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PubMed2003

Effects of ACE I/D and AT1R-A1166C polymorphisms on blood pressure in a healthy normotensive primary care population: first results of the Hippocates study.

BACKGROUND: Several studies have assessed the relationship between the angiotensin-converting enzyme (ACE) I/D or angiotensin II type 1 receptor (AT(1)R)-A C polymorphisms and blood pressure (BP). Since most data have been obtained in selected populations, the present study was performed in a healthy normotensive primary care population. OBJECTIVE: To investigate the individual effects of the aforementioned polymorphisms and their interaction on BP. METHODS: This cross-sectional study included 198 healthy subjects. Office BP was measured and polymorphisms were genotyped (polymerase chain reaction). Polymorphism interaction was tested using the following model: systolic blood pressure (SBP) (or diastolic blood pressure, DBP) = b(0)+ b(1)X + b(2)Y + b(3)XY, in which X and Y represent the polymorphisms' risk alleles. RESULTS: The ACE I/D polymorphism was associated with SBP (P = 0.002) and DBP (P = 0.004); highest pressures tracked with the DD genotype. Furthermore, in multiple linear regression analysis the ACE D allele was associated with SBP (P = 0.005) and DBP (P = 0.001), when adjusted for body mass index (BMI) and age. With respect to the AT(1)R-A C polymorphism, SBP was highest in the CC genotype (P = 0.025). In linear regression analysis the C allele was not associated with SBP. No synergistic effect of ACE D and AT(1)R C alleles on BP was found. Nevertheless, highest DBP tracked with the DDCC combination in comparison with other homozygous allele combinations (P = 0.030). CONCLUSIONS: This study confirmed an association of ACE I/D and AT(1)R-A C polymorphisms with BP in a healthy normotensive primary care population. Although synergistic effect of both polymorphisms on BP does not seem to be present, an additive effect on DBP is likely.

Adenine↗
PubMed2004

Fat distribution, body mass index and blood pressure in 22,090 men and women in the Norfolk cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk) study.

OBJECTIVE: To determine the relation between fat distribution and blood pressure, independent of body mass index. DESIGN: Cross-sectional, population-based study. PARTICIPANTS AND METHODS: Participants, 9936 men and 12,154 women aged 45-79 years, were recruited from general practices in Norfolk, United Kingdom for the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk) study. Participants filled in a health and lifestyle questionnaire and their blood pressure and anthropometry were measured at a clinic. We mainly used waist-hip ratio (WHR) to assess body fat distribution. RESULTS: Systolic blood pressure (SBP) and diastolic blood pressure (DBP) increased linearly across the whole range of waist-hip ratio in both men and women. The relation was independent of age, body mass index (BMI) and other covariates. Separately, waist and hip circumferences were positively related to SBP and DBP. When adjusted for BMI, waist circumference was positively related to SBP (in women) and DBP (in both men and women), whereas hip circumference was inversely related to SBP (but not DBP) in both men and women. Stratifying by tertiles of waist and hip circumference, age- and BMI-adjusted SBP and DBP were highest among those with high waist and small hip circumference measures. CONCLUSION: Waist-hip ratio was independently related to blood pressure. Waist-hip ratio could reflect the separate and opposite relations of waist and hip circumferences on blood pressure. Characterizing patterns of fat distribution may have implications in the assessment and control of obesity-related blood pressure elevation.

Abdomen↗
PubMed1990

Effects of nifedipine, BAY K 8644, and pertussis toxin on pressor response to sarafotoxin-b in pithed rats.

The pressor actions of sarafotoxin-b (SRTX-b) were examined in pithed rats in the presence of the calcium channel antagonist nifedipine or the calcium channel activator BAY K 8644 intraarterially (i.a.) and also after pretreatment with pertussis toxin intravenously (i.v.). SRTX-b produced dose-dependent pressor effects in the pithed rat. The diastolic blood pressure (DBP) recorded in animals treated with the vehicle was 41 +/- 1 mm Hg; administration of BAY K 8644 0.1 or 0.3 mg/kg increased DBP pressure to 50 +/- 1 and 52 +/- 1 mm Hg, respectively, whereas nifedipine 0.1 or 0.3 mg/kg decreased DBP to 39 +/- 1 and 33 +/- 1 mm Hg, respectively. The actions of SRTX-b were significantly inhibited by nifedipine, whereas BAY K 8644 potentiated the pressor actions of SRTX-b. We observed that animals pretreated with pertussis toxin 25 or 50 micrograms/kg 3 days before we conducted the experiments had significantly lower DBP as compared with saline-treated animals. Treatment with pertussis toxin caused the DBP dose-response curve to SRTX-b to be displaced to the right. These results indicate that a nifedipine-sensitive (presumably extracellular) calcium pool is partly responsible for the pressor response induced by SRTX-b. They further suggest that in vascular smooth muscle, at least in some vascular beds, SRTX-b activates a pertussin toxin-sensitive G-protein that is coupled to a receptor-operated calcium or nonspecific cation channel.

3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethy↗
PubMed1990

Comparison of felodipine and hydrochlorothiazide for the treatment of mild to moderate hypertension in black Africans.

A double-blind, parallel-group study was performed to assess the antihypertensive effects and tolerability of felodipine and hydrochlorothiazide (HCT) in black patients with mild to moderate uncomplicated hypertension [entry supine diastolic blood pressure (DBP) of 96-116 mm Hg]. The medicines were given as monotherapy and the additional effect of metoprolol was assessed in patients unresponsive to felodipine or HCT alone. After a 4-week placebo period, 45 patients were randomly allocated to treatment with felodipine (21) or HCT (24). Initial doses of felodipine 2.5 mg or HCT 12.5 mg twice daily were doubled after 1 week and doubled again after week 4 in cases with supine DBP above 90 mm Hg. At week 8, metoprolol 100 mg twice daily was added to the regimen of uncontrolled patients (supine DBP greater than 90 mm Hg) and maintained for the remaining 4-week trial period. Felodipine significantly reduced supine and erect systolic BP (SBP) and DBP after 4, 8, and 12 weeks of treatment. Responses to HCT were similar although standing diastolic BP at week 4 and standing SBP at week 8 were not significantly reduced. After 4 weeks, the mean fall in supine DBP was significantly greater for the felodipine than the HCT group. Eight patients on felodipine and 14 in the HCT group required additional metoprolol to achieve BP control. A significantly greater number of adverse effects were associated with HCT than felodipine treatment. Monotherapy with felodipine produced a more rapid control of hypertension, was more frequently effective, and was associated with a lower incidence of side effects than HCT.

Adult↗
PubMed1992

Efficacy and tolerability of isradipine and metoprolol in treatment of hypertension: the Finnish Isradipine Study in Hypertension (FISH).

Eight hundred seventy-six men and women with diastolic blood pressure (DBP) of 95-115 mm Hg during a 4-week placebo period were included in a multicenter trial; 479 patients had previously been treated for hypertension. The patients were randomized to receive isradipine or metoprolol; both groups were comparable for age, weight, height, smoking habits, and duration of hypertension. By the end of the placebo period, 79 patients did not fulfill the final entry criteria and were withdrawn. The isradipine group consisted of 398 patients (164 women and 234 men), and the metoprolol group consisted of 399 patients (173 women and 226 men). The initial dose of isradipine was 1.25 mg twice daily (b.i.d.), and the initial dose of metoprolol was 50 mg b.i.d.; the doses were doubled after 4 weeks if DBP had not decreased to less than or equal to 90 mm Hg. After 8 weeks, the isradipine group began combination therapy with metoprolol 50 mg b.i.d. and the metoprolol group began combination therapy with isradipine 1.25 mg b.i.d. if DBP was not less than or equal to 90 mm Hg. After 8 weeks monotherapy, mean BP (MBP) was reduced by 13/11 mm Hg (161/104 to 148/93) in the isradipine group and by 15/12 mm Hg (160/103 to 145/91) in the metoprolol group. Monotherapy with isradipine normalized DBP to less than or equal to 90 mm Hg in 52% with a mean dose of 4.26 mg daily, and monotherapy with metoprolol normalized DBP in 58% with a mean dose of 155 mg daily.1+

Adult↗
PubMed2000

Antihypertensive efficacy of manidipine and enalapril in hypertensive diabetic patients.

Recent studies showed that in diabetic hypertensive patients, administration of angiotensin-converting enzyme (ACE)-inhibitors or calcium antagonists can effectively lower blood pressure (BP) and prevent diabetes-related cardiovascular complications with no adverse metabolic effects. We sought to assess the antihypertensive and metabolic effects of the new dihydropyridine calcium antagonist manidipine (M) in patients with diabetes mellitus and essential hypertension as compared with the ACE inhibitor enalapril (E). After 3 weeks of placebo, 101 (62 men; age range, 34-72 years) hypertensives with type II diabetes mellitus were randomized to M 10-20 mg or E 10-20 mg, od, for 24 weeks. At the end of the placebo period and the active-treatment phase, BP was measured with a mercury sphygmomanometer (office, O) and over the 24 h by ambulatory (A) monitoring. ABP recordings were analyzed to obtain 24-h, day (6 a.m. to midnight), and night (midnight to 6 a.m.) average systolic (S) and diastolic (D) BP and heart rate (HR) values. Homogeneity of the antihypertensive effect over the 24 h was assessed by the smoothness index [SI: i.e., the ratio between the average of the 24 hourly BP changes after treatment and the corresponding standard deviation (the higher the SI, the more uniform is the BP control by treatment over the 24 h]. The O SBP and DBP were significantly (p < 0.01) and similarly reduced by M (16 +/- 10 and 13 +/- 6 mm Hg, n = 49) and E (15 +/- 10 and 13 +/- 6 mm Hg, n = 45). The percentage of patients whose O DBP was reduced < or = 85 mm Hg (i.e., the value indicated to be the optimal DBP goal in diabetic hypertensives) was similar for M (37%) and E (40%). The reduction of 24-h BP also was similar between M (n = 38) and E (n = 38) for both drugs (systolic, 6 +/- 11 and 8 +/- 10 mm Hg; diastolic, 5 +/- 8 and 5 +/- 7; NS, M vs. E). The antihypertensive effect was distributed in a similar homogeneous fashion throughout the dosing interval, as shown by the similar SI values (M, 0.6 +/- 1.2 for SBP and 0.6 +/- 0.9 for DBP; E, 0.6 +/- 0.8 for SBP and 0.5 +/- 0.7 for DBP; NS, M vs. E). O and A HR were unchanged by either treatment. Markers of glucose and lipid metabolism and renal function were not significantly modified by treatment both with M and with E. In the diabetic hypertensives, M was as effective and metabolically neutral as the ACE-inhibitor E.

Adult↗
PubMed1979

Predicting blood pressure control in hypertensive patients: an approach to quality-of-care assessment.

In assessing the quality of medical care, techniques were needed which can predict which patients are likely to have good or poor health outcomes. This study describes one way of identifying a subgroup of hypertensive patients whose diastolic blood pressures (DBP) are at high risk of remaining uncontrolled while under treatment. Medical care and patient variables were measured for 123 hypertensive medical clinic patients. Stepwise discriminant analysis identified a set of six variables which best distinguished between patients with well-controlled and uncontrolled DBP. When measurements of these variables were divided into high and low risk responses for uncontrolled DBP, the number of high risk variables was directly related to the proportion of patients with uncontrolled DBP. The variables also predicted DBP control among 63 patients in an entirely different medical care setting.

Aged↗
PubMed1980

Medical care use and hypertension.

We examined the relationship between the use of medical care and diastolic blood pressure (DBP) in 2,939 individuals residing in a rural Southern biracial community. The nonuse of medical care, defined as the absence of reported physician visits in the year preceding the survey, increased with higher levels of DBP among those not receiving antihypertensive treatment. Nearly one half of individuals with untreated DBP greater than or equal to 100 mm Hg had not seen a physician in the preceding year, whether aware of their hypertension or not. The association between nonuse of medical care and untreated diastolic hypertension could not be explained by demographic differences or differences in self-reported health. Despite the fact that all were referred for evaluation of their elevated blood pressure, only 28 per cent of moderate hypertensives (DBP greater than or equal to 100 mm Hg) visited their physician in the 3-month period following the survey. In contrast, 27 per cent of those with DBP less than or equal to 99 mm Hg visited their physician, although few were specifically referred.

Adolescent↗
PubMed1994

Effectiveness and costs of veterans affairs hypertension clinics.

The effectiveness and costs of care for hypertension are examined in a stratified random sample of 3,087 patients from a network of 32 Veterans Affairs Hypertension Screening and Treatment Clinics (HSTP). During 2.5 years of follow-up, 66% and 88% of patients, respectively, had mean diastolic blood pressure (DBP) levels of 90 or 95 mm Hg or less; 73% remained fully in care; and the mean cost of ambulatory care per patient-year was $647 in 1989 dollars. Higher follow-up DBP levels were found in patients who were younger, had higher DBP levels, or were receiving medication on their first visits to a clinic, were receiving more intense treatment regimens at the beginning of the follow-up period, or had been under the care of the clinic for shorter periods. Patients who were more likely to remain in care were older, received more intense treatment regimens, had prior cardiovascular complications, or had been under the care of the clinic for a longer time. Higher annual costs were associated with higher entry DBP levels, shorter durations of care, more intense regimens, and prior cardiovascular complications. Overall, patient characteristics explained 13% of the variance in mean follow-up DBP, and 31% of variance in costs. Wide variations were found among clinics in clinical outcomes and costs. After controlling for differences in patient characteristics, clinic characteristics associated with better blood pressure control were more frequent clinic visits, shorter waiting times, more time spent in patient counseling, having therapists who had a single supervisor, and better staff satisfaction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2001

Heart rate and blood pressure changes with endurance training: the HERITAGE Family Study.

PURPOSE: The purpose of this study was to determine the magnitude of change in resting and exercise heart rate (HR) and blood pressure (BP), by race, sex, and age, after a 20-wk endurance training program in 507 healthy and previously sedentary subjects from the HERITAGE Family Study. METHODS: After baseline measurements, subjects exercised on cycle ergometers 3 d x wk(-1) for a total of 60 exercise sessions starting at 55% of VO2max for 30 min x session(-1) and building to 75% of VO2max for 50 min x session(-1) for the last 6 wk. HR and BP at rest and during exercise (50 W, 60% of VO2max maximal exercise) were each determined in duplicate on two different days both before and after training (resting values at 24-h and 72-h posttraining). RESULTS: After the period of training, there was a small decrease in resting HR (-2.7 to -4.6 beats x min(-1) across groups at 72-h posttraining), and small changes (i.e., < 3 mm Hg) in resting systolic (SBP), diastolic (DBP), and calculated mean BP (MBP), which varied by race, sex, and age. During exercise at the same absolute work rate (50 W), HR, SBP, DBP, and MBP were all significantly reduced, with greater reductions in HR in women compared with men, and greater reductions in BP in blacks and older subjects compared with whites and younger subjects, respectively. At the same relative work rate (60% VO2max), HR, DBP, and MBP were reduced, but SBP remained unchanged. Blacks had a greater reduction in DBP, but whites had a greater reduction in HR. Finally, at maximal exercise, there was a small decrease in HR, with men and whites decreasing more than women and blacks; an 8 mm Hg increase in SBP, with men increasing more than women; a 4 mm Hg decrease in DBP, with blacks decreasing more than whites; and no change in MBP. CONCLUSION: In conclusion, the reductions in resting HR and BP with training were generally small, but the reductions during exercise were substantial and clinically important, with the older and the black populations experiencing greater reductions.

Adolescent↗
PubMedDate not supplied

Cardiovascular reactivity, emotional factors, and home blood pressures in black males with and without a parental history of hypertension.

Differences in cardiovascular responses to mental stress, psychological factors, and self-determined home blood pressure between black individuals with and without a family history of essential hypertension (EH) may suggest mechanisms responsible for the high incidence of EH in blacks. In this study, 12 black male students with a parental history of EH and 12 without a parental history of EH participated in a laboratory session during which two mental challenge tasks (anagrams and mental arithmetic) were presented. Following the laboratory session all subjects made daily recordings of their morning and evening blood pressure for four weeks (28 days) after the laboratory session. The results showed that sons of hypertensive parents had higher systolic (SBP) and diastolic (DBP) than sons of normotensive parents at rest and during mental challenge; no reliable differences in heart rate were observed. Sons of hypertensive parents had higher self-determined home blood pressure (SBP and DBP) and scored significantly higher on psychological measures of Trait-Anger/Temperament, Anger-Out, and Submissiveness. Apparently there was no significant change in SBP or DBP over the four weeks prior to final examinations in either of the groups. Although the resting blood pressure level, weight, and family history predicted a large proportion of the variance in home SBP and DBP, the amount of explained variance, particularly for DBP, was significantly increased by the inclusion of psychological variables and the level of cardiovascular responses (and not the delta change) to mental challenge in the regression equation. These findings indicate that the degree to which self-determined home blood pressures can be predicted is enhanced significantly by considering both the level of cardiovascular responses to stress and psychological measures of the experience and expression of anger. The implications of these results are discussed in light of current research demonstrating that average home blood pressures are a better predictor of cardiac complications than casual (office) blood pressures.

Adult↗
PubMed2000

Validation of A&D UA-767 device for the self-measurement of blood pressure.

BACKGROUND: The validation of self-measurement devices has been recommended. Automatic monitor A&D UA-767 (A&D Company, Ltd, Tokyo, Japan) is well known and widely used, but not tested according to the Association for Advancement of Medical Instrumentation (AAMI) and British Hypertension Society (BHS) recommendations. OBJECTIVE: To perform a clinical validation for use by adults of the A&D UA-767 device according to the criteria of the AAMI and a modified BHS protocol. METHODS: The test concerned 101 subjects (57 men and 44 women) aged 15-85 years with arm circumferences of 22-39 cm, a systolic blood pressure (SBP) range of 89-206 mmHg, and a diastolic blood pressure (DBP) range of 53-122 mmHg. For each subject, three readings of the UA-767 were compared with simultaneous auscultatory measurements by two trained independent observers who used a mercury manometer and dual stethoscope. The results were graded according to the BHS (1990 and 1993) and AAMI recommendations. RESULTS: Observers showed close agreement, with mean differences of 1.1+/-2.4 mmHg for SBP and -0.7+/-2.0 mmHg for DBP. The proportion of values agreeing to within 5, 10 and 15 mmHg were 93, 100, and 100% for SBP and 97, 100, and 100% for DBP for the two observers. The sphygmomanometer measurements were 132+/-24/79+/-14 mmHg (mean+/-SD). The average difference between the mercury sphygmomanometer and A&D UA-767 readings for SBP and DBP were, respectively, -0.4+/-5.4 and -0.4+/-4. 8 mmHg. The proportion of values agreeing to within 5,10, and 15 mmHg were 82, 94, and 98% for SBP and 80, 95, and 98% for DBP for the observers and device (A/A grade for BHS). CONCLUSIONS: For an adult population, the A&D UA-767 device for the self-measurement of blood pressure satisfied the AAMI criteria, achieved a BHS grade of A/A and can therefore be recommended for monitoring blood pressure in home and clinical conditions by patients with mild-to-moderate arterial hypertension.

Adolescent↗
PubMed2004

The Accoson Greenlight 300, the first non-automated mercury-free blood pressure measurement device to pass the International Protocol for blood pressure measuring devices in adults.

BACKGROUND: Accurate blood pressure measurement is critical to successful care of the hypertensive patient. The mercury manometer is rapidly being removed from clinical practice due to concerns about environmental contamination. The Accoson Greenlight 300 device is the first non-automated mercury-free device for auscultatory blood pressure measurement to pass the International Protocol for validation of blood pressure measuring devices in adults. METHODS: Fifty-one patients were enrolled to obtain the 33 patients required to fill the three systolic blood pressure (SBP) ranges (low 90-129 mmHg, medium 130-160 mmHg, high 161-180 mmHg) and diastolic blood pressure (DBP) ranges (low 40-79 mmHg, medium 80-100 mmHg, high 101-130 mmHg). Nine sequential blood pressure measurements by two observers with the mercury manometer and the supervisor with the Greenlight 300 were taken. The first two observer blood pressures were used to classify the SBP and DBP range. The readings were then analyzed in two phases to determine whether the device passed the International Protocol. RESULTS: The device passed Phase 1 using 15 subjects. In Phase 2.1 (n=33) for the 99 readings of SBP, 84 of 99 were within 5 mmHg, 95 of 99 were within 10 mmHg, and 98 of 99 were within 15 mmHg. For the 99 readings of DBP, 74 of 99 were within 5 mmHg, 90 of 99 were within 10 mmHg, and 96 of 99 were within 15 mmHg. In Phase 2.2 (n=33) for SBP, 33 of 33 had 2 of 3 SBP within 5 mmHg and none had all three readings >or=5 mmHg. For DBP, 27 of 33 had 2 of 3 of their DBP within 5 mmHg and only three had all three readings > or =5 mmHg. CONCLUSIONS: The Accoson Greenlight 300 is the first electronic non-automated blood pressure measurement device to pass the International Protocol.

Adult↗
PubMed2004

Sustained antihypertensive activity of telmisartan compared with valsartan.

BACKGROUND: Early morning blood pressure (BP) surge and 24 h mean BP are linked to target-organ damage and cardiovascular events. Antihypertensive agents should sustain BP control, particularly in the last 6 h of the dosing interval or if dosing is missed. The efficacies of the long half-life telmisartan compared with shorter half-life valsartan in the last 6 h of the dosing interval following active treatment and during 24 h after a missed dose were compared. METHODS: In two identically designed multinational, randomized, double-blind, forced-titration studies, hypertensive patients (seated diastolic blood pressure (DBP), 95-109 mm Hg, 24 h mean ambulatory DBP, > or = 85 mm Hg) received once-daily telmisartan (40- 80 mg) or valsartan (80-160 mg) for a total of 8 weeks; uptitration occurred after 2 weeks low-dose treatment. After 4 weeks high-dose treatment, patients were given either 1 days double-blind active therapy or placebo (that is, missed dose). Following a further 2 weeks active treatment, a cross-over was performed: patients who had previously received 1 days placebo received active therapy and vice versa. At baseline and after the two active or missed doses, 24 h ambulatory BP monitoring was performed. Data from the studies were pooled, as prospectively planned and analyzed using the intent-to-treat population. RESULTS: After active therapy, last 6 h mean DBP was reduced by 7.6+/-7.9 mm Hg with telmisartan (n=447) compared with 5.8+/-7.8 mm Hg with valsartan (n=430) (P=0.0044). Last 6 h mean systolic blood pressure (SBP) was reduced by 11.1 mm Hg with telmisartan compared with 9.1 mm Hg with valsartan (P=0.0066). After a missed dose, 24 h mean DBP was reduced by 7.2+/-6.5 mm Hg with telmisartan (n=437) compared with 5.5+/-6.2 mm Hg with valsartan (n=431) (P=0.0004). The reduction in 24 h mean SBP after a missed dose was 10.7 mm Hg with telmisartan and 8.7 mm Hg with valsartan (P=0.0024). Absence of treatment-by-study interaction indicated that pooling of studies was appropriate. All 24 hourly mean reductions in DBP and SBP were greater for telmisartan than valsartan. Both treatments were well tolerated. CONCLUSIONS: Due to its longer half-life, telmisartan offers more sustained BP control, especially at the end of the dosing period and provides sustained efficacy in poorly compliant patients in the event of a missed dose with a statistical superiority compared with valsartan.

Adult↗
PubMed2005

Validation of the AGILIS ambulatory blood pressure monitor according to the European Society of Hypertension International Protocol for validation of blood pressure measuring devices in adults.

BACKGROUND: We evaluated the clinical validity of the AGILIS ambulatory blood pressure monitor according to the European Society of Hypertension International Protocol. METHODS: The blood pressure (BP) was measured at the same arm by two certified observers using two mercury columns and a double stethoscope, then by the volunteer with the automatic device, these measurements were done seven times sequentially using 33 volunteers. For the randomization of the patient, one ABPM measure was compared to the mean of three manual measures. Then, we had three ABPM measures and four manual measures. Each ABPM measure, being compared to two manual measures. Blood pressure readings and recordings were blinded. Position of the subjects was standardized. RESULTS: Phase 1: To pass phase 1, the device had to have at least 25 of the 45 measurements within 5 mmHg, 35 within 10 mmHg or 40 within 15 mmHg of the comparative observer measurements. The AGILIS monitor had 35 measurements lying within 5 mmHg, 42 within 10 mmHg and 45 within 15 mmHg for systolic BP (SBP), 35 within 5 mmHg, 44 within 10 mmHg and 45 within 15 mmHg for diastolic BP (DBP). It passed the criteria for SBP and DBP. Phase 2: To pass phase 2.1, a device must have at least 60 of 99 measurements within 5 mmHg, 75 within 10 mmHg and 90 within 15 mmHg of the comparative observer measurements, and in addition must also have either 65 within 5 mmHg and 80 within 10 mmHg, or 65 within 5 mmHg and 95 within 15 mmHg, or 80 within 10 mmHg and 95 within 15 mmHg. The AGILIS monitor had 78 measurements within 5 mmHg, 91 within 10 mmHg and 96 within 15 mmHg for SBP; and 70 measurements within 5 mmHg, 92 within 10 mmHg and 96 within 15 mmHg for DBP. It passed the criteria for SBP and DBP. For phase 2.2 using the AGILIS monitor, 27 subjects had at least two of the differences within 5 mmHg and none had any differences within 5 mmHg for SBP; 27 subjects had at least two of the differences within 5 mmHg and three subjects had no differences within 5 mmHg for DBP. The results are in concordance with the requested criteria for phase 2.2. CONCLUSION: Thus the AGILIS device fulfils the validation criteria of the international protocol.

Adult↗
PubMed2006

Infradian awake and asleep systolic and diastolic blood pressure rhythms in humans.

BACKGROUND: Blood pressure shows 24-h rhythms with a significant seasonal fluctuation. OBJECTIVES: To characterize 2-month to 12-month infradian rhythms in the mean awake and asleep systolic blood pressure (SBP) and diastolic blood pressure (DBP) in humans. METHODS: A total of 1689 participants underwent 24-h ambulatory blood pressure monitoring during different periods of the year. The mean daily temperature, humidity, barometric pressure and wind velocity values for the same time span and geographical location were obtained. Fourier analysis was used to fit 12-month, 6-month, 4-month, 3-month and 2-month rhythms to the mean awake and asleep SBP and DBP and to metereological variables. RESULTS: The awake mean SBP and DBP values showed significant 12-month and 3-month rhythms (respectively, R2 = 55%, P < 0.001 and R2 = 45% P < 0.001), with a peak in July (winter) and a trough-peak difference of 6.2 +/- 1.6 mmHg (P < 0.001, SBP) and 4.2 +/- 1.5 mmHg (P < 0.001, DBP). In contrast, asleep blood pressure means showed mainly 3-month rhythms (SBP, R2 = 19%, P < 0.02; DBP, R2 = 43% P < 0.02). Mean daily temperature and humidity showed at 12-month, 6-month, 4-month, 3-month and 2-month rhythms, barometric pressure showed 12-month and 6-month rhythms, and wind velocity showed 12-month and 3-month rhythms. Minimal temperature values and maximal humidity values coincided with elevated blood pressure values. CONCLUSION: Awake blood pressure means exhibited mainly circannual fluctuations while asleep blood pressure means showed principally 3-month rhythms. Infradian blood pressure variations correlated with some meteorological variables.

Aged↗
PubMed2005

Is the area under blood pressure curve the best parameter to evaluate 24-h ambulatory blood pressure monitoring data?

BACKGROUND: Ambulatory blood pressure monitoring (ABPM) provides relevant data about blood pressure over a 24-h period. The analysis of parameters to determine the blood pressure profile from these data is of great importance. OBJECTIVES: To calculate areas under systolic and diastolic blood pressure curves (SBP-AUC/DBP-AUC) and compare with systolic and diastolic blood pressure load (SBPL/DBPL) and 24-h systolic and diastolic blood pressure (24-h SBP/24-h DBP) in order to determine which provides the best correlation with left ventricular mass index (LVMI). METHODS: ABPM measurements (1143 individuals) were analyzed to obtain 24-h SBP/24-h DBP, SBPL/DBPL, and SBP-AUC/ DBP-AUC, using Spacelabs (90207) and CardioSistemas devices. Left ventricular mass was determined using an echocardiograph HP Sonos 5500 and LVMI was calculated. RESULTS: The correlations between all possible pairs within the group 24-h SBP/SBPL/SBP-AUC and 24-h DBP/DBPL/DBP-AUC were high and statistically significant. The correlations between 24-h SBP/24-h DBP and SBP-AUC/DBP-AUC with SBPL/DBPL close to 100%, were lower than those mentioned above. The correlations of the parameters obtained by ABPM with LVMI were also high and statistically significant, except for blood pressure load between 90 and 100%, and for 24-h SBP of 135 mmHg or less and SBPL higher than 50%. CONCLUSIONS: SBPL/DBPL and SBP-AUC/DBP-AUC can be used for the evaluation of ABPM data owing to the strong correlation with 24-h SBP/24-h DBP and with LVMI, except when SBPL is close to 100% or 24-h SBP is below 135 mmHg but SBPL is above 50%. SBP-AUC/DBP-AUC, however, are a better alternative because they do not have the limitations of blood pressure load or even of 24-h blood pressure present.

Adult↗
PubMed1989

An Auxin-Regulated Gene of Arabidopsis thaliana Encodes a DNA-Binding Protein.

We have isolated a single-copy gene from the plant Arabidopsis thaliana, called dbp, which encodes a lysine-rich, DNA-binding protein. The Dbp protein has a molecular weight and a composition resembling histone H1. When the dbp gene was expressed in bacteria, the protein product bound DNA nonspecifically. The dbp gene is expressed constitutively in all parts of the plant but is induced five times above this basal level in apical zones. In vitro hormone-depletion experiments showed that the expression in the shoot apex could be induced by exogenous auxin. In situ hybridizations in the root apex indicated that the expression of dbp is enhanced in the region of cell division.

Journal Article↗