Journal of clinical hypertension (Greenwich, Conn.)最新文献

{"title":"Discrepant acute effect of saline loading on blood pressure, urinary sodium and potassium according to salt intake level: EpiSS study.","authors":"Wenjuan Peng,&nbsp;Yunyi Xie,&nbsp;Kuo Liu,&nbsp;Han Qi,&nbsp;Zheng Liu,&nbsp;Juan Xia,&nbsp;Han Cao,&nbsp;Chunyue Guo,&nbsp;Yanyan Sun,&nbsp;Xiaohui Liu,&nbsp;Bingxiao Li,&nbsp;Fuyuan Wen,&nbsp;Fengxu Zhang,&nbsp;Ling Zhang","doi":"10.1111/jch.14106","DOIUrl":"https://doi.org/10.1111/jch.14106","url":null,"abstract":"<p><p>Acute dietary salt intake may cause an elevation in blood pressure (BP). The study aimed to assess the acute effect of saline loading on BP in subjects with different levels of salt intake. This study is based on the baseline survey of systemic epidemiology of salt sensitivity study. The sodium excretion in the 24-hour urine was calculated for estimating the level of salt intake. Subjects were performed an acute oral saline loading test (1 L), and data of 2019 participants were included for analyses. Multivariate linear regression and stratified analyses were performed to identify associations between 24-hour urinary sodium (24hUNa) with BP changes. Due to saline loading, systolic BP (SBP), pulse pressure, and urinary sodium concentration were significantly increased, while diastolic BP, heart rate, and urinary potassium concentration were significantly decreased. The SBP increments were more significant in subjects with lower salt intake, normotensives, elders, males, smokers, and drinkers. There was a significant linear negative dose-response association between SBP increment with 24hUNa (β = -0.901, 95% CI: -1.253, -0.548), especially in lower salt intake individuals (β = -1.297, 95% CI: -2.338, -0.205) and hypertensive patients (β = -1.502, 95% CI: -2.037, -0.967). After excluding patients who received antidiabetic or antihypertensive medicines, the effects of negative associations weakened but remained significantly. In conclusion, acute salt loading leads to an increment in SBP, and the increased SBP was negatively related with 24hUNa. This study indicated avoiding acute salt loading was important for escaping acute BP changes, especially in lower salt intake populations.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":" ","pages":"289-300"},"PeriodicalIF":2.8,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jch.14106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38628907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"24-h ambulatory blood pressure variability and hypertensive nephropathy in Han Chinese hypertensive patients.","authors":"Ming-Hui Hung,&nbsp;Chin-Chou Huang,&nbsp;Chia-Min Chung,&nbsp;Jaw-Wen Chen","doi":"10.1111/jch.14108","DOIUrl":"https://doi.org/10.1111/jch.14108","url":null,"abstract":"<p><p>Blood pressure (BP) is characterized by spontaneous oscillation over time, which is described as BP variability (BPV). The current study aimed to investigate whether short-term BPV was correlated with hypertensive nephropathy in Han Chinese individuals with hypertension. A single-center prospective cohort study of 300 Han Chinese participants with hypertension was conducted in Taiwan. Five different BPV parameters were derived from ambulatory BP monitoring (ABPM), including standard deviation (SD), weighted SD (wSD), coefficient of variation (CoV), successive variation (SV), and average real variability (ARV). Renal event was defined as > 50% reduction in baseline estimated glomerular filtration rate (eGFR). The average age of the participants was 63.5 years. The baseline eGFR was 84.5 mL/min/1.73 m² . The participants were divided into two groups according to the wSD of systolic BP (SBP). Survival was assessed via a Kaplan-Meier analysis. During the 4.2-year follow-up, the participants with the highest SBP wSD tertile had a greater number of renal events (6.0%) than their counterparts (0.5%) (log-rank test, p = .007). The Cox proportional hazard regression model was used to assess the independent effects of BPV, and results showed that 24-h SBP (HR = 1.105; 95% CI = 1.020-1.197, p = .015) and 24-h DBP (HR = 1.162; 95% CI = 1.004-1.344, p = .044) were independently associated with renal events. However, BPV parameters were only associated with renal events univariately, but not after adjusting for baseline characteristics, 24-h mean BP, and office BP. Therefore, the risk of hypertensive nephropathy was independently associated with 24-h mean BP, but not with ambulatory BPV, in Han Chinese participants with hypertension.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":" ","pages":"281-288"},"PeriodicalIF":2.8,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jch.14108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38632570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of lower nighttime diastolic blood pressure and hypoxia with silent myocardial injury: The Japan Morning Surge-Home Blood Pressure study.","authors":"Kana Kubota,&nbsp;Satoshi Hoshide,&nbsp;Kazuomi Kario","doi":"10.1111/jch.14132","DOIUrl":"https://doi.org/10.1111/jch.14132","url":null,"abstract":"<p><p>Whether marked nocturnal blood pressure (BP) reduction is associated with cardiovascular disease (CVD) is still controversial. In addition, no report has yet discussed the relationship between lower nocturnal BP and CVD, involving modification by nighttime hypoxia. We evaluated 840 patients who had one or more cardiovascular risk factors by measuring their high-sensitivity cardiac troponin T (Hs-cTnT), N-terminal pro-B-type natriuretic peptide (NT-pro BNP), and nighttime saturation levels and performing ambulatory BP monitoring. The lowest tertile in nighttime diastolic BP (DBP) (≤66 mmHg) had increased likelihood of the presence of ≥0.014 ng/ml of Hs-cTnT compared with the second tertile (odds ratio [OR] 1.91, 95% confidence interval [CI] 1.01-3.63), and the lowest tertile of minimum blood oxygen saturation (≤81%) had increased likelihood of the presence of ≥0.014 ng/ml of Hs-cTnT compared with the third tertile (OR 2.15, 95% CI 1.13-4.10). Additionally, the patients with both lowest tertile of nighttime DBP and minimum SpO2 showed increased likelihood of the presence of ≥0.014 ng/ml of Hs-cTnT compared with those without this combination (OR 2.93, 95% CI 1.40-6.16). On the other hand, these associations were not found in the presence of ≥125 pg/ml of NT-pro BNP. In the clinical population, each of lower nocturnal DBP and nighttime hypoxia was associated with asymptomatic myocardial injury, which was represented as higher Hs-cTnT, and coexisting lower nocturnal DBP and nighttime hypoxia had an additive effect on the risk of myocardial injury.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":" ","pages":"272-280"},"PeriodicalIF":2.8,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jch.14132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38707096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automatically assessed P-wave predicts cardiac events independently of left atrial enlargement in patients with cardiovascular risks: The Japan Morning Surge-Home Blood Pressure Study.","authors":"Ayako Yokota,&nbsp;Tomoyuki Kabutoya,&nbsp;Satoshi Hoshide,&nbsp;Kazuomi Kario","doi":"10.1111/jch.14136","DOIUrl":"https://doi.org/10.1111/jch.14136","url":null,"abstract":"<p><p>A prolonged P-wave in electrocardiography (ECG) reflects atrial remodeling and predicts the development of atrial fibrillation (AF). The authors enrolled 810 subjects in the Japan Morning Surge Home Blood Pressure (J-HOP) study who had ≥1 cardiovascular (CV) risk factor. The duration of P-wave was automatically analyzed by standard 12-lead electrocardiogram. Left atrial (LA) enlargement and left ventricular hypertrophy (LVH) were measured on echocardiography. The primary end points were fatal/nonfatal cardiac events: myocardial infarction, sudden death, and hospitalization for heart failure. The maximum P-wave duration (Pmax) from the 12 leads was selected for analysis. The authors compared four prolonged P-wave cutoffs (Pmax = 120, 130, 140, 150 ms) and cardiac events. LA diameter and left ventricular mass index (LVMI) were significantly associated with Pmax (r = 0.08, P = .02 and r = 0.17, P < .001, respectively). When the cutoff level was Pmax 120 or 130 ms, prolonged P-wave was not associated with cardiac events (P = .45 and P = .10), but when a prolonged P-wave was defined as Pmax ≥ 140 ms (n = 50) or Pmax ≥ 150 ms (n = 19), the patients in those groups had significantly higher incidence of cardiac events than others (P < .001 and P = .03). A Cox proportional hazards model including age, gender, body mass index, smoking, regular drinker, hypertension, dyslipidemia, diabetes, office systolic blood pressure, heart rate, LA enlargement, and LVH revealed that prolonged P-wave defined as Pmax ≥ 140 ms was independently associated with cardiac events (hazard ratio: 4.23; 95% confidence interval: 1.30-13.77; P = .02). In conclusion, the automatically assessed prolonged P-wave was associated with cardiac events independently of LA enlargement and LVH in Japanese patients with CV risks.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":" ","pages":"301-308"},"PeriodicalIF":2.8,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jch.14136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38728609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reclassification of adolescent hypertension by ambulatory blood pressure monitoring using adult norms and association with left ventricular hypertrophy.","authors":"Jessica Fallon Campbell,&nbsp;Shweta Shah,&nbsp;Poyyapakkam Srivaths,&nbsp;Alisa A Acosta","doi":"10.1111/jch.14156","DOIUrl":"https://doi.org/10.1111/jch.14156","url":null,"abstract":"<p><p>2017 pediatric blood pressure (BP) guidelines applied adult BP norms to define clinic hypertension (HTN) in patients ≥ 13 years. 2014 pediatric ambulatory BP monitor (ABPM) guidelines recommend age- and sex-specific percentile norms for patients < 18 years. The authors evaluated reclassification of HTN when applying adult ABPM norms in patients ≥ 13 years and assessed the association of left ventricular hypertrophy (LVH) with HTN. Charts of patients 13-17 years with ABPM 9/2018-5/2019 were reviewed for sex, age, height, weight, BP medication, ABPM results, and left ventricular mass index (LVMI). American Heart Association 2005 (AHA 2005), AHA 2017 (AHA 2017), and European Society of Hypertension 2018 (ESH 2018) guidelines for adult ABPM were compared with 2014 AHA pediatric norms (pABPM). HTN was defined by each guideline using only ABPM. ABPM and clinic BP were used to classify white coat hypertension (WCH) and masked hypertension (MH). LVH was defined as LVMI > 51 g/m^2.7 . 272 patients had adequate ABPM. 124 patients also had echocardiogram. All adult norms resulted in significant reclassification of HTN. LVMI correlated significantly with systolic BP only. The odds of a patient with HTN having LVH was significant using AHA 2005 (OR: 8.75 [2.1, 36.4], p = .03) and ESH 2018 (OR: 4.94 [1, 24.3], p = .002). Significant reclassification of HTN occurs with all adult norms. HTN is significantly associated with LVH using AHA 2005 and ESH 2018. Applying pediatric norms for ABPM while using adult norms for clinic BP causes confusion. Guideline selection should balance misdiagnosis with over-diagnosis.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":" ","pages":"265-271"},"PeriodicalIF":2.8,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jch.14156","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38800040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apolipoprotein B and Insulin Resistance in Hypertensive Compared With Normotensive Patients: An Epidemiological Study.","authors":"Prasanna Santhanam,&nbsp;Ayman Elkadry,&nbsp;Rodhan Khthir,&nbsp;Larry Dial,&nbsp;Omolola Olajide","doi":"10.1111/jch.12600","DOIUrl":"https://doi.org/10.1111/jch.12600","url":null,"abstract":"To the Editor: Cross-sectional studies performed recently have suggested that the prevalence of type 2 diabetes in persons with familial hypercholesterolemia might be lower than unaffected individuals (1.75% vs 2.93%, respectively; P&lt;.01). Moreover, statin therapy might increase the risk of type 2 diabetes by 46% with substantial decreases in insulin secretion and resistance as reported by the researchers in the Metabolic Syndrome in Men (METSIM) cohort. The exact relationship between cholesterol and insulin resistance remains unclear in persons with hypertension. We have attempted to evaluate the relationship between Apolipoprotein B (Apo B) and insulin resistance in hypertensive patients. We performed an analysis of the cross-sectional data from the National Health and Nutrition Examination Survey1 for the period 2008–2012 to evaluate the relationship between Apo B and insulin resistance in both a normotensive and hypertensive population. We stratified the serum Apo B levels into low (&lt;100 mg/dL) and high (≥100 mg/dL) groups. Data on variables including age at screening, body mass index (kg/m), waist circumference (cm), mean systolic blood pressure (mm Hg), and cholesterol (mg/dL) were tabulated. We excluded persons 18 years or younger from our analysis. Blood pressure (BP) was categorized as normotensive (systolic BP &lt;140 mm Hg) and hypertensive (systolic BP ≥140 mm Hg). The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated using the formula (–fasting insulin (lU/mL)9fasting blood glucose (mg/dL)/405). We performed the independent sample t test comparing variables between the two groups. Additionally, we performed nonparametric (spearman) correlation between Apo B and HOMA-IR, Apo B and fasting serum insulin level(s) (lU/mL), and Apo B and fasting blood glucose (mg/dL) in both normotensive and hypertensive patients. SPSS version 21 (IBM, Armonk, NY) was used for statistical analysis. There were 3557 persons with normal BP and 497 with hypertension in the study population. Persons with low Apo B and high Apo B levels were equally distributed between normotensive and hypertensive patients (chi-square, 0.89). There was no difference in the mean Apo B level between normotensives and hypertensive patients (87.8 [ 25.1] vs 87.5 [ 25.3], P=.80). The results of the comparison (Student t test) between the low Apo B group and the high Apo B group in persons with hypertension is summarized in the Table. The high Apo B group had significantly higher fasting insulin, insulin resistance (HOMA-IR), and fasting blood glucose levels (P=.04, P&lt;.01, and P&lt;.01, respectively). There was a significant positive correlation between Apo B, fasting insulin, and fasting blood glucose levels, as well as HOMA-IR in both the normotensive and hypertensive groups. However, the relationship between Apo B and fasting insulin levels was stronger in hypertensive patients (Spearman correlation coefficient (q)=0.198, P&lt;.01) as compared with persons withou","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":" ","pages":"79-80"},"PeriodicalIF":2.8,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jch.12600","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33365555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehypertension--what is it and should it be treated?","authors":"Marvin Moser,&nbsp;Thomas D Giles,&nbsp;Joseph L Izzo,&nbsp;Henry R Black","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":" ","pages":"812-8"},"PeriodicalIF":2.8,"publicationDate":"2006-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26406340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endothelial vascular function in hypertensive patients after renin-angiotensin system blockade.","authors":"Leoní Adriana Souza-Barbosa,&nbsp;Sílvia E Ferreira-Melo,&nbsp;Samira Ubaid-Girioli,&nbsp;Eduardo Arantes Nogueira,&nbsp;Juan Carlos Yugar-Toledo,&nbsp;Heitor Moreno","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>It is unclear whether single and combined pharmacologic inhibition of the renin-angiotensin-aldosterone system have similar effects on endothelial function and blood pressure (BP). The authors evaluated 63 hypertensive patients divided into 4 groups (hydrochlorothiazide 25 mg/d; irbesartan [IRBE] 150 mg/d; quinapril [QUIN] 20 mg/d; or IRBE 150 mg/d + QUIN 20 mg/d) and 25 healthy normotensive subjects (normal) followed for 12 weeks. Endothelium-dependent dysfunction measured as flow-mediated dilation at Weeks 0 and 12 were: normal, 11.5%+/-2.4% vs 13.5%+/-2.0%; hydrochlorothiazide, 7.3%+/-2.0% vs 12.8%+/-3.1%; QUIN, 7.2%+/-2.8% vs 13.2%+/-2.1%; IRBE, 7.1%+/-2.8% vs 13.0%+/-2.9%; and IRBE + QUIN, 7.5%+/-1.9% vs 12.8%+/-3.0%. Nitroglycerin-mediated responses were: normal, 26.0%+/-1.9% vs 24.0%+/-2.5%; hydrochlorothiazide, 17.0%+/-2.2% vs 18.3%+/-2.6%; QUIN, 17.8%+/-3.2% vs 23.4%+/-3.0%; IRBE, 16.8%+/-3.6% vs 24.7%+/-2.0%; and IRBE + QUIN, 17.3%+/-3.0% vs 25.1%+/-2.5%. Antihypertensive therapy restored BP to normal and improved the endothelium-dependent and -independent dysfunction after renin-angiotensin-aldosterone system blockade. In a further finding, the combined effect of angiotensin-converting enzyme inhibition and angiotensin II type 1 receptor blockade was not superior to the action of either of these treatments separately.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":" ","pages":"803-9; quiz 810-1"},"PeriodicalIF":2.8,"publicationDate":"2006-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26406339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of whey peptides on cardiovascular disease risk factors.","authors":"Joel J Pins,&nbsp;Joseph M Keenan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Previous studies have shown that peptides derived from milk proteins can improve blood pressure. Therefore, the authors tested the blood pressure-lowering effects of a hydrolyzed whey protein supplement rich in bioactive peptides. In a 6-week controlled study, 30 prehypertensive or stage 1 hypertensive subjects (blood pressure >or=120/80 mm Hg and <or=155/95 mm Hg) were randomized to receive 20 g/d of either a hydrolyzed whey protein (active treatment) or an unmodified whey protein (control treatment). Blood pressure, blood lipids, safety measures, side effects, and diet were evaluated throughout the trial. After completion of treatment, a 4-week follow-up was conducted. There was a mean reduction of 8.0+/-3.2 mm Hg in systolic blood pressure (P<.05) and of 5.5+/-2.1 mm Hg in diastolic blood pressure (P<.05) in the treatment group compared with the control group. Low-density lipoprotein cholesterol and high-sensitivity C-reactive protein were significantly improved by treatment. Whey-derived peptides might be a viable treatment option for prehypertensive and/or stage 1 hypertensive populations.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":" ","pages":"775-82"},"PeriodicalIF":2.8,"publicationDate":"2006-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26406335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}