Abstract:
BACKGROUND:Our objective was to investigate the association between hypertension and concurrent impairments in mobility, cognition, and mood; the role of brain white matter hyperintensities in mediating this association; and the impact of these impairments on disability and mortality in elderly hypertensive individuals. METHODS AND RESULTS:-Blood pressure, gait speed, digit symbol substitution test, and the Center for Epidemiological Studies Depression Scale were measured yearly (1992-1999) on 4700 participants in the Cardiovascular Health Study (age: 74.7, 58% women, 17% blacks, 68% hypertension, 3600 had brain magnetic resonance imaging in 1992-1993, survival data 1992-2005). Using latent profile analysis at baseline, we found that 498 (11%) subjects had concurrent impairments and 3086 (66%) were intact on all 3 measures. Between 1992 and 1999, 651 (21%) became impaired in all 3 domains. Hypertensive individuals were more likely to be impaired at baseline (odds ratio 1.23, 95% confidence interval 1.04 to 1.42, P=0.01) and become impaired during the follow-up (hazard ratio=1.3, 95% confidence interval 1.02 to 1.66, P=0.037). A greater degree of white matter hyperintensities was associated with impairments in the 3 domains (P=0.007) and mediated the association with hypertension (P=0.19 for hypertension after adjusting for white matter hyperintensities in the model, 21% hazard ratio change). Impairments in the 3 domains increased subsequent disability with hypertension (P<0.0001). Hypertension mortality also was increased in those impaired (compared with unimpaired hypertensive individuals: HR=1.10, 95% confidence interval 1.04 to 1.17, P=0.004). CONCLUSIONS:Hypertension increases the risk of concurrent impairments in mobility, cognition, and mood, which increases disability and mortality. This association is mediated in part by microvascular brain injury.
journal_name
Circulationjournal_title
Circulationauthors
Hajjar I,Quach L,Yang F,Chaves PH,Newman AB,Mukamal K,Longstreth W Jr,Inzitari M,Lipsitz LAdoi
10.1161/CIRCULATIONAHA.110.978114subject
Has Abstractpub_date
2011-03-01 00:00:00pages
858-65issue
8eissn
0009-7322issn
1524-4539pii
CIRCULATIONAHA.110.978114journal_volume
123pub_type
杂志文章相关文献
CIRCULATION文献大全abstract::The purpose of this study was to identify preoperative and intraoperative variables predictive of left ventricular dysfunction 6 months after aortic valve replacement. Patients were considered to have postoperative left ventricular dysfunction if the end-diastolic-volume index was greater than or equal to 101 ml/m2 or...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究
doi:
更新日期:1989-09-01 00:00:00
abstract::All physicians increasingly will encounter patients who have implanted cardioverter-defibrillators (ICDs) for protection from ventricular arrhythmias. This advisory provides a concise summary relevant to the assessment and management of patients with ICDs, including those who present to primary care or emergency depar...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/01.CIR.0000149716.03295.7C
更新日期:2004-12-21 00:00:00
abstract:BACKGROUND:Several mechanisms have been advanced to explain Mobitz type II atrioventricular block in the ischemically damaged His-Purkinje system. Only recently, however, has an animal model been developed to study this form of conduction defect in vivo and in vitro. METHODS AND RESULTS:Conduction defects were induced...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.87.4.1389
更新日期:1993-04-01 00:00:00
abstract::This is a report of a 10-year-old child who underwent surgery for complex congenital heart disease consisting of corrected transposition of the great vessels, ventricular septal defect, patent ductus arterisus, severe left-sided atrioventricular (AV) valve insuffieicney (Ebstein's deformity) and Wolff-Parkinson-White ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.61.6.1256
更新日期:1980-06-01 00:00:00
abstract:BACKGROUND:Vascular endothelial growth factor (VEGF) is an important active protein for the induction of angiogenesis and improvement in cardiac function after myocardial ischemia; however, the lack of a delivery system targeted to the injured myocardium reduces the local therapeutic efficacy of VEGF and increases its ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.800565
更新日期:2009-04-07 00:00:00
abstract::Systemic, renal and splanchnic hemodynamics, intravascular volume, circulating catecholamine levels and plasma renin activity were compared in 39 patients with borderline hypertension and 28 normotensive subjects, who were less than 5% (n = 42, lean patients) or more than 40% overweight (n = 25, obese patients). Lean ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.66.1.55
更新日期:1982-07-01 00:00:00
abstract::In 72% of 143 patients undergoing a second coronary bypass grafting, mural or occlusive late thrombosis was observed histologically in 69% of 173 resected grafts. Late thrombosis was particularly prevalent in atherosclerotic grafts (80.2% vs. 40.4% in nonatherosclerotic grafts) and was always noted in 16 grafts with a...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract:BACKGROUND:Right ventricular (RV) function is the major determinant for both functional capacity and survival in patients with pulmonary arterial hypertension (PAH). Despite the recognized clinical importance of preserving RV function, the subcellular mechanisms that govern the transition from a compensated to a decomp...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.120.047626
更新日期:2020-10-13 00:00:00
abstract::In previous studies from this laboratory, we found that approximately 30% of women with chest pain and normal coronary arteries demonstrated either a decrease in or a failure to increase radionuclide ejection fraction during exercise. To examine the hypothesis that this apparent abnormality in left ventricular functio...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.70.3.357
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND:To simplify extensive primary repair of the thoracic aorta in acute type A aortic dissection, we developed the open triple-branched stent graft placement technique. The early results of this new technique are reported. METHODS AND RESULTS:Between June 2008 and November 2009, 30 patients with acute Stanford ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.110.946012
更新日期:2010-10-05 00:00:00
abstract::One hundred eighteen consecutive patients undergoing valve replacement for aortic stenosis were analyzed to determine the incidence of and predisposing factors to postoperative atrial tachyarrhythmias. Univariate and multivariate analyses were performed on 70 clinical, hemodynamic, radiographic, electrocardiographic, ...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1985-09-01 00:00:00
abstract::Systolic time intervals, stroke volume, cardiac output and (dZ/dt)/RZ index were serially estimated in 51 normal healthy volunteers at sea level, for ten days after air induction to 3658 m altitude and on return to sea level. The subjects were divided into three groups and were administered a diuretic, beta methyldigo...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.57.6.1180
更新日期:1978-06-01 00:00:00
abstract:BACKGROUND:Although c-Kit+ adult progenitor cells were initially reported to produce new cardiomyocytes in the heart, recent genetic evidence suggests that such events are exceedingly rare. However, to determine if these rare events represent true de novo cardiomyocyte formation, we deleted the necessary cardiogenic tr...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.118.033703
更新日期:2018-09-04 00:00:00
abstract:BACKGROUND:We compared ischemic preconditioning (IP) induced with a single cycle of transient ischemia and reperfusion with that induced by multiple cycles in terms of (1) efficacy of protection against myocardial necrosis and (2) susceptibility to pharmacological blockade by inhibition of protein kinase C (PKC) or ele...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.96.3.984
更新日期:1997-08-05 00:00:00
abstract:BACKGROUND:Cardiac allograft vascular disease is characterized by accelerated and diffuse intimal proliferation involving both the microvasculature and epicardial vessels. Because in vivo documentation of this complication is now possible with intracoronary ultrasound imaging, we can examine the relationship of intimal...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.91.6.1647
更新日期:1995-03-15 00:00:00
abstract:BACKGROUND:Hypertrophic cardiomyopathy (HCM) is characterized by myocardial hypertrophy of unknown etiology. Missense mutations of the cardiac beta-myosin-heavy-chain (beta-MHC) gene that may be responsible for cardiac hypertrophy have been detected in patients with HCM. On the other hand, gross structural abnormalitie...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.91.12.2911
更新日期:1995-06-15 00:00:00
abstract::Conventional wall motion analysis of contrast ventriculograms assesses only that part of the wall that is tangential to the x-ray beam. To assess regional left ventricular function in three dimensions, a new computerized method based on densitometric analysis of digital subtraction left ventriculograms was developed a...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.77.2.457
更新日期:1988-02-01 00:00:00
abstract:BACKGROUND:Concern that trans-fatty acids formed in the partial hydrogenation of vegetable oils may increase the risk of coronary disease has existed for several decades, but direct evidence on this relation in humans is limited. METHODS AND RESULTS:With a case-control design, we studied the association between intake...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.89.1.94
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:We compared the efficacy and safety of different dosages of a low-molecular-weight heparin, CY 216 D (Fraxiparine), in the treatment of submassive pulmonary embolism with unfractionated heparin in a prospective, randomized, dose-finding study. METHODS AND RESULTS:The primary outcome was the evolution of pul...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.cir.85.4.1380
更新日期:1992-04-01 00:00:00
abstract:BACKGROUND:Sporadic aortic aneurysm and dissection (AAD), caused by progressive aortic smooth muscle cell (SMC) loss and extracellular matrix degradation, is a highly lethal condition. Identifying mechanisms that drive aortic degeneration is a crucial step in developing an effective pharmacologic treatment to prevent d...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.119.041460
更新日期:2020-01-07 00:00:00
abstract:BACKGROUND:It is unclear whether increased left ventricular (LV) mass in overweight individuals is related to their adiposity or to greater fat-free mass (FFM). METHODS AND RESULTS:We compared echocardiographic LV mass to FFM and adipose body mass by bioelectric impedance and to anthropometric measurements in 3107 Ame...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.98.23.2538
更新日期:1998-12-08 00:00:00
abstract:BACKGROUND:Exaggerated pulmonary hypertension is thought to play an important part in the pathogenesis of high-altitude pulmonary edema (HAPE). Endothelin-1 is a potent pulmonary vasoconstrictor peptide that also augments microvascular permeability. METHODS AND RESULTS:We measured endothelin-1 plasma levels and pulmon...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.99.20.2665
更新日期:1999-05-25 00:00:00
abstract:BACKGROUND:Few data are available on the prevalence of hypertension in Mexico. METHODS AND RESULTS:We compared the prevalence of mild hypertension (systolic blood pressure > or = 140 mm Hg and/or diastolic blood pressure > or = 90 mm Hg and/or use of antihypertensive medications) in 1500 low-income Mexican Americans w...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.90.3.1542
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:Mutations in the cardiac sodium (Na) channel gene (SCN5A) give rise to the congenital long-QT syndrome (LQT3) and the Brugada syndrome. Na channel blockade by antiarrhythmic drugs improves the QT interval prolongation in LQT3 but worsens the Brugada syndrome ST-segment elevation. Although Na channel blockade...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/hc3501.093797
更新日期:2001-09-04 00:00:00
abstract::We studied 14 patients to determine whether sustained-release diltiazem is a satisfactory long-term substitute for the combination of propranolol plus hydrochlorothiazide (HCTZ), control phase, in the treatment of systemic hypertension with coexisting chronic stable angina pectoris. All patients had either one- or two...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1989-12-01 00:00:00
abstract::One thousand four Medtronic Hall valves (601 mitral, 398 aortic, and five tricuspid) were implanted in 847 patients between December 1979 and June 1987. Total experience at the end of June 1987 was 2,640 patient-years of follow-up. Prothrombin time ratios were reviewed for all patients (16,866 observations), and these...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract:BACKGROUND:This multicenter trial was conducted to determine the efficacy and safety of pimobendan, an inotropic agent with calcium-sensitizing properties and activity as a phosphodiesterase inhibitor, in patients with heart failure. METHODS AND RESULTS:One hundred ninety-eight ambulatory patients with symptoms of mod...
journal_title:Circulation
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1161/01.cir.85.3.942
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Specific transcription factors (TFs) modulate cardiac gene expression in murine models of heart failure, but their relevance in human subjects remains untested. We developed and applied a computational approach called transcriptional genomics to test the hypothesis that a discrete set of cardiac TFs is assoc...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.106.632430
更新日期:2006-09-19 00:00:00
abstract:BACKGROUND:The maternal circulatory system and hormone balance both change dynamically during pregnancy, delivery, and the postpartum period. Although atrial natriuretic peptides and brain natriuretic peptides produced in the heart control circulatory homeostasis through their common receptor, NPR1, the physiologic and...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.119.039761
更新日期:2020-02-18 00:00:00
abstract:BACKGROUND:Tumor necrosis factor-alpha (TNF-alpha) and angiotensin II (Ang II) modulate heart failure in part by provoking the hypertrophic response. Signal transduction pathways of those factors are implicated in reactive oxygen intermediates (ROIs). Therefore, we hypothesized that TNF-alpha and Ang II might cause myo...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.98.8.794
更新日期:1998-08-25 00:00:00