scholarly journals Disorders of Orthostatic Blood Pressure Response Are Associated With Cardiovascular Disease and Target Organ Damage in Hypertensive Patients

2010 ◽  
Vol 23 (8) ◽  
pp. 829-837 ◽  
Author(s):  
X.-H. Fan ◽  
Y. Wang ◽  
K. Sun ◽  
W. Zhang ◽  
H. Wang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Blood Pressure Response ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Pressure Response ◽  
Target Organ ◽  
Hypertensive Patients ◽  
Orthostatic Blood Pressure

Essential hypertension: Diagnosis, assessment, and treatment

2020 ◽  
pp. 3753-3778
Author(s):  
Bryan Williams ◽  
John D. Firth
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Severe Hypertension ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Target Organ ◽  
Elevated Blood ◽  
Hypertensive Patients ◽  
Assessment And Treatment ◽  
Hypertension Diagnosis

Essential hypertension is invariably symptomless and usually detected by routine screening or opportunistic measurement of blood pressure. However, once a patient has been labelled as ‘hypertensive’ it is not uncommon for them to associate preceding symptoms to their elevated blood pressure. Some patients will claim that they can recognize when their blood pressure is elevated, usually on the basis of symptoms such as plethoric features, palpitations, dizziness, or a feeling of tension. Screening surveys have demonstrated that these symptoms occur no more commonly in untreated hypertensive patients than they do in the normotensive population. However, there are two important caveats to the symptomless nature of essential hypertension: (1) symptoms may develop as a consequence of target organ damage, (2) headache may be a feature of severe hypertension.

P1680High density lipoprotein cholesterol (HDL-C) levels and endothelial glycocalyx integrity in treated hypertensive patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Triantafyllidi ◽  
D Benas ◽  
A Schoinas ◽  
S Vlachos ◽  
D Vlastos ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Target Organ Damage ◽  
Linear Regression Analysis ◽  
Smoking Habit ◽  
Organ Damage ◽  
Target Organ ◽  
Endothelial Glycocalyx ◽  
Analysis Model ◽  
Hypertensive Patients

Abstract Background Endothelial dysfunction indicates target organ damage in hypertensive patients. The integrity of endothelial glycocalyx (EG) plays a vital role in vascular permeability, inflammation and elasticity and finally to cardiovascular disease. We aimed to investigate the role of increased HDL cholesterol levels (HDL-C), which usually are considered protective against cardiovascular disease, in EG integrity in older hypertensive patients. Methods We studied 120 treated hypertensive patients older than 50 years were divided regarding HDL-C tertiles in group HDLH, (HDL-C >71 mg/dl, upper HDL-C tertile) and group HDLL, (HDL-C <71 mg/dl, two lower HDL-C tertiles). Increased perfusion boundary region (PBR) of the sublingual arterial microvessels (ranged from 5–9 micrometers) using Sideview Darkfield imaging was measured as a non-invasive accurate index of reduced EG thickness. Results PBR 5–9 was significantly decreased in group HDLH (p=0.04). In the whole population, HDL-C was inversely but moderately related with PBR 5–9 (r=−0.22, p=0.01). In a multiple linear regression analysis model, using age, BMI, smoking habit, HDL-C, LDL-C and office SBP, as independent variables, we found that BMI (β=0.25, p=0.006) independently predicted PBR 5–9 in the whole population. Differences in PBR5-9 between HDL groups Conclusions In older hypertensive patients, HDL-C ranged between 71–101 mg/dl might moderately protect EG and subsequently endothelial function. Future studies in several groups of low or high risk hypertensives are needed in order to evaluate the beneficial role of extremely elevated HDL-C regarding cardiovascular risk evaluation as well as endothelial glycocalyx as a novel index of target organ damage in essential hypertension.

scholarly journals Blood Pressure Response to Zofenopril or Irbesartan Each Combined with Hydrochlorothiazide in High-Risk Hypertensives Uncontrolled by Monotherapy: A Randomized, Double-Blind, Controlled, Parallel Group, Noninferiority Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Ettore Malacco ◽  
Stefano Omboni ◽  
Gianfranco Parati
Keyword(s):  
Blood Pressure ◽  
Renal Damage ◽  
Blood Pressure Response ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Target Organ ◽  
Double Blind ◽  
Treatment Groups ◽  
Parallel Group ◽  
Plaque Regression

In this randomized, double-blind, controlled, parallel group study (ZENITH), 434 essential hypertensives with additional cardiovascular risk factors, uncontrolled by a previous monotherapy, were treated for 18 weeks with zofenopril 30 or 60 mg plus hydrochlorothiazide (HCTZ) 12.5 mg or irbesartan 150 or 300 mg plus HCTZ. Rate of office blood pressure (BP) response (zofenopril: 68% versus irbesartan: 70%;p=0.778) and 24-hour BP response (zofenopril: 85% versus irbesartan: 84%;p=0.781) was similar between the two treatment groups. Cardiac and renal damage was equally reduced by both treatments, whereas the rate of carotid plaque regression was significantly larger with zofenopril. In conclusion, uncontrolled monotherapy treated hypertensives effectively respond to a combination of zofenopril or irbesartan plus a thiazide diuretic, in terms of either BP response or target organ damage progression.

P5470Studying target organ damage indices in newly diagnosed and never treated extreme dipper patients with essential hypertension

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Triantafyllidi ◽  
A Schoinas ◽  
D Benas ◽  
M Varoudi ◽  
D Birba ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Target Organ ◽  
Newly Diagnosed ◽  
Night Time ◽  
Hypertensive Patients ◽  
Blood Pressure Decrease ◽  
Damage Indices

Abstract Background Cardiovascular risk estimation in arterial hypertension includes the investigation for target organ damage indices (TOD). 24h ambulatory blood pressure monitoring (ABPM) represents the gold standard method for the confirmation of the arterial hypertension disease. Dipping phenomenon, defined as blood pressure decrease >10% during night-time measurements, leads to hypertension burden reduce during night and carries a positive prognostic significance. However, there are doubts regarding its prognosis when it becomes augmented (extreme dipping defined as blood pressure decrease >20% during night-time measurements). Aim of our study is to explore TOD existence between extreme dipper and dipper hypertensive patients with newly diagnosed and never treated arterial hypertension. Methods From the 480 total patients with newly diagnosed and never treated arterial hypertension who subjected to ABPM, we excluded 190 non-dipper patients and we divided the rest 290 hypertensives (mean age 49±11 years, 193 males) in normal dippers (n=245, mean age 49±11 years, 160 males) and extreme dippers (n=45, mean age 49±10 years, 33 males). Both groups were subjected to the following measurements: arterial stiffness (PWV), 24h microalbumin levels (MAU), carotid intima-media thickness (IMT), diastolic dysfunction (E/Ea), left ventricular mass index (LVMI) and coronary flow reserve (CFR). Results We did not find any differences within groups regarding age, sex distribution, BMI, office SBP/DBP, cenrtal SBP/DBP and daytime average SBP/DBP as well as PWV, MAU, IMT, E/Ea and CFR. We noticed that extreme dippers had reduced 24h average SBP/DBP (p=0.001 and p=0.02, respectively) and increased LVMI (86±18 vs. 79±20 gr/m2, p=0.04) compared to normal dippers. Differences in LVMI Conclusions Extreme dipper hypertensive patients have an increased LVMI, probably as a result of myocardial hypoxia due to severe blood pressure reduction over night. Our results point to the possible increased cardiovascular risk in this group of hypertensive patients.

scholarly journals Comparison of Central, Ambulatory, Home and Office Blood Pressure Measurement as Risk Markers for Mild Cognitive Impairment in Hypertensive Patients

2017 ◽  
Vol 7 (2) ◽  
pp. 274-282 ◽  
Author(s):  
Teodora Yaneva-Sirakova ◽  
Latchezar Traykov ◽  
Julia Petrova ◽  
Dobrin Vassilev
Keyword(s):  
Blood Pressure ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Pulse Pressure ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Target Organ ◽  
Risk Markers ◽  
Hypertensive Patients ◽  
Central Pulse Pressure

Aims: We compared the role of central blood pressure (BP), ambulatory BP monitoring (ABPM), home-measured BP (HMBP) and office BP measurement as risk markers for the development of mild cognitive impairment (MCI). Methods: 70 hypertensive patients on combination medical therapy were studied. Their mean age was 64.97 ± 8.88 years. Eighteen (25.71%) were males and 52 (74.28%) females. All of the patients underwent full physical examination, laboratory screening, echocardiography, and office, ambulatory, home and central BP measurement. The neuropsychological tests used were: Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). SPSS 19 was used for the statistical analysis with a level of significance of 0.05. Results: The mean central pulse pressure values of patients with MCI were significantly (p = 0.016) higher than those of the patients without MCI. There was a weak negative correlation between central pulse pressure and the results from the MoCA and MMSE (r = –0.283, p = 0.017 and r = –0.241, p = 0.044, respectively). There was a correlation between ABPM and MCI as well as between HMBP and MCI. Conclusions: The correlation of central BP with target organ damage (MCI) is as good as for the other types of measurements of BP (home and ambulatory). Office BP seems to be the poorest marker for the assessment of target organ damage.

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