Blood pressure recording in the ambulatory patient and evaluation of cardiovascular risk

Many large epidemiological studies, such as the one going on in Framingham [1], have clearly established that hypertension is one of the major risk factors for cardiovascular diseases. Well controlled intervention trials have also clearly demonstrated that antihypertensive therapy can significantly reduce the incidence of complications such as stroke, congestive heart failure and possibly myocardial infarction [2-4]. There exists no doubt about the important causal relationship between elevated blood pressure and cardiovascular complications. The measurement of blood pressure has thus become one of the most frequent procedures carried out by any practising physician. Notwithstanding, some doubt has been expressed whether all patients with a slightly elevated blood pressure at the physician's office are indeed prone to suffer a heart attack or a stroke and need lifelong antihypertensive therapy [5, 6]. Does the casual blood pressure measurement at the physician's office accurately assess the risk of each individual patient of suffering a heart attack in the future?

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Effects of tonin on the response to norepinephrine by the aortic strip of the hypertensive rat

Canadian Journal of Physiology and Pharmacology ◽

10.1139/y81-116 ◽

1981 ◽

Vol 59 (8) ◽

pp. 790-793 ◽

Cited By ~ 2

Author(s):

R. Garcia ◽

E. L. Schiffrin ◽

G. Thibault ◽

R. Boucher ◽

J. Genest

Keyword(s):

Blood Pressure ◽

Smooth Muscle ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

Hypertensive Rats ◽

Aortic Smooth Muscle ◽

Hypertensive Group ◽

Aortic Strip ◽

The One

The response to norepinephrine (NE) of arterial smooth muscle from two types of experimental hypertensive rats was investigated. Aortic strips from one-kidney, one-clip hypertensive animals were less responsive to NE than those from their normotensive controls but strips from two-kidney, one-clip hypertensive animals showed no difference from their corresponding controls. The contractility in response to NE was the same in all groups. These results suggest that the mechanisms responsible for the lesser reactivity in the one-kidney hypertensive group are not a consequence of elevated blood pressure itself but may be related to changes in the intrinsic sensitivity of aortic smooth muscle.Tonin potentiated the contraction induced by NE in aortic strips from hypertensive and normotensive rats. This effect was more pronounced in the one-kidney, one-clip hypertensive animals, so that although the aortic smooth muscle from these animals is less reactive to NE, the decreased reactivity can be more than compensated by the presence of tonin. The mechanism of potentiation is not yet clear but the fact that Saralasin did not inhibit it suggests that angiotensin Il is not generated in situ.

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Time to Initiation of Antihypertensive Therapy After Onset of Elevated Blood Pressure in Patients With Primary Proteinuric Kidney Disease

Kidney Medicine ◽

10.1016/j.xkme.2019.10.012 ◽

2020 ◽

Vol 2 (2) ◽

pp. 131-138

Author(s):

Donald J. Weaver ◽

Anne Waldo ◽

Gia J. Oh ◽

Elaine S. Kamil ◽

Matthew Elliott ◽

...

Keyword(s):

Blood Pressure ◽

Kidney Disease ◽

Antihypertensive Therapy ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

Time To Initiation

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The prevalence of elevated blood pressure in a sample of slovene children and adolescents: a pilot study

Slovenian Journal of Public Health ◽

10.2478/sjph-2018-0010 ◽

2018 ◽

Vol 57 (2) ◽

pp. 72-80

Author(s):

Tjaša Hertiš ◽

Tadej Petek ◽

Nataša Marčun Varda

Keyword(s):

Blood Pressure ◽

Relative Risk ◽

Children And Adolescents ◽

Blood Pressure Measurement ◽

Public Health Problem ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

Anthropometric Measures ◽

Important Public Health Problem ◽

Cross Sectional

Abstract Introduction The aim of our study was to determine the prevalence of prehypertensive and elevated blood pressure in the hypertensive range (elevated BP) and obtain some anthropometric measures in Slovene children and adolescents. Methods In the cross-sectional study lasting one year, we measured BP using mercury sphygmomanometers, as well as height, weight, waist, and hip circumferences in schools. Data from regular check-ups (oscillometric measurements) were also added to increase the sample size. Participants were 2-19 years old. For statistical analysis, we used two-sided multivariate analysis of variance, Pearson’s r, and chi-squared test. Results From altogether 1594 participants, 723 (45.4%) were boys and 871 (54.6%) girls. The prevalence of elevated BP on a single oscillometric blood-pressure measurement was 12.0% (95% CI: 10.3 to 13.9), and an additional 13.9% (95% CI: 12.0 to 15.9) had prehypertensive BP. In Riva-Rocci measurements, elevated BP was present in only 7.1% (95% CI: 4.9 to 10.1) and prehypertensive BP additionally in 3.9% (95% CI: 2.4 to 6.4) in comparison to oscillometric measurements, which showed higher prevalence. Importantly, overweight participants had a 1.75 times greater relative risk for prehypertensive BP (95% CI: 1.22 to 2.53; p<0.01). Obesity carried a 1.79 times greater relative risk (95% CI: 1.22 to 2.63; p<0.01) for BP outside of the normotensive BP range. Conclusion Arterial hypertension is becoming an important public health problem, especially due to the childhood obesity. It seems to concern also Slovene young population with prevalence of elevated BP at around 7.1% after a single auscultatory BP measurement.

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Adherence to Antihypertensive Therapy and Elevated Blood Pressure: Should We Consider the Use of Multiple Medications?

PLoS ONE ◽

10.1371/journal.pone.0137451 ◽

2015 ◽

Vol 10 (9) ◽

pp. e0137451 ◽

Cited By ~ 24

Author(s):

Khedidja Hedna ◽

Katja M. Hakkarainen ◽

Hanna Gyllensten ◽

Anna K. Jönsson ◽

Karolina Andersson Sundell ◽

...

Keyword(s):

Blood Pressure ◽

Antihypertensive Therapy ◽

Elevated Blood Pressure ◽

Elevated Blood

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Hypertension and its Determinants Among School Going Adolescents: A Cross Sectional Study in Nepal

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v39i2.25377 ◽

2019 ◽

Vol 39 (2) ◽

pp. 87-94

Author(s):

Sujata Shakya ◽

Shanti Bajracharya

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Blood Pressure Measurement ◽

Cross Sectional Study ◽

Lifestyle Changes ◽

Elevated Blood Pressure ◽

Bivariate Analysis ◽

Elevated Blood ◽

Sectional Study ◽

Cross Sectional

Introduction: Hypertension is a chronic life threatening non- communicable disease. It increases the risk for cardiovascular diseases even leading to premature death. Almost half of the adults with hypertension had elevated blood pressure during childhood. With globalisation and lifestyle changes, adolescents are exposed to various risk factors. However, diagnosis in this population is difficult due to absence of symptoms. Thus, regular blood pressure screening is essential in these groups. This study aimed to find out the prevalence of hypertension and its determinants among the school going adolescents of Kathmandu, Nepal. Methods: This was a descriptive cross sectional study which included five private secondary schools of Kathmandu, Nepal. The adolescent students studying in classes VIII, IX and X were the study subjects. Two stage cluster random sampling technique was used to select 356 participants. Data collection was done by doing anthropometric measurements, blood pressure measurement and through self administered questionnaire. Results: The study depicted that the prevalence of elevated blood pressure was 12.4%, stage 1 hypertension 32.3% and stage 2 hypertension 9.8%. Similarly, 13.8% were overweight and 1.4% were obese. Bivariate analysis depicted significant association of prevalence of hypertension with gender, religion and obesity (p < 0.05). The multivariate analysis shows that the significant predictors of elevated blood pressure and/or hypertension were gender and obesity. Males were six times more likely to have elevated blood pressure (AOR = 6.058, CI = 2.571 - 14.274) and 2.8 times more likely to be hypertensive (AOR = 2.838, CI = 1.688 - 4.773) compared to females. Similarly, compared to obese/ overweight students, thin and normally built ones have less likelihood of having elevated blood pressure and hypertension. Conclusions: Hypertension has been prevalent among adolescents, due to various behavioural risk factors. This is really challenging and of public health significance. Regular screening of adolescents is essential for early detection and management of hypertension.

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Mechanisms underlying developmental programming of elevated blood pressure and vascular dysfunction: evidence from human studies and experimental animal models

Clinical Science ◽

10.1042/cs20070113 ◽

2007 ◽

Vol 114 (1) ◽

pp. 1-17 ◽

Cited By ~ 119

Author(s):

Anne Monique Nuyt

Keyword(s):

Blood Pressure ◽

Vascular Dysfunction ◽

Renin Angiotensin System ◽

Later Life ◽

Epidemiological Studies ◽

Experimental Models ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

Early Life Conditions

Cardiovascular-related diseases are the leading cause of death in the world in both men and women. In addition to the environmental and genetic factors, early life conditions are now also considered important contributing elements to these pathologies. The concept of ‘fetal’ or ‘developmental’ origins of adult diseases has received increased recognition over the last decade, yet the mechanism by which altered perinatal environment can lead to dysfunction mostly apparent in the adult are incompletely understood. This review will focus on the mechanisms and pathways that epidemiological studies and experimental models have revealed underlying the adult cardiovascular phenotype dictated by the perinatal experience, as well as the probable key causal or triggering elements. Programmed elevated blood pressure in the adult human or animal is characterized by vascular dysfunction and microvascular rarefaction. Developmental mechanisms that have been more extensively studied include glucocorticoid exposure, the role of the kidneys and the renin–angiotensin system. Other pathophysiological pathways have been explored, such as the role of the brain and the sympathetic nervous system, oxidative stress and epigenetic changes. As with many complex diseases, a unifying hypothesis linking the perinatal environment to elevated blood pressure and vascular dysfunction in later life cannot be presumed, and a better understanding of those mechanisms is critical before clinical trials of preventive or ‘deprogramming’ measures can be designed.

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Blood pressure measurement under standardized indoor condition may mask seasonal blood pressure variation in men with mildly elevated blood pressure

Clinical and Experimental Hypertension ◽

10.3109/10641963.2014.960975 ◽

2014 ◽

Vol 37 (4) ◽

pp. 317-322 ◽

Cited By ~ 5

Author(s):

Tomomi Hattori ◽

Masanori Munakata

Keyword(s):

Blood Pressure ◽

Pressure Measurement ◽

Blood Pressure Measurement ◽

Pressure Variation ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

Blood Pressure Variation

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Blood pressure measurement in overweight, underweight and normal BMI undergraduate students of a private medical college: correlation of BMI with blood pressure

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20172592 ◽

2017 ◽

Vol 5 (7) ◽

pp. 2921

Author(s):

Shah Mohd Abbas Waseem ◽

Rubeena Bano

Keyword(s):

Blood Pressure ◽

Medical Students ◽

Undergraduate Students ◽

Blood Pressure Measurement ◽

Later Life ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

Medical College ◽

Increased Risk ◽

Males And Females

Background: It is estimated that by 2025 around 46.5% of India’s population will be suffering from hypertension and associated complications. Thus, early detection of hypertension can prevent complications in later life. Higher BMI is associated with increased risk of elevated blood pressure. Weight related problems are on rise in college/University students. The medical students are at greater risk owing to various stressors. Thus, the present study was undertaken to measure blood pressure and BMI of undergraduate MBBS students and to find correlation with them.Methods: 253 students were enrolled in the study. BMI (Kg/m2) and blood pressure (mmHg) were measured. The data was analysed using appropriate statistical tests.Results: BMI was 22.54±2.85 and 20.75±2.99 Kg/m2 respectively in males and females (p<0.001). 21.34% and 12.65% were found to be underweight and overweight respectively. SBP and DBP in males and females was found to be 120.54±9.48/79.71±4.77 and 110.80±0.98/74.40±5.45 mmHg respectively (p<0.001). 67.98%, 28.07% and 3.95% students were found to be normo, pre-and hypertensive respectively. Significant positive correlation of BMI with SBP and DBP was found both in males and females.Conclusions: There is weight related concerns and associated complications like elevated blood pressure in medical students.

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