Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “DBP”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 775 records · Page 43Linked to original sources
PubMed1987

Nitrendipine as an antihypertensive agent.

A double-blind, stratified and randomized multicentre trial was carried out to compare the antihypertensive efficacy of nitrendipine with that of propranolol. The dose of nitrendipine was 5-20 mg b.d., and of propranolol, 40-120 mg b.d. With nitrendipine (N = 137), systolic blood pressure (SBP) and diastolic blood pressure (DBP) fell from 156 +/- 1 to 140 +/- 1 mmHg and from 101 +/- 0 to 89 +/- 1 mmHg respectively (mean +/- SEM) (P less than 0.0001). On propranolol (N = 138), SBP fell from 156 +/- 1 to 144 +/- 2 mmHg and DBP decreased from 101 +/- 0 to 91 +/- 1 mmHg (P less than 0.0001). In a subgroup of 11 patients on nitrendipine, mean 24-hour SBP dropped from 137 +/- 4 to 128 +/- 4 mmHg and DBP fell from 92 +/- 2 to 87 +/- 2 mmHg (P less than 0.01). On propranolol, mean 24-hour SBP and DBP were decreased from 142 +/- 4 to 128 = 4 mmHG (P less than 0.05) and from 89 +/- 2 to 84 +/- 2 mmHg (P less than 0.09), respectively. Plasma renin activity was not altered significantly by nitrendipine (N = 89), but was significantly reduced from 1.86 +/- 0.24 to 1.37 +/- 0.75 ng ml-1 h-1 by propranolol (N = 88, P less than 0.002). Plasma renin activity was inversely correlated with age, but was not related to the reduction of SBP or DBP.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2001

Aerobic exercise and resting blood pressure in older adults: a meta-analytic review of randomized controlled trials.

BACKGROUND: It is well established that resting systolic and diastolic blood pressure (SBP and DBP, respectively) increases as one ages. This study used the meta-analytic approach to examine the effects of aerobic exercise for reducing resting SBP and DBP in older adults. METHODS: Study data were compiled through use of the following: (i) computer searches (MEDLINE, Current Contents, and Sport Discus), (ii) cross-referencing from bibliographies of retrieved studies and review articles, and (iii) an expert who reviewed our reference list. Inclusion criteria and sources for this study were (i) randomized trials, (ii) aerobic activity as the only exercise intervention, (iii) a nonexercise control group, (iv) an assessment of changes in resting SBP and/or DBP, (v) within-study ages of subjects > or = 50 years, (vi) English-language studies published in journals, and (vii) studies published between January 1966 and January 1998. Net changes in resting BP were calculated as the exercise minus control group difference. RESULTS: Fourteen primary outcomes were derived from seven studies. Decreases of approximately 2% and 1% were found for resting SBP and DBP, with only changes in SBP as statistically significant (SBP, mean +/- SD = -2 +/- 3 mm Hg, 95% confidence interval [CI] = -4 to -1 mm Hg; DBP, mean +/- SD = -1 +/- 2 mm Hg, 95% CI = -2 to 0 mm Hg). CONCLUSIONS: This study supports the efficacy of aerobic exercise for reducing resting SBP in older adults. However, a need exists for studies that address the effectiveness of this intervention for reducing resting BP in older adults.

Aged↗
PubMed1996

The relationship of blood lead and dietary calcium to blood pressure in the normative aging study.

BACKGROUND: Previous studies have demonstrated a positive relationship between elevated blood lead (BPb) and blood pressure (BP), but few have additionally examined the role of dietary calcium. METHODS: The cross-sectional relationship between BPb and BP and the possible protective influence of increased dietary calcium on that relationship was examined among 798 male participants in the Normative Aging Study (NAS), a cohort of older men with relatively low BPb levels. RESULTS: The age range of these subjects was 43-93 years (mean = 66.1, SD = 7.4 years) and blood lead concentrations ranged form 0.5 to 35 mcg/dl (median = 5.6 mcg/dl). For the cohort overall, neither ln blood lead nor dietary calcium were significantly correlated with BP. In multivariate linear regression analyses that adjusted for age, body mass index, dietary calcium intake (adjusted for total calorie intake), alcohol intake, sitting heart rate, kilocalories/week expended in exercise, haematocrit, and smoking status, a unit increase in ln BPb predicted an increase on 1.2 mmHg diastolic blood pressure (DBP) (95% CI : 0.11, 2.2; P = 0.03). Adjusted calcium intake of 800 mg/day predicted a decrease of 3.2 mmHg systolic blood pressure (SBP) (95% CI : -5.6, -0.24, P = 0.03). There was no evidence of an interaction between dietary calcium intake and blood lead on BP. When the analyses were restricted to those men <=74 years old, a unit increase in ln BPb predicted an increase of 1.6 mmHg DBP (n = 681; 95% CI : 0.42, 2.7; P = 0.007). However, when men on antihypertensive medication (AHM) were excluded from the analyses, ln BPb was not significantly associated with increased DBP nor was adjusted calcium significantly associated with SBP. CONCLUSIONS: The study did support the hypothesis that increased BPb was associated with increased DBP in a cohort of older men with low blood lead, but there was no evidence of interaction between BPb and dietary calcium on BP. However, the relationship between increased BPb and DBP did not hold when those on anti-hypertensive medications were excluded.

Adult↗
PubMed2004

Analysis of phthalate contamination in infusion solutions by automated on-line in-tube solid-phase microextraction coupled with high-performance liquid chromatography.

Contamination of infusion solutions with phthalates was analyzed, and its origin was determined. Phthalates were determined by on-line in-tube solid-phase microextraction coupled with high-performance liquid chromatography (in-tube SPME-HPLC) with UV detection. In-tube SPME is an extraction technique for organic compounds in aqueous samples, in which analytes are extracted from the sample directly into an open tubular capillary by repeated draw/eject cycles of sample solution. The infusion solutions were used without any pretreatment, and the phthalates in these solutions were automatically analyzed by the on-line in-tube SPME-HPLC system. The limits of detection of phthalates in the infusion solutions were 1-10 ng/mL. With a few exceptions, the recoveries of phthalates added to the infusion solutions were above 80%. Di-n-butyl phthalate (DBP) was detected at a concentration of 7-60 ng/mL in most infusion solutions in plastic containers but was not detected in those in glass bottles. On the other hand, no other phthalates were detected in infusion solutions in either plastic or glass containers. Large amounts of DBP were detected in the adhesive used to affix the paper labels to the plastic bottles and bags, but not in the plastic containers themselves. Furthermore, DBP was shown to be readily eluted from the adhesive into water and alcohol and easily pass through the plastic. These results indicated that the source of the DBP was the adhesive used to affix the paper labels, and DBP contaminated the infusion solutions by passing through the plastic. The in-tube SPME-HPLC method is simple and rapid and provides a useful tool for the screening and determination of phthalate contamination in infusion solutions.

Adhesives↗
PubMed2006

Megalin-mediated endocytosis of vitamin D binding protein correlates with 25-hydroxycholecalciferol actions in human mammary cells.

The major circulating form of vitamin D is 25-hydroxycholecalciferol [25(OH)D3], which is delivered to target tissues in complex with the serum vitamin D binding protein (DBP). We recently observed that mammary cells can metabolize 25(OH)D3 to 1,25-dihydroxycholecalciferol [1,25(OH)(2)D3], the vitamin D receptor (VDR) ligand, and the objective of our study was to elucidate the mechanisms by which the 25(OH)D3-DBP complex is internalized by mammary cells prior to metabolism. Using fluorescent microscopy and temperature-shift techniques, we found that T-47D breast cancer cells rapidly internalize DBP via endocytosis, which is blunted by receptor-associated protein, a specific inhibitor of megalin-mediated endocytosis. Endocytosis of DBP was associated with activation of VDR by 25(OH)D3 but not 1,25(OH)(2)D3 (as measured by induction of the VDR target gene, CYP24). We also found that megalin and its endocytic partner, cubilin, are coexpressed in normal murine mammary tissue, in nontransformed human mammary epithelial cell lines, and in some established human breast cancer cell lines. To our knowledge, our studies are the first to demonstrate that mammary-derived cells express megalin and cubilin, which contribute to the endocytic uptake of 25(OH)D3-DBP and activation of the VDR pathway.

25-Hydroxyvitamin D3 1-alpha-Hydroxylase↗
PubMed2002

Combined treatment with 4-(N-methyl-N-nitrosamino)-1- (3-pyridyl)-1-butanone and dibutyl phthalate enhances ozone-induced genotoxicity in B6C3F1 mice.

Potential toxicological interactions of 4-(N-methyl-N-nitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and/or dibutyl phthalate (DBP) with ozone were investigated. Male and female B6C3F1 mice were exposed to ozone (0.5 p.p.m.), NNK (1.0 mg/kg), DBP (5000 p.p.m.) and different combinations of these toxicants 6 h/day for 16, 32 and 52 weeks. Two cytogenetic end-points, determined by the chromosomal aberration (CA) and supravital micronucleus (SMN) assays, were investigated in vivo. Our results show that all treated groups of both sexes showed genotoxic effects when compared with the control group. Additive and/or synergistic responses were observed in the CA assay for all test periods when mice of both sexes were exposed to ozone and NNK, ozone and DBP and the combination of ozone, NNK and DBP. In the SMN assay, additive interactions were noted for both sexes in the 16 and 32 week studies, similar to the results with the CA assay. All combination groups of both sexes showed synergistic interactions in the 52 week study. The results indicate that combined exposure to ozone, NNK and DBP in both sexes of mice has enhanced genotoxic effects compared with exposure to ozone alone.

Animals↗
PubMed2006

Association of low blood pressure with increased mortality in patients with moderate to severe chronic kidney disease.

BACKGROUND: Blood pressure shows an inverse association with mortality in patients with chronic kidney disease (CKD) on dialysis. It is unclear if the same phenomenon exists in patients with CKD not yet on dialysis. METHODS: We examined the association of systolic (SBP) and diastolic (DBP) blood pressure with all-cause mortality in a historical prospective cohort of 860 patients (age 68.1+/-10.1 years, 99.1% male, 24.4% black) with estimated glomerular filtration rate (GFR) < 60 ml/min/1.73 m2. We used Cox models to adjust for the effects of age, race, diabetes mellitus, atherosclerotic cardiovascular disease (ASCVD), congestive heart failure, smoking, antihypertensive medications, body mass index, GFR, albumin, cholesterol, haemoglobin and proteinuria. To examine the role of comorbidities, we performed subgroup analyses based on prevalent ASCVD status and level of estimated GFR. RESULTS: Higher SBP and higher DBP were both associated with lower mortality [adjusted hazard ratio (95% confidence interval) for SBP 133-154, 155-170 and > 170 mmHg, compared with < 133 mmHg, respectively: 0.61 (0.44-0.85), 0.62 (0.45-0.87) and 0.68 (0.49-0.96); and for DBP 65-75, 76-86 and > 86 mmHg, compared with < 65 mmHg: 0.85 (0.62-1.18), 0.72 (0.52-1.00) and 0.60 (0.41-0.86)]. The same association was present for both SBP and DBP only in subgroups with GFR < or = 30 ml/min/1.73 m2 and for DBP only in the subgroup with ASCVD. CONCLUSIONS: Lower blood pressure is associated with higher mortality in patients with moderate to severe CKD, but interactions with kidney function and with ASCVD suggest that blood pressure may play a surrogate rather than a causative role in this association.

Age Distribution↗
PubMed1982

Serial blood pressure measurements and cardiovascular disease in a Japanese cohort.

A cohort of 16,711 residents of Hiroshima and Nagasaki have participated in a program of biennial clinical examination and history taking that began in 1958. During 1958-1974, a total of 621 confirmed cases of cerebrovascular disease and 218 confirmed cases of coronary heart disease were incident. This study makes a detailed examination of the relationship between a series of biennial examination blood pressure (BP) measurements and cardiovascular disease risk. Two aspects are emphasized: the quantitative relationship between risk and both systolic blood pressure (SBP) and diastolic blood pressure (DBP), and the predictive value of BP levels some years in the past, given more recent BP determinations. Cerebral hemorrhage incidence is shown to depend markedly on recent DBP level, while earlier DBP levels make an additional important contribution to risk prediction. Corresponding SBP levels have little additional predictive value. With cerebral infarction, SBP is the more important predictor, though elevated DBP conveys some additional risk at high SBP levels. Recent BP levels are more strongly predictive for cerebral infarction than are BP levels some years earlier. Elevated SBP is also an important predictor of coronary heart disease risk in this population, while elevated DBP does not appear to be predictive at specified SBP. SBP levels several years in the past are more closely associated with coronary heart disease risk than are recent SBP readings. The dependence of BP relative risk functions on sex and age is examined and some departures from the results just listed are noted at younger ages. Implications for disease mechanism and hypertensive therapy are discussed.

Adult↗
PubMed1995

Influence of systolic and diastolic blood pressure on stroke risk: a prospective observational study.

The purpose of this study was to estimate the influence of systolic (SBP) and diastolic blood pressure (DBP) on stroke risk. The Copenhagen City Heart Study is a prospective survey of 19,698 women and men who were invited to two cardiovascular examinations at 5-year intervals. Blood pressure was measured in participants once at each examination, together with other variables. Initial cases of stroke and transient ischemic attack were recorded from hospital records and death certificates from 1976 through 1988. When entered separately in the Cox regression model, both SBP and DBP had significant effects on stroke risk. In the lower 60% of the blood pressure distribution in the population, the relative risk of stroke was nearly constant, followed by a gradual increase in the upper 40% of blood pressure distribution. However, when SBP and DBP were entered simultaneously in the model, the effect of DBP vanished, while the pattern of the association between SBP and stroke risk remained unchanged. Persons on antihypertensive treatment had higher risk for stroke than non-treated persons with the same blood pressure, relative risk = 1.6 (95% confidence interval (CI) 1.2-2.2). The relative risk for the highest SBP levels, shared by nearly 3% of the population, was 4.0 (95% CI 2.2-7.3). The attributable risk of SBP in the upper 40% of SBP distribution, i.e., above the mean for each age and sex group, was 22%. Our results indicate that: 1) the association between blood pressure and stroke risk was not log-linear, and 2) SBP was a stronger stroke predictor than DBP.

Adult↗
PubMed1993

Use of demineralized bone as an osteoinductive orbital enucleation implant in the rabbit.

Implanted allogeneic demineralized bone particles (DBP) may be transformed into endochondral bone by inductive or conductive new bone formation. Using a rabbit model, enucleation or evisceration was performed, and DBP was implanted into the socket. Histology confirmed endochondral bone formation in both groups. A morphologic difference existed between enucleation and evisceration: compact bone was produced following evisceration, and cancellous bony spheres were formed following enucleation. Serial quantitative computed tomography (qCT) was performed to monitor mineral density and proved to be an ideal technique to monitor bone mineralization noninvasively in the postoperative orbit. Bone mineral density (BMD, mg/ml) increased approximately 300% in DBP implanted orbits when compared to controls at 6 weeks. The ideal mass/volume ratio of DBP to socket volume was 400 mg/ml. The rapidly formed bone is well vascularized and creates a stable integrated orbital implant, following enucleation and evisceration surgery. DBP implantation into the central orbit results in inductive bone formation with interesting potential in socket and orbit reconstruction.

Animals↗
PubMed1988

Mortality findings beyond five years in the hypertension detection and follow-up program (HDFP).

The primary objective of the Hypertension Detection and Follow-up Program (HDFP) was to determine, in a community-based population of hypertensive subjects, the effect on 5-year all-cause mortality of standardized intensive drug treatment, designated stepped care, compared with the usual community care, designated referred care. Hypertensive subjects were screened from a base population of 159,000 black and white men and women aged 30-69 years, identified from 14 United States communities, and randomly allocated to stepped and referred care groups according to baseline diastolic blood pressure (DBP) strata: stratum I, DBP 90-104 mmHg; stratum II, DBP 105 +/- 114 mmHg; stratum III, DBP greater than or equal to 115 mmHg. The treatment period was designed to last 5 years, and 5-year mortality results have been published previously. However, since the 10,940 participants were recruited over a 14-month period, and treatment extended approximately 6 months beyond the end of the 5th year of the last enrolled participant, most were treated for 6 or more years before the study was terminated. A 2-year post-trial surveillance study in the HDFP population provided an opportunity to determine mortality rates in the stepped and referred care groups for 6.7 years. These data show that the mortality advantage of stepped care persisted beyond 5 years and was even greater after 6.7 years. Moreover, a stepped care advantage was demonstrated in all major population subgroups, including all four race-sex groups, all age groups and all three DBP strata.(ABSTRACT TRUNCATED AT 250 WORDS)

Antihypertensive Agents↗
PubMed1991

Pressor actions of arginine vasopressin in pithed Sprague-Dawley, Wistar-Kyoto and spontaneously hypertensive rats before and after treatment with nifedipine or pertussis toxin.

The pressor actions of arginine vasopressin (AVP) were examined in pithed Sprague-Dawley and Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHR). Prior to pithing, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded via an intra-arterial catheter from sodium pentobarbital anaesthetized rats. SBP and DBP recorded from SHR were significantly greater than those from Sprague-Dawley and WKY rats. However, after pithing, there were no significant differences between DBP among the various strains. Pertussis toxin pretreatment significantly reduced the prepithing SBP and DBP of the SHR but not Sprague-Dawley or WKY rats. Administration of nifedipine significantly reduced DBP of pithed rats. The dose-diastolic pressure response curves obtained from infusion of AVP in Sprague-Dawley and WKY rats were not significantly different from one another, but the maximal vasopressor responses to AVP in pithed SHR were enhanced. Administration of nifedipine to Sprague-Dawley and WKY rats did not affect the dose-response curve to AVP, but nifedipine administration in SHR led to a significant inhibition of the pressor responses to AVP. Furthermore, pertussis toxin pretreatment of rats significantly reduced a component of the AVP pressor effect in SHR but not Sprague-Dawley or WKY rats. We speculate that, in SHR, vasopressin receptors are coupled to a pertussis toxin-sensitive G protein that, in turn, may couple to a dihydropyridine-sensitive calcium channel and also to a pertussis-insensitive G protein that is probably coupled to the phospholipase C/intracellular calcium release process. A component of the elevated blood pressure in SHR is also regulated by a pertussis toxin-sensitive process.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Impaired microcirculation in mild-to-moderate essential arterial hypertension.

OBJECTIVE: The aim of this study was to correlate capillary morphology and erythrocyte velocity to blood pressure in mild-to-moderate essential arterial hypertension. DESIGN: Ambulatory blood pressure measurement may provide more precise information about a patient's mean blood pressure than office measurements. METHODS: Fifteen patients with recently diagnosed, previously untreated mild-to-moderate essential hypertension underwent 24-h ambulatory blood pressure recording and a capillaroscopic examination of finger microcirculation. Erythrocyte velocity was determined by the flying spot technique. RESULTS: Both mean 24-h ambulatory systolic blood pressure (SBP) and mean 24-h ambulatory diastolic blood pressure (DBP) were significantly inversely correlated with capillary erythrocyte velocity. However, the correlation between erythrocyte velocity and office SBP and office DBP was less significant. Capillary length was related to 24-h ambulatory DBP but not to office DBP. Capillary number was not related to any blood pressure parameter. CONCLUSIONS: These results indicate that, in patients with mild-to-moderate essential hypertension, erythrocyte velocity is significantly lower than for matched controls. It is also inversely related to mean 24-h ambulatory SBP and 24-h ambulatory DBP.

Blood Flow Velocity↗
PubMed1992

Relation between treated blood pressure and death from ischaemic heart disease at different ages: a report from the Department of Health Hypertension Care Computing Project.

OBJECTIVE: To determine the relation between mortality from ischaemic heart disease (IHD) and treated blood pressure at different ages. DESIGN: Prospectively, 6216 patients were studied for a mean of 107 months. SETTING: Of the total patients, 95% were followed in five hospital-based hypertension clinics and the remainder in four group general practices. PATIENTS: Respectively, 2250 and 2126 hypertensive men and women aged < 60 years and 822 and 1018 aged > or = 60 years. MAIN OUTCOME MEASURES: Mortality (any mention on the death certificate) from IHD. RESULTS: Four hundred and sixty-seven patients died with IHD mentioned on the death certificate. The relation between both diastolic blood pressure (DBP) and systolic blood pressure (SBP) during the first 3-12 months of treatment and subsequent IHD mortality was examined. Under the age of 60 years the relative hazard rate (RHR) for death from IHD tended to increase with DBP in both men and women. Above the age of 60 years there was no important or significant relation between IHD mortality and treated DBP. For SBP there was no reduction in the positive relation between IHD mortality and blood pressure in the older age groups. The RHR for SBP ranged between 1.008 and 1.021 in men and women over and under the age of 60 years. CONCLUSIONS: The positive relation between DBP and IHD mortality decreased with increasing age and, in women aged > or = 60 years, even inverted, partly explaining the negative relation reported between DBP and total mortality in the very old.

Adolescent↗
PubMed1996

Blood pressure and isolated systolic hypertension and the risk of coronary heart disease and mortality in elderly men (the Zutphen Elderly Study).

OBJECTIVE: To investigate the associations of diastolic blood pressure (DBP) and systolic blood pressure (SBP) with the risk of coronary heart disease, sudden cardiac and all-cause death in elderly men. DESIGN: A cohort study. SETTING: The Dutch town of Zutphen. SUBJECTS: Eight hundred and eighty-five randomly selected men, aged 64-84 years. MAIN OUTCOME MEASURES: Relative risks adjusted for age, body mass index, total and high-density lipoprotein cholesterol, cigarette smoking, alcohol consumption, use of blood pressure-lowering medications without a specific indication for hypertension, and the physician who measured the blood pressure. RESULTS: Neither DBP nor SBP was associated significantly with the incidence of a first coronary heart disease event and no clear associations were observed with mortality from coronary heart disease. However, positive associations with sudden cardiac death were observed. The adjusted relative risk for men with definite isolated systolic hypertension was 9.20. The risk of dying from coronary heart disease not recorded additionally as sudden death was highest in men at the lower end of the DBP and SBP distributions and in men using antihypertensives. DBP and SBP were positively associated with all-cause mortality when possible comorbidity at the time of the blood pressure measurement was accounted for. Overall, the highest risk for all endpoints was observed in men on antihypertensive medication, who formed a distinct group with a clustering of cardiovascular risk factors. CONCLUSION: Elevated DBP and SBP, and especially isolated systolic hypertension, are important predictors of sudden cardiac death in elderly men. The highest risk of non-sudden coronary heart disease mortality was found at the lower end of the blood pressure distributions and among men on antihypertensive medication.

Aged↗
PubMed2001

Blood pressure is linked to salt intake and modulated by the angiotensinogen gene in normotensive and hypertensive elderly subjects.

OBJECTIVES: To evaluate salt sensitivity in elderly subjects with different forms of hypertension and controls and to investigate any modulation by genotype DESIGN: Randomized, double-blinded, placebo-controlled latin-square SETTING: Tertiary referral hospital PARTICIPANTS: Community subjects (n = 46) aged > or = 60 years classified as isolated systolic hypertension [ISH; systolic blood pressure (SBP) > or = 160, diastolic blood pressure (DBP) < 90 mmHg, n = 19], diastolic +/- systolic hypertension (SDH; DBP > or = 90 mmHg, n = 10) and normotension (SBP < 160, DBP < 90 mmHg, n = 17). INTERVENTION: Four 14 day treatments, 50, 100, 200 and 300 mmol/day of sodium chloride supplementation interspersed with 14 day washout periods on a salt-restricted diet. MAIN OUTCOME MEASURES: The 24 h blood pressure, heart rate, weight, urinary sodium and creatinine clearance measured during baseline, treatment and washout periods and angiotensinogen (AGT) and angiotensin converting enzyme (ACE) genotypes. RESULTS: For the entire cohort, the mean +/- standard error (SE) of change from baseline in SBP for 50, 100, 200 and 300 mmol/day salt was 7.7+/-2.4, 12.1+/-2.4, 16.6+/-3.0, 18.5+/-2.6 mmHg, respectively. For DBP, the respective changes were: -0.1+/-1.5, 2.4+/-1.6, 3.0+/-1.5, 5.8+/-1.7 mmHg. The increase in SBP among ISH subjects was significantly higher than among subjects in the SDH and normotensive groups (P < 0.05). AGT genotype influenced the effect of salt dose on the change in DBP (P = 0.006) but not SBP (P = 0.7). CONCLUSIONS: In healthy, older subjects, a linear increase in BP occurred with increasing salt dose, it appeared most pronounced in ISH subjects and could be modulated by AGT genotype.

Aged↗
PubMed2002

Heritability of blood pressure in Nigerian families.

OBJECTIVES: There are few studies of familial aggregation of blood pressure in African populations. This study was undertaken to provide estimates of heritability for four blood pressure phenotypes: systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure. METHODS: A population-based sample of 528 pedigrees or extended families, comprising 1825 measured individuals, was studied in a poor urban community in Ibadan, Nigeria. RESULTS: The mean SBP was 121.7 (SD 22.6) mmHg for men and 120.7 (SD 26.8) mmHg for women, while the mean DBP was 74.6 (SD 14.1) mmHg for men and 75.5 (SD 15.2) mm Hg for women. The study sample was lean [mean body mass index (BMI) approximately 21 kg/m2]. Maximum-likelihood heritability estimates were obtained under a polygenic model with simultaneous estimation of household effects using a variance components method, as implemented in the SOLAR software package. Heritability estimates of the traits were 34% for SBP, 29% for DBP, 36% for MAP and 13% for pulse pressure. Household effects were statistically significant for DBP (7.1%) and MAP (4.5%). Measured covariates (age, sex and BMI) accounted for 25, 24, 26 and 16% of the total variance, respectively, for SBP, DBP, MAP and pulse pressure. CONCLUSIONS: These figures suggest that, similar to that reported in other populations, blood pressure is a heritable trait. Studies similar to this are needed to describe the familial aggregation of other complex traits in sub-Saharan African populations and to serve as a prelude to the identification of susceptibility genes involved in the pathophysiology of common complex diseases, including blood pressure and hypertension.

Adolescent↗
PubMed2002

High remaining risk in poorly treated hypertension: the 'rule of halves' still exists.

OBJECTIVES: To estimate risk factors for stroke, to examine how different categories of patients with increased blood pressure are associated with risk for first-ever stroke event, and to estimate the proportions of these categories in a geographically defined population in northern Sweden. SETTING: The study was nested within the Västerbotten Intervention Program and the Northern Sweden MONICA cohorts. DESIGN AND PARTICIPANTS: A population-based cross-sectional study and an incident case-control study were carried out. The incident case-control study comprised 129 cases of first-ever stroke diagnosed during 1985-96, with two randomly selected controls per case, chosen from the same geographically defined population. The cross-sectional study was based on 59,735 participants. Blood pressure status was categorized as: normotensive [systolic blood pressure (SBP) <140 mmHg and diastolic blood pressure (DBP) <90 mmHg]; treated and adequately controlled hypertension (SBP <140 mmHg and DBP <90 mmHg); treated but poorly controlled hypertension (SBP > or = 140 mmHg or DBP > or = 90 mmHg, or both); untreated hypertension (SBP > or = 140 mmHg or DBP > or = 90 mmHg, or both); newly detected increased blood pressure (SBP > or = 140 mmHg or DBP > or = 90 mmHg, or both). MAIN OUTCOME MEASURE: Risk for first-ever stroke. RESULTS: In the cross-sectional study, 68% of individuals were normotensive, 3% had treated and adequately controlled hypertension, 6% had treated but poorly controlled hypertension, 7% had untreated hypertension, and 16% had newly detected increased blood pressure. In univariate analysis of the case-control study, history of diabetes, daily smoking, obesity, increased blood pressure and the hypertension categories 'treated but poorly controlled' and 'untreated' were associated with an increased stroke risk. In multivariate logistic regression analysis, only diabetes and the hypertension categories treated but poorly controlled and untreated remained significant, with odds ratios 6.1 (95% confidence interval 2.4 to 15.3) and 4.3 (95% confidence interval 1.7 to 10.5), respectively. Only one of the 129 individuals who suffered stroke had treated and adequately controlled hypertension. CONCLUSIONS: The study illustrates the importance of adequate blood pressure control and, at the same time, that the vast majority in the population with increased blood pressure did not receive optimal care. Thus the 'rule of halves' still exists, and the high remaining risk in poorly treated hypertensive individuals in Sweden is remarkable and requires attention from the medical profession.

Adult↗