American Journal of Hypertension

BACKGROUND: We aimed to evaluate dynamic alterations in cerebral total hemoglobin concentration (HbT) in individuals with orthostatic hypotension (OH) and orthostatic intolerance (OI) symptoms using a portable NIRS system. METHODS: Participants comprised 238 individuals (mean age, 47.9 years) without a history of cardiovascular, neurodegenerative, or cerebrovascular diseases, including those with unexplained OI symptoms and healthy volunteers. Participants were categorized by the presence of OH based on the supine-to-stand blood pressure (BP) drop and OI symptoms using on OH questionnaires: classic OH (OH-BP), OH symptoms alone (OH-Sx), and control groups...

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BACKGROUND: Over half of South African adults 45 years and older have hypertension but its effective management along the treatment cascade (awareness, treatment, control) remains poorly understood. METHODS: We compared the prevalence of all stages of the hypertension treatment cascade in the rural HAALSI cohort of older adults at baseline and after four years of follow-up using household survey and blood pressure data. Hypertension was a mean systolic blood pressure >140 mmHg, or diastolic > 90 mmHg, or current use of anti-hypertension medication...

BACKGROUND: Accurate blood pressure (BP) measurement is essential to identify and manage hypertension. Prior studies have reported a difference between BP measured in routine patient care and in research studies. We aimed to investigate agreement between BP measured in routine care and research-grade BP in Kaiser Permanente Southern California, a large, integrated healthcare system with initiatives to standardize BP measurements during routine patient care visits. METHODS: We included adults ≥65 years old with hypertension, taking antihypertensive medication and participating in the Ambulatory Blood Pressure in Older Adults (AMBROSIA) study in 2019-2021...

BACKGROUND: Self-monitoring of blood pressure is a key strategy in managing hypertension but may be challenging and burdensome for patients. The aim of the study was to describe the perspectives and experiences of self-monitoring of blood pressure in patients with hypertension. METHODS: MEDLINE, Embase, PsycINFO, CINAHL were searched from database inception to March 2022. We used thematic synthesis to analyze the data. RESULTS: Thirty-five studies involving 872 patients aged 18-95 years were included...

BACKGROUND: Hypertension plus obstructive sleep apnea (OSA) is recommended in some guidelines as an indication to screen for primary aldosteronism (PA), yet prior data has brought the validity of this recommendation into question. Given this context, it remains unknown whether this screening recommendation is being implemented into clinical practice. METHODS: We conducted a population-based retrospective cohort study of all adult Ontario (Canada) residents with hypertension plus OSA from 2009-2020 with follow-up through 2021 utilizing provincial health administrative data...

BACKGROUND: Hypertensive individuals with higher heart rates and anxiety have greater cardiovascular morbidity and mortality. Despite the correlation between hypertension, heart rate, and anxiety, scant attention has been paid to the effect of hypertension drug therapy on behavioral outcomes in cardiovascular disease. Ivabradine, an inhibitor of hyperpolarization-activated, cyclic nucleotide-gated funny channels (HCNs), has been used clinically to reduce heart rates and has been shown to improve quality of life in patients with angina and heart failure...

INTRODUCTION: The Ideal Life BP Manager™ measures BP and automatically transmits results to the patient's medical record independent of internet access, but has not been validated. Our objective was to conduct a validation study of the Ideal Life BP Manager™ in pregnant women using a validation protocol. METHODS: Pregnant participants were enrolled into three subgroups per the AAMI/ESH/ISO protocol: normotensive (systolic blood pressure (SBP) <140 and diastolic blood pressure (DBP) < 90), hypertensive without proteinuria (SBP ≥ 140 or DBP ≥ 90), and preeclampsia (SBP ≥ 140 or DBP ≥ 90 with proteinuria)...

OBJECTIVE: Nocturnal hypertension assessed by a home blood pressure monitoring (HBPM) device is associated with an increased risk of cardiovascular events. However, it is still difficult to assess nighttime blood pressure (BP) frequently. The purpose of this cross-sectional study was to identify significant correlates of nocturnal hypertension assessed by an HBPM device in patients with hypertension who are treated with antihypertensive drugs. METHODS: We measured nighttime BP, morning BP, and evening BP by an HBPM device for 7 consecutive days in 365 medicated patients with hypertension...

BACKGROUND: Hydrogen sulfide (H2S) is widely distributed throughout the nervous system with various antioxidant and anti-inflammatory properties. Hypertension involves an increase in reactive oxygen species (ROS) and inflammation in the hypothalamic paraventricular nucleus (PVN). However, it is unclear how H2S in PVN affects hypertension. METHODS: Our study used spontaneously hypertensive rats (SHR) and control Wistar Kyoto (WKY) rats, microinjected with Adenovirus-Associated Virus (AAV)-CBS (cystathionine beta-synthase overexpression) or AAV-ZsGreeen in bilateral PVN, or simultaneously injected with virus-carrying nuclear factor erythroid 2-related factor 2 (Nrf2)-shRNA for 4w...

BACKGROUND: The prevalence of medication non-adherence in the setting of resistant hypertension varies from 5 to 80% in the published literature. The aim of this systematic review was to establish the overall prevalence of non-adherence and evaluate the effect of the method of assessment on this estimate. METHODS: MEDLINE, EMBASE, Cochrane, CINAHL, and Web of Science (database inception to Nov 2020) were searched for relevant articles. We included studies including adults with a diagnosis of resistant hypertension, with some measure of adherence...

BACKGROUND: Hypertension is becoming a serious public health problem and non-invasive estimation of central hemodynamics and artery stiffness have been identified as important predictors of cardiovascular disease. METHODS: The study included 4,311 participants, both sex, aged between 20 and 79 years. Arterial velocity pulse index, arterial pressure volume index (AVI, API, the index of artery stiffness), central systolic blood pressure, central artery pulse pressure (CSBP, CAPP, estimated via oscillometric blood pressure monitor) and 10-year risk score of cardiovascular disease in China (China-PAR) and Framingham cardiovascular risk score (FCVRS) were assessed at baseline...

Pregnancy is marked by the onset of rapid hemodynamic alterations in order to accommodate the needs of the developing fetus. Arterial stiffness is an independent predictor of cardiovascular events and mortality, and its measurement in clinical practice has been recommended. It follows a U-shaped curve in uncomplicated pregnancy, decreasing to a nadir in mid-pregnancy and rising at term. Systemic vasodilation occurs due to elevated nitric oxide, prostacyclin, endothelium-derived hyperpolarizing factor, estrogen, progesterone, and relaxin...

BACKGROUND: P21-activated kinase 1 (Pak1) has an effect on cell apoptosis and recently been reported to play an important role in various cardiovascular diseases, in which vascular smooth muscle cell (VSMC) apoptosis is a key process. Thus, we hypothesized that Pak1 may be a novel target to regulate vascular smooth muscle cell (VSMC) behaviors. METHODS AND RESULTS: In the present study, we found that the expression of Pak1 was dramatically upregulated in VSMCs upon H2O2 administration and were dependent on stimulation time...

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BACKGROUND AND AIM: Numerous studies targeting left ventricular (LV) systolic function by measuring LV ejection fraction (LVEF) in patients with pheochromocytoma and paraganglioma (PPGL) either failed to reveal any impairment of this parameter or found a super-normal systolic function compared to essential hypertensives or normotensive controls. In order to provide an updated piece of information on LV systolic dysfunction in the PPGL setting, we performed a meta-analysis of speckle tracking echocardiography (STE) studies investigating LV mechanics via global longitudinal strain (GLS), a more sensitive index of LV systolic function than LVEF...

BACKGROUND: Animals exposed to cold stress develop hypertension; however, the effects of cold-induced hypertension on pregnancy remain unclear and need more research. We therefore, aimed to investigate the impacts of cold-stress stimulation on mice pregnancy. METHODS AND RESULTS: Four groups of mice were used in the study: non-pregnant control group (NN), non-pregnant cold-stress group (NC), pregnant control group (PN) and pregnant cold-stress group (PC). control groups were kept at 25℃, and the cold-stress groups were kept in a room for cold-stress stimulation (4 ± 2℃) for 4 hours (then back to 25℃) every day from the 1st to the 18th day...

INTRODUCTION: Myocardial work (MW) is an index of LV function based on pressure-strain loops and brachial cuff pressure measurement. MW has been proposed as more sensitive than conventional functional parameters, as it accounts for afterload and myocardial deformation. However, many studies have been limited to assessment of global MW indices, neglecting regional differences in cardiac function associated with hypertension and consequent cardiac remodeling. We aimed to quantify regional MW in pediatric hypertension and compare the findings in renal or renovascular hypertension (RHTN) with essential hypertension (EHTN)...

BACKGROUND: The rates of uncontrolled hypertension, along with downstream cardiovascular outcomes, has been worsening in this country. Despite the plethora of antihypertensive medications on the market, the prevalence of resistant hypertension (RH) is estimated to be 13.7%. Therefore in addition to increased clinical education and focus on lifestyle management of hypertension and medication compliance, new therapies are needed to address this rise in hypertension. METHODS: A systematic review of the available medical literature was performed to identify emerging treatment options for RH...

No abstract text is available yet for this article.