Abstract:
OBJECTIVE:To carry out a population-based evaluation of withdrawal of treatment in primary care using repeated ambulatory blood pressure monitoring (ABPM) assessment to avoid subjecting patients to prolonged periods of excess risk. METHOD:Patients from two community practices (total population 11 034 patients) being administered monotherapy for hypertension, were identified and invited to participate. Subjects were withdrawn from treatment if they had no significant co-morbidity and daytime ABPM blood pressure was < or = 150/90 mmHg. Antihypertensive therapy was restarted if daytime ABPM blood pressure was > 150/90 mmHg during weeks 4, 8, 12, 26, 39 and 52. RESULTS:Of 126 eligible patients 53 had a co-morbidity and 37 declined to participate. Of the 36 patients who entered the study 10 were excluded because they had elevated ABPM blood pressures during treatment and one because they had echocardiographic left ventricular hypertrophy. Of the 25 patients from whom monotherapy was withdrawn, we restarted treatment of 19 before week 52. If clinic blood pressure monitoring had been used instead of ABPM, different decisions would have been taken in eight of 25 cases. The costs of the ABPM-determined withdrawal of treatment programme were greater than the expected savings in drug costs, even assuming that all six patients from whom treatment was withdrawn remained without treatment for a further 9 years. This conclusion was not sensitive to reducing the number of ABPM measurements and to inflation in study-drug costs. However, if all patients had been treated with the most expensive drug, then even the full ABPM programme could have saved money within 9 years. CONCLUSIONS:Antihypertensive therapy could be withdrawn from only a small proportion of patients in the community on the basis of ABPM. The costs of the programme are likely to exceed savings unless the cost of drugs administered is substantially higher than that observed in this study.
journal_name
J Hypertensjournal_title
Journal of hypertensionauthors
Prasad N,Davey PG,Watson AD,Peebles L,MacDonald TMdoi
10.1097/00004872-199715120-00021subject
Has Abstractpub_date
1997-12-01 00:00:00pages
1519-26issue
12 Pt 1eissn
0263-6352issn
1473-5598journal_volume
15pub_type
杂志文章abstract::The binding of 125I-angiotensin II to human blood cells was investigated. Blood was drawn from healthy volunteers and platelets prepared with minimal contamination of red cells and white blood cells (less than 0.1%). Using thin layer chromatography, degradation of 125I-angiotensin II by platelets could be demonstrated...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-198504000-00004
更新日期:1985-04-01 00:00:00
abstract:OBJECTIVE:To assess the trends in blood pressure (BP) and in body mass index (BMI) in the hypertensive and normotensive population in Finland during 1982-1997. DESIGN:Four independent cross-sectional standardized population surveys were conducted in 1982, 1987, 1992 and 1997. SETTING:The provinces of North Karelia an...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200018030-00003
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to identify the time of blood pressure (BP) drop in the orthostatic hypotension test, and to propose a realistic and appropriate duration in the orthostatic hypotension test. METHODS:A total of 879 consecutive patients (61-year-old and 44% women) with positive on the orthostatic...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002554
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Cardiovascular diseases represent the most common cause of death in the English-speaking Caribbean, and hypertension represents the most important predisposing condition. However, direct between-country comparative studies in the Caribbean have not previously been undertaken. OBJECTIVE:To obtain estimates o...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVE:To examine the association of blood pressure (BP) with cardiovascular mortality in real-world settings and investigate whether that association varied by use of antihypertensive medication at baseline. METHODS:Data from 27 728 Japanese men and women, aged 40-79 years, free of stroke, coronary heart disease, ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002073
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:We examined the relationship between brachial-ankle pulse wave velocity and the development of cardiovascular disease in a general Japanese population. METHODS:A total of 2916 community-dwelling Japanese individuals without history of cardiovascular disease aged at least 40 years were followed up for an aver...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32835c5c23
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:It is not well known which exercise intensity is needed to obtain blood pressure reductions in response to endurance training. We therefore compared the effect of training at lower and higher intensity on blood pressure, and, in addition on other cardiovascular risk factors, in at least 55-year-old sedentary ...
journal_title:Journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1097/HJH.0b013e328322cf60
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Coffee is widely consumed in the Western diet and therefore has important implications for public health. Research findings pertaining to the effects of coffee consumption on cardiovascular health are conflicting, and the role of caffeine is not clear. OBJECTIVE:To examine the relationship between coffee in...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1097/01.hjh.0000249696.19360.be
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVE:To determine the long-term efficacy and safety of a fixed, very-low-dose tablet combining one-half the standard dose of perindopril with one-quarter the standard dose of indapamide as first-line treatment in elderly patients. DESIGN:Double-blind, randomized, placebo-controlled study in an outpatient setting....
journal_title: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:10.1097/00004872-200018030-00013
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Orthostatic hypotension, blood pressure (BP) variability, and arterial stiffness are three markers of cardiovascular risk beyond the average BP. However, the relationships between these three parameters are not well known. AIM:To examine the relationships between orthostatic hypotension, BP variability, and...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002374
更新日期:2020-06-01 00:00:00
abstract::The effect of haemorrhagic hypotension on plasma catecholamine levels was studied in anesthetized normotensive and DOCA-salt hypertensive rats. The basal levels of plasma norepinephrine (NE) were significantly higher in DOCA-salt hypertensive rats than in normotensive rats. Moreover, the elevations in plasma NE and ep...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-198903000-00011
更新日期:1989-03-01 00:00:00
abstract:OBJECTIVE:Similar to cancer, pulmonary arterial hypertension (PAH) is characterized by vascular remodeling, which leads to obliteration of the small pulmonary arteriole, with marked proliferation of pulmonary artery smooth muscle cells (PASMC) and/or endothelial cells dysfunction. Aberrant expression of tumor suppresso...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001475
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to evaluate the influence of renal sympathetic nerves on the production of interleukin (IL)-6 in the kidney of normotensive Wistar rats and spontaneously hypertensive rats (SHR). DESIGN:In acute studies, the left kidney was exposed and the renal nerves were electrically stimulated to...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199305000-00004
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVE:It has been suggested that non-invasive aortic stiffness measurements can be used as an indicator of atherosclerosis. The relationships of arterial stiffness with arterial wall hypertrophy and atherosclerosis however, have rarely been investigated in large-scale studies. The present study reports the associat...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200201000-00013
更新日期:2002-01-01 00:00:00
abstract:PURPOSE:To study the feasibility of vascular mechanics at the aortic arch with two-dimensional speckle tracking echocardiography, as well as to define normal values and to compare results between hypertensive patients and healthy patients. METHODS:We included 107 patients (61 healthy patients and 46 hypertensive patie...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001336
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE:Genome-wide association studies have linked variants of fat mass and obesity-associated protein (FTO) to obesity. However, the molecular function of FTO remains unclear. In this study, we sought to investigate the potential effects of FTO in modulating cholesterol deposition in macrophage foam cells, as well ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000001255
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:To assess the dilatory effectiveness of nitric oxide donors in resistance arteries of patients with arterial hypertension in comparison with that in those of normotensive controls. BACKGROUND:Endothelium-dependent vasodilation has been demonstrated to be impaired in arterial hypertension. Besides disturbance...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199607000-00014
更新日期:1996-07-01 00:00:00
abstract:OBJECTIVE:Epidemiological studies suggest that intrauterine growth restriction (IUGR) due to maternal undernutrition during pregnancy represents a major risk factor for hypertension and diabetes in adult age. However, placental insufficiency, rather than maternal malnutrition, is the main cause of IUGR in the Western w...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199917090-00002
更新日期:1999-09-01 00:00:00
abstract::Left ventricular hypertrophy (LVH), despite its adaptive nature, increases cardiovascular morbidity and mortality. Novel approaches for protection against pathological heart remodelling are presented in this supplement. Melatonin diminishes myocardial fibrosis in rats exposed to continuous light and N-nitro-L-arginine...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000388487.43460.db
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Anandamide (AEA), one of the endocannabinoid compounds, has an important regulatory function by serving as an autocrine/paracrine or endocrine factor throughout the body via activation of the cannabinoid receptor 1 (CB1) and/or the transient receptor potential vanilloid type 1 (TRPV1) channels. However, the ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/01.hjh.0000249706.42230.a8
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:The Glu298Asp, T786C and 4a/4b genetic polymorphisms within the endothelial nitric oxide synthase (e-NOS) gene may predispose to hypertension, ischaemic heart disease and renal damage, possibly by reducing the generation of nitric oxide (NO), a fundamental substance in renal and cardiovascular biology. That ...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e3281268548
更新日期:2007-07-01 00:00:00
abstract:OBJECTIVE:Experimental data show that ouabain is a modulator of the sodium-potassium pump, which plays an important role in sodium homeostasis and blood pressure regulation. We investigated the distribution of plasma ouabain in the general population in relation to blood pressure and other determinants of sodium homeos...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-200308000-00010
更新日期:2003-08-01 00:00:00
abstract:OBJECTIVES:Endothelial dysfunction is established in aged individuals; however, the mechanism(s) are not fully elucidated. We have previously identified l-arginine transport as a potential rate-limiting factor in nitric oxide (NO) production in heart-failure patients, characterized with endothelial dysfunction. We ther...
journal_title:Journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1097/00004872-200402000-00016
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:The optimal time to initiate antihypertensive therapy among patients with acute ischemic stroke remains uncertain. We tested the effects of blood pressure reduction among patients with acute ischemic stroke according to time from onset to initiation of antihypertensive treatment. METHODS:We randomly assigned...
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.0000000000001288
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVES:Blood pressure (BP) measurement in atrial fibrillation (AF) patients is problematic and automated monitors are regarded as inaccurate. The optimal procedure for validating BP monitors in AF is questionable. This study evaluated the accuracy of a novel professional oscillometric upper-arm cuff device (Microli...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000002684
更新日期:2020-10-16 00:00:00
abstract::We have previously reported that pressor doses of angiotensin II induce atrial natriuretic factor (ANF) release. Since the number of glomerular and vascular ANF receptors may vary inversely with plasma ANF levels, we investigated whether they are modified by angiotensin II. Male rats were infused intraperitoneally for...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1991-12-01 00:00:00
abstract::The benefit of blood pressure-lowering therapy in individuals with normal blood pressure who are at high cardiovascular risk creates a challenge in how best to advocate such therapy. Arguments based on a putative causal role for blood pressure and the need to reduce blood pressure may be less likely to succeed than ar...
journal_title:Journal of hypertension
pub_type: 社论
doi:10.1097/HJH.0b013e3280127961
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:Blood pressure (BP) increases both in winter and in the last trimester of pregnancy. Some interaction seems to exist between season and gestational age. The present study observed home BP values during pregnancy with adjustment for seasonal variation and gestational age. METHODS:We observed 10353 home BP mea...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0b013e32831364a7
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVE:The aim of this cross-sectional study was to investigate the association between consumption of sugar-sweetened and diet soft drinks with blood pressure (BP) in adolescents. METHODS:Fifth graders of 20 public schools were invited to participate in an intervention aimed at behavioral dietary changes and had t...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/HJH.0000000000000800
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:To evaluate autonomic nervous function by power-spectral analysis of heart-rate variability in salt-sensitive and non-salt-sensitive patients with essential hypertension under the conditions of low and high salt intakes. DESIGN AND METHODS:The blood pressures, heart rates, and electrocardiogram R-R intervals...
journal_title:Journal of hypertension
pub_type: 杂志文章
doi:10.1097/00004872-199715070-00004
更新日期:1997-07-01 00:00:00