[Effects of yishenjiangyafang on blood pressure and protecting renal function in RPH rats]

[Article in Chinese]

Chen ML, Liu WJ, Wang CY, Zhu XM, Yin JF, Wang DX, Liu P.

Department of Clinical Pharmacology, General Hospital of Chinese PLA, Beijing 100853, China.

OBJECTIVE: To study the effects and mechanism of Yishenjiangyafang, a prescription of Chinese traditional herbs used for renal hypertension, on blood pressure and protecting renal function of RPH rats. METHOD: The 5/6 kidney of rat was resected to set up the RPH rat model. Blood pressure, Cr(creatinine), Ccr(creatinine clearance) and BUN(urea nitrogen) were measured dynamically. After eight weeks treatment, plasma content of PAR A II TXB2, 6-keto-PGF1 were measured. At same time, The change of renal pathology was observed. RESULT: Yishenjiangyafang could reduce blood pressure Cr, but had no effect on BUN of RPH rat. The indexes of PAR, A II of each different dosage group of Yishenjiangyafang were decreased. At the same time, it reduced plasma content of TXB2, and increased 6-keto-PGF1 alpha. Glomerulosclerosis and atrophy of renal tubule in Yishenjiangyafang group RPH rats were better than those of the contrast group and the Capten group. CONCLUSION: Yishenjiangyafang can reduce blood pressure of RPH rats and has protective effects on its kidney. Yishenjiangyafang can perform its effects of reducing blood pressure and protecting kidney by influencing the RAS of RPH rats.

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Blood pressure regulates the activity and function of the Na-K-2Cl cotransporter in vascular smooth muscle.

Jiang G, Akar F, Cobbs SL, Lomashvilli K, Lakkis R, Gordon FJ, Sutliff RL, O'Neill WC.

Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA.

The Na-K-2Cl cotransporter (NKCC1) is one of several transporters that have been linked to hypertension, and its inhibition reduces vascular smooth muscle tone and blood pressure. NKCC1 in the rat aorta is stimulated by vasoconstrictors and inhibited by nitrovasodilators, and this is linked to the contractile state of the smooth muscle. To determine whether blood pressure also regulates NKCC1, we examined the acute effect of hypertension on NKCC1 in rats after aortic coarctation. In the hypertensive aorta (28-mmHg rise in mean blood pressure), an increase in NKCC1 activity (measured as bumetanide-sensitive (86)Rb efflux) was apparent by 16 h and reached a plateau of 62% greater than control at 48 h. In contrast, there was a slight decrease in NKCC1 activity in the hypotensive aorta (21% decrease in mean blood pressure). Measurement of NKCC1 mRNA by real-time PCR revealed a fivefold increase in the hypertensive aorta compared with the hypotensive aorta or sham aorta. The inhibition by bumetanide of isometric force response to phenylephrine was significantly greater in the hypertensive aorta than in the control aorta or hypotensive aorta. We conclude that NKCC1 in rat aortic smooth muscle is regulated by blood pressure, most likely through changes in transporter abundance. This upregulation of NKCC1 is associated with a greater contribution to force generation in the hypertensive aorta. This is the first demonstration that NKCC1 in vascular smooth muscle is regulated by blood pressure and indicates that this transporter is important in the acute response of vascular smooth muscle to hypertension.

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Tea intake is inversely related to blood pressure in older women.

Hodgson JM, Devine A, Puddey IB, Chan SY, Beilin LJ, Prince RL.

University of Western Australia School of Medicine and Pharmacology, and the Western Australian Institute for Medical Research (WAIMR),Royal Perth Hospital Unit.

Background - Tea is rich in polyphenols, which have activities consistent with blood pressure lowering potential. The effects of long-term regular ingestion of tea on blood pressure remain uncertain. Objective - To investigate the relationships of tea intake and a biomarker of exposure to tea-derived polyphenols (4-O-methylgallic acid) with blood pressure. Methods - This was a cross-sectional study of 218 women over 70 y. Clinic blood pressures were measured, tea intake was assessed using a 24 h dietary recall, and 4-O-methylgallic acid was measured for the same period in a 24 h urine sample. Results - Mean (95% CI) daily tea intake was 525 (475, 600) mL. Mean systolic and diastolic blood pressures were 138.1(135.6,140.6)/73.5(72.1, 74.9) mmHg. Using linear regression analysis, higher tea intake and higher 4-O-methylgallic acid excretion were associated with significantly lower systolic (P=0.002 and P=0.040, respectively) and diastolic (P=0.027 and P<0.001, respectively) blood pressures. A 250 mL/d (1 cup) increase in tea intake was associated with a 2.2 (0.8,3.6) mmHg lower systolic blood pressure and a 0.9 (0.1, 1.7) mmHg lower diastolic blood pressure. Conclusions - The observed associations for both tea intake and 4-O-methylgallic acid are consistent with the hypothesis that long-term regular ingestion of tea may have a favorable effect on blood pressure in older women.

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The effects of diminazene aceturate on systemic blood pressure in clinically healthy adult dogs.

Joubert KE, Kettner F, Lobetti RG, Miller DM.

Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Private Bag X04, Onderstepoort 0110, South Africa. kjoubert op.up.ac.za

Diminazene aceturate is a commonly used antibabesial agent. It has been postulated that diminazine may induce a decrease in blood pressure and exacerbate the hypotension presented in dogs with babesiosis. This study was undertaken to assess the effect of diminazine aceturate on the blood pressure of healthy dogs. Six healthy German shepherd dogs between 18 and 24 months of age with a mean weight of 30.4 +/- 2.75 kg were used. Blood pressure was directly measured at the following time intervals: -5, 0, 5, 10, 15, 20, 25, 30, 35, 40, 50, 60, 90 and 120 minutes after treatment with diminazine aceturate (4.2 mg/kg) intramuscularly. No statistical difference (P > 0.05) was found in blood pressure between any of the time intervals. An increase in heart rate was seen 5 minutes after the administration of diminazine aceturate but no change in blood pressure was evident. This study concluded that diminazene aceturate in its current formulation with antipyrine does not alter blood pressure in healthy adult dogs.

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Target blood pressure for patients with type 2 diabetes is difficult to achieve in the setting of a busy diabetes clinic.

Agha A, Dillon D, Corbett M, Sreenan S.

Department of Endocrinology and Diabetes Mellitus, James Connolly Memorial Hospital, Dublin, Ireland. amaragha yahoo.com

BACKGROUND: Target blood pressure control in patients with type 2 diabetes should be 130/85 mmHg or less; however, it is not clear how achievable this target is in clinical practice. AIM: To assess the adequacy of blood pressure control in patients with type 2 diabetes attending a busy outpatient clinic. METHODS: One hundred and eight patients with type 2 diabetes were assessed for the presence of hypertension using a cut-off value of 130/85 mmHg. Antihypertensive treatment and diabetic complications were evaluated. RESULTS: Hypertension was present in 67% of patients, in whom 90% were receiving anti-hypertensive treatment. Forty-nine per cent of the treated patients achieved target blood pressure. Of the undertreated patients, 55% were on one antihypertensive agent, 30% were on two agents and 15% were on three or more agents. The corresponding figures for the adequately treated patients were 28%, 31% and 41%, respectively (p=0.03). CONCLUSION: Adequate blood pressure control was underachieved in this patient group underlying the difficulty in treating blood pressure to target values in patients with type 2 diabetes in the setting of outpatient diabetes clinics. A more aggressive strategy, in particular the use of multiple antihypertensive agents should be adopted.

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Blood pressure control among hypertensives managed in a specialised health care setting in Nigeria.

Isezuo AS, Njoku CH.

Department of Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.

In spite of the plethora of anti-hypertensives, hypertension remains an important cause of morbidity and mortality among Nigerian hypertensive population. To determine blood pressure control rate, defined as the proportion of treated hypertensive population with systolic and diastolic blood pressures less than 140 mmHg and 90 mmHg respec tively. One hundred and ten (110) treated adult Nigerian hypertensives aged 28-80 (mean 46.02 +/- 15.20) years with male: female ratio of 1:1.4 who have been commenced on treatment for at least 6 months were selected by simple random sampling for determination of blood pressure control rate and its determinant factors using clinic blood pressures. Blood pressure control rate was 42.70%. Pre-treatment mean blood pressure was significantly higher than the value at least 6 months post commencement of treatment: (170.09 +/- 15.20/108.98 +/- 15.85 mmHg versus 146.10 +/- 24.50/93.8 +/- 21.90 mmHg) (t=8.73; p<0.05). In the group with uncontrolled blood +/- 17.91 mmHg in 42 (66.6%), rose by 10.50 +/- 1.0 mmHg in 8 (12.70%) and was unchanged in 13 (20.66%) patients. Diastolic blood pressure fell by 22.22 +/- 14.58 mmHg in 32 (50.8%), rose by 7.88 +/- 6.66 mmHg in 16 (25.40%) and was unchanged in 15 (23.80%) patients. Clinic compliance and family history of hypertension were associated with satisfactory blood pressure control. Blood pressure control rate among the study population was low. Compliance and family re-enforcement should be encouraged.

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Ophthalmodynamometric determination of the central retinal vessel collapse pressure correlated with systemic blood pressure.

Jonas JB.

Universitats-Augenklinik, Theodor-Kutzer-Uffer 1-3, 68167 Mannheim, Gemany. Jost.Jonas augen.ma.uni-heidelberg.de

AIMS: To evaluate whether determination of the central retinal artery and vein collapse pressure correlate with systemic blood pressure measurements, using a new Goldmann contact lens associated ophthalmodynamometric device METHODS: The prospective clinical study included 92 eyes of 92 patients presenting with cataract or refractive problems (n = 40; control study group) or with retinal and orbital pathologies (n = 52). With topical anaesthesia, a Goldmann contact lens fitted with a pressure sensor in its holding ring was placed onto the cornea. Pressure was asserted onto the globe by pressing the contact lens, and the pressure value at the time when the central retinal artery and vein started pulsating were noted as central retinal artery and vein collapse pressure. Additionally, the brachial arterial blood pressure was measured. RESULTS: In the control study group, central retinal artery collapse pressure was highly significantly correlated with diastolic blood pressure (correlation coefficient r = 0.77; p<0.001) and systolic blood pressure (r = 0.35; p = 0.03). Central retinal vein collapse pressure was statistically independent of diastolic blood pressure (p = 0.11). In eyes with retinal or orbital diseases, the correlation coefficients were lower than in the control study group. In eyes with retinal arterial occlusions, central retinal vessel collapse pressure measurements were not correlated with arterial blood pressure measurements. CONCLUSIONS: Depending on coexisting retinal or orbital diseases, ophthalmodynamometric estimation of the central retinal artery collapse pressure, performed during a routine Goldmann contact lens ophthalmoscopy, correlates with systemic blood pressure measurements.

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Observed factors responsible for resistant hypertension in a teaching hospital setting.

Salako BL, Ayodele OE.

Department of Medicine, College of Medicine, University of Ibaban, University College Hospital, Ibadan, Nigeria.

Assessment of control of hypertension by some authors has revealed that optimal blood pressure control is not yet achieved in many of those that are on treatment. Resistant hypertension, plays a part as one of the factors responsible for this poor control state. Because of the peculiar problems posed by this group of hypertensives, we assessed the burden and factors responsible for resistant hypertension among hypertensive subjects attending the Medical Outpatient Clinic of the University College Hospital, Ibadan, Nigeria. Resistant hypertension was defined as blood pressure [symbol: see text] 140/90 mmHg in the presence of use of a combination of three antihypertensive drugs, including a diuretic at near maximum doses for at least one month. Five hundred and sixty-six consecutive subjects (218 males and 348 females) with a mean age of 56.0 +/- 14.3 years were screened for resistant hypertension. One hundred and forty-four (mean age 54.55 +/- 15.1 years), were fully controlled with a blood pressure of 120 +/- 9/77 +/- 2 mmHg. 394 men age of 56.7 +/- 11.7 years had non-resistant hypertension with blood pressure of 167.5 +/- 23/102.3 +/- 1.2 mmHg. Only 28 (5%) of the whole study group (mean age 51.8 +/- 9.7 years) were found to have resistant hypertension with a blood pressure of 176.4 +/- 43/109.6 +/- 14.8 mmHg. The subjects with resistant hypertension were significantly younger than those with non-resistant hypertension P < 0.02. There was no significant difference between their systolic blood pressure (P > 0.3) whereas; there was a significant difference between their diastolic blood pressure P < 0.002. Among those who had resistant hypertension, non-compliance was documented in 14 (50%) while it was in 73 (18.5%) of those without resistant hypertension P < 0.00053. Alcohol, tobacco, Obesity, use of non-steroidal anti-inflammatory drugs and excessive use of salt were not found as key factors responsible for resistant hypertension in this study.

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