Factors determining cardiac hypertrophy in hypertensive patients with or without peripheral vascular disease

1998 ◽  
Vol 95 (3) ◽  
pp. 261-267 ◽  
Author(s):  
M. BRAHIMI ◽  
B. I. LEVY ◽  
M. E. SAFAR ◽  
H. DABIRÉ
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Cardiac Hypertrophy ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Pulse Pressure ◽  
Systolic Pressure ◽  
Cardiac Mass ◽  
Peripheral Vascular ◽  
Hypertensive Patients

1.Coronary ischaemic disease and congestive heart failure are the principal causes of mortality in patients with peripheral vascular disease. Whether cardiac hypertrophy is present and even more pronounced in peripheral vascular disease than in other populations has never been explored. 2.Twenty-five hypertensive patients were investigated, 11 without and 14 with peripheral vascular disease, matched for age, sex, mean arterial pressure and antihypertensive drug treatment. Cardiac mass was determined using echocardiography together with measurement of systemic blood pressure, ratio between ankle systolic pressure (ASP) and brachial systolic pressure (BSP), and standard biochemical parameters including natriuresis per 24 ;h. 3.At the same mean arterial pressure, patients with peripheral vascular disease had a significantly higher cardiac mass (157±12 versus 116±6 ;g/m2; P< 0.01), pulse pressure (81±5 versus 55±4 ;mmHg; P< 0.01) and natriuresis (180±17 versus 144±6 ;mmol/24 h; P< 0.01) than controls. Using univariate correlations, cardiac mass was positively associated with pulse pressure, mean arterial pressure and natriuresis, and negatively with the ASP/BSP ratio. On the basis of multivariate regression analysis, only natriuresis was positively correlated to cardiac mass. 4.Patients with peripheral vascular disease develop a higher degree of cardiac hypertrophy in comparison with hypertensive subjects with the same level of mean arterial pressure. Sodium intake rather than mechanical factors seems to be the major modulating factor which influences the degree of cardiac hypertrophy.

Comparative effects of levosimendan, OR-1896, OR-1855, dobutamine, and milrinone on vascular resistance, indexes of cardiac function, and O2 consumption in dogs

2008 ◽  
Vol 294 (1) ◽  
pp. H238-H248 ◽  
Author(s):  
Patricia N. Banfor ◽  
Lee C. Preusser ◽  
Thomas J. Campbell ◽  
Kennan C. Marsh ◽  
James S. Polakowski ◽  
...  
Keyword(s):  
Oxygen Consumption ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Pulse Pressure ◽  
Myocardial Oxygen Consumption ◽  
Plasma Concentrations ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Systemic Resistance ◽  
Dose Dependent

Levosimendan enhances cardiac contractility via Ca2+ sensitization and induces vasodilation through the activation of ATP-dependent K+ and large-conductance Ca2+-dependent K+ channels. However, the hemodynamic effects of levosimendan, as well as its metabolites, OR-1896 and OR-1855, relative to plasma concentrations achieved, are not well defined. Thus levosimendan, OR-1896, OR-1855, or vehicle was infused at 0.01, 0.03, 0.1, and 0.3 μmol·kg−1·30 min−1, targeting therapeutic to supratherapeutic concentrations of total levosimendan (62.6 ng/ml). Results were compared with those of the β1-agonist dobutamine and the phosphodiesterase 3 inhibitor milrinone. Peak concentrations of levosimendan, OR-1896, and OR-1855 were 455 ± 21, 126 ± 6, and 136 ± 6 ng/ml, respectively. Levosimendan and OR-1896 produced dose-dependent reductions in mean arterial pressure (−31 ± 2 and −42 ± 3 mmHg, respectively) and systemic resistance without affecting pulse pressure, effects paralleled by increases in heart rate; OR-1855 produced no effect at any dose tested. Dobutamine, but not milrinone, increased mean arterial pressure and pulse pressure (17 ± 2 and 23 ± 2 mmHg, respectively). Regarding potency to elicit reductions in time to peak pressure and time to systolic pressure recovery: OR-1896 > levosimendan > milrinone > dobutamine. Levosimendan and OR-1896 elicited dose-dependent increases in change in pressure over time (118 ± 10 and 133 ± 13%, respectively), concomitant with reductions in left ventricular end-diastolic pressure and ejection time. However, neither levosimendan nor OR-1896 produced increases in myocardial oxygen consumption at inotropic and vasodilatory concentrations, whereas dobutamine increased myocardial oxygen consumption (79% above baseline). Effects of the levosimendan and OR-1896 were limited to the systemic circulation; neither compound produced changes in pulmonary pressure, whereas dobutamine produced profound increases (74 ± 13%). Thus levosimendan and OR-1896 are hemodynamically active in the anesthetized dog at concentrations observed clinically and elicit cardiovascular effects consistent with activation of both K+ channels and Ca2+ sensitization, whereas OR-1855 is inactive on endpoints measured in this study.

scholarly journals PEMBERIAN INFUSED WATER ROSELLA (Hibiscus Sabdariffa L.) TERHADAP STABILISASI HEMODINAMIK (MEAN ARTERIAL PRESSURE AND PULSE PRESSURE) PADA PENDERITA HIPERTENSI A LITERATURE RIVIEW

2021 ◽  
Vol 8 (1) ◽  
pp. 19-28
Author(s):  
Hariyono Hariyono
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Literature Review ◽  
Blood Vessel ◽  
Arterial Pressure ◽  
Pulse Pressure ◽  
Data Sources ◽  
Hibiscus Sabdariffa ◽  
Hypertensive Patients ◽  
Vessel Disease

Introduction: hypertension was a blood vessel disease and was the most common in the community.  The administration of rosella (Hibiscus sabdariffa l. ) was used as a new way to reduce the risk of heart and blood vessel disease including hypertension, to stabilize mean arterial pressure and pulse pressure in hypertensive patients after infused rosella water and hibiscus sabdariffa l which was linked to the literature empirical published in the last five years.  Researched methods: design: a literature review.  Data sources from comprehensive electronic searched searches conducted on google scholar (2015-2020), PubMed (2015-2020), complementary index (2015-2020), oaister (2015-2020), articles used in this review were published in Bahasa English and Indonesian.  Results: researched in the searched for 10 journals, found that consumption of roselle could reduce systolic blood pressure by an average of 5. 5% while diastolic blood pressure was 4. 0%.  So that changes in mean arterial pressure and pulse pressure were more stable after consuming hibiscus sabdariffa l.  Conclusion: Previous studies had shown that there was an effect of infused water rosella (Hibiscus sabdariffa l. ) on stabilization of mean arterial pressure and pulse pressure in hypertensive patients.

Screening by Trained Nurses for Peripheral Vascular Disease in Continuous Ambulatory Peritoneal Dialysis Patients with and without Diabetes

2003 ◽  
Vol 23 (2_suppl) ◽  
pp. 134-138 ◽  
Author(s):  
Suk-Yi Ng ◽  
Suk-Wai Cheng ◽  
Wai-Ling Chu ◽  
Sing-Leung Lui ◽  
Wai-Kei Lo
Keyword(s):  
Peritoneal Dialysis ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Doppler Ultrasound ◽  
Systolic Pressure ◽  
Vascular Complications ◽  
Diabetic Patients ◽  
Peripheral Vascular ◽  
Vibration Perception

Objective We studied the effectiveness of a screening program for peripheral vascular disease (PVD) carried out by trained renal nurses in patients with and without diabetes on continuous ambulatory peritoneal dialysis (CAPD). Patients and Methods We recruited 30 stable diabetic and 30 stable non diabetic CAPD patients into this cross-sectional study. Trained renal nurses measured the patients’ ankle-to-brachial systolic pressure index (ABI) using a Doppler ultrasound machine and their foot vibration perception (VPT) using a biothesiometer, and administered a questionnaire on foot symptoms. An ABI < 1.0 was regarded as abnormal and suggestive of the presence of PVD. An ABI < 0.7 or > 1.3 was regarded as severely abnormal. Findings for VPT were classified as normal or abnormal. Patients were then followed for 1 year for any overt development of clinical PVD, leg complications, and other vascular complications and for clinical outcome. Results The mean age of the patients was 63 ± 9 years, and the ratio of men to women was 1:1.3. An abnormal ABI was seen in 22 patients (37%). The questionnaire detected clinical PVD symptoms in 3 patients. Abnormal ABI and VPT findings were more frequent in diabetic patients. After 12 months of follow-up, patients with an abnormal ABI (and particularly those with a severely abnormal ABI) were more likely to develop leg complications and any type of cardiovascular disease than were patients with a normal ABI. Foot vibration perception had no predictive value on subsequent development of leg complications. When risk factors including age, ABI, and VPT were analyzed by logistic regression, only ABI was a significant independent predictor of subsequent lower-limb vascular complications [odds ratio (OR): 21.0; 95% confidence interval (CI): 2.35 to 187.0; p = 0.00064]. The OR for moderately abnormal ABI was 13.0 (95% CI: 1.015 to 166.3); for severely abnormal ABI, it was 27.4 (95% CI: 2.35 to 187.0, p = 0.0045). Conclusions Measurement of ABI by Doppler ultrasound is a useful and effective screening test for PVD in CAPD patients. In this study, VPT was not shown to be predicative of future leg complications, indicating that peripheral neuropathy plays a less important role in the development of such complications. Our results proved that trained renal nurses can play an active role in detecting foot problems in renal patients by ABI measurement.

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