摘要:

The accuracy of blood pressure readings taken by the portable semiautomatic blood pressure recorder Rentier M 2000 was investigated in 101 unselected, untreated volunteers. On the average, pressures recorded during usual daily activities were lower by approximately 10 mm Hg than pressures measured in the office. However, individual ambulatory pressures could not be predicted from office readings, and the difference varied among the volunteers from + 14 to −43 mm Hg. The reproducibility of office and ambulatory pressures was investigated in 84 subjects. There was a highly significant correlation between pressure levels determined at a 3- to 4-month interval with both the conventional auscultatory method in the office and the Remler ambulatory recorder. These data demonstrate that the Remler M 2000 ambulatory blood pressure recorder, when used properly, provides reproducible blood pressure profiles during customary daily activities. The ambulatory pressure recorder seems particularly useful for a baseline evaluation of the usual daily blood pressure, which in the individual subject differs in a highly unpredictable manner from the blood pressure measured at the physician's office.

ISSN:0194-911X    

出版商:OVID    

年代:1984

数据来源: OVID

ISSN:0194-911X    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

There has been a dramatic increase in the number of women breast-feeding during the last decade. Since little is known about the excretion of antihypertensive drugs into human breast milk, the management of hypertension during lactation can be problematical. To enable the clinician to better advise the hypertensive, lactating mother, the published literature on the excretion of antihypertensive agents into human milk has been reviewed and is presented in this report.

ISSN:0194-911X    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

To determine the usefulness of the cold pressor test as a predictor of hypertension, we compared the blood pressure recordings available from 142 patients in 1979 with readings obtained during performance of two cold pressor tests, the first in 1934 when these subjects were children, and the second in 1961. Forty-eight subjects were hyperreactors to the tests in either 1934 or 1961, and 94 were normoreactors. At last follow-up, blood pressures in 14 of the hyperreactors were between 140 and 160 mm Hg systolic or 90 and 100 mm Hg diastolic (Stratum 1) and in 20 exceeded 160 mm Hg systolic or 100 mm Hg diastolic (Stratum 2). Ten normoreactors had casual blood pressures in Stratum 1 and eight in Stratum 2. Hypertension had thus occurred in 71% of the hyperreactors and 19% of the normoreactors. Fifteen hyperreactors were receiving antihypertensive therapy, and this reduced the severity of the casual blood pressure elevation in most patients to Stratum 1. Antihypertensive therapy had been started in three normoreactors. The duration of follow-up, 45 years, and the mean age at follow-up, almost 57 years, were greater in this study than in any previously reported study. Early hyperreactivity was related to future hypertension in enough subjects to suggest that an abnormal response to an external cold stimulus may be useful as an indicator of future hypertension.

ISSN:0194-911X    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

In this paper we examine the relationship of growth, obesity, and the degree of sexual and bone maturation to blood pressure in a U.S. national probability sample of 2165 children examined by the U.S. National Center for Health Statistics on two occasions, approximately 4 years apart. Subjects who maintained, increased, or decreased their peer rank order of blood pressure are described. Children who maintained their blood pressure in the upper quintile were taller, heavier, more obese, had greater bone age, greater numbers of permanent teeth, and were more sexually mature than their peers, while those maintaining their blood pressure in the lowest quintile of blood pressure were shorter, lighter, less obese, had lesser bone age, fewer permanent teeth, and were less sexually mature. Subjects whose blood pressures were initially in the lowest four quintiles and then rose to the top quintile were also taller, heavier, more obese, and had greater bone age, while those with blood pressures falling to the lowest quintile from the upper four quintiles were shorter, lighter, less obese, and had lesser bone age. Thus, the level at which blood pressure tracks during childhood is related to growth, obesity, and to the degree of maturation acquired. In addition, children whose blood pressures are rising or falling in relation to their peers have body growth and maturation characteristics similar to those who maintain their rank order high or low respectively.

ISSN:0194-911X    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Increased sympathetic nerve activity may play an important role in the pathogenesis of essential hypertension. It is well known that both dietary sodium intake and age influence the plasma norepinephrine (NE) concentration. The present study was undertaken to evaluate the effects of age on sympathetic nerve activity in patients with essential hypertension and normal control subjects under low-, regular-, and high-sodium regimens (mean 24-hour sodium excretions: 30 ± 4,116 ± 7, 280 ± 15 mEq, respectively). Plasma NE and eplnephrine (E) were analyzed by trihydroxyindole methods after high-performance liquid chromatography separation. Subjects were categorized by age into young (⩽40 yrs), middle-aged (40–60 years), and old (⩾60 years) subgroups. Mean plasma NE in hypertensive patients was significantly higher (p< 0.01) than in normal subjects on each of the sodium regimens. In normal control subjects, there was a significant positive correlation between age and plasma NE with all three sodium intakes. However, no correlation was seen in hypertensive patients on any of the sodium regimens, because in the young subgroup of hypertensive patients the mean plasma NE was significantly higher than that of normal control subjects. These results suggest that the increased sympathetic nerve activity plays an important role in the pathogenesis of essential hypertension, especially in young patients.

ISSN:0194-911X    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The baseline observations in the Puerto Rico Heart Health Program during 1965–1968 involved blood pressure determinations, other measurements, and a 24-hour dietary recall in 7932 men aged 45–64 years. This extensive data base provided an opportunity to test the hypothesis that low calcium intake is related to increased blood pressure level. Among men without baseline coronary heart disease and not taking antihypertensive medication, there was an inverse relationship between milk consumption and definite hypertension in urban Puerto Rican men and older rural men. When data from all age and area groups had been averaged, a twofold increase in hypertension was found in subgroups who drank no milk compared to those who consumed over 1 quart of milk a day. Similar trends were found when an estimate of total calcium intake from food, principally from milk, was used. With multivariate analysis while known correlates of blood pressure were simultaneously considered, an independent effect persisted between milk consumption and blood pressure. These results appeared to confirm an inverse association between calcium and hypertension. It was still not possible to ascribe a causal relationship between calcium and blood pressure, however, due to the intricate network of covarying food intakes, the factors related to absorption or lack of absorption of calcium, and the possible role that unmeasured social and cultural factors may play in the observed relations.

ISSN:0194-911X    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

To study left ventricular (LV) diastolic function of the heart in relation to blood pressure (BP) and other signs of hypertensive cardiac and peripheral vascular changes, isovolumic relaxation time and early diastolic filling were determined in four BP groups of untreated 49-year-old men: normotensive subjects (n = 20), men with borderline hypertension (n = 30), mild hypertension (n = 45), and moderate to severe hypertension (n = 24). Isovolumic relaxation time, measured as the distance between aortic closure (A2, phonocardiography) and mitral valve opening (echocardiography), and early diastolic filling, measured as the distance between mitral valve opening and the O point of the apexcardiogram, tended to increase with BP level, and the total interval from aortic closure to the O point (A2O interval) was significantly prolonged in the two groups with mild and moderate to severe hypertension. A prolonged A2O interval (⩾117% of expected value at observed heart rate) was seen in several hypertensives, who had no obvious increase in LV wall thickness on M mode echocardiography. This suggests that a prolonged LV relaxation time may be an early sign of cardiac involvement in primary hypertension. In the group with moderate to severe hypertension, an increase in LV wall thickness was seen together with an increase in resistance at maximal dilation in the calf. This supports the theory that when changes in cardiac structure develop they occur in parallel with structural changes also in the periphery.

ISSN:0194-911X    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Platelet aggregation induced by 5 μM adenosine 5′-diphosphate (ADP) was significantly higher in men with a family history of essential hypertension than in men without such a history when they were fed a low fat-cholesterol diet with low salt. Platelet aggregation activity was remarkably increased in both groups when the diet was changed from low salt into high salt. Platelet aggregation activity was higher in the group with a positive family history of hypertension on the low fat-cholesterol plus high salt diet than in the group without a family history under the same conditions. The activity was slightly increased in both groups when fed a high fat-cholesterol diet with low salt. There was no significant difference in the platelet aggregation between the two groups. The activity was significantly increased in both groups on the high fat-cholesterol diet after the diet was changed from low salt to high salt. Under both the low and high fat-cholesterol diets, the mean blood pressure was significantly elevated in response to excessive salt intake in the group with a family history of essential hypertension, but it was not elevated in the group without such a family history.

ISSN:0194-911X    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

We have previously described elevated Li,-Naocountertransport (CT) and Na-K cotransport (CO) in red cells of Caucasian patients from Boston. In this study, we report both transport systems in black patients from Philadelphia. The maximal rate (Vmax) of CT was assayed by measuring the Nao-stimulated Li efflux from cells containing ±6 mmol Li/liter. The Vmaxof outward cotransport was assayed by measuring the furosemide-sensitive component of Na and K efflux into Mg medium from cells containing 50 mmol/Iiter of both ions. The mean value of CT for 18 normotensive (NT) subjects with no family history of hypertension, (−) FHH, was 0.18 ± 0.05 (mmol/liter cells × hour); and in 14 hypertensive (HT) patients, 0.18 ± 0.07. The mean values of Na and K cotransport were, respectively (mmol/liter cells × hour), in 18 NT subjects with (−) FHH, 0.38 ± 0.24 and 0.50 ± 0.28 in 18 HT subjects, 0.25 ± 0.17 and 0.24 ± 0.14. We conclude that there is no difference in the Vmaxfor CT between the two groups of black subjects, but that the Vmaxfor Na-K CO was significantly reduced in the HT group. Notably, the offspring of HT patients (age 14 years,n= 17) also had a marked reduction in the Vmaxof Na (0.15 ± 0.17) K cotransport (0.19 ± 14) in comparison with the mean value of Na (0.40 ± 072) and K (0.60 ± 0.3) cotransport measured in offspring (n = 10) of NT subjects (age 14 years). Two main differences between the patterns of red cell cation transport were found in this sample of black patients in comparison with previous studies in Caucasian subjects. First, hypertensive blacks had no significant elevation of Li-Na countertransport, as previously observed in Caucasians; second, the Vmaxof Na-K cotransport was significantly lower in hypertensive blacks than a previous sample of hypertensives. These measurements of red cell cation transport have uncovered heterogeneity in the types of disturbances of Na transport that might be present in the hypertensive population in different frequencies. The results indicate that in this subset of black hypertensive patients and their offspring, the capacity to transport Na against its electrochemical gradient is lower than in hypertensive subjects with elevated countertransport and Na-K cotransport.

ISSN:0194-911X    

出版商:OVID    

年代:1984

数据来源: OVID