The Value of Portably Recorded Blood Pressures in the Initiation of Treatment of Moderate Hypertension

1973 ◽  
Vol 45 (s1) ◽  
pp. 195s-198s ◽  
Author(s):  
Maurice Sokolow ◽  
Dorothee Perloff ◽  
Ronald Cowan
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Arterial Pressure ◽  
Antihypertensive Therapy ◽  
Moderate Hypertension ◽  
Vascular Involvement ◽  
Pressure Elevation ◽  
Blood Pressures ◽  
Hypotensive Therapy ◽  
Reduce Risk

1. The value of making portable-recorder measurements of blood pressure has been studied. 2. The danger associated with mild arterial pressure elevation is not immediate, but almost any reduction in pressure is likely to reduce risk. 3. Patient and doctor together must decide what burden of side effects of hypotensive therapy is tolerable. 4. Such decisions will become rational only when the probability of vascular involvement can be accurately assessed in a given patient. 5. The likelihood of arresting the disease through antihypertensive therapy must similarly be assessed.

Arterial hypertension + past stroke – a case report

2021 ◽  
Vol 14 (3) ◽  
pp. 324-326
Author(s):  
Maria Łukasiewicz ◽  
Marta Swarowska-Skuza
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Chronic Disease ◽  
Side Effects ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Systolic Hypertension ◽  
The Elderly ◽  
Isolated Systolic Hypertension ◽  
Special Group

Arterial hypertension, as a very widespread chronic disease, and thus differing in both pathomechanism and course in patients, requires a significant individualization of pharmacotherapy. One such special group is the elderly. Both the low-renin pathomechanism of arterial hypertension and its phenotype (isolated systolic hypertension) imply the choice of a specific pharmacotherapy. Additionally, in this group, side effects should be observed much more vigilantly, while target blood pressure values should be treated more liberally. An example of antihypertensive therapy in a patient belonging to the group described is presented in the following case.

scholarly journals Effects on cognitive function, psychoemotional state, efficiacy and safety of antihypertensive therapy by metoprolol retard in females with the mild to moderate hypertension

2006 ◽  
Vol 12 (4) ◽  
pp. 358-361
Author(s):  
T. S. Poljatykina ◽  
I. E. Mishina ◽  
G. I. Bulychev ◽  
V. L. Geller ◽  
G. I. Sevastjanova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Cognitive Function ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Moderate Hypertension ◽  
Combined Therapy ◽  
Psychoemotional State ◽  
Long Acting

The paper presents the results of research in which 50 women with essential hypertension illness (arterial hypertension I-II degree) have taken part. 20 patients received long-acting metoprolol therapy (Egilok - retard, EGIS AO) in the dose of 25-100 mg, if necessary in a combination with hydrochlorothiazide 25 mg. In group of comparison (30 subjects) treatment with enalapril (5-10 mg/сут) or by a combination of enalapril and hydrochlorothiazide was administarted. It is shown, that monotherapy by metoprolol-retard allowed to reach a «target» levels of blood pressure in 89,5 % of women, in 10,5 % cases the combined therapy was required. At 12-week of treatment significant improvement of parameters of concentration of attention and anxiety decrease was observed.

The Influence of Physical Activity on Arterial Pressure during Ambulatory Recordings in Man

1980 ◽  
Vol 58 (1) ◽  
pp. 115-117 ◽  
Author(s):  
D. B. Rowlands ◽  
T. J. Stallard ◽  
R. D. S. Watson ◽  
W. A. Littler
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Heart Rate ◽  
Arterial Pressure ◽  
Ambulatory Blood Pressure ◽  
Physical Activities ◽  
Hypertensive Patients ◽  
Arterial Blood ◽  
Significant Difference ◽  
Hypotensive Therapy

1. Ambulatory blood pressure recordings were made over a 48 h period on six hypertensive patients. The conditions of study were standardized, particularly with regard to physical activity, and during one period of each day the patients were randomly allocated to be active or inactive. 2. Results show that blood pressure was highest during physical activity and lowest during sleep. There was no significant difference between the arterial pressures measured during the same physical activities carried out at the same time each day. However, during the same time on consecutive days when activity was randomized, there was a significant difference between the pressure recordings during physical activity compared with those during inactivity. Heart rate changes showed a similar trend during the randomized period. 3. Physical activity and sleep have a profound effect on continuous arterial blood pressure recordings and these are independent of time alone. These observations should be taken into account when using this ambulatory system to assess hypotensive therapy.

scholarly journals Sex differences in blood pressure responsiveness to spontaneous K-complexes during stage II sleep

2020 ◽  
Author(s):  
Ian Mark Greenlund ◽  
Carl A. Smoot ◽  
Jason R. Carter
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Arterial Pressure ◽  
Cardiac Cycle ◽  
Pressor Response ◽  
Systolic Arterial Pressure ◽  
Stage Ii ◽  
Men And Women ◽  
Blood Pressures ◽  
Blood Pressure Responses

K-complexes are a key marker of non-rapid eye movement sleep (NREM), specifically during stages II sleep. Recent evidence suggests the heart rate responses to a K-complexes may differ between men and women. The purpose of this study was to compare beat-to-beat blood pressure responses to K-complexes in men and women. We hypothesized that the pressor response following a spontaneous K-complex would be augmented in men compared to women. Ten men (Age: 23 ± 2 years, BMI: 28 ± 4 kg/m2) and ten women (Age: 23 ± 5 years, BMI: 25 ± 4 kg/m2) were equipped with overnight finger plethysmography and standard 10-lead polysomnography. Hemodynamic responses to a spontaneous K-complex during stable stage II sleep were quantified for 10 consecutive cardiac cycles, and measurements included systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and heart rate. K-complex elicited greater pressor responses in men when blood pressures were expressed as SAP (cardiac cycle × sex: p = 0.007) and DAP (cardiac cycle × sex: p = 0.004). Heart rate trended to be different between men and women (cardiac cycle × sex: p = 0.078). These findings suggest a divergent pressor response between men and women following a spontaneous K-complex during normal stage II sleep. These findings could contribute to sex-specific differences in cardiovascular risk that exist between men and women.

Nutritional management of hypertension: controversies and frontiers Proceedings of one more meeting?

1986 ◽  
Vol 64 (6) ◽  
pp. 770-771
Author(s):  
Frans H. H. Leenen
Keyword(s):  
Blood Pressure ◽  
Weight Loss ◽  
Side Effects ◽  
Antihypertensive Therapy ◽  
Mild Hypertension ◽  
Severe Hypertension ◽  
Nutritional Management ◽  
Blood Pressure Elevation ◽  
Cardiovascular Morbidity And Mortality ◽  
Treatment Of Hypertension

In recent years antihypertensive therapy has evolved from treatment for a relatively small number of patients with severe hypertension to treatment for millions of people with mild to severe hypertension. We now treat not only patients at high risk for future cardiovascular morbidity and mortality, of whom nearly all are benefitting from antihypertensive therapy, but also much larger groups of patients each individually at low risk. In this latter group only a small percentage actually benefits from antihypertensive therapy. For example, in the Australian trial in subjects with mild hypertension and no other evidence of cardiovascular disease, only two excess deaths were prevented at the expense of 1000 patient-years of drug treatment (Australian Therapeutic Trial 1980). For most individual members of this group normalizing their mild blood pressure elevation appears to offer no benefit, yet all of them are exposed to antihypertensive therapy and its side effects. When instituting antihypertensive pharmacotherapy in patients with mild hypertension one has to be concerned about these side effects, not just the objective ones (e.g., effects on plasma lipoproteins or glucose which may offset any gains to be obtained by lowering blood pressure), but also subjective ones (e.g., fatigue, impotence) which may markedly affect the quality of life.Nonpharmacologic, in particular nutritional, management of mild hypertension has intuitively major appeal for "lowering blood pressure without side effects." Many studies have evaluated the effects of dietary changes on blood pressure. Several recent symposia have addressed the issue of nutrition and hypertension. Despite this, the report from the first Consensus Development Conference of the Canadian Hypertension Society ("on the management of mild hypertension in Canada") states "Because of conflicting evidence and problems with patient compliance, the conference had difficulty reaching consensus on the effectiveness of salt restriction and, for the obese, of weight reduction in lowering blood pressure" (Logan 1984).This issue of the Canadian Journal of Physiology and Pharmacology contains the proceedings of a workshop "Nutritional Management of Hypertension: Controversies and Frontiers," held in Harrison Hot Springs, British Columbia, September 6–7, 1985. This workshop was organized under the auspices of the Canadian Hypertension Society and made possible by generous financial support from ICI Pharma, Canada (general sponsorship) as well as from the National Institute of Nutrition for the obesity session, and from the Dairy Bureau of Canada for the sodium–calcium session.To define more clearly the controversies and uncertainties, this workshop was organized in a different way than previous meetings dealing with this issue. A clinical scientist working in a particular area was invited to outline the evidence in favour of a given dietary manipulation for the treatment of hypertension, and another one to outline the evidence against. This evaluation would particularly concern evidence regarding "efficacy" and "effectiveness". A discussant then presented an evaluation of the two position papers, followed by a general discussion and a summary by the session chairman. This type of scrutiny of our current knowledge was done for sodium restriction, calcium supplementation, and weight loss. As part of this evaluation two speakers addressed the closely related issues of practical aspects of diet management (e.g. compliance) and the consequences–risks of weight loss in relation to the pathophysiology of obesity.In the last part of the workshop possible future developments in nutrition and hypertension were reviewed, such as "nutrition in the young, early intervention?," vegetarian approach to hypertension, role of dietary fats, and proteins and precursors.The organizing committee very much appreciated that Dr. David Sackett was willing to serve as the scientific chairman of this workshop, to summarize the present "state of the art" on diet modulation in the management of hypertension as well as to propose recommendations for treatment of hypertension in clinical practice and for future research directions.It was a pleasure for me to serve as chairman of the organizing committee. As President of the Canadian Hypertension Society I would like to thank all session chairmen, speakers, discussants, and participants for their enthusiasm and eagerness to explore the topic of nutrition and hypertension. I hope that the scientific information and insight that the proceedings of this workshop offer will convey their commitment.

Propranolol — B.P. (‘Inderal’) and Hydrochlorothiazide Combination in Hypertension

1973 ◽  
Vol 1 (7) ◽  
pp. 616-619 ◽  
Author(s):  
P D Nigam ◽  
R Ravishankar ◽  
K A Ramachandren ◽  
P C Sikand
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Congestive Heart Failure ◽  
Side Effects ◽  
Blood Pressure Control ◽  
Postural Hypotension ◽  
Moderate Hypertension ◽  
Pressure Control

Twenty patients with mild and moderate hypertension were treated with varying doses of propranolol along with hydrochlorothiazide 25 mg daily. In eighteen patients ( 90%) the blood pressure control was good. Bronchospasm, congestive heart failure, significant postural hypotension and other bothersome side-effects were not observed. Propranolol has the merit of causing a slow reduction in blood pressure without troublesome side-effects.

scholarly journals Changes in Blood Pressure During Induction of Anesthesia and Oral and Maxillofacial Surgery by Type and Timing of Discontinuation of Antihypertensive Drugs

2010 ◽  
Vol 57 (1) ◽  
pp. 13-17 ◽  
Author(s):  
Yoshihiro Momota ◽  
Kazuhiro Kaneda ◽  
Kumiko Arishiro ◽  
Naotaka Kishimoto ◽  
Seiji Kanou ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Antihypertensive Therapy ◽  
Drug Class ◽  
Antihypertensive Drugs ◽  
Perioperative Complications ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Anesthetic Agents ◽  
Frequency Of Use ◽  
Blood Pressures

Abstract The purpose of this study was to evaluate the effects of an antihypertensive drug class and the timing of discontinuation of antihypertensive therapy on blood pressure during oral and maxillofacial surgery for 129 patients on antihypertensive therapy receiving general anesthesia. Blood pressures at loss of response to stimulation and 5–15 minutes after intubation were significantly lower than those before induction, although the type of antihypertensive therapy did not affect changes in blood pressure. No significant correlation was observed between systolic blood pressure (SBP) on the ward and change in SBP during surgery, though patients with higher blood pressure on the ward tended to exhibit larger differences between SBP on the ward and the lowest SBP during surgery. Frequency of use of vasopressors during surgery was significantly higher in patients who discontinued antihypertensive therapy on the day before surgery than in those who continued antihypertensive therapy on the day of surgery. These findings suggest that appropriate preoperative antihypertensive therapy is important for minimizing change in blood pressure during surgery and preventing perioperative complications. Patients undergoing antihypertensive therapy should be carefully monitored perioperatively by observation for interactions between antihypertensive and anesthetic agents and minimizing interruption schedules for antihypertensive therapy.

Evidence for Peripheral Vascular Involvement in Mild Elevation of Blood Pressure in Man

1976 ◽  
Vol 51 (s3) ◽  
pp. 65s-68s
Author(s):  
R. Sivertsson ◽  
R. Sannerstedt ◽  
Y. Lundgren
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Cardiac Index ◽  
Structural Changes ◽  
Vascular Involvement ◽  
Control Group ◽  
Study Group ◽  
Blood Pressure Elevation ◽  
Pressure Elevation ◽  
Arterial Blood

1. Cardiac output at rest, intra-arterial blood pressure and hand blood flow at maximal vasodilatation were studied in two groups of 18–25-year-old men: forty-four with mild blood pressure elevation were referred from a military enlistment centre, and twenty-nine normotensive volunteers were mainly recruited from the same enlistment centre. 2. The study group was characterized by a significantly higher cardiac index at rest, and a significantly higher blood flow resistance in the hand at maximal vasodilatation than the control group, indicating the presence of structural modifications in the resistance vessels of patients with mild blood pressure elevation. 3. The tendency to increased vascular resistance in the blood vessels of the hand at maximal vasodilatation was more pronounced in patients with a normal cardiac index than in those with a high index. This suggests inclusion in the study group of tense, anxious individuals with an elevated cardiac index but otherwise normal circulation, but does not exclude the possibility that these patients may develop structural changes later on.

Association between decreased blood pressure and azotaemia in canine babesiosis

2014 ◽  
Vol 17 (1) ◽  
pp. 173-175 ◽  
Author(s):  
W. Zygner ◽  
O. Gójska-Zygner
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Serum Creatinine ◽  
Renal Damage ◽  
Systolic Arterial Pressure ◽  
Babesia Canis ◽  
Canine Babesiosis ◽  
Tubular Necrosis ◽  
Blood Pressures

Abstract Acute tubular necrosis (ATN) was described in canine babesiosis. Hypotension is considered as one of the factors which influence the development of hypoxic renal damage. In this study hypotension defined as mean arterial pressure (MAP) < 80 mmHg was detected in 7 out of 48 dogs (14.6%) infected with Babesia canis. Lower systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and MAP were detected in azotaemic dogs infected with B. canis. Statistically significant negative correlations between blood pressures (SAP, DAP and MAP) and serum creatinine and urea concentrations showed the influence of decreased blood pressure on the development of azotaemia and is probably also associated with ATN in canine babesiosis.

The Addition of Visken to Methyldopa Therapy in Hypertension: A Multicentre Study

1976 ◽  
Vol 4 (2) ◽  
pp. 128-131 ◽  
Author(s):  
J E Murphy
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Multicentre Study ◽  
Treatment Regimen ◽  
Sleep Disturbances ◽  
Supine Blood Pressure ◽  
Blood Pressures

Forty-one patients completed the study where Visken was added to the treatment regimen of patients whose blood pressures were poorly controlled on methyldopa or who were experiencing side-effects with methyldopa. Supine blood pressure was reduced from 177/108 mm Hg before Visken therapy to 159/96 mm Hg after twelve weeks of taking Visken. The dose of methyldopa was reduced from a mean 921 mg at the start to 445 mg at the end. Fourteen patients were able to stop methyldopa therapy. The number of side-effects reported was reduced as the study continued and fifteen patients commented that they felt better on Visken. Nine patients did not complete the trial, three of these because of side-effects, viz insomnia, lethargy and sleep disturbances.

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