Abstract:
:Antihypertensive drugs are often initiated and adjusted over a period of weeks to months. It is not clear whether the time and inconvenience of this approach is necessary. We studied whether or not drug adjustment over several days in the context of a physician-nurse team could produce a durable blood pressure benefit according to home blood pressure measurements. Sixty-eight patients (aged 65 +/- 1 years, 47% men) were referred for management of hypertension. Indications for referral were new hypertension (13%), known/controlled hypertension (30%), or known/uncontrolled hypertension (57%). Patients had one to three brief nurse visits/day and were provided with an accurate semiautomated device for self-blood pressure (BP) measurement. Sixty patients provided follow-up data. Group 1 (n = 16) required no change in their preexisting drug regimen during clinic visits, whereas group 2 (n = 44) had drug therapy initiated or adjusted over 4 +/- 1 days. Patients were evaluated at baseline, at dismissal from the clinic, and at latest follow-up (mailed-in report of 42 readings taken over 7 days at 1- to 3-month intervals). Mean follow-up was 11 +/- 0.5 months. Mean BP at baseline, dismissal, and latest follow-up for group 1 were 132 +/- 4/73 +/- 2, 130 +/- 6/70 +/- 2, and 125 +/- 3/73 +/- 3 mm Hg (P = not significant). Mean BP for group 2 at the same intervals were 150 +/- 4/80 +/- 2, 139 +/- 3 (P < .01 v baseline)/75 +/- 2, 133 +/- 2 (P < .01 v baseline and < .05 v dismissal)/74 +/- 1 (P < .01 v baseline). The BP control rate (blood pressures less than 140/90 mm Hg) was 75% in group 2. Drug number/dose remained the same or lower in 87% and 91% of patients during follow-up in groups 1 and 2, respectively. These results suggest that a clinically significant lowering of blood pressure can often be achieved over several days and maintained for up to 1 year. Increased use of rapid drug titration, a physician-nurse team approach, and self-BP measurement at prescribed intervals have the potential to improve BP control rates and reduce the expense and inconvenience associated with the treatment of hypertension.
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Canzanello VJ,Jensen PL,Hunder Idoi
10.1016/s0895-7061(00)01273-5subject
Has Abstractpub_date
2001-04-01 00:00:00pages
345-50issue
4 Pt 1eissn
0895-7061issn
1941-7225pii
S0895-7061(00)01273-5journal_volume
14pub_type
杂志文章abstract:BACKGROUND:In hypertensives, nondippers are more likely than dippers to suffer silent, as well as overt, hypertensive target organ damage. In this study, we investigated whether a nondipper status was associated with target organ damage in normotensives. METHODS:We performed ambulatory blood pressure (BP) monitoring, ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(03)00567-3
更新日期:2003-06-01 00:00:00
abstract::Responses of renin release and blood pressure to aspirin DL-lysine (ASP) were examined to find out if the responses could help in the differentiation between unilateral renovascular hypertension (RVH) and hyperreninemic essential hypertension (EHT). The two studies involved ten patients with unilateral RVH, eight with...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/4.9.761
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:This study analyzed whether hypertension induced by N(omega)-nitro-l-arginine methyl ester (L-NAME) is associated with dysregulation of the main antioxidant enzymes (superoxide dismutase [SOD], catalase, glutathione peroxidase [GPX], and glutathione reductase [GR]) and whether chronic administration of tempo...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2004.12.022
更新日期:2005-06-01 00:00:00
abstract::Cardiovascular morbid events occur as a consequence of vascular and cardiac disease, which can be identified long before symptoms of organ involvement become apparent. Early detection of abnormalities in the small arteries, especially deficiency of endothelial nitric oxide bioactivity, and of structural changes of rem...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/s0895-7061(01)02092-1
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:Differences between the antihypertensive responses to drug therapy measured by office blood pressure (OBP) and ambulatory blood pressure monitoring (ABPM) techniques have been noted but rarely analyzed. We studied whether the OBP and 24-h ABPM responses to hydrochlorothiazide differ and, if so, the relevance...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1016/j.amjhyper.2004.10.021
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:Pregnancy-induced hypertension (PIH) is associated with chronic hypertension (HTN) and cardiovascular complications. We investigated the factors that predict the development of chronic HTN in women with PIH. METHODS:The study population comprised 108 women with PIH and 87 healthy age-matched women control s...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpv073
更新日期:2016-01-01 00:00:00
abstract::The Captopril Prevention Project (CAPPP) is an ongoing prospective intervention study in 10,800 hypertensive patients in Sweden and Finland. Patients are randomized to treatment with either conventional antihypertensive therapy, ie, diuretics or beta-blockers, or the angiotensin-converting enzyme inhibitor captopril. ...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:Obstructive sleep apnea (OSA) and left ventricular (LV) hypertrophy are considered to be closely associated. However, the relationship has not yet been fully demonstrated and is hence still controversial. The purpose of this study was to assess in hypertensive male patients the relationship between OSA and c...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpv115
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Morning blood pressure (BP) surge seems to be a risk factor for cardiovascular events. Although physical activity after arising significantly affects morning BP surge, it has remained unclear whether morning BP surge after controlling for physical activity (morning BP reactivity) is associated with target or...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.06.015
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Schlager inbred hypertensive mice (BPH/2J) have been suggested to have high blood pressure (BP) due to an overactive sympathetic nervous system (SNS). The brain nuclei associated with the hypertension are also those involved in the integration of the cardiovascular responses to stress. Therefore, in the pres...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2010.69
更新日期:2010-08-01 00:00:00
abstract::There are a variety of radiopharmaceuticals that can be used to perform captopril renography effectively. We examined a number of technetium and iodine compounds and the circumstances under which each radiopharmaceutical compound is the compound of choice. Considerations of cost, ease of use, reliability, dosage, and ...
journal_title:American journal of hypertension
pub_type: 共识发展会议,杂志文章,评审
doi:10.1093/ajh/4.12.747s
更新日期:1991-12-01 00:00:00
abstract:BACKGROUND:Prenatal lipopolysaccharide (LPS) exposure causes hypertension in rat offspring through an unknown mechanism. Here, we investigated the role of the intrarenal renin-angiotensin system (RAS) in hypertension induced by prenatal LPS exposure and also explored whether adipose tissue-derived mesenchymal stem cell...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpx117
更新日期:2017-11-06 00:00:00
abstract:BACKGROUND:Evaluating effect of acute or chronic use of antihypertensives on risk of falls in older adults. METHODS:Data sources: Systematic search of primary research articles in CINAHL, Cochrane, EBM, EMBASE, and MEDLINE databases from January 1 2007 to June 1 2017. Study selection: Research studies of cohort, case-...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpx189
更新日期:2018-03-10 00:00:00
abstract::The role of an endogenous sodium pump inhibitor in the pathogenesis of hypertension has been reported in several papers. Unfortunately, because of the unknown structure and lack of biochemical characterization, some discrepancies have arisen. In this study we report a method to obtain extracts from human plasma that a...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/1.3.56s
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:We compared the cost-effectiveness of hypertension treatment in non-Hispanic blacks and non-Hispanic whites according to 2014 US hypertension treatment guidelines. METHODS:The cardiovascular disease (CVD) policy model simulated CVD events, quality-adjusted life years (QALYs), and treatment costs in 35- to 7...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpw047
更新日期:2016-10-01 00:00:00
abstract::Primary investigators of randomized drug trials in hypertension were invited to rate quality of such trials. The intention of the survey was to ask if antihypertensive drug therapy reduces incidence of coronary heart disease (CHD) in hypertensive patients. Response was obtained for 7 of the 11 invited investigators, c...
journal_title:American journal of hypertension
pub_type: 杂志文章,meta分析
doi:10.1093/ajh/7.8.703
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND:Liddle's syndrome (LS) is a monogenic form of hypertension simulating a mineralocorticoid excess, and is currently suspected in young hypokalemic hypertensives. The aims of the study were: (i) to evaluate the clinical phenotype of LS in a newly identified Italian family of Sicilian origin carrying a gain-of-...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2011.76
更新日期:2011-08-01 00:00:00
abstract::Essential hypertension conveys an increased risk of cardiovascular morbidity and mortality. The common finding of an autonomic imbalance in these patients contributes not only to the etiology of hypertension itself, but also to the cardiac risk and resulting adverse sequelae. A high sympathetic tone in particular is r...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/s0895-7061(00)00228-4
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:The renal resistive index (RI) measured using Doppler ultrasonography has been used as a diagnostic tool in the daily work-up of kidney diseases. A better understanding of its relationship with preclinical organ damage may help in determining overall cardiovascular risk in hypertensive patients. METHODS:We ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2012.113
更新日期:2012-12-01 00:00:00
abstract::The nature of the cardiovascular response to isometric exercise is still debated. An adequate blood supply to exercising muscles at the onset of contraction seems to be an important factor controlling the extent of pressor response to isometric contraction. In comparison to normotensive subjects without familiar hyper...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/1.3.106s
更新日期:1988-07-01 00:00:00
abstract::Recent publications purporting to show that calcium antagonists, when used for the treatment of hypertension or in the post myocardial infarction patient, would paradoxically increase the rate of heart attack and mortality have cast doubts on the safety and efficacy of this drug class. All three studies are retrospect...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/s0895-7061(96)00387-1
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:Dyslipidemia in hypertensive sibships may be characterized by atherogenic small low-density lipoprotein (LDL) particles. Whether LDL particle size is associated with the extent of coronary atherosclerosis in hypertensive sibships is unknown. METHODS:Subjects (n = 792, mean age 62 years, 60% women) were asce...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2004.06.012
更新日期:2004-09-01 00:00:00
abstract::To evaluate potential physiological actions of atrial natriuretic peptide (ANP) in humans, normal male volunteers were studied in the supine and head-up tilt positions both in the absence and presence of an ANP infusion at a rate which increased plasma ANP levels to ranges observed during physiological stimuli such as...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/4.3.219
更新日期:1991-03-01 00:00:00
abstract::The objective of the present study was to determine the relationship between plasma renin levels, and the development of hypertension and cardiac hypertrophy in TGR (mREN2)27 hypertensive rats. Systolic blood pressure and left ventricular mass index (LVMI) were measured in transgenic heterozygote and normotensive Spra...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(95)00254-5
更新日期:1995-12-01 00:00:00
abstract::In essential hypertension (EHT) the presence of a metabolic syndrome increases the risk of cardiovascular disease. A cell membrane abnormality is implicated but its role in cardiovascular disease is unclear. Neutrophil accumulation, which occurs by beta2-integrin (CD11b/CD18) expression, followed by release of proinfl...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(01)02136-7
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:Erectile dysfunction (ED) is common among men taking antihypertensive drugs to control blood pressure. We evaluated the safety and efficacy of sildenafil citrate for treating ED in men taking multiple antihypertensive medications in a randomized, double-blind, placebo-controlled trial. METHODS:A total of 56...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/j.amjhyper.2004.07.004
更新日期:2004-12-01 00:00:00
abstract::This study included the introduction of a new, qualitative, self-structured measure of quality of life (QOL) after meta-analysis had shown that prestructured quantitative measures yielded insignificant results. This study compared the pre- and post-treatment evaluations of 268 men with mild hypertension, aged 40 to 65...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1093/ajh/6.3.62s
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:Sleep apnea is being studied as a risk factor for hypertension. This observational chart review was conducted to determine the long-term effects of continuous positive airway pressure (CPAP) treatment on blood pressure (BP) in a sample of sleep apnea patients from urban and rural populations. METHODS:This s...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2004.11.031
更新日期:2005-05-01 00:00:00
abstract::Cicletanine sulfate was tested on bicarbonate-dependent pHi changes in cultured vascular smooth muscle (A10 line). Cicletanine sulfate exhibited double reactivity with regard to the cell alkalinization induced by bicarbonate uptake. The analysis of 11 concentration-response curves revealed a high reactivity component ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/6.8.674
更新日期:1993-08-01 00:00:00
abstract:BACKGROUND:Seventeen percent of youth in the United States are obese. Obesity has been linked to higher prevalence of hypertension. Past studies were limited by their size and conflicting results. The aim of this study was to analyze trends in adolescents' obesity between 1998 and 2011 and to evaluate the relationship ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpv007
更新日期:2015-09-01 00:00:00