scholarly journals A correlation between the fluctuations of cytokine concentrations measured in the morning and evening and the circadian blood pressure rhythm in patients with stage II essential hypertension

2019 ◽  
pp. 65-70 ◽  
Author(s):  
OA Radaeva ◽  
AS Simbirtsev ◽  
AV Khovryakov
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Blood Pressure Monitoring ◽  
Organ Damage ◽  
Time Of Day ◽  
Stage Ii ◽  
Healthy Controls ◽  
Cytokine Levels ◽  
Pathophysiological Role

Today, increasing attention is being paid to the role of circadian rhythms in pathology. There are time-of-day-dependent immune markers that provide valuable information about disease progression. The aim of this study was to measure evening and morning concentrations of a few cytokines (interleukins, adhesion molecules, tumor necrosis/growth factors, etc.) in the peripheral blood of patients with stage II essential hypertension and to investigate how they correlate with a nocturnal blood pressure decline. Blood samples were collected from 90 patients with stage II EH at 7:00 a.m. and 8:00 p.m. Cytokine concentrations were measured using immunoassays. Based on 24-h blood pressure monitoring, the patients were distributed into 3 groups: dippers, non-dippers and night-peakers. The morning to evening ratios of cytokine concentrations in patients with EH differed from those in healthy controls due to an increase in the evening concentrations of somnogenic cytokines (IL1β, IL1α) and LIF, sLIFr, and M-CSF whose daily fluctuations patterns remain understudied. On the whole, the fluctuation patterns of the measured cytokines in patients with stage II EH who had had the condition for 10 to 14 years and were receiving no antihypertensive treatment at the time of our study differed from those displayed by healthy controls. A twenty percent rise in the evening concentrations of IL1α, LIF, sLIFr, M-CSF, and erythropoietin contributes significantly to pathological blood pressure rhythms (as demonstrated by the groups of non-dippers and night-peakers) in patients with stage II EH receiving no antihypertensive therapy. Understanding the pathophysiological role of cytokine levels and their fluctuations over a 24-h cycle could inspire new methods for EH prevention and reduce end-organ damage.

scholarly journals The Clinical Significance of Circadian Rhythm and Blood Pressure Variability

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Rafidah Hanim Mokhtar ◽  
Maizatul Azma Masri ◽  
Hanis Hidayu Kasim ◽  
Azizi Ayob
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Variability ◽  
Blood Pressure Monitoring ◽  
Target Organ Damage ◽  
Circadian Variation ◽  
Biological Clock ◽  
Organ Damage ◽  
Time Of Day ◽  
Cardiac Events ◽  
Factors Affecting

— Sleep-wake cycle is the most evident 24 hour rhythms observed in humans. This circadian variation is a normal biological clock. The physiological phenomenon, however has been able to explain the onset of cardiac events that also tend to occur during certain time of day. It has been known that there is a tendency for major cardiovascular episodes to occur during the mid-morning hours. With the advent of ambulatory blood pressure monitoring, the fluctuations of blood pressure throughout the day are able to be captured. This is called blood pressure variability (BPV). The factors affecting BPV include age, sex, physical activity, mental activity, behavioural and environmental. Recent studies have shown that high BPV is associated with target organ damage, in particular cardiovascular and coronary artery diseases. In the effort to explain the mechanisms related to these complications out of excessive BPV, several studies explored the role of history of family with hypertension, hyperglycaemia and hyperlipidemia towards developing pre-existing condition that lead to high BPV.

scholarly journals Which Monitor? An Analysis of 2000 Incident Reports

1993 ◽  
Vol 21 (5) ◽  
pp. 529-542 ◽  
Author(s):  
R. K. Webb ◽  
J. H. Van Der Walt ◽  
W. B. Runciman ◽  
J. A. Williamson ◽  
J. Cockings ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pulse Oximeter ◽  
Blood Pressure Monitoring ◽  
Low Pressure ◽  
Organ Damage ◽  
Mechanically Ventilated ◽  
Blood Pressure Monitors ◽  
International Monitoring ◽  
Oxygen Analyser

The role of monitors in patients undergoing general anaesthesia was studied by analysing the first 2000 incidents reported to the Australian Incident Monitoring Study; 1256 (63%) were considered applicable to this study. In 52% of these a monitor detected the incident first; oximetry (27%) and capnography (24%) detected over half of the monitor detected incidents, the electrocardiograph 19%, blood pressure monitors 12%, a low pressure (circuit) alarm 8%, and the oxygen analyser 4%. Of the other monitors used, 5 first detected 1–2% of incidents, and the remaining 8 less than 0.5% each. The oximeter would have detected over 40% of the monitor detected incidents had its more informative modulated pulse tone always been relied upon instead of the “bleep” of the ECG. A theoretical analysis was then carried out to determine which of an array of 17 monitors would reliably have detected each incident had each monitor been used on its own and had the incident been allowed to evolve. To facilitate “scoring” of monitors, the incidents were categorized empirically into 60 clinical situations; 40% of applicable incidents were accounted for by only 5 clinical situations, 60% by 10 and nearly 80% by 20. 98% were accounted for by the 60 situations. A pulse oximeter, used on its own, would theoretically have detected 82% of applicable incidents (nearly 60% before any potential for organ damage). These figures for capnography are 55% and 43 % and for oximetry and capnography combined are 88% and 65%, respectively. With the addition of blood pressure monitoring these become 93% and 65%, and of an oxygen analyser, 95 and 67%. Other monitors, including the ECG, each increase the yield by by less than 0.5%. The international monitoring recommendations and those of the Australian and New Zealand College of Anaesthetists are thoroughly vindicated by the patterns revealed in this study. The priority sequence of monitor acquisition for those with limited resources should be stethoscope, sphygmomanometer, oxygen analyser if nitrous oxide is to be used, pulse oximeter, capnograph, high pressure alarm, and, if patients are to be mechanically ventilated, a low pressure alarm (or spirometer with alarm); an ECG, a defibrillator, a spirometer and a thermometer should be available.

scholarly journals The relationship of plasma renin , angiotensin , and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension

2019 ◽  
Author(s):  
Yang Liu ◽  
Yao Lin ◽  
Ming-Ming Zhang ◽  
Tong Zheng ◽  
Xiao-Hui Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Blood Pressure Monitoring ◽  
Target Organ Damage ◽  
Plasma Renin ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Cardiac Damage ◽  
Renin Angiotensin

Abstract Background To investigate the relationships of plasma RAAS levels to BPV and TOD in children with essential hypertension.Methods A case-control study was conducted on 132 children diagnosed with essential hypertension, comprising 103 males and 29 females with the mean age of 11.8 ± 2.4 years. The plasma RAAS levels were measured by enhanced chemiluminescence method, and the ambulatory blood pressure was monitored for 24h, followed by calculation of the coefficients of variability (CV). Data on indicators for assessing fundus, cardiac, and renal damages. The correlations of plasma RAAS levels to BPV and TOD were studied. Comparison between groups was analyzed by SPSS 20．Results Among the 132 children, 88 cases had target organ damage. The daytime CV of systolic blood pressure of the high angiotensin II (AT II) group was significantly higher than that of the normal AT II group (t = 2.365, P = 0.019). Plasma AT II and aldosterone levels were significantly associated with left ventricular mass index (r = 0.316, P < 0.01; r = 0.176, P = 0.043), and plasma AT II was positively correlated with the LVMI (r = 0.316; P < 0.01).Conclusions The AT II level in children with essential hypertension affected the variability of daytime SBP. Plasma AT II and aldosterone levels were associated with cardiac damage, especially the AT II. Results from this study provide an objective basis for the protection against subclinical cardiac damage in childhood hypertension.Keywords Blood pressure monitoring · Child · Hypertension · Renin-angiotensin-aldosterone system

DAILY BLOOD PRESSURE PATTERN DISORDERS IN PATIENTS WITH STAGE II ESSENTIAL HYPERTENSION AND FREQUENT PREMATURE BEATS

2020 ◽  
Vol 16 (71) ◽  
pp. 072
Author(s):  
N. V. Kuzminova ◽  
A. V. Ivankova ◽  
V. P. Ivanov ◽  
S. E. Lozinsky ◽  
I. I. Knyazkova ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Stage Ii ◽  
Pressure Pattern ◽  
Premature Beats

ABPM Comparison of the Anti-Hypertensive Profiles of Telmisartan and Enalapril in Patients with Mild-to-Moderate Essential Hypertension

2002 ◽  
Vol 30 (6) ◽  
pp. 543-552 ◽  
Author(s):  
J Amerena ◽  
S Pappas ◽  
J-P Ouellet ◽  
L Williams ◽  
D O'Shaughnessy
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Blood Pressure Monitoring ◽  
Study Drug ◽  
Pressure Control ◽  
Moderate Essential Hypertension ◽  
Open Label ◽  
Night Time ◽  
Once Daily

In this multicentre, prospective, randomized, open-label, blinded-endpoint (PROBE) study, the efficacy of 12 weeks' treatment with once-daily telmisartan 40–80 mg and enalapril 10–20 mg was evaluated using ambulatory blood pressure monitoring (ABPM) in 522 patients with mild-to-moderate essential hypertension. Patients were titrated to the higher dose of study drug at week 6 if mean seated diastolic blood pressure (DBP) was ≥ 90 mmHg. The primary endpoint was the change from baseline in ambulatory DBP in the last 6 h of the 24-h dosing interval after 12 weeks' treatment. Telmisartan and enalapril produced similar reductions from baseline in DBP and systolic blood pressure (SBP) over all ABPM periods evaluated (last 6 h, 24-h, daytime and night-time). Telmisartan produced a significantly greater reduction in mean seated trough DBP, measured unblinded with an automated ABPM device in the clinic, amounting to a difference of −2.02 mmHg ( P < 0.01). A significantly greater proportion of patients achieved a seated diastolic response with telmisartan than enalapril (59% versus 50%; P < 0.05), also measured with the same ABPM device. Both treatments were well tolerated. Compared with telmisartan, enalapril was associated with a higher incidence of cough (8.9% versus 0.8%) and hypotension (3.9% versus 1.1%). Therefore, telmisartan may provide better long-term compliance and, consequently, better blood pressure control than enalapril.

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