Abstract:
OBJECTIVES:The aim of this study was to determine whether pulse pressure is a risk factor for coronary artery disease using data from the MRC trial of treatment of mild hypertension, and whether the effect of anti-hypertensive drug therapy on pulse pressure may be a determinant of outcome in treated patients. METHODS:Logistic regression and Cox regression analyses were used to compare systolic and diastolic blood pressure, pulse pressure and mean blood pressure as predictors of coronary events and stroke in the MRC Mild Hypertension Trial. The effects of anti-hypertensive drug treatment with bendrofluazide and propranolol on pulse pressure were assessed using 1-year follow-up data. Event rates in the placebo-treated group and responses to anti-hypertensive treatment were measured in quartiles of age-adjusted entry pulse pressure. A 'four-corners' analysis was performed, with subjects divided into the upper and lower halves of the distributions of systolic and diastolic blood pressure at entry. RESULTS:Pulse pressure was a stronger predictor of coronary events than systolic, diastolic or mean blood pressure in males by logistic regression. Pulse pressure was similar to systolic pressure as a coronary event predictor on Cox regression. Stroke was predicted most strongly by mean blood pressure. Fatal and non-fatal coronary event rates increased progressively in ascending quartiles of age-adjusted pulse pressure, but there was also a strong correlation with systolic blood pressure. The values of partial logistic regression coefficients in models containing both systolic and diastolic blood pressure also supported a role for pulse pressure in predicting coronary events and for mean blood pressure in predicting stroke. Coronary risk, but not stroke, was inversely related to diastolic blood pressure in the four-corners analysis. In a Cox model, regressions of coronary event probability on systolic blood pressure at entry were significantly and inversely related to diastolic blood pressure categorized in quartiles. Bendrofluazide but not propranolol decreased pulse pressure significantly and was associated with a reduction in cardiovascular events overall, but no definite relationship between the effect of drugs on pulse pressure and specific responses to treatment was seen. CONCLUSION:Pulse pressure is a strong risk factor for coronary events in untreated hypertensive male subjects in the MRC Mild Hypertension Trial, whereas stroke is best predicted by mean blood pressure. Bendrofluazide and propranolol have different effects on pulse pressure which may be related to their relative efficacy in the treatment of hypertension, but this possibility requires further study in more suitable populations.
journal_name
J Hypertensjournal_title
Journal of hypertensionauthors
Millar JA,Lever AF,Burke Vdoi
10.1097/00004872-199917080-00004subject
Has Abstractpub_date
1999-08-01 00:00:00pages
1065-72issue
8eissn
0263-6352issn
1473-5598journal_volume
17pub_type
临床试验,杂志文章abstract:OBJECTIVES:The goal of this study was to compare the cardiovascular responses to behavioural stressors of three groups of adolescents who differed in blood pressure status across assessments. DESIGN:Casual blood pressure of adolescents who were identified as having elevated blood pressure during a school screen was re...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200101000-00003
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:To examine the changes in plasma brain natriuretic peptide (BNP), atrial natriuretic peptide (ANP) and blood pressure in patients with essential hypertension on a low, normal and high sodium intake. DESIGN AND METHODS:Twelve patients with mild-to-moderate essential hypertension were studied. Plasma, urinary ...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVE:To clarify the spectrum of the left ventricular responses in hypertension in man by means of coupled analysis of elastances. In the present study we analysed the 'functional' coupling of the left ventricle and the arterial system in terms of the arterial effective elastance (E(a)) divided by a value of end-sy...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVE:The present study was designed to investigate the effect of nicardipine administration upon systolic blood pressure (SBP) and cardiac hypertrophy in spontaneously hypertensive rats (SHR). DESIGN:SBP, heart: and left ventricle: body weight ratios, the cross-sectional area of cardiocytes, and the ultrastructur...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199206000-00002
更新日期:1992-06-01 00:00:00
abstract:OBJECTIVE:The objective is to evaluate the relationship between cholesterolemia, serum apolipoprotein B (apoB) level and blood pressure in a large sample of general population. METHODS:The Brisighella Heart Study (BHS) is a prospective, population-based longitudinal epidemiological investigation. For this study, we an...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32834f6b11
更新日期:2012-03-01 00:00:00
abstract::A10 vascular smooth muscle cells were placed in a flow chamber and exposed to the circulation of foetal calf serum at different rates and pressures. Under unidirectional laminar flow, physiological flow rates and pressures had almost no effect on internal sodium content. Indeed, pressure values greater than 150 mmHg w...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199111000-00008
更新日期:1991-11-01 00:00:00
abstract:OBJECTIVES:The global morbidity and mortality related to hypertension and associated disorders increases continuously and novel therapeutic strategies are still in high demand. Increasing evidence suggests the important role in blood pressure regulation of cytochrome P-450-dependent metabolites of arachidonic acid. Epo...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002462
更新日期:2020-09-01 00:00:00
abstract::Using antibodies raised against angiotensin I and II, and high-performance liquid chromatography (HPLC) of plasma extracts, we have quantified six angiotensin peptides in venous (cubital vein) and arterial (brachial) plasma of normal male subjects. The concentrations of venous plasma (fmol/ml, mean +/- s.d., n = 29) f...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199002000-00011
更新日期:1990-02-01 00:00:00
abstract:OBJECTIVE:It has been postulated that hypertension in the spontaneously hypertensive rat (SHR) results from autoimmune damage to the SHR vasculature. The objective of this study was to isolate autoreactive T-cells specific for arterial antigens, and to characterize these cells. DESIGN:The presence of autoreactive T-ce...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199312000-00002
更新日期:1993-12-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that combination therapy might be a powerful tool to reduce blood pressure variability (BPV) in the treatment of hypertension. METHODS:In chronic studies, male spontaneously hypertensive rats were given drugs in their rat chow for 18 weeks (n = 9 or 10 for each group of rats). Doses we...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3282ef547f
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:To determine adrenocorticotrophin dose-response relationships for increase of blood pressure and metabolic parameters of the Sprague-Dawley rat. METHODS:We injected 120 male Sprague-Dawley rats twice daily subcutaneously for 10 days with 0.5, 1, 5, 50, 100, 200 or 500 microg/kg synthetic adrenocorticotrophin...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199816050-00006
更新日期:1998-05-01 00:00:00
abstract:OBJECTIVES:Recent studies have revealed an association between coronary risk factors and both the number and function of bone marrow-derived endothelial progenitor cell (EPC). We investigated the effect of angiotensin II (Ang II) on EPC senescence, leading to the impairment of proliferative activity. METHODS AND RESUL...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200501000-00018
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVES:The genes responsible for obesity are also candidate genes for obesity-related conditions, such as hypertension and type 2 diabetes. A functional polymorphism in the uncoupling protein 2 (UCP2) promoter has been reported to be associated with obesity in Caucasians. To clarify the contribution of this polymor...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200401000-00018
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Constitutional hypotension (CHT) is defined as a SBP below 105 mmHg. As autonomic-related symptoms are frequently reported in CHT, these symptoms suggest that the cardiovascular autonomic control is perturbed in individuals with CHT. METHODS:We investigated the autonomic cardiovascular control of 15 women w...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001790
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVES:To investigate whether glucose or insulin is the cause of increases in oxidative stress and blood pressure in insulin-resistant animals, and to evaluate the effects of alpha-lipoic acid (LA) on the production of the superoxide anion (O2-) in the aorta and blood pressure elevations in various models of diabet...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000160215.78973.ba
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVES:This study presents a reliable index inspired by the total variability concept of real analysis in mathematics, called average real variability (ARV), for the prognostic significance of blood pressure variability (BPV) overcoming the pitfalls of the commonly used standard deviation (SD). BACKGROUND:Recent s...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000160205.81652.5a
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVES:Arterial stiffness is associated with excess morbidity and mortality, independently of other cardiovascular risk factors. Age is the main determinant responsible for arterial wall changes leading to arterial stiffening. Environmental and genetic factors may however influence the magnitude of the effects of a...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200103000-00008
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:The Fas-Fas ligand (FasL) system is involved in apoptosis in many types of cells. Recently, the expression of FasL on endothelial cells was reported. FasL is cleaved by a metalloproteinase and released in serum as soluble FasL (sFasL). Vasoactive substances, including metalloproteinase, are modulated by endo...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200205000-00024
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVE:To compare the effects of a cardioselective beta-blocker (nebivolol) with those of an angiotensin-converting enzyme inhibitor (enalapril) on parameters of insulin sensitivity, peripheral blood flow and arterial stiffness during one extended glucose clamp experiment. DESIGN:A randomized, double-blind crossove...
journal_title:Journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.hjh.0000234121.48272.67
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:In 68 randomized controlled trials (RCTs), blood pressure (BP) lowering was obtained by using drugs of different classes. We have investigated whether BP lowering by any of the major drug classes is effective in reducing the cardiovascular outcomes. METHODS:A total of 55 RCTs (19,5 267 indivi...
journal_title:Journal of hypertension
pub_type: 杂志文章,meta分析,评审
doi:10.1097/HJH.0000000000000447
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:To ascertain the relationships between the kinetic properties of erythrocyte Na+-H+ exchange [maximum kinetic energy (Vmax), Michaelis constant (Km) for internal H+ and Hill's coefficient], Na+-Li+ (Vmax and Km for external Na+), and metabolic parameters in normotensive controls and hypertensive subjects. MA...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:Recent cross-sectional studies have suggested that higher serum sodium levels may be a marker of elevated blood pressure. It is unclear whether serum sodium levels are related to the risk of developing hypertension in the community. METHODS:We investigated the association of serum sodium with longitudinal b...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32830fe4a5
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:Preeclampsia is associated with an elevated risk of cardiovascular disease later in life. Women with a history of preeclampsia are at risk of developing hypertension as well as ischemic heart disease. Identification of women at the highest risk is important to initiate preventive strategies. We investigated w...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002497
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:The major advantage of dual inhibitors of neutral endopeptidase (NEP) and angiotensin converting enzyme (ACE) is their ability to lower blood pressure irrespective of renin or volume status. The aim of this study was to determine whether dual NEP/ACE inhibition produces different effects on cardiovascular str...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200018060-00013
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVE:Aldosterone is produced in the ventricle of patients with hypertension. The present study was designed to examine whether adrenocorticotropic hormone (ACTH) and cortisol are also produced from the heart in patients with essential hypertension. METHODS:The study population consisted of 57 patients with essent...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200502000-00024
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVE:Exercise training has antihypertensive and renoprotective effects in humans and rats. However, the effects of exercise training on renal disorders that occur with salt-sensitive hypertension remains unclear. The study aim was to investigate the effects and mechanisms of exercise training on renal function in ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002409
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:Spontaneously hypertensive rats (SHR) are sensitive to a high salt intake and we investigated the question of whether flow-induced dilation is affected by this type of diet, as flow responses are especially sensitive to small changes in extracellular sodium concentrations. METHODS:We evaluated the effects of...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199816100-00013
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVES:Treatment modifications--addition, uptitration, switching, and downtitration--are necessary to address issues such as unattained blood pressure goals, adverse drug events, drug cost, or patient dissatisfaction which lead to treatment discontinuation. This study assessed the patterns of treatment modification...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000806
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:Sodium is the mineral that has been, mainly, linked to hypertension and cardiovascular disease. It is found naturally in many foods, but is also used in the food industry and manufacturing. Identification of total sodium intake, as well as 'hidden' sodium intake from food sources early in life is necessary. ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e328345ef35
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVE:In essential hypertension, the mechanical properties of the radial artery have been shown to be largely unaltered, whereas more controversial and less reliable data have been obtained for the common carotid artery. We therefore examined the distensibility/pressure relationships of the predominantly elastic co...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199715120-00070
更新日期:1997-12-01 00:00:00