary risk factors (smoking, diabetes mellitus, hypertension, dyslipidemia) did not reveal significant relationship with late loss of minimal and mean lumen diameters. CONCLUSIONS: The present study showed a considerable and uniform lumen loss of SVGs after one year, irrespective of coronary risk factors. Graft length shortening was seen more than elongation.

Yamamoto H, Teramoto S, Yamaguchi Y, Ouchi Y. · Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. · Hypertens Res. · Pubmed #18250556 No free full text.

Abstract: Obstructive sleep apnea syndrome (OSAS) is recognized as one of the risk factors of hypertension and cardiovascular disorders. In the current study, we hypothesized that the hypoxic stress and oxidative stress caused by obstructive sleep apnea would increase circulating adrenomedullin (ADM) levels in untreated OSAS patients as compared to an age and body mass index (BMI)-matched control group and an age-matched, but normal-BMI control group. We further hypothesized that nasal continuous positive airway pressure (nCPAP) treatment may decrease OSAS-induced hypoxic stress, oxidative stress and ADM levels. To examine these hypotheses, we measured circulating ADM and reactive oxygen species (ROS) from leukocytes before and after nCPAP therapy in OSAS patients. The circulating levels of ADM and amount of ROS in untreated OSAS patients were significantly greater than those in the controls. No differences in ADM levels were found between the increased-BMI controls and normal-BMI controls. We observed that nCPAP treatment decreased sleep apneas, nocturnal oxyhemoglobin desaturation, the circulating ADM, and ROS production by leukocytes in OSAS patients. The ADM levels were associated with the magnitude of oxyhemoglobin desaturation rather than the number of sleep apneas. These observations suggest that nCPAP therapy could reduce OSAS-induced nocturnal hypoxemia, generation of ROS, and ADM in patients with OSAS.

Pokojski S, Busch C, Grgic I, Kacik M, Salman W, Preisig-Müller R, Heyken WT, Daut J, Hoyer J, Köhler R. · Department of Internal Medicine-Nephrology, Philipps-University, Baldingerstrasse, 35033 Marburg, Hessen, Germany. · Cardiovasc Res. · Pubmed #18339646 links to  free full text

Abstract: AIMS: Potassium channels are essential elements of endothelial function. Recently, evidence emerged that the TWIK (tandem of P domains in a weak inwardly rectifying K+ channel)-related K+ channel (TREK-1) of the two-pore domain potassium channel gene family (K2P) may be involved in the regulation of vascular tone. However, the functional and molecular characterization of vascular TREK-1 is incomplete. In this study, we therefore analysed the functional expression of TREK-1 in the endothelium. Moreover, we hypothesized that changes in channel expression may contribute to altered endothelial vasodilator response under conditions of elevated blood pressure. METHODS AND RESULTS: Gene expression and function of endothelial TREK-1 were analysed by single-cell RT-PCR, the patch-clamp technique and pressure myography in murine carotid arteries (CA). K+ outward currents displaying the characteristics of TREK-1 were observed following various TREK-1-activating stimuli such as membrane stretch, intracellular acidosis, polyunsaturated fatty acids, isoflurane (ISOFL), riluzole, and acetylcholine (ACh). In K(Ca)3.1(-/-) mice exhibiting elevated blood pressure, endothelial TREK-1 currents and TREK-1 mRNA expression were enhanced as compared with normotensive control mice. TREK-1-mediated vasodilator responses to alpha-linolenic acid, ISOFL, or ACh were increased. A similar up-regulation of endothelial TREK-1 was observed in spontaneously hypertensive rats. CONCLUSION: We have found that TREK-1 is an endothelial K+ channel capable of producing hyperpolarization and vasodilation. A correlation between hypertension and up-regulation of TREK-1 was observed in two different animal models of elevated blood pressure. Thus, TREK-1 may play a protective role in the cardiovascular system by providing a novel type of endothelial hyperpolarization-mediated vasodilator response.

Oliveira AC, Oliveira AM, Adan LF, Oliveira NF, Silva AM, Ladeia AM. · Bahian School of Medicine and Public Health, Science Development Foundation of Bahia, Salvador, Bahia, Brazil. · Obesity (Silver Spring). · Pubmed #18356840 No free full text.

Abstract: OBJECTIVE: Metabolic syndrome (MS) is on the rise in youth. As high-sensitivity C-reactive protein (hs-CRP) is associated with cardiovascular/metabolic disorders, we evaluated the association between MS and its components and hs-CRP in a sample of Brazilian overweight and obese youth. METHODS AND PROCEDURES: A total of 407 students (229 girls, 273 with excessive weight, 11.3+/-3.2 years) were evaluated. Measurement included BMI, waist circumference (WC), blood pressure, lipids, insulin, and hs-CRP. Excessive weight was defined using BMI z -score; MS by the modified National Cholesterol Education Program-Adult Treatment Panel III. RESULTS: Subjects were classified into two groups: with MS (n=72) and without (n=335). hs-CRP means and medians were higher in MS group (1.41 mg/l vs. 1.06 mg/l, P<0.001; 2.21 mg/l vs. 1.23 mg/l, P<0.001). Associations between hs-CRP quartiles and insulin resistance (IR) (P<0.001), MS (P<0.001), WC (P<0.000), BMI z-score (P<0.001), hypertension (P<0.001), hypertriglyceridemia (P<0.001), and low HDL-c (P=0.023) were significant; adjustment of hs-CRP for BMI z-score eliminated the previous association, except for the number of MS components (nMSc) (P<0.001). Adjusting for homeostasis model assessment method of IR (HOMA-IR) did not eliminate the relation between hs-CRP and MS components. Furthermore, increases in BMI z-score and nMSc were associated with an increased hs-CRP. Excessive weight (odds ratio (OR), 7.9; confidence interval (CI), 4.7-13.4; P=0.000), hypertension (OR, 2.3; CI, 1.3-4.2; P=0.003), and hypertriglyceridemia (OR, 2.3; CI, 1.5-3.7; P<0.001) were independently associated with hs-CRP. DISCUSSION: In youth, hs-CRP is strongly related with MS and its components, and is also determined by the body composition. This association indicates a precocious proinflammatory state.