Path analysis of familial resemblance in blood pressure in Middle Dalmatia, Croatia.

Skaric-Juric T.

Institute for Anthropological Research, Zagreb, Croatia.

The familial resemblance in blood pressure in Middle Dalmatia, Croatia, has been analyzed using the Path-analytic approach. The sample consisted of 1,126 examinees (526 males and 600 females, aged 17 to 87), inhabitants of the Middle Dalmatia's islands of Brac, Hvar, Korcula and the Peljesac peninsula. The Path analysis was performed with the assumption that each family member (father, mother, offspring 1 and 2) has a latent variable (C) that influences both the blood pressure values (P) and the morphological dimensions significantly correlated with blood pressure (Q). According to the estimates revealed from the most parsimonious models, the diastolic blood pressure has a more pronounced genetic component (h2 = 30-32%) than the systolic blood pressure (h2 = 15%). In contrast to the low intergenerational influences, the members of the same generation showed pronounced effects of shared environment. Common (non-transmitted) offsprings' environment (B) explains 44% of variance of the individual offspring's environment (C) in systolic and 33-35% in diastolic blood pressure. The correlation of father's and mother's environment (u2) was high in the case of diastolic blood pressure (33-44%) but for the systolic blood pressure it was not significantly different from zero. According to the presented results in insular/peninsular population of Middle Dalmatia, family resemblance of systolic and diastolic blood pressure differs. The resemblance is higher in diastolic blood pressure with stronger additive genetic component and stronger environmental and/or genetic component related with morphology. The sources of high heritability of diastolic blood pressure in Middle Dalmatia as well as the sources of high prevalence of hypertension in the same population are the phenomena that might be connected and thus deserve to be further explored in incoming analyses.

Online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12974151&dopt=Abstract blood pressure, high blood pressure




A retrospective review of the effect of COX-2 inhibitors on blood pressure change.

Cho J, Cooke CE, Proveaux W.

Global Health Outcomes, Pharmacia Corporation, Peapack, NJ, USA. mjeanniecho hotmail.com

The objective of this study was to compare the difference between celecoxib and rofecoxib on blood pressure change. A retrospective review of medical records where the mean blood pressure in a 90-day period before and after start of the cyclooxygenase (COX)-2 inhibitors, celecoxib, and rofecoxib was compared. Data were abstracted from 249 patient records, of which 109 were included. The mean systolic blood pressures at baseline were comparable at 134.14 mm Hg and 134.05 mm Hg for the celecoxib (n = 52) and rofecoxib groups (n = 57), respectively (P = NS). A nonsignificant decrease in systolic blood pressure was observed for the celecoxib group (-1.15 mm Hg), while a statistically significant increase in systolic blood pressure was seen in the rofecoxib group (4.76 mm Hg, P = 0.044). The mean diastolic blood pressures at baseline were not significantly different between the two groups, and changes in the postperiod were also not statistically different compared with baseline values. The average total daily dose of COX-2 inhibitor was 219.2 mg for celecoxib and 25.23 mg for rofecoxib. A post hoc analysis of patients aged 65 years and older showed that the mean systolic blood pressure in the rofecoxib group increased by 7.37 mm Hg (P = 0.016), while there was an insignificant decrease for the celecoxib group (-1.94 mm Hg). This study showed that there were no significant changes in blood pressure after celecoxib initiation. While in the rofecoxib group, there was a significant increase in systolic blood pressure with an even greater increase for patients aged 65 years and older.

Online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12975714&dopt=Abstract blood pressure, high blood pressure




Risk factors for intubation as a guide for noninvasive ventilation in patients with severe acute cardiogenic pulmonary edema.

Masip J, Paez J, Merino M, Parejo S, Vecilla F, Riera C, Rios A, Sabater J, Ballus J, Padro J.

ICU Department, Hospital Dos de Maig, Consorci Sanitari Integral, Dos de Maig 305, 08025, Barcelona, Spain. jmasip medicina.ub.es

OBJECTIVE: Noninvasive ventilation may reduce the endotracheal intubation rate in patients with acute cardiogenic pulmonary edema. However, criteria for selecting candidates for this technique are not well established. We analyzed a cohort of patients with severe acute cardiogenic pulmonary edema managed by conventional therapy to identify risk factors for intubation. These factors were used as guide for indications for noninvasive ventilation. DESIGN AND SETTING: Observational cohort registry in the ICU and emergency and cardiology departments in a community teaching hospital. PATIENTS:. 110 consecutive patients with acute cardiogenic pulmonary edema, 80 of whom received conventional oxygen therapy. INTERVENTIONS: Physiological measurements and blood gas samples registered upon admission. MEASUREMENTS AND RESULTS: Twenty-one patients (26%) treated with conventional oxygen therapy needed intubation. Acute myocardial infarction, pH below 7.25, low ejection fraction (<30%), hypercapnia, and systolic blood pressure below 140 mmHg were independent predictors for intubation. Conversely, systolic blood pressure of 180 mmHg or higher showed to be a protective factor since only two patients with this blood pressure value required intubation (8%)], both presenting with a pH lower than 7.25. Considering systolic blood pressure lower than 180 mmHg, patients who showed hypercapnia presented a high intubation rate (13/21, 62%) whereas the rate of intubation in patients with normocapnia was intermediate (6/23, 26%). All normocapnic patients with pH less than 7.25 required intubation. No patient with hypocapnia was intubated regardless the level of blood pressure. CONCLUSIONS: Patients with pH less than 7.25 or systolic blood pressure less than 180 mmHg associated with hypercapnia should be promptly considered for noninvasive ventilation. With this strategy about 40% of the patients would be initially treated with this technique, which would involve nearly 90% of the patients that require intubation.

Online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=13680119&dopt=Abstract blood pressure, high blood pressure




Trigeminal nerve-mediated reflex arterial blood pressure decrease and vasodilatation in lower lip of the rabbit.

Yasuda M, Izumi H.

Dento-oral Anesthesiology, Tohoku University Graduate School of Dentistry, 980-8575 Sendai, Japan.

We measured the effects of electrical stimulation of the central cut end of the lingual nerve on lower lip blood flow (LBF) and on arterial blood pressure in urethane-anesthetized, artificially ventilated, cervically vagosympathectomized rabbits. Different effects were observed depending on the stimulus frequency. Increasing the stimulus frequency above 5 Hz produced progressively larger ipsilateral LBF increases until the optimal frequency was reached at 20 Hz. In contrast, stimulation at above 0.5 Hz evoked progressively larger decreases in both contralateral LBF and arterial blood pressure until the optimal frequency was reached at around 10 and 2 Hz, respectively. Thus, the optimal stimulus frequencies for the ipsilateral LBF increase and the arterial blood pressure decrease were widely different. The lingual nerve-evoked change (i.e., fall) in arterial blood pressure showed a significant correlation with the contralateral LBF decrease, but not with the ipsilateral LBF increase. Prior administration of hexamethonium at 10 mg/kg markedly reduced both the ipsilateral LBF increase and arterial blood pressure decrease, although it was more effective against the former than against the latter. Pretreatment with scopolamine (muscarinic-receptor antagonist, 0.1 mg/kg), phentolamine (alpha-adrenoceptor antagonist, 0.1 mg/kg), or propranolol (beta-adrenoceptor antagonist, 0.1 mg/kg) failed to affect either response. However, 1.0 mg/kg phentolamine significantly reduced both responses (P<0.05). These results indicate that, in the rabbit, the LN-evoked reflex increase in ipsilateral LBF is (a) largely independent of any concomitant arterial blood pressure change and (b) probably due to active vasodilatation mediated via parasympathetic mechanisms. In contrast, the evoked decrease in contralateral LBF was proportional to the decrease in arterial blood pressure, suggesting that the former was secondary to the latter.

Online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14499946&dopt=Abstract blood pressure, high blood pressure




Rhinitis and blood pressure in adults.

Heinrich J, Topp R, Brasche S.

GSF-Institute of Epidemiology, PO Box 1129, D-85758 Neuherberg, Germany. joachim.heinrich gsf.de

Recently, a study of 330 adults reported increased systolic blood pressure and higher hypertension rates in men with rhinitis. We replicated this study using data from a population-based sample of 896 subjects participating in the European Respiratory Health Survey and in a study on "Monitoring of Trends and Determinants of Cardiovascular Diseases" in Erfurt, Germany. Rhinitis was assessed by questionnaire, blood pressure was measured using a standardized method, and subjects were asked about current use of any high blood pressure medication. After adjustment for age, body mass index, and smoking, neither average systolic (p = 0.17) nor diastolic blood pressure (p = 0.60) was statistically significantly different between men with and without rhinitis. The adjusted prevalence rate of hypertension was also not different between males with and without rhinitis (p = 0.25). In addition, no statistically significant associations between rhinitis and blood pressure were seen in women. We could not confirm the conclusion of the previous study that men with rhinitis need special attention for blood pressure control.

Online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14500262&dopt=Abstract blood pressure, high blood pressure




Relationship between birth weight and blood pressure variability in children.

Pearce MS, O'Sullivan JJ.

Paediatric and Lifecourse Epidemiology Research Group, School of Clinical Medical Sciences, University of Newcastle upon Tyne, UK. m.s.pearce ncl.ac.uk

This cross-sectional study investigates the relationship between birth weight, 24-h blood pressure and blood pressure variability in childhood. Blood pressure was measured in 976 schoolchildren, free from cardiovascular disease, aged between 6 and 16 years. Blood pressure variability was estimated as the standard deviation of the 24-h mean (systolic and diastolic) blood pressure values. Linear regression showed that variation in systolic or diastolic blood pressure was not significantly associated with birth weight. Similarly, no association was found between blood pressure variability and birth weight when using the birth weight groups used by a previous study. Adjusting for other covariates, including mean 24-h blood pressure, made little difference to the observed results. No interactions were observed between birth weight and either gender or age on blood pressure variability. The results of this study do not support the suggestion of a significant association between birth weight and blood pressure variation in childhood. This might suggest that blood pressure variability is influenced mainly by environmental or lifestyle factors, but as little research has been published in this area, further investigation is required and in particular it would be important to assess the use of other measures of blood pressure variation.

Online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14504625&dopt=Abstract blood pressure, high blood pressure




Correlates of urinary albumin excretion in young adult blacks and whites: the Coronary Artery Risk Development in Young Adults Study.

Murtaugh MA, Jacobs DR Jr, Yu X, Gross MD, Steffes M; Coronary Artery Risk Development in Young Adults Study.

Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA.

The rate of urinary albumin excretion is an important risk factor for kidney failure, stroke, and cardiovascular disease, perhaps because higher albumin excretion reflects endothelial cell dysfunction. The authors characterized urinary albumin excretion according to blood pressure, diabetes mellitus, and other factors in 2,582 Black and White participants in the Coronary Artery Risk Development in Young Adults (CARDIA) Study who were aged 18-30 years in 1985-1986. Urinary albumin and creatinine concentrations were determined using single untimed samples 10 and 15 years later. The albumin:creatinine ratio was analyzed as a continuous variable and a dichotomous variable (higher albumin excretion, including microalbuminuria (25-249 mg/g) and macroalbuminuria (>or=250 mg/g)). Seventy percent of persons with increased albumin excretion were both normoglycemic and normotensive (systolic/diastolic blood pressure <140/90 mmHg and no use of antihypertensive drugs). Even when diabetic subjects, who have greater risk, were excluded, albumin excretion rose continuously as blood pressure increased among Blacks; increases started at systolic/diastolic blood pressures of 130/85 mmHg among Whites. Furthermore, blood pressure measured up to 15 years earlier predicted incident higher albumin excretion at year 15. These findings persisted after adjustment for age, body mass index, smoking, and blood lipid and plasma insulin levels. A risk of higher urinary albumin excretion exists at blood pressure levels below those commonly regarded as hypertension, with a greater risk among Blacks than among Whites.

Online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14507604&dopt=Abstract blood pressure, high blood pressure




Increased C-reactive protein concentrations in never-treated hypertension: the role of systolic and pulse pressures.

Schillaci G, Pirro M, Gemelli F, Pasqualini L, Vaudo G, Marchesi S, Siepi D, Bagaglia F, Mannarino E.

Medicina Interna, Angiologia e Malattie da Arteriosclerosi, Policlinico Monteluce, Universita degli Studi di Perugia, Via B. Brunamonti 51, 06122 Perugia, Italy. skill unipg.it

OBJECTIVE: To test whether the plasma concentration of C-reactive protein (CRP), a sensitive marker of systemic inflammation, is increased in patients with newly diagnosed, never-treated hypertension and whether blood pressure and its pulsatile component, pulse pressure, are correlated with plasma CRP concentration independently of a consistent number of cardiovascular risk factors. DESIGN: Cross-sectional study in a hospital outpatient hypertension clinic. METHODS: A total of 135 newly diagnosed, never-treated patients with hypertension and 40 healthy matched non-hypertensive controls underwent office and 24-h blood pressure measurement and blood sampling for determination of plasma CRP and serum lipid concentrations. RESULTS: Plasma CRP concentration was greater in hypertensive individuals (1.85 mg/l, interquartile range 0.74-3.64) than in control individuals (1.01 mg/l, interquartile range 0.67-1.88; P = 0.02). In the entire population, CRP had a significant direct association with office systolic blood pressure and pulse pressure, but not with diastolic blood pressure. Among hypertensive patients, plasma CRP was related to 24-h systolic blood pressure (r = 0.28, P < 0.01) and pulse pressure (r = 0.32, P < 0.01), but not to diastolic blood pressure (r = 0.12, P > 0.2). CRP was also directly associated with body mass index (r = 0.25, P < 0.01), serum low-density lipoprotein cholesterol (r = 0.21, P = 0.03) and serum triglycerides (r = 0.21, P = 0.03). In the multivariate analysis, systolic blood pressure and pulse pressure, but not diastolic blood pressure, were significant predictors of plasma CRP concentration when a consistent number of cardiovascular risk factors was controlled for simultaneously. CONCLUSIONS: Systolic blood pressure and pulse pressure, but not diastolic blood pressure, are predictors of plasma C-reactive protein concentrations in patients with newly diagnosed, never-treated hypertension, irrespective of the potential proinflammatory action of traditional cardiovascular risk factors.

Online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14508189&dopt=Abstract blood pressure, high blood pressure