Abstract:
:The most common reason for an outpatient physician visit is for the diagnosis and treatment of hypertension. The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC) VII, which is increasingly evidence-based, advises the clinician to use studies of the mean response and benefit derived from reduction in blood pressure (BP) from antihypertensive therapy and to translate this data into recommendations for the individual hypertensive patient. We believe that the increasingly aggressive approach to hypertension mandated by JNC VII calls into question the use of physician-measured BP. Ample evidence has shown that phycisians have not been adequately trained to measure BP and, therefore, rarely measure BP to the standards asked for by JNC VII or the American Heart Association (AHA) guidelines. In addition, the white coat effect dilutes the validity and usefulness of physician-measured BPs. Finally, in the evidenced-based studies used to derive the JNC VII guidelines, BPs were measured by nurses, other "trained observers," or automated devices, not physicians. Accurate BP measurement is critical to diagnosis and management of hypertension. We recommend, therefore, that for this purpose physicians should not measure BP themselves but should rely on BPs from well-trained and monitored observers or validated automated devices to improve the quality of care of the hypertensive patient.
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Graves JW,Sheps SGdoi
10.1016/j.amjhyper.2003.12.007subject
Has Abstractpub_date
2004-04-01 00:00:00pages
354-60issue
4eissn
0895-7061issn
1941-7225pii
S0895706103012524journal_volume
17pub_type
社论,评审abstract:BACKGROUND:High blood pressure (BP) is associated with the presence and severity of subclinical disease. Less is known about associations between normal levels of BP and various measures of subclinical disease. METHODS:The Multi-Ethnic Study of Atherosclerosis (MESA) enrolled 6814 participants free of clinical cardiov...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2006.04.002
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Guidelines recommend that patients with newly elevated office blood pressure undergo ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring (HBPM) to rule-out white coat hypertension before being diagnosed with hypertension. We explored patients' perspectives of the barriers and facili...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpy062
更新日期:2018-07-16 00:00:00
abstract:BACKGROUND:The collateral circulation is important in maintenance of blood supply to the ischemic kidney distal to renal artery stenosis (RAS). Obesity metabolic syndrome (MetS) preserves renal blood flow (RBF) in the stenotic kidney, but whether this is related to an increase of collateral vessel growth is unknown. We...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpy127
更新日期:2018-11-13 00:00:00
abstract::Nitric oxide synthase (NOS) blockade increases blood pressure (BP) and modifies glomerular and tubular function. Angiotensin II (AII) blockade restores glomerular and tubular function but does not lower BP. We measured plasma renin activity (PRA), plasma (AIIp), and kidney tissue (AIIk) AII with radioimmunoassay to in...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(97)00123-4
更新日期:1997-10-01 00:00:00
abstract::Components of the kallikrein kinin system have been associated with the pathophysiology of hypertension in animal and human studies. In this study, we examined the distribution of four different polymorphisms of the kinin B1 and B2 receptor genes in a population of 120 normotensive and 77 hypertensive African-American...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(00)01215-2
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:It is known that essential hypertension may be implicated in the development of cognitive impairment that is associated to microvascular disease of the brain. It has been hypothesized that increased arterial stiffness of the large arteries may lead to microvascular changes due to increased pulsatile flow. Ou...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.35
更新日期:2009-05-01 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:Few population studies have described the heritability and intrafamilial concordance of the retinal microvessels, or the genetic or environmental correlations of the phenotypes of these vessels. METHODS:We randomly selected 413 participants from 70 families (mean age, 51.5 years; 50.1% women) from a Flemish...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hps064
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Despite readily available treatments, control of blood pressure (BP) with population aging remains suboptimal. Further, there are gaps in the understanding of the management of high BP in the aged. We explored antihypertensive treatment and control among elderly hypertensive participants free from overt card...
journal_title:American journal of hypertension
pub_type: 杂志文章,多中心研究
doi:10.1093/ajh/hpz192
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Essential hypertension ranks among the strongest cardiovascular risk factors. Cytokine production by monocytes plays a key role in atherosclerosis development and acute coronary syndromes. We investigated whether stimulated monocyte cytokine release and its inhibition by glucocorticoids would differ between ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2004.01.010
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:In uremic animals, vitamin D receptor (VDR) agonists like paricalcitol (Pc) attenuate cardiac hypertrophy, but this effect has not been replicated consistently in humans with chronic kidney disease. Elevated fibroblast growth factor 23 (FGF23) levels cause cardiac hypertrophy with activation of the myocardia...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpy154
更新日期:2019-01-01 00:00:00
abstract::The aim of this study was to assess the macrostructure of the kidney and the grade of heterogeneity in renal cortical circulation in the early stages of essential hypertension. The subjects consisted of 84 patients (<50 years old) who underwent dynamic computed tomography (CT) because of various abdominal diseases and...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(00)01281-4
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:Endothelial dysfunction and arterial stiffening are commonly observed in type 2 diabetes. These abnormalities might be secondary to increased plasma concentrations of homocysteine. We sought to determine whether oral folic acid supplementation, by lowering homocysteine levels, enhanced endothelial function a...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.amjhyper.2004.08.036
更新日期:2005-02-01 00:00:00
abstract::High affinity Ca2(+)-activated, Mg2(+)-dependent ATP-ase [Ca2+ + Mg2+)-ATPase) activities were characterized in the membrane fractions of the porcine aorta. The (Ca2+ + Mg2+)-ATPase activity, similar to those found in the plasma membranes of the erythrocyte and the heart, ie, Ca2(+)-pumping ATPase activity, was not fo...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/3.8.249
更新日期:1990-08-01 00:00:00
abstract:BACKGROUND:Hypertension and smoking independently contribute to the risk of stroke. Our objective was to investigate home blood pressure (HBP) levels, day-by-day BP variability, and smoking in the prediction of stroke in Japanese men. METHODS:In this study, 902 men (mean age, 58.6 years) without a past history of stro...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2012.62
更新日期:2012-08-01 00:00:00
abstract::Compliance is commonly defined as the extent to which a person's behavior coincides with medical or health advice. There is evidence that noncompliance is a common problem with many medications, including antihypertensive treatment. Since noncompliance can have serious adverse effects on patient health it is important...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/0895-7061(95)00195-6
更新日期:1995-10-01 00:00:00
abstract:BACKGROUND:Many patients prefer herbal medications to conventional drugs. Limited trial evidence suggests that garlic preparations reduce high blood pressure (BP). METHODS:We searched electronic databases through March 2014 to identify all randomized controlled trials that compared a garlic preparation to placebo in h...
journal_title:American journal of hypertension
pub_type: 杂志文章,meta分析,评审
doi:10.1093/ajh/hpu165
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Recent studies have shown that hyperuricemia may be associated with incident hypertension (HTN). We examined whether serum uric acid (SUA) is a predictor of HTN and target organ damage (TOD) 20 years later in initially healthy middle-aged individuals. METHODS:Participants from the Suivi Temporaire Annuel No...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpaa030
更新日期:2020-09-10 00:00:00
abstract::After nephrectomy, the level of arterial pressure is determined by the permitted degree of fluid volume expansion. With kidneys present, the fundamental requirement for fluid volume homeostasis is met by maintaining the balance between sodium and water intake and output. When one-kidney, one-clip (1-K,1-C) hypertensio...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/4.10.534s
更新日期:1991-10-01 00:00:00
abstract::Our objective was to describe the relationship of arterial stiffness and hypertension in a large, population-based sample of men and women. Hypertension-related increases in arterial stiffness may reflect the distending pressure and/or structural alterations in the artery. Included were 10,712 participants, ages 45 to...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(99)00281-2
更新日期:2000-04-01 00:00:00
abstract::To examine the effects of hypertension on renal graft function, we studied the clinical course of 144 kidney transplant recipients who had functioning grafts for three to 13 years. The patients were divided into three groups: normotensive (n = 32), controlled hypertensive (n = 49) and uncontrolled hypertensive group (...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/2.5.341
更新日期:1989-05-01 00:00:00
abstract::Our objective was to evaluate pretreatment predictors of longevity, particularly blood pressure, in a large cohort of hypertensive men. During 1974 to 1976, 10,367 male hypertensive veterans (47% black) were identified at screening and subsequently characterized in 32 special Veterans Administration (VA) hypertension ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(99)00214-9
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:Hypertensive disorders of pregnancy, including preeclampsia (PE), affect approximately 7-10% of pregnancies in the US. Clinical and experimental studies strongly suggest that the maternal immune system plays a role in the development of these disorders; however, few therapeutic options exist aside from deliv...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.125
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:Overweight/obese young men have increased sympatho-excitation to cold and pain stress-induced by the cold pressor test (CPT) that may lead to abnormal hemodynamic responses. Concurrent CPT and exercise may augment the sympathetic-induced increases in aortic blood pressure (BP), pressure wave reflection (augm...
journal_title:American journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1093/ajh/hpv043
更新日期:2015-11-01 00:00:00
abstract::The comparative efficacy of the calcium antagonists isradipine and nifedipine in reducing left ventricular peak systolic wall tension was assessed in 25 patients with essential hypertension (20 men, 5 women; mean age: 49 years). After 2 weeks of treatment with either isradipine (2.5 mg twice daily) or slow-release nif...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/ajh/6.3.92s
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:Blood pressure is a complex quantitative trait with a strong genetic component. In this study, we leveraged the Veterans Affairs electronic medical record system to explore the relationship between Paraoxonase 1 (PON1)-108 C/T (rs705379) and mean arterial blood pressure (MAP). METHODS:Outpatient blood press...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2012.106
更新日期:2012-11-01 00:00:00
abstract::It is premature to state that ambulatory blood pressure (ABP) values below a given level should be considered normal, and those above it abnormal, in terms of prognostic implications on cardiovascular (CV) morbidity. We do not know whether CV morbidity in hypertensive subjects with apparently normal ABP (white coat hy...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:
更新日期:1993-06-01 00:00:00
abstract:BACKGROUND:The prevalence of hypertension in the Middle East is not well defined. We examined the prevalence, awareness, treatment, and control of hypertension in Iran. METHODS:The Survey of Risk Factors of Noncommunicable Diseases was conducted in 2005 and contains a representative sample of the Iranian adult populat...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2008.154
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:Hypertension and proteinuria are risk factors for adverse renal outcomes in patients with chronic kidney disease. This study investigated the associations of blood pressure and proteinuria on renal function in a community-based population. METHODS:We analyzed data from a nationwide database of 141,514 subje...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpv003
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVES:Central blood pressure (BP) can be used to define hypertension. A central BP approach may be more sensitive than a conventional brachial BP approach in detecting hypertension. We aimed to compare the 2 approaches in estimating the prevalence hypertension in a nationally representative population. METHODS:A ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpx178
更新日期:2018-02-09 00:00:00