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PubMed1997

Modulation of circadian expression of D-site binding protein by the schedule of parenteral nutrition in rat liver.

The aim of this study was to investigate the changes in the circadian rhythm of the expression of liver-specific genes caused by different schedules of parenteral nutrition (PN). Rats received PN continuously throughout the day or intermittently during the night or day for 7 days. They were examined for gene expression of D-site binding protein (DBP), albumin, and cytochrome P450 cholesterol 7alpha-hydroxylase (CYP7) in the liver. The nocturnal PN group showed circadian expression of DBP messenger RNA (mRNA) and protein with a peak at 10 PM, in the same manner as the control rats receiving normal chow feeding. However, the diurnal PN group showed inverted expression of DBP mRNA and protein with a peak at 10 AM. CYP7 mRNA levels exhibited good synchronization with the levels of DBP mRNA in all groups, whereas albumin mRNA levels did not show such synchronization. Gel mobility-shift assay disclosed that the binding activity of the nuclear extracts to the CYP7 gene promoter was changed by the PN schedule in accordance with the expression of CYP7 mRNA. The PN schedule modulates the circadian rhythm of DBP expression and may have an effect on hepatic bile acid formation through transcriptional regulation of the CYP7 gene.

Albumins↗
PubMed2002

Relationships of the systolic blood pressure response during exercise with insulin resistance, obesity, and endurance fitness in men with type 2 diabetes mellitus.

The purpose of the present study was to investigate the relationships among the resting systolic (SBP) and diastolic blood pressure (DBP) or SBP response during exercise with insulin resistance evaluated by a homeostasis model (HOMA-IR), abdominal fat accumulation (visceral fat area [VFA], subcutaneous fat area [SFA]) by computed tomography (CT), and an estimation of the maximal oxygen uptake (V*O2max) in 63 Japanese middle-aged male patients with type 2 diabetes mellitus (type 2 DM). Body mass index (BMI) and waist-to-hip ratio (WHR) in type 2 DM subjects were significantly higher than in age-matched healthy male control subjects (n = 135) with normal glucose tolerance. Resting SBP (127.7 +/- 16.2 mm Hg v 119.4 +/- 13.0 mm Hg) and DBP (82.2 +/- 11.9mmHg v 76.8 +/- 9.4 mm Hg) levels, and the percentage of hypertension (20.6% v 1.5%) in type 2 DM subjects were significantly higher than in the control subjects (P <.05). According to a multiple regression analysis for resting blood pressure in type 2 DM, VFA was found to be an independent predictor of SBP, while V*O2max and HOMA-IR were independent predictors of DBP. In the controls, however, HOMA-IR was not found to be a significantly independent predictor for either resting SBP or resting DBP. Measurement of the SBP response during graded exercise using a ramp test was performed by an electrical braked cycle ergometer in 54 patients with type 2 DM only. The SBP was measured at 15-second intervals during exercise. The exercise intensity at the double product breaking point (DPBP), which strongly correlated with the exercise intensity at the lactate threshold, was used as an index for the SBP response to standardized exercise intensity. The SBP corresponding to exercise intensity at DPBP (SBP@DPBP) was evaluated as an index of the SBP response to standardized exercise intensity. The change in SBP (deltaSBP = SBP@DPBP - resting SBP) was significantly and positively associated with log area under the curve for glucose (log AUCPG) during a 75-g oral glucose tolerance test (OGTT). In addition, deltaSBP significantly and negatively correlated with the log area under the curve for insulin (log AUCIRI) and log AUCIRI/log AUCPG. Based on these results, insulin resistance was suggested to be independently associated with the resting DBP and SBP response to standardized exercise intensity in type 2 DM patients.

Anthropometry↗
PubMed1988

Reevaluation of contribution of physical fitness, body weight, and different sports activity to resting blood pressure in young men.

The purposes of the present study were to evaluate the relationship between resting blood pressure and maximal oxygen uptake (VO2max) and to elucidate the association of different types of sports activity on the resting blood pressure in Japanese young men with a wide range of VO2max. The subjects (n = 46) consisted of untrained subjects (n = 24), judo athletes (n = 11), and triathletes (n = 11) aged 21 to 35 years. Systolic (SBP) and diastolic (DBP) blood pressures were measured in the sitting position after 5 min of resting, and VO2max was directly measured by the Douglas bag method. SBP, DBP, and mean blood pressure (MBP) were negatively correlated with VO2max and positively correlated with body weight. A stepwise selective multiple regression analysis for SBP resulted in two significantly correlating variables: VO2max and body weight. For DBP and MBP, the analysis resulted in two explaining variables: VO2max and body weight. Two independent variables explained 37% of the variation of the SBP, 43% of that of DBP, and 54% of that of MBP. These results indicate that variance in resting blood pressure is partly accounted for by the variance in endurance capacity (i.e., VO2max). However, SBP, DBP, and MBP were significantly higher in judo athletes compared with untrained men (P less than 0.05) when it was compared with the same range of VO2max. These results indicate that resting blood pressure is probably influenced with VO2max, while the relationship is influenced by the type and intensity of training and other factors.

Adult↗
PubMed1986

Association of the adenovirus DNA-binding protein with RNA both in vitro and in vivo.

The multifunctional DNA-binding protein (DBP) encoded by human adenovirus binds RNA. The association of purified DBP with RNA in vitro was demonstrated by using either a gel filtration or a filter binding assay. This association is sensitive to ionic strength and exhibits no apparent sequence specificity. DBP also interacts with RNA in vivo; it can be crosslinked to polyadenylylated RNA by UV-irradiation of intact cells during the late phase of adenovirus infections. The 46-kDa carboxyl-terminal domain of DBP binds RNA in vitro and was found to be associated with polyadenylylated RNA in vivo. This is the same domain that interacts with DNA. However, the differences in sensitivity of DBP to trypsin when bound to RNA versus DNA suggest that RNA and DNA either bind at different sites within this domain or induce different conformational changes within the protein.

Adenoviruses, Human↗
PubMed1998

Vitamin D-binding protein gene transcription is regulated by the relative abundance of hepatocyte nuclear factors 1alpha and 1beta.

Vitamin D-binding protein (DBP)/Gc-globulin, the major carrier of vitamin D and its metabolites in blood, is synthesized predominantly in the liver in a developmentally regulated fashion. By transient transfection analysis, we identified three regions in the 5'-flanking region of the rat DBP gene, segments F-2, B, and A, that contain tissue-specific transcriptional determinants. Gel mobility shift and DNase I footprinting analyses showed that all three regions contained binding sites for the hepatocyte nuclear factor 1 (HNF1), a transcriptional regulator composed of HNF1alpha and HNF1beta hetero- and homodimers. The activity of the most proximal segment A (coordinates -141 to -43) was DBP promoter-specific, position-dependent, and positively controlled by HNF1alpha. In contrast, the two more distal determinants (segments F-2 and B; coordinates -1844 to -1621 and -254 to -140, respectively) acted as classical enhancers in transfected hepatocyte-derived HepG2 cells; their activities were promoter- and orientation-independent, and disruption of their respective HNF1-binding sites resulted in marked loss of DBP gene expression. Remarkably, the activities of these two distal elements depended upon the relative levels of HNF1alpha and HNF1beta; HNF1alpha had a major stimulatory effect, whereas HNF1beta acted as a trans-dominant inhibitor of HNF1alpha-mediated enhancer activity. These results suggested that the net expression of the DBP gene reflected a balance between the two major HNF1 species; the relative abundance of HNF1alpha and HNF1beta proteins in a cell may thus play a critical role in determining the pattern of gene expression.

Animals↗
PubMed2005

The effects of drinks made from simple sugars on blood pressure in healthy older people.

The objective of the research was to determine the blood pressure (BP) lowering effects in older people of 50 g carbohydrate drinks with varying carbohydrate content using a randomised, cross-over study with ten (six females) healthy older subjects (mean age 72.20 (sem 1.50) years). BP, heart rate and glucometer-derived blood glucose levels were determined at baseline and following the ingestion of equal volumes (300 ml) of water and carbohydrate drinks with varying nutrient content (glucose, sucrose and fructose). A significant decline in BP over the first 60 min was seen following glucose (systolic BP (SBP) P<0.01, diastolic BP (DBP) P<0.01, mean arterial BP (MAP) P=0.03) and sucrose (SBP P<0.01, DBP P<0.01, MAP P<0.01) ingestion, although the decrease occurred earlier after glucose than sucrose ingestion (SBP 7.33 (sem 2.19) v. 21.00 (sem 4.30) min (P=0.03) and MAP 11.22 (sem 3.10) v. 17.00 (sem 3.78) min (P=0.03)). BP increased after water ingestion (SBP P=0.04, DBP P=0.18, MAP P=0.02) but did not change after fructose ingestion (SBP P=0.36, DBP P=0.81, MAP P=0.34). Post hoc analyses revealed that the BP (SBP, DBP and MAP) decrease following glucose and sucrose ingestion were similar but significantly greater than following fructose or water ingestion. Sucrose, which is used widely (table sugar), reduces BP as much as glucose. In contrast to this, fructose ingestion causes no change in BP. Further studies are required to determine if the substitution of glucose or sucrose with fructose may be beneficial in the medical management of older people with severe symptomatic postprandial hypotension.

Aged↗
PubMed2005

Dietary balanced protein in broiler chickens. 2. An economic analysis.

An economic model was developed that calculates economic optimal dietary balanced protein (DBP) contents for broiler chickens, based on performance input and prices of meat and feed. Input on broiler responses to DBP content (growth rate, feed conversion, carcase yield and breast meat yield) was obtained from the model described by Eits et al. (2005). Changes in broiler age, price of protein-rich raw materials and large changes (40%) in meat prices resulted in economic relevant differences in DBP content for maximum profit. Effects of changes in sex or feed price on DBP content for maximum profit were negligible. Formulating diets for maximum profit instead of maximum broiler performance can strongly increase the profitability of a broiler production enterprise. DBP content for maximum profitability depends on how the broilers are marketed; as whole birds, carcase or portions.

Animal Feed↗
PubMed2005

Dietary balanced protein in broiler chickens. 1. A flexible and practical tool to predict dose-response curves.

An empirical model of exponential form was developed, different versions of which can be used to predict growth rate, feed conversion and carcase and breast meat yield of broiler chickens as a function of dietary balanced protein (DBP) content. The model was developed to support decision-making by nutritionists. The model helps in determining DBP contents that maximise profit. The model avoids the practical disadvantages of existing methods. In contrast with mechanistic models, only data that are generally known by broiler nutritionists are required as input. Compared with predictions derived from one or a few feeding trials, the model predictions are more accurate (because the model was derived from many data-sets) and more flexible (because a description of the type of broiler was included as input for the model). Broiler response studies from the literature and the Nutreco Poultry and Rabbit Research Centre (27 data-sets in total) were used in the model development to select significant variables, to quantify the parameters and to evaluate the accuracy of the predictions. Input variables were DBP content, maximum performance level, age, year (indicating genetic potential) and sex. The model, including the assumption that the shape of the dose-response curves to DBP content is independent of broiler and feed characteristics, gave an accurate simulation of growth rate, feed conversion and breast meat for nearly all data-sets. Effects of DBP content on carcase yield were relatively small, except for carcases without skin and skin fat.

Animal Feed↗
PubMedDate not supplied

Pathogenesis of male reproductive tract lesions from gestation through adulthood following in utero exposure to Di(n-butyl) phthalate.

Di(n-butyl) phthalate (DBP) acts as an antiandrogen by decreasing fetal testicular testosterone synthesis when male rats are exposed in utero. DBP-exposed male rats develop malformations of the reproductive tract secondary to the reduced fetal androgen levels. However, these malformations and the associated histologic lesions have only been described in adult rats. The objective of this study was to describe the male reproductive tract lesions in fetal, early postnatal, and young adult male rats following DBP exposure in utero. Pregnant Sprague-Dawley rats were exposed to 500 mg/kg/day DBP by gavage on gestation days (GD) 12 to 21. Male reproductive tracts were examined on GD 16 to 21 and on postnatal days (PND) 3, 7, 16, 21, 45, and 70. In the fetal testes, large aggregates of Leydig cells, multinucleated gonocytes, and increased numbers of gonocytes were first detected on GD 17 and increased in incidence to 100% by GD 20 and 21. These lesions resolved during the early postnatal period, while decreased numbers of spermatocytes were noted on PND 16 and 21. On PND 45, there was mild degeneration of the seminiferous epithelium, which progressed to severe seminiferous epithelial degeneration on PND 70. On PND 70, the degeneration was concurrent with ipsilateral malformed epididymides, which caused obstruction of testicular fluid flow and secondary pressure atrophy in the seminiferous tubules. In the fetus, the epididymal lesion was observed as decreased coiling of the epididymal duct. The decreased coiling progressed into the early postnatal period and adulthood, at which time malformed epididymides were apparent. As the animals were only dosed in utero, these findings indicate that DBP can initiate fetal testicular and epididymal changes that may not manifest as clear malformations until adulthood. The pathogenesis of lesion development from the fetus to the adult is important for comparison of antiandrogens with differing modes of action.

Androgen Antagonists↗
PubMed1988

A method to define reference profiles for ambulatory blood pressure, with application to blood pressure profiles in 158 young subjects.

Ambulatory blood pressures (systolic, SBP, diastolic, DBP) and heart rate were determined over 24 h every 15 min in the day and every 15 min in the night in 72 normal subjects aged 21 +/- 1 SEM with normal casual office pressures (WHO's criteria: office DBP less than or equal to 90 mmHg, office SBP less than or equal to 140 mmHg) and in 86 essential hypertensive subjects aged 21 +/- 1, with borderline office pressure (WHO's criteria: office DBP less than or equal to 95 mmHg, office SBP less than or equal to 160 mmHg). Complete 24-hour profiles (mean +/- SD) were reported. In the average, mean ambulatory DBP in the normal group was about 72.5 mmHg in "day time" (9 a.m.-9 p.m.) and 63.5 mmHg in "night time" (midnight-7 a.m.). Ambulatory SBP in the normal group were about 126 mmHg and 110 mmHg for the same time periods. In the borderline hypertensive group, the figures were 74 mmHg (day-time) and 67 mmHg (night time) for diastolic pressure and 140 mmHg (day time) and 118 mmHg (night time) for systolic pressure. However, when the normal and borderline groups were defined as above on the basis of office pressure, ambulatory blood pressure profiles in the two groups showed a large overlap. A method was proposed to reduce this overlap by partially reallocating the subjects on the basis of ambulatory blood pressure. First, a typical profile was defined for each group and a distance was defined between two arbitrary profiles. Then a subject in the normal (resp. hypertensive) group was reallocated to the hypertensive (normal) group if his profile was closer to the typical profile of the hypertensive (normal) group than the typical profile of his own group. Applied to ambulatory DBP profiles, this method reallocated 49 subjects (over the total of 158), significantly reduced the initial overlap of BP profiles between the two groups, and defined reference profiles for "normal" and "borderline" ambulatory blood pressures.

Adult↗
PubMed1992

Cardiovascular risk factors in obese children in relation to weight and body fat distribution.

To assess the relationship between obesity and body fat distribution with cardiovascular risk factors in children, various measures of obesity and waist-to-hip circumference ratio (WHR) were related to serum lipids, lipoproteins, apolipoproteins, glucose, insulin, uric acid, systolic (SBP) and diastolic blood pressure (DBP). In boys univariate analysis revealed an association of triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (ApoB), the ratio ApoAI/ApoB, cholesterol/HDL-C, glucose and insulin to WHR. SBP and DBP and serum uric acid correlated with all measures of obesity [body mass index (BMI), percent overweight, percent body fat, skinfolds], but not with WHR. In girls lipid parameters (triglycerides, LDL-C, HDL-C, HDL2, ApoAI, ApoB) and atherogenic ratios correlated with measures of obesity and WHR. Glucose, insulin, SBP and DBP showed the highest correlation with WHR (r = 0.598, p less than 0.001 and r = 0.713, p less than 0.001). Multivariate analysis in girls revealed a first step dependency of ApoAI, the ratio cholesterol/ApoAI, insulin, SBP and DBP on WHR, triglycerides, HDL-C, LDL-C and the ratio ApoAI/ApoB, a first step dependency on percent body fat mass. In boys triglycerides, ApoB and the ratio ApoAI/ApoB were related to WHR for insulin, SBP and DBP, but a positive association with the WHR was found, explaining 33, 21.8, and 22.6% of the variance. This study demonstrates that cardiovascular risk factors in obese children are related to obesity and body fat distribution. Obese children with predominantly abdominal fat mass show a risk profile that is less favorable than gluteal-femoral fat distribution. Evaluation of body fat distribution in obese children, therefore, may help to identify persons most susceptible to cardiovascular risk in adulthood.

Adipose Tissue↗
PubMed2000

Comparative study of home and office blood pressure in hypertensive patients treated with enalapril/HCTZ 20/6 mg: the ESPADA study.

The introduction and generalization of 24-h ambulatory blood pressure (BP) monitoring has shown the clinical relevance of home BP. The aim of this study was to assess the validity of home-measured BP for monitoring and controlling patients with arterial hypertension while on a homogeneous treatment. An additional objective was to establish the degree of office BP control obtained. This was a prospective, longitudinal, observational and multicenter study in a cohort of 156 patients of both sexes, aged over 18 years and with essential hypertension. All of them received the fixed combination enalapril/HCTZ 20/6 mg as the only hypertensive agent for at least 4 weeks previously. Office BP was the average of three measurements. For home BP, a semi-automated device (OMRON HEM 705 CP) was used. The patients measured their BP twice a day for 2 consecutive days. The average differences between the two measuring methods were low, but significant: 3.99 mmHg for systolic BP (SBP; p < 0.05), 2.02 mmHg for diastolic BP (DBP; p < 0.05). Pearson's regression coefficient between the office and home values was highly significant (p < 0.0001) for SBP, DBP and heart rate. Home BP measurement was highly reproducible as shown by the high within-class correlation coefficient for individual measurements on the first day compared with the second: 0.88 (95% confidence interval, CI 0.82-0.92; p < 0.00001) for SBP and 0.89 for DBP (95% CI 0.83-0.93; p < 0.00001). The percentage of patients with strict office DBP and SBP control (< 140/90 mmHg) was 61.3% and with DBP control (<90 mmHg) 92%. In conclusion, in the ESPADA study, the application of home BP measurement is valid, reproducible and shows a high correlation with office BP.

Age Factors↗
PubMed2006

Biochemical responses of two typical duckweeds exposed to dibutyl phthalate.

Effect of dibutyl phthalate (DBP) on physiologic and biochemical characteristics of two species of duckweed (Spirodela polyrhiza and Lemna minor) from Tai Lake in China was investigated. The results indicated that different degree of poisoning symptoms appeared on duckweeds after 7 days' exposure to different concentrations of DBP. With the increase of DBP concentration, content of chlorophyll and soluble protein decreased sharply, and activity of anti-oxidant enzyme systems including catalase (CAT), superoxide dismutase (SOD) and malondialdehyde (MDA) content increased significantly and decreased afterwards. With the concentration of DBP of 0.5 mg/L and 0.005 mg/L, SOD activity of Spirodela polyrhiza and Lemna minor reached peak value respectively, while CAT activity were maximum under the concentration of 1mg/L and 0.05 mg/L. It could be concluded that DBP can affect the growth of both Spirodela polyrhiza and Lemna minor, and the former has better endurance to exposure than the latter.

Araceae↗
PubMed2005

DNA methylation of estrogen receptor alpha gene by phthalates.

The phthalates are ubiquitous industrial plasticizers and include agents such as di(2-ethylhexyl) phthalate (DEHP), dibutyl phthalate (DBP), and butyl benzyl phthalate (BBP), which are classified as endocrine disruptors because of their anti-androgenic or pro-estrogenic effects. A recent study suggested that DBP produced the hypomethylation of c-myc protooncogene in mouse liver to activate c-myc. In the present study, DNA hypomethylation at the promoter region of the estrogen receptor alpha (ERalpha) gene was investigated by methylation-specific polymerase chain reaction (MSP) in a human breast cancer (MCF7) and in a normal (MCF10A) cell line after DBP treatment. Yeast-based estrogen receptor transcription assays showed that hERalpha gene expression was induced by BBP but not DBP. Moreover, MCF7 cells treated with BBP or DBP at 10(-5)M led to the demethylation of ERalpha promoter-associated CpG islands. These data suggest that an altered ER mRNA expression by BBP might be related to aberrant DNA methylation in the promoter region of ERalpha.

Cell Line↗
PubMed1999

Enhanced binding of HLF/DBP heterodimers represents one mechanism of PAR protein transactivation of the factor VIII and factor IX genes.

The regulatory regions of the genes for coagulation Factors VIII and IX contain binding sites for both liver-enriched and ubiquitous transcriptional regulators. We investigated the role of the liver-enriched protein, hepatic leukemia factor (HLF), in mediating transcriptional regulation of the Factor VIII and IX genes. Using transient transfection assays in HepG2 hepatoma cells, we demonstrated the ability of HLF alone and in synergistic combination with the D-box binding protein (DBP), another proline and acidic-rich (PAR) protein family member, to transactivate these promoters. HLF is capable of binding to multiple sites in both the Factor VIII and Factor IX promoters. At least some of the synergistic activation of the Factor VIII promoter seen with HLF and DBP cotransfection can be attributed to increased binding of HLF-DBP heterodimers to two Factor VIII promoter sites. We have also demonstrated that an E2A-HLF chimera, derived from a t(17;19) translocation in pre-B acute lymphoblastic leukemia (ALL) cells, is capable of mediating expression from the Factor VIII and Factor IX promoters in both hepatoma cells and pre-B ALL cells. These observations indicate that the PAR family of transcription factors plays an important and complex role in regulating expression of the Factor VIII and Factor IX genes, involving the binding of both homodimeric and heterodimeric complexes of HLF and DBP to several sites in the promoters. Finally, these studies reaffirm the potential role of dimeric transcription factor complexes in mediating interactions with specific promoter elements, which, in the case of the Factor VIII promoter, results in dramatically enhanced binding of HLF-DBP heterodimers to two cis-acting sequences. These observations further our understanding of the role played by members of the PAR family of transcription factors in regulating expression of the Factor VIII and Factor IX genes.

Basic-Leucine Zipper Transcription Factors↗
PubMed1988

Prediction of renovascular hypertension. Comparison of clinical diagnostic indices.

One hundred and six patients were determined to have renovascular hypertension (RVH) out of 3520 patients with hypertension referred by their physicians for a 1-day blood pressure study (1-day BP study) to evaluate the presence of secondary forms of hypertension. The clinical indices (including serum potassium and creatinine concentrations) most likely to predict RVH were analyzed. Patients unlikely to have RVH were those with a diastolic blood pressure (DBP) less than or equal to 90 mm Hg (with or without BP medication) with a serum potassium concentration less than 3.4 mEq/L. A two- to threefold increased prevalence of RVH was associated with DBP greater than 110 mm Hg, an age of onset of hypertension of 51-69 years, or age of onset greater than 60 years with a DBP less than or equal to 100 mm Hg. A four- to sixfold increase came with an age of onset greater than 60 years, serum potassium (with or without BP medication) 2.9-3.3 mEq/L, or serum potassium less than 3.4 mEq/L with DBP greater than 90 mm Hg. A seven- to ninefold increase came with age of onset greater than 60 years with DBP greater than 110 mm Hg or serum potassium (with or without BP medication) of 2.3-2.8 mEq/L.

Adult↗
PubMed1993

Noninvasive ambulatory 24 h blood pressures and basal blood pressures predict development of sustained hypertension from a borderline state.

A sample of 143 male borderline hypertensives aged 35 to 45, screened from a population cohort, were subjected to psychological stress, static work, and ambulatory 24 h blood pressure (BP) monitoring to assess the predictive power of BP reactivity in the development of established hypertension. After 1 year, a follow-up showed that 21 subjects (14.7%) had developed established hypertension (causal diastolic (D) BP > or = 95 mm Hg), 25 subjects (15.7%) had become normotensive (causal DBP < 85 mm Hg), and 97 (67.8%) remained within the borderline range (causal DBP 85 to 94 mm Hg). Those who developed established hypertension had considerably higher initial basal resting blood pressures than those who remained borderline: systolic (S) BP 134.2 +/- 12.5 v 127.6 +/- 10.7 mm Hg, P < .05 and DBP 86.8 +/- 7.9 v 80.4 +/- 7.0 mm Hg, P < .01. They had also somewhat higher BP values during mental arithmetic exercises and hand-grip work (peak DBP 101.1 +/- 8.8 v 96.8 +/- 8.7 mm Hg, P < .05, and 131.4 +/- 14.8 v 123.5 +/- 12.9 mm Hg, P < .05, respectively). Those subjects who developed established hypertension had significantly higher 24 h mean blood pressures than those who remained borderline (24 h SBP 133.3 +/- 11.4 v 126.0 +/- 10.1 mm Hg, P < .01, and DBP 84.7 +/- 5.7 v 81.6 +/- 6.8 mm Hg, P < .05). This difference was attributed mainly to the differences found during daytime (07:00 to 19:00) hours but was also found to be nominally dependent upon those found during nighttime (01:00 to 07:00) hours.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

The use of nitrendipine in the treatment of elderly hypertensives.

The ability of nitrendipine to control blood pressure (BP) over a 24-hour period was assessed in elderly patients over 65 years of age with a systolic BP (SBP) greater than 170 mmHg, and a diastolic BP (DBP) greater than 100-130 mmHg. Twenty-two patients were randomized equally to two groups: group 1 received the drug once daily and group 2, twice daily. The study was double-blind, with patients in group 1 receiving a matching placebo tablet instead of the second dose of nitrendipine before retiring to bed. Patients attended the hospital clinic at 10 a.m. before taking their morning tablet, so that BP was recorded 24 hours (group 1) or 12 hours (group 2) after nitrendipine. The study design permitted one dose titration if the target SBP of less than 170 mmHg or DBP of less than 100 mgHg was not achieved after three weeks of active therapy; the dose was doubled and the patients received 6 weeks of therapy at the preferred dosage. Mean DBP after 6 weeks' nitrendipine was comparable in the two groups and significantly lower than that with placebo (P less than 0.001), but mean systolic BP was lowered only in group 2 patients (P less than 0.001). There was no significant difference in mean SBP or DBP between patients on 20 mg daily and 10 mg b.d. Therefore, in elderly patients, once daily nitrendipine controls DBP as satisfactorily as the same daily dose given in two divided doses, but does not reduce SBP as adequately.

Aged↗