Abstract:
BACKGROUND:Secondary prevention of stroke with antihypertensive drugs is now standard practice, but it is unclear how soon after a cerebrovascular event antihypertensive therapy should be initiated or re-started. Due to impaired cerebral autoregulation, changes in systemic blood pressure may be reflected in cerebral perfusion, especially in hypertensive patients immediately post-stroke. Conversely, early initiation in hospital may better assure continued long-term treatment. We have investigated the effect of the angiotensin II receptor antagonist (ARA) losartan on mean arterial blood pressure (MABP), global and focal cerebral blood flow (CBF), and glomerular filtration rate (GFR) in hypertensive patients 2-7 days after stroke. METHODS:Twenty-four patients without occlusive carotid disease but with MABP between 110 and 145 mmHg were studied within 2-7 days of ischaemic stroke/transient ischaemic attack (TIA). They were randomized to receive either placebo or losartan (25 or 50 mg daily). MABP and internal carotid artery (ICA) flow were measured at baseline, over the following 24 h and at 2 weeks. Brain hexamethylpropyleneamine oxime single photon emission computed tomography (HMPAO SPECT) was performed before dosing and at the estimated time of peak drug effect (6-8 h after the first dose). GFR was measured at baseline and at 2 weeks. RESULTS:The mean National Institutes of Health (NIH) score of randomized patients was 2.6; losartan was generally well tolerated and no patient suffered a deterioration in neurological function. A mean placebo-corrected intra-subject reduction in MABP of 9.5 mmHg was observed in treated patients from 1-12 h (P = 0.0001), with a maximal fall of 18.1 mmHg at 9 h post-dose (P = 0.002). No change occurred in ICA flow, or cortical or hemispheric CBF measured by HMPAO SPECT. No significant change in GFR was seen within or between groups. DISCUSSION:Losartan may be introduced within 2-7 days of mild stroke in hypertensive patients in whom significant carotid occlusive disease has been excluded without affecting global or regional CBF, or affecting GFR.
journal_name
J Hypertensjournal_title
Journal of hypertensionauthors
Nazir FS,Overell JR,Bolster A,Hilditch TE,Reid JL,Lees KRdoi
10.1097/00004872-200405000-00022subject
Has Abstractpub_date
2004-05-01 00:00:00pages
989-95issue
5eissn
0263-6352issn
1473-5598pii
00004872-200405000-00022journal_volume
22pub_type
临床试验,杂志文章,随机对照试验abstract:OBJECTIVE:To verify the benefit of renin-angiotensin system blockade in hypertension, the effects of 24 weeks' losartan and ramipril treatment, both alone and in combination, on urinary albumin excretion (UAE) and circulating transforming growth factor beta1 (TGF beta1) have been evaluated in hypertensive subjects with...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.hjh.0000160225.01845.26
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVES:Current clinical guidelines of primary aldosteronism recommend adrenalectomy (AdX) for unilateral primary aldosteronism based on the studies showing the potential superiority of AdX over the medical treatment. However, since most medically treated cases consisted of bilateral primary aldosteronism and all su...
journal_title:Journal of hypertension
pub_type: 杂志文章,多中心研究
doi:10.1097/HJH.0000000000002070
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:As a new category of blood pressure (BP) classification according to the Seventh Report of The Joint National Committee, prehypertension has aroused people's great concern in recent years due to its associations with increased incidence of cardiovascular disease. However, there is little information about th...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32834f9dd3
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVE:To investigate whether the glycoprotein (gp130)-mediated survival pathway, which protects cardiomyocytes from apoptosis, is depressed in left ventricular hypertrophy hypertensive patients with chronic heart failure. METHODS:Transvenous endomyocardial biopsies were obtained in 52 hypertensive patients with le...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32828626e2
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:Studies were undertaken to clarify the pathophysiologic significance of endogenous endothelin in the control of blood pressure and renal hemodynamics in spontaneously hypertensive rats (SHR). DESIGN:The technique of passive immunization was used to neutralize endogenous endothelin in order to estimate the co...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1992-08-01 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:BACKGROUND:The effects of aspirin in subjects without cardiovascular disease are controversial. In the intensively treated patients of the Hypertension Optimal Treatment (HOT) Study, randomization to low-dose aspirin (75 mg daily) versus placebo significantly reduced cardiovascular events (-15%) and myocardial infarcti...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004872-200211000-00031
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVE:Endothelin is thought to be related to cardiovascular disease. The purpose of this study was to determine whether endothelin levels could be reduced by a calcium antagonist and a 'natural factor'. DESIGN:Since calcium ionophores can induce endothelin-1 messenger RNA synthesis in cultured endothelial cells, t...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199309000-00012
更新日期:1993-09-01 00:00:00
abstract::To establish the role of angiotensin converting enzyme inhibitors in the management of hypertension in the elderly, 16 patients were treated with captopril in a randomized double-blind placebo-controlled cross-over study. Clinic blood pressure, ambulatory blood pressure, renal function and mental performance, with emp...
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:1989-04-01 00:00:00
abstract:OBJECTIVE:Considering the growing body of evidence that indicates the contribution of superoxide anions (O2) and other reactive oxygen species (ROS) to the development of hypertension, we assessed whether animal models of hypertension have a benefic effect with tempol, a superoxide dismutase mimetic, to help augment th...
journal_title:Journal of hypertension
pub_type: 杂志文章,meta分析,评审
doi:10.1097/HJH.0000000000000422
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE:Hypertension and fractures related to osteoporosis are major public health problems that often coexist. This study examined the associations between exposure to different antihypertensive drug classes and the risk of hip fracture in hypertensive patients. METHOD:We included 59 246 individuals, 50 years and o...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002245
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVES:To review, on a genome-wide scale, a linkage result obtained in an earlier candidate gene analysis in this same study sample, and to look for other possible contributing genetic loci predisposing to hypertension in this population. DESIGN:An affected sibpair linkage study with highly polymorphic genetic mar...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200018110-00008
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVES:We assessed the prevalence and determinants of high blood pressure (BP), and barriers to diagnosis and treatment, in Dar es Salaam, Tanzania. METHODS:We surveyed and screened 2174 community-dwelling adults aged at least 40 years in 2014 and conducted a follow-up after 1 year. RESULTS:Median BP was 131/81 m...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001117
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to evaluate the 24-h urinary sodium excretion in children of 10-12 years at a school in the north of Portugal and to examine the influence on salt intake and blood pressure of three different educational interventions for 6 months. METHODS:Blood pressure (BP) and sodium excretion in ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e328363572f
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVES:Mean blood pressure varies moderately with outdoor air temperature in many western populations. Substantial uncertainty exists, however, about the strength of the relationship in other populations and its relevance to age, adiposity, medical treatment, climate and housing conditions. METHODS:To investigate ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32835465b5
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:Blood pressure normally declines during the night ('dipping'); a blunted nocturnal decline is an important cardiovascular risk factor. Marriage may be associated with lower ambulatory blood pressure, although this may be confounded by socio-economic and dietary factors. We examined the association of marital ...
journal_title:Journal of hypertension
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/HJH.0000000000000107
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVES:Cardiovascular dysautonomia can be present at early, late and even prodromal stages of Parkinson's disease. This study aimed to describe the characteristics of 24-h ambulatory blood pressure (BP) monitoring and investigate the frequency of cardiovascular dysautonomia in Parkinson's disease without an abnorma...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002536
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Besides its capacity to regulate organ and tissue growth, the insulin-like growth factor I exerts biologic actions that resemble those of insulin. Tissue access of the factor depends on the distribution of the circulating bound factor between its binding protein 3 that remains within the intravascular space ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199715100-00014
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVES:The role of circadian rhythm of energy and macronutrient intake in influencing cardiometabolic risk factors is increasingly recognized. However, little is known of the association between time of energy intake and blood pressure. We examined the association between time-of-day of energy intake and subsequent...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32835ecc06
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVE:To investigate the characteristics and expression of transforming growth factor (TGF)-beta receptor subtypes on vascular smooth muscle cells (VSMC) from spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto (WKY) rats. METHODS:The effects of TGF-beta 1 on DNA synthesis were evaluated by [3H]-th...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199508000-00003
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVES:Patients with end-stage renal-disease under hemodialysis have increased cardiovascular risk and experience severe blood pressure (BP) fluctuations during the dialysis session and the subsequent interdialytic period. BP variability (BPV) may be an additional risk factor for cardiovascular events and prelimina...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001478
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVES:Local atrial tissue angiotensin II (AngII) level is elevated in atrial fibrillation (AF), but the mechanism is unknown. We hypothesized that atrial myocytes express all components of the renin-angiotensin system (RAS) and investigated whether rapid depolarization alone is sufficient to increase paracrine Ang...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3282f34a4a
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVE:In previous studies we demonstrated that the administration of furosemide associated with L-arginine contributes to enhanced hypotension and induces greater water than electrolyte excretion, in both normal and expansion conditions. The aim of the present study was to elucidate the interaction between furosemi...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000125445.28861.8a
更新日期:2004-08-01 00:00:00
abstract::Basal platelet function was measured in 35 40-year-old men with untreated mild essential hypertension and compared with 44 age-matched normotensive men. The groups differed significantly with respect to platelet size in venous blood (hypertensive, 7.46 +/- 0.10 X 10(-15) l versus normotensive, 7.11 +/- 0.09 X 10(-15) ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1987-08-01 00:00:00
abstract:OBJECTIVES:Current evidence demonstrates that both genetic and environmental factors influence blood pressure. The sympathetic nervous system is a key player in blood pressure control and functional genetic variants of the beta-2 adrenergic receptor (B2AR) have been identified and implicated in the pathogenesis of hype...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000209983.28735.33
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:Nephrin, a cytoskeletal protein which localizes to the slit pore of podocytes, may play a role in proteinuria. This study examines the possible relationship between nephrin expression and albuminuria in normotensive and hypertensive diabetic rats. METHODS:Streptozotocin diabetes was induced in both Wistar-Ky...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200205000-00034
更新日期:2002-05-01 00:00:00
abstract::Atrial natriuretic peptide (ANP) plays a pivotal role in modulation of vascular function and it is also involved in the pathophysiology of several cardiovascular diseases. We provide an updated overview of the current appraisal of ANP vascular effects in both animal models and humans. We describe the physiological imp...
journal_title:Journal of hypertension
pub_type: 杂志文章,评审
doi:10.1097/HJH.0b013e32835ed5eb
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:To investigate the rate of albumin excretion and the prevalence of albuminuria in hypertensive individuals relative to the normotensive population, and to clarify the quantitative importance of confounding variables. DESIGN AND METHODS:We examined the morning urines of all consecutive non-diabetic and diabet...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199605000-00016
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:Dopamine receptors induce natriuresis in kidney. Previous studies have shown interactions between different subtypes of dopamine receptors in renal proximal tubule (RPT) cells. We hypothesize that D3 receptors have an interaction with D4 receptors in RPT cells from normotensive rats (Wistar-Kyoto, WKY) and s...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000986
更新日期:2016-08-01 00:00:00
abstract:AIMS:Myocardial fibrosis is a relevant component of hypertensive heart disease (HHD). Novel cardiovascular magnetic resonance (CMR) imaging techniques have shown potential in quantification of diffuse cardiac fibrosis, with T1 mapping, and estimating preclinical cardiac dysfunction, with strain analysis. Molecular biom...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002504
更新日期:2020-10-01 00:00:00