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, covering 69% of patients and 75% of CHD cases. Principal component analysis was used to construct a quality score based on answers to 12 questions along visual analog scales. The score correlated well with the answer to a global question of overall quality given by the raters. No systematic tendency toward favoring one's own trial could be demonstrated, therefore, all raters have contributed to the rating. The trials with the highest rated quality to answer the research question were Systolic Hypertension in the Elderly Program (SHEP), Australian National Blood Pressure Study, Medical Research Council, Veterans Administration, and European Working Party of Hypertension in the Elderly. The large Heart Detection and Follow-up Program (HDFP) trial was rated at 11th place among the trials with a score of < 40% of the SHEP. The small trials performed in the 1960s were placed at the bottom of the ranking list. Because SHEP is the only trial without diastolic hypertension, results were given with and without SHEP results. When incorporating the quality score into a meta-analysis of CHD outcome, results were dependent on whether SHEP was included or not. For diastolic hypertension only, the effect of therapy was estimated to be about 8% for all higher quality studies, whereas inclusion of the lower quality HDFP changed it to 14%. When isolated systolic hypertension trial was pooled with the others, no major relation to quality rating was observed. A 14% CHD preventive efficacy was established when pooling the three top quality studies. This stayed unchanged until HDFP at rank 11 was included raising this estimate to 16%. Inclusion of the two latest published trials in the elderly, the Medical Research Council trial of treatment of hypertension in older adults and the Swedish Trial in Old Patients with hypertension, did not change this overall estimate of 16% (standard error = 3.8%). It is concluded that if all randomized drug trials in hypertension had the same treatment efficacy, the estimated CHD prevention would be in the range of 15%. Subgroup analyses revealed no relationship to age, but a difference in efficacy was shown depending on whether the trials were performed in the United States or elsewhere. Also, patients at higher risk levels showed better benefit than lower risk patients.
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Holme I,Ekelund LG,Hjermann I,Leren Pdoi
10.1093/ajh/7.8.703subject
Has Abstractpub_date
1994-08-01 00:00:00pages
703-12issue
8eissn
0895-7061issn
1941-7225pii
0895-7061(94)90045-0journal_volume
7pub_type
杂志文章,meta分析abstract:BACKGROUND:The risk for cardiovascular events increases within hours of near-roadway exposures. We aimed to determine the traffic-related air pollution (TRAP) and biological mechanisms involved and if reducing particulate matter <2.5 µm (PM2.5) inhalation is protective. METHODS:Fifty healthy-adults underwent multiple ...
journal_title:American journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1093/ajh/hpz113
更新日期:2019-10-16 00:00:00
abstract:BACKGROUND:Ionized magnesium levels are elevated in fetal blood compared with maternal blood, suggesting that the placenta may possess an active transport mechanism for magnesium. In the present study, we sought to determine the existence of an active transport mechanism for magnesium in the placenta using cultured tro...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(02)02272-0
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:Research on associations between blood pressure, brain structure, and cognitive function has produced somewhat inconsistent results. In part, this may be due to differences in age ranges studied and because of sex differences in physiology and/or exposure to risk factors, which may lead to different time cou...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpu120
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Many studies have examined differences in hypertension across race/ethnic groups but few have evaluated differences within groups. METHODS:We investigated within-group geographic variations in hypertension prevalence among 3,322 black and white participants of the Multi-Ethnic Study of Atherosclerosis (MESA...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.211
更新日期:2010-01-01 00:00:00
abstract::To determine if a remodeling of the collagen matrix would occur in the absence of hypertrophy and cell necrosis and if such a remodeling could alter active and passive stiffness of the intact myocardium, five rats with genetic hypertension (SHR) were treated (SHRT) with hydralazine for 32 weeks, beginning at four week...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/2.9.675
更新日期:1989-09-01 00:00:00
abstract::Insulin acutely inhibits contraction of primary cultured vascular smooth muscle (VSM) cells from canine femoral artery by inhibiting contractile agonist-induced Ca2+ influx. Insulin also inhibits contraction at step(s) distal to intracellular Ca2+ concentration (Ca2+i) by stimulating cyclic guanosine monophosphate (GM...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(99)00239-3
更新日期:2000-04-01 00:00:00
abstract::The effects of long-term oral administration of quinapril on the occurrence of stroke and on mortality were investigated in young salt-loaded stroke-prone spontaneously hypertensive rats (SHR-SPs) during the treatment period (8th-34th week of age) and up to 6 weeks thereafter. Simultaneously, blood pressure, saline in...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/6.11.951
更新日期:1993-11-01 00:00:00
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...
journal_title:American journal of hypertension
pub_type: 社论,评审
doi:10.1016/j.amjhyper.2003.12.007
更新日期:2004-04-01 00:00:00
abstract::We have previously reported that myocardial microsomal Na+,K(+)-ATPase activity, arterial wall ouabain-sensitive 86Rb uptake, and arterial smooth muscle cell membrane potentials are decreased and plasma Na(+)-K+ pump inhibitory activity is increased in rats during the fifth week of one-kidney, one-clip hypertension. W...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract::Angiotension converting enzyme (ACE) inhibitors and beta-blockers have been reported to possess disparate effects on insulin sensitivity. The aim of this study was to study the effects of the selective beta-1 blocker bisoprolol and of the ACE inhibitor captopril on cellular insulin action in hypertensive individuals. ...
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/s0895-7061(97)00320-8
更新日期:1997-12-01 00:00:00
abstract::The induction of learned helpless (LH) behavior in rats is a widely used model of unipolar depression. Recent studies have linked depression with hypertension and insulin resistance as observed in obesity, but the propensity of these disorders to manifest depression has not been reported. In this study, the LH behavio...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(99)00271-x
更新日期:2000-06-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2008.215
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:The independent prognostic value of daytime and night-time blood pressure (BP) variability estimated by noninvasive 24-h BP monitoring is unclear. METHODS:We followed 2649 initially untreated subjects with essential hypertension for up to 16 years (mean, 6). Variability of BP was estimated by the standard d...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2006.07.017
更新日期:2007-02-01 00:00:00
abstract::To determine whether baroreflex is changed centrally before the development of hypertension in DOCA-salt treated rats, aortic depressor nerve was stimulated electrically 5 days after DOCA-salt treatment in urethane-anesthetized rats: compared with those of sham-operated control rats, blood pressure was not elevated in...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/1.3.23s
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:Home blood pressure measurement (HBPM) is recommended by hypertension guidelines, particularly in the elderly. However, feasibility of HBPM in this age group has not been fully established. Our objective was therefore to assess HBPM feasibility in elderly individuals of the general population. METHODS:After...
journal_title:American journal of hypertension
pub_type: 杂志文章,多中心研究
doi:10.1038/ajh.2012.121
更新日期:2012-12-01 00:00:00
abstract::This review analyses methods and devices used worldwide to evaluate the arterial stiffness. Three main methodologies are based upon analysis of pulse transit time, of wave contour of the arterial pulse, and of direct measurement of arterial geometry and pressure, corresponding to regional, systemic and local determina...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/s0895-7061(02)02962-x
更新日期:2002-08-01 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::A wide pulse pressure (PP) may constitute an independent predictor of cardiovascular morbidity and mortality. We assessed the reference values of brachial clinic PP, according to age and gender in a nonselected population (61,724 subjects) who were undergoing a routine systematic health examination. According to mean ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(01)01284-5
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:The reduction of coronary flow reserve (CFR) found in arterial hypertension may be due to changes in afterload, left ventricular (LV) structure, and metabolic factors. Also, insulin-like growth factor-1 (IGF-1) may be associated with the magnitude of CFR in relation to its modulating action on cardiac and en...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(02)02967-9
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:Genetic factors may influence blood pressure (BP) responses to dietary potassium intake. We examined the association of genetic variants in the apelin-APJ system and angiotensin-converting enzyme 2 (ACE2) with BP responses to potassium supplementation. METHODS:We conducted a 7-day potassium supplementation ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2010.36
更新日期:2010-06-01 00:00:00
abstract::National standards govern the manufacture and marketing of medical devices in the United States, including those for indirect blood pressure measurement in man. There are no comparable standards for devices for recording in laboratory animals. Noninvasive tail cuff blood pressure (BP) recording in the rat is widely ac...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(96)00321-4
更新日期:1997-02-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/2.6.440
更新日期:1989-06-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/2.2.7s
更新日期:1989-02-01 00:00:00
abstract:BACKGROUND:Insulin inhibits contraction and migration of primary confluent, cultured canine vascular smooth muscle cells (VSMCs) with inducible nitric oxide synthase (iNOS) by stimulating cyclic GMP (cGMP) production. The present study was performed to determine how insulin stimulates guanylate cyclase activity in thes...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(01)02289-0
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Azilsartan medoxomil (AZL-M), an angiotensin II receptor blocker, demonstrates antihypertensive and organ protective effects in hypertension. We investigated the efficacy of AZL-M to ameliorate metabolic syndrome and kidney damage associated with type 2 diabetes using Zucker diabetic fatty (ZDF) rats. METHO...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpu016
更新日期:2014-08-01 00:00:00
abstract::The term "blood pressure" was coined almost 300 years ago by the man who first measured it, the Reverend Stephen Hales of England. However, our understanding of the pathogenesis and consequences of hypertension, as well as the available treatments for it, have remained greatly limited and inadequate until only the pas...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/s0895-7061(02)03004-2
更新日期:2002-10-01 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 antidiabetic drug metformin lowers blood pressure (BP) more in spontaneously hypertensive rats (SHR) compared with Wistar-Kyoto rats (WKY), and the hypotensive effect is enhanced by high dietary salt. To determine whether enhanced hypotension is secondary to greater decreases in sympathetic nerve activity (SNA), w...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(99)00119-3
更新日期:1999-12-01 00:00:00
abstract::In order to further characterize previously described racial differences in intracellular Ca2+ homeostasis, the activity of sarcoplasmic-endoplasmic reticulum Ca2+-ATPase was measured in cultured skin fibroblasts from normotensive African-Americans and whites. Cells originated from apparently healthy, normotensive Afr...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(96)00415-3
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:As a serious pregnancy-specific condition, preeclampsia (PE) is a serious pregnancy-specific condition characterized by insufficient trophoblastic invasion and shallow placental implantation. Long noncoding RNA uc.187, which is transcribed from an ultra-conserved region is highly expressed in the placental t...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpaa011
更新日期:2020-04-29 00:00:00