Abstract:
BACKGROUND:Although a hypertensive response to exercise (HRE) is associated with cardiac risk and masked hypertension (MHT), its mechanisms and appropriate treatment remain unclear. We investigated spironolactone as a treatment for abnormal vascular and myocardial stiffness in HRE. METHODS:In this randomized, double-blind, placebo-controlled study of 115 patients (54 ± 9 years, 57% men) with an HRE (≥210/105 mm Hg in men; ≥190/105 mm Hg in women) but no prior history of hypertension or myocardial ischemia, MHT prevalence was 40%. Patients were randomized to spironolactone 25mg daily (n = 58) or placebo (n = 57) and underwent evaluation at baseline and 3 months with exercise echocardiography, VO2max, pulse wave velocity (PWV), exercise and central blood pressure (BP), and 24-hour ambulatory BP. Changes in left ventricular mass index (LVMI), Doppler-derived E/em ratio (LV filling pressure), and myocardial strain were assessed. RESULTS:Baseline 24-hour systolic BP (SBP) was 133 ± 10 mm Hg and peak-exercise SBP was 219 ± 16 mm Hg. Peak systolic strain (0.3 ± 3.6% vs. -0.1 ± 3.2, P = 0.56), E/em (-1.1 ± 2.3 vs. -0.6 ± 1.7, P = 0.30), VO(2max) (0.4 ± 4.9 vs. -0.9 ± 4.1 ml/kg/min, P = 0.15), and adjusted PWV did not significantly change with treatment, despite reduction in exercise SBP, 24-hour SBP, and LVMI. The change in exercise E/em was of borderline significance (-0.3 ± 2.4 vs. 0.8 ± 2.8, P = 0.06) and became significant after adjustment for baseline differences (P = 0.01). Patients with higher LVMI significantly increased VO(2max) (1.1 ± 5.6 vs. -2.4 ± 4.4 ml/kg/min, P < 0.05) and reduced exercise E/e(m) (-0.7 ± 2.7 vs. 1.9 ± 2.8, P < 0.05). CONCLUSIONS:In HRE patients without previous hypertension, short-term spironolactone reduced exercise BP, 24-hour ambulatory BP, LVMI, and E/e(m) but did not significantly alter exercise capacity or myocardial strain.
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Hare JL,Sharman JE,Leano R,Jenkins C,Wright L,Marwick THdoi
10.1093/ajh/hpt008subject
Has Abstractpub_date
2013-05-01 00:00:00pages
691-9issue
5eissn
0895-7061issn
1941-7225pii
hpt008journal_volume
26pub_type
杂志文章,随机对照试验abstract::When injected into the medullary site of the hypotensive action of clonidine, imidazolines and related compounds decrease blood pressure (BP), whereas no phenylethylamine compounds were capable of producing such an effect at the same site. There is much biochemical and pharmacologic evidence to support the involvement...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/s0895-7061(01)02238-5
更新日期:2001-11-01 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::The effects of increased dietary calcium intake on blood pressure and arterial function were investigated in one-kidney deoxycorticosterone-salt hypertensive Wistar rats. The calcium content of the control diet was 1.1%, and that of the high calcium diet, 2.5%. During the 10-week study calcium supplementation markedly...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/7.6.520
更新日期:1994-06-01 00:00:00
abstract:BACKGROUND:Aim of this study was to evaluate the effect of the telmisartan-amlodipine combination at different doses on urinary albumin excretion rate (UAER) in hypertensive diabetic patients with microalbuminuria. METHODS:After a 2-week placebo period, 300 hypertensive patients with type 2 diabetes and microalbuminur...
journal_title:American journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.amjhyper.2006.10.002
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Although the renin-angiotensin system and insulin resistance (IR) have been identified as major regulators of plasminogen activator inhibitor type-1 (PAI-1), their roles in hypertensive subjects is not clearly defined. METHODS:We examined the effect of dietary salt restriction on PAI-1 levels in 239 hyperte...
journal_title:American journal of hypertension
pub_type: 杂志文章,多中心研究
doi:10.1016/s0895-7061(02)02952-7
更新日期:2002-08-01 00:00:00
abstract::Conflicting reports exist as to whether air traffic controllers (ATC) have an increase in blood pressure (BP) and prevalence of hypertension because of the stressful nature of their job. We have addressed the issue in male ATC working at the Linate airport of Milan. A total of 80 ATC participated, and the 24 h blood p...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(97)00321-x
更新日期:1998-02-01 00:00:00
abstract::While only a small percentage of the population has high blood pressure, a much larger segment of the US population has a high-normal (above optimal) blood pressure, and is at increased risk for hypertension and its cardiovascular sequelae. Hypertension is thus a population-wide problem and must be approached in much ...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/4.11s.646s
更新日期:1991-11-01 00:00:00
abstract::The ambulatory blood pressure load is generally defined as the proportion of elevated systolic or diastolic pressures over a 24 h period. This value represents the chronic pressure overload that induces myocardial and vascular damage associated with the hypertensive disease process. Blood pressure load has been define...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/0895-7061(96)87761-2
更新日期:1996-10-01 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::Endothelin-1 is a potent vasoconstrictor peptide produced in blood vessels and other tissues that may play an important role in the control of local blood flow and could be involved in the pathogenesis of hypertension. Our previous studies have documented increases in endothelin-1 peptide content and gene expression i...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(95)96213-4
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:B-type natriuretic peptide (BNP) increases the risk of death and cardiovascular events in patients without heart failure, even at BNP values within the "normal" range. The reasons for this are unclear. METHODS:We performed two separate studies (n = 33 and n = 129) on subjects with type 2 diabetes mellitus i...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.06.016
更新日期:2005-12-01 00:00:00
abstract::This multicenter, randomized, controlled clinical trial assessed the influence of sodium chloride intake on the antihypertensive effect of the calcium channel blocker isradipine. Participants with uncomplicated hypertension controlled by isradipine entered a 4-week sodium-restricted (60 to 80 mmol/24 h) period. Partic...
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/s0895-7061(96)00295-6
更新日期:1997-01-01 00:00:00
abstract::The nonpeptide angiotensin II (AII)-receptor antagonist losartan is a selective blocker of the pressor effects of AII. It is now being evaluated as an anti-hypertensive drug in multicenter clinical trials in the United States and other countries. Preliminary inpatient studies have shown that after 5 days of treatment,...
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/5.12.247s
更新日期:1992-12-01 00:00:00
abstract:BACKGROUND:Increases in blood pressure were reported in overworked public workers following the Mid-Niigata earthquake. This study aimed to compare blood pressure changes between public employees and the general population after the Great East Japan Earthquake of March 2011. METHODS:We analyzed 1,776 individuals from ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpt065
更新日期:2013-09-01 00:00:00
abstract::Previous studies showed that alpha 2-adrenergic receptors and imidazoline-guanidinium receptive sites (IGRS) are colocalized in rabbit and human renal proximal tubule. In the present study we investigated the localization of these two binding sites in the renal medulla from human kidney. Binding studies performed with...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/5.4.69s
更新日期:1992-04-01 00:00:00
abstract::The aim of this study was to compare the efficacy (lowering diastolic blood pressure to 90 mm Hg or less) of urapidil, a postsynaptic alpha-blocker with central action with that of captopril in a randomized, double-blind, multicenter study. Two hundred ninety-five essential hypertensives (WHO I/II) (140 male, 155 fema...
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/1.3.233s
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:Salt sensitivity of blood pressure (SSBP) increases the risk of cardiovascular complications, and the heritability of SSBP is about 50% in Chinese population. However, studies identifying genes involved in BP responses to acute sodium loading and diuresis shrinkage are still limited. METHOD:A total of 342 e...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpx179
更新日期:2018-03-10 00:00:00
abstract::Despite advances in the availability and quality of antihypertensive medications and the institution of national programs to educate people about the seriousness of hypertension, much remains to be done. The percentages of people who are aware of their disease, are being treated for it, and are achieving adequate cont...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/s0895-7061(00)00273-9
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:Determinants of exercise capacity have not been clearly defined in hypertensive patients. Doppler tissue imaging (DTI), a recently developed echocardiographic modality, is useful for evaluating left ventricular (LV) function regardless of loading conditions. The present study was performed to identify the de...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(03)00842-2
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Ryanodine receptor (RyR) dysfunction in skeletal muscle (RyR1) leads to malignant hyperthermia, and in cardiac muscle (RyR2) triggers cardiac arrhythmias. We hypothesized that RyR dysfunction in vascular smooth muscle could increase vascular resistance and hypertension, and may contribute to increased atrial...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpaa021
更新日期:2020-04-29 00:00:00
abstract:BACKGROUND:Functional status may be useful for identifying older adults who benefit from lower blood pressure. We examined whether functional status modifies the effect of antihypertensive treatment among older adults. METHODS:Post hoc analyses of the Systolic Hypertension in the Elderly Program (SHEP), a randomized t...
journal_title:American journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1093/ajh/hpv177
更新日期:2016-06-01 00:00:00
abstract::To study potential ionic factors predisposing to vascular disease in hypertension, particularly among black subjects, we used a recently developed combined magnesium and calcium specific, ion selective electrode apparatus to measure extracellular ionized calcium (Ca-ion), ionized magnesium (Mg-ion), and Ca-ion/Mg-ion ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(97)00364-6
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:This study investigated the relationship of ethnicity to the differences between blood pressure (BP) measured in a clinic setting and by ambulatory blood pressure monitoring (ABPM) in individuals with a previous diagnosis of hypertension (HT) and without a previous diagnosis of hypertension (NHT). METHODS:A...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpu211
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Various factors are implicated in the circadian pattern of cardiovascular vulnerability. The exact mechanisms involved in the peak incidence of cardiovascular events occurring during the early morning hours after awaking are not completely known. The purpose of our study was to investigate the circadian vari...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.09.020
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Our aim was to assess whether home blood pressure (HBP) and ambulatory BP monitoring measurement (ABPM), in addition to office BP (OBP) predict changes of cardiovascular biomarkers during antihypertensive treatment. METHODS:Two hundred and fifty-two hypertensive patients (mean age, 68 years; men: 41%) under...
journal_title:American journal of hypertension
pub_type: 杂志文章,多中心研究
doi:10.1038/ajh.2011.229
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:We have recently shown that the renin enhancer, a regulatory element of renin gene transcription, is important in the long-term control of basal blood pressure (BP). In this study, we examined whether the renin enhancer deficit alters the acute pressor response to emotional stress in mice. METHODS:Under flu...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2007.02.010
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:We examined the associations of epithelial sodium channel (ENaC) genes with blood pressure (BP) changes and hypertension incidence in a longitudinal family study. METHODS:A total of 2,755 Han Chinese participants of the Genetic Epidemiology Network of Salt Sensitivity (GenSalt) baseline examination were eli...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpu060
更新日期:2014-11-01 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
abstract:BACKGROUND:The expression of Na(+)-K(+)-2Cl(-) cotransporter 1 (NKCC1) is upregulated in spontaneously hypertensive rat (SHR). We investigated whether expression of NKCC1 is epigenetically regulated during postnatal development of hypertension. METHODS:The mesenteric arteries from 5-, 10-, and 18-week-old Wistar-Kyoto...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2011.136
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Pulse pressure, a measure of central arterial stiffness and a predictor of cardiovascular mortality, has known genetic components. METHODS:To localize the genetic effects of pulse pressure, we conducted a genome-wide linkage analysis of 1,892 American-Indian participants of the Strong Heart Family Study (SH...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2007.34
更新日期:2008-02-01 00:00:00