Abstract:
:The objective of this study was to test the relationship between neurologic and microvascular complications of type 1 diabetes mellitus. It was hypothesized that the mechanisms operative in autonomic dysfunction seen in diabetic patients with microangiopathy play a role in the rapidity of progression to renal failure. Twenty-six type 1 diabetic patients with proteinuria were studied with computerized monitoring of heart rate variation during timed ventilation, assumption of upright posture, and Valsalva maneuver and with 24-h ambulatory blood pressure monitoring at baseline. Renal function was evaluated over the ensuing 12 months of intensive insulin therapy. Blood pressure was treated so as to achieve consistent 24-h readings < 140/90 mm Hg. Angiotensin converting enzyme inhibitors were the preferred antihypertensive agents. Serial serum creatinine concentrations were compared using repeated measures analysis of variance. Over 12 months there were no significant serum creatinine changes for any autonomic test group with normal results at baseline. Groups with abnormal autonomic results at baseline demonstrated statistically significant increases in serum creatinine over 12 months compared to their baseline. Of the tests, Valsalva separated groups of patients with similar degrees of baseline renal impairment. Each of the sympathetic plus Valsalva combinations demonstrated a significant difference in progression of serum creatinine increase over 12 months. In each instance, if both sympathetic and Valsalva results were abnormal, there was a statistically significant increase in serum creatinine over 12 months when compared to groups in which one or both test results were normal. There is a relationship between autonomic function and the progression of renal dysfunction. The inability to vary the heart rate to a Valsalva maneuver identifies a degree of parasympathetic dysfunction that permits unopposed sympathetic tone, heralding more rapid renal destruction. A simple inexpensive bedside laboratory test discerned a relatively low-risk group of diabetic patients with proteinuria that demonstrated no deterioration in renal function over 12 months. When the Valsalva maneuver was markedly abnormal the presence of a mean arterial pressure > 100 mm Hg was associated with a greater likelihood of rapid renal deterioration. This group at higher risk of renal deterioration should undergo aggressive lowering of mean arterial blood pressure to < 95 mm Hg.
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Weinrauch LA,Kennedy FP,Gleason RE,Keough J,D'Elia JAdoi
10.1016/s0895-7061(97)00472-xsubject
Has Abstractpub_date
1998-03-01 00:00:00pages
302-8issue
3 Pt 1eissn
0895-7061issn
1941-7225pii
S089570619700472Xjournal_volume
11pub_type
杂志文章abstract::The comparative efficacy of the calcium antagonists isradipine and nifedipine in reducing left ventricular peak systolic wall tension was assessed in 25 patients with essential hypertension (20 men, 5 women; mean age: 49 years). After 2 weeks of treatment with either isradipine (2.5 mg twice daily) or slow-release nif...
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/6.3.92s
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:We determined the prognostic value of the Cornell/strain [C/S] index, a simple electrocardiographic (ECG) index for left ventricular hypertrophy (LVH) defined by the presence of either a classic strain pattern or a Cornell voltage (sum of R in aVL + S in V(3)) >2.0 mV in women or 2.4 mV in men, or both. MET...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1016/s0895-7061(03)00912-9
更新日期:2003-08-01 00:00:00
abstract::The aim of this study was to investigate the effects of dietary calcium and sodium on blood pressure (BP) in normotensive rats (Wistar, WKY), spontaneously hypertensive rats (SHR) and Dahl rats and on calmodulin (CaM) activator, a newly-discovered hydrophobic compound that increases CaM activity in SHR and spontaneous...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/3.8.210
更新日期:1990-08-01 00:00:00
abstract:BACKGROUND:Currently, total hyperhomocysteinemia (tHHcy) is a well-known condition linked to a higher risk of vascular disease. Prevalence of HHcy increases in elderly persons as the risk associated with it persists. Because factors can be potentially reduced in the elderly, it is important to carry out epidemiologic s...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(01)02165-3
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:High salt diet causes cardiac hypertrophy and fibrosis and increases cardiac aldosterone, while decreasing plasma aldosterone. The present study assessed, in Wistar rats, the effect of high salt diet on left and right ventricle (LV and RV, respectively) weight and fibrosis both with and without the aldostero...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(02)03268-5
更新日期:2003-04-01 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 present study examined the inhibitory action of temporary treatment with an angiotensin type 1 (AT(1)) receptor blocker (ARB) on vascular remodeling using hypertensive mice with overexpression of the human renin (hRN) and angiotensinogen (hANG) genes. METHODS:hRN/hANG transgenic mice (hRN/hANG-Tg) were ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2011.6
更新日期:2011-05-01 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: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::Molecular evidence, using DNA fingerprint analyses, of extensive genetic heterogeneity between spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKY) and even within some of the WKY colonies has been reported. Thus we investigated the genetic relations between Dahl S and R rats newly inbred by Dr. Iwai. Gen...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1997-05-01 00:00:00
abstract::Cardiovascular diseases (CVD) are the major causes of mortality in persons with diabetes, and many factors, including hypertension, contribute to this high prevalence of CVD. The incidence of hypertension in patients with diabetes is approximately twofold higher than in age-matched subjects without the disease, and co...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/j.amjhyper.2003.07.009
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:Hypertension treatment is important in managing chronic renal insufficiency (CRI). Little is known, however, about the blood pressure (BP) control achieved or the pattern of antihypertensive drug prescription among CRI patients. METHODS:Using computerized medical records, we studied 3,089 adult hypertensive...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(01)02202-6
更新日期:2001-12-01 00:00:00
abstract::The results of ambulatory blood pressure monitoring (ABPM) in children after kidney transplant were analyzed to ascertain any alteration in circadian BP profile, degree of hypertension, and efficacy of therapy. The data were also compared with casual BP data and left ventricular mass index (LVMI). We have examined 30 ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(97)00484-6
更新日期:1998-04-01 00:00:00
abstract::It is likely that a number of independent heritable traits, each encoded by a singular gene, contribute to pathologic elevations in blood pressure in humans. Genetic polymorphisms of individual genes may result in intermediate phenotypes which, by themselves, do not raise blood pressure, but, coupled with environmenta...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(95)00155-I
更新日期:1995-09-01 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::To study the circulating humoral factor modifying transmembrane sodium transport, plasma was obtained from 12 patients with essential hypertension (EH) fed a high sodium diet (NaCl 15 to 17 g/d) for seven days and thereafter a low sodium diet (NaCl 2 to 3 g/d) for seven days. Ouabain-sensitive 86Rb+ influx into the re...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/2.7.560
更新日期:1989-07-01 00:00:00
abstract:BACKGROUND:C-reactive protein (CRP) predicts cardiovascular outcome. Oxidative stress is considered to be involved in endothelial alteration. We hypothesized that in essential hypertension (EH), oxidative stress, as measured by 8-iso-prostaglandin-F(2alpha) (8-iso-PGF(2alpha)), should be associated with increased CRP a...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.09.005
更新日期:2006-03-01 00:00:00
abstract::Angiotensin-converting enzyme inhibitors (ACEIs), introduced in clinical practice in 1980, are a relatively new class of drugs. They have been useful in the treatment of hypertension, where they are effective monotherapy in 40% to 50% of the patients and in combination therapy in up to 90%. They are also useful in the...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/2.1.57
更新日期:1989-01-01 00:00:00
abstract::Barriers to high blood pressure (HBP) care and control have been reported in the literature for > 30 years. Few reports on barriers, however, have focused on the young black man with HBP, the age/sex/race group with the highest rates of early severe and complicated HBP and the lowest rates of awareness, treatment, and...
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(99)00121-1
更新日期:1999-10-01 00:00:00
abstract::The sensitivity and specificity of screening and diagnostic studies for renovascular hypertension has been the focus of debate and disappointment for many years. The use of these studies has been further restricted by the insistence of clinicians that studies provide visual identification of the anatomy of the renal v...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/4.12.663s
更新日期:1991-12-01 00:00:00
abstract::In this review we have analyzed the present knowledge about the differentiation and growth processes in vascular smooth muscle cells (SMC) in hypertension. The study of smooth muscle (SM) and nonmuscle (NM) myosin isoform expression has permitted us to identify a three-stage specific maturational pathway, namely, feta...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/7.7.661
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Blood pressure is a complex quantitative trait with a strong genetic component. In this study, we leveraged the Veterans Affairs electronic medical record system to explore the relationship between Paraoxonase 1 (PON1)-108 C/T (rs705379) and mean arterial blood pressure (MAP). METHODS:Outpatient blood press...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2012.106
更新日期:2012-11-01 00:00:00
abstract::Changes in the lipid composition of the membrane affect its fluidity and function. These variables are altered in various forms of hypertension. Our hypothesis was that the rapid increase in blood pressure (BP) caused by inhibition of nitric oxide production would lead to alterations in membrane fluidity similar to th...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(00)01184-5
更新日期:2000-11-01 00:00:00
abstract::Cocaine causes acute hypertension by blocking catecholamine reuptake. There is evidence that it also impairs the peripheral endothelial nitric oxide system, which is normally vasodilatory. We further explored the role of nitric oxide in cocaine-induced vasoconstriction in anesthetized rats, and in vitro by using isola...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(98)00041-7
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:Sustained hypotension after an acute dynamic exercise bout is due primarily to peripheral vasodilation. We tested the hypothesis that adenosine-mediated vasodilation contributes to hypotension after exercise, by determining the effect of blocking its actions with caffeine. METHODS:Fourteen healthy middle-ag...
journal_title:American journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.amjhyper.2005.07.022
更新日期:2006-02-01 00:00:00
abstract::Blood pressure responses to 1 week of low (20 mmol sodium/day) and high (300 mmol sodium/day) salt intake were investigated in a double-blind, randomized study in 46 white, nonobese subjects with essential hypertension (13 women, 33 men; mean age 45.3 +/- 2.2 years, age range 25 to 80 years). The individuals were clas...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0895-7061(95)00213-9
更新日期:1995-08-01 00:00:00
abstract:BACKGROUND:Diabetes mellitus (DM) and hypertension (HT) frequently coexist. Increased central aortic pressures indexes are associated with HT; however, possible associations of these indexes with future development of DM have never been studied in HT. METHODS:We recruited 178 patients with uncomplicated nondiabetic HT...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2010.145
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:On the basis of evidence of plasma leptin (LE) effects on cardiovascular system, we assessed possible association of LE and Doppler-derived left ventricular (LV) diastolic function in arterial hypertension. METHODS:Doppler echocardiography, blood sample for fasting plasma LE levels, and euglycemic hyperinsu...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(01)02137-9
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:We aimed to assess the predictive value of circulating levels of des-acyl ghrelin, an abundant form of ghrelin in humans, for the risk of cardiovascular disease (CVD) in older hypertensive patients. We simultaneously evaluated other biomarkers, such as high-molecular-weight (HMW) adiponectin, high-sensitivit...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpt232
更新日期:2014-05-01 00:00:00
abstract::We have previously reported that weight gain induced by high-fat diet (HFD) leads to an increase in mean arterial pressure (MAP, +14%) and heart rate (HR, +31%) in the adult rabbit. In the present study, we tested the hypothesis that an increased activity of the sympathetic nervous system may contribute to the develop...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(99)00267-8
更新日期:2000-05-01 00:00:00