Journal of hypertension

Publications in this journal

• Article: The difficult art of detecting left ventricular hypertrophy in obesity: not all ECG criteria are created equal.

  Giuseppe Schillaci, Francesca Battista, Giacomo Pucci
  Journal of hypertension 06/2013; 31(6):1272.
• Article: Renal angioplasty for treatment of hypertensive patients with fibromuscular dysplasia. No country for old men.

  Alberto Morganti, Chiara Lonati
  Journal of hypertension 06/2013; 31(6):1091-3.
• Article: Letter on 'Sodium-dependent modulation of systemic and urinary renalase expression and activity in the rat remnant kidney'.

  Janete Quelhas-Santos, Manuel Pestana
  Journal of hypertension 06/2013; 31(6):1274-5.
• Article: Positive association between testosterone, blood pressure, and hypertension in women: longitudinal findings from the Study of Health in Pomerania.

  Benedict Ziemens, Henri Wallaschofski, Henry Völzke, Rainer Rettig, Marcus Dörr, Matthias Nauck, Brian G Keevil, Georg Brabant, Robin Haring
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  ABSTRACT: : The association between sex hormones and blood pressure (BP) in women has been investigated mostly in cross-sectional studies yielding inconsistent results. : Data from 1428 women from the population-based Study of Health in Pomerania were used. Associations of total testosterone, androstenedione, sex hormone-binding globulin (SHBG), and free testosterone concentrations with BP and hypertension were analyzed in multivariable cross-sectional and longitudinal regression models in the full sample and stratified by menopausal status. : A positive association between total testosterone and BP was revealed in the full sample [SBP: β per standard deviation (SD) increase: 3.22; pulse pressure (PP): β per SD increase: 2.30] and among postmenopausal women (DBP: β per SD increase: 3.33; SBP: β per SD increase: 7.11; PP: β per SD increase: 3.77). Longitudinal analyses also showed a positive association between baseline total testosterone and follow-up BP. Furthermore, low total testosterone concentrations were associated with a decreased risk of prevalent hypertension in all women [relative risk (RR) quartile 1 (Q1) vs. Q4, 0.79; 95% confidence interval, CI 0.67-0.94]. Low SHBG was associated with prevalent hypertension in postmenopausal women (RR 1.27; 95% CI 1.06-1.53) and with incident hypertension in the full sample (RR 1.73; 95% CI 1.10-2.75). : The present population-based study is the first to show a consistent positive association between total testosterone and BP in both, cross-sectional and longitudinal analyses, suggesting high total testosterone as a risk marker of increased BP, as well as prevalent hypertension in women.
  Journal of hypertension 06/2013; 31(6):1106-13.
• Article: Protein intake in type 1 diabetes: putting controversies into perspectives.

  Fabio Angeli, Gianpaolo Reboldi, Paolo Verdecchia
  Journal of hypertension 06/2013; 31(6):1086-90.
• Article: Hypertension-related target organ damage: is it a continuum?

  Stefano Perlini, Guido Grassi
  Journal of hypertension 06/2013; 31(6):1083-5.
• Article: Letter on 'Sodium-dependent modulation of systemic and urinary renalase expression and activity in the rat remnant kidney'.

  Jolanta Malyszko, Ewa Koc-Zorawska, Maciej Banach, Michal Mysliwiec
  Journal of hypertension 06/2013; 31(6):1272-3.
• Article: Sexual activity and function among middle-aged and older men and women with hypertension.

  Erica S Spatz, Maureen E Canavan, Mayur M Desai, Harlan M Krumholz, Stacy T Lindau
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  ABSTRACT: OBJECTIVE:: To determine the association of hypertension (HTN) and its treatment with sexual function in middle-aged and older adults. METHODS:: We studied a nationally representative sample of community-residing adults aged 57-85 years (n = 3005) from the National Social Health, Life and Aging Project. Adults were categorized by HTN status (treated, untreated, and no HTN). Antihypertensive medication use was classified into calcium channel blocker; β-blocker; angiotensin-converting enzyme inhibitor/angiotensin receptor blocker; diuretic; and α-blocker. For each HTN and medication group, we determined the prevalence and adjusted odds of being sexually active and of having any sexual problem. RESULTS:: Among men, comparing treated HTN with untreated HTN and no HTN, sexual activity was less prevalent (66.5 vs. 75.9 vs.71.5%, P <0.01) and sexual problems were more prevalent (69.1 vs. 57.7 vs. 54.3%; P ≤ 0.01). There was no association between treated HTN and sexual activity [odds ratio, OR = 0.86 (95% confidence interval 0.51-1.45)] and a nonsignificant association between treated HTN and sexual problems [OR = 1.49 (0.94-2.37)]. Among women, the prevalence of sexual activity was lower in the treated and untreated HTN groups than the no HTN group (35.2 vs. 38.3 vs. 58.0%, P <0.01); the prevalence of sexual problems was similar (73.7 vs. 65.3 vs. 71.7%; P = 0.301). Women in the treated HTN [OR = 0.61 (0.39-0.95)] and untreated HTN [0.54 (0.30-0.96)] groups had a lower odds of sexual activity compared with no HTN. There were no significant associations between antihypertensive medication class and sexual activity or problems in men or women. CONCLUSION:: The relationship between HTN and sexual health is different for older men and women. Prospective, comparative effectiveness trials are needed.
  Journal of hypertension 06/2013; 31(6):1096-1105.
• Article: Diurnal variation in excitation-contraction coupling is lost in the adult spontaneously hypertensive rat heart.

  Helen E Collins, Helen E Turrell, Nilesh J Samani, Glenn C Rodrigo
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  ABSTRACT: : Excitation-contraction coupling of the normotensive rat heart exhibits a time-of-day variation in its response to isoproterenol (ISO), with a decrease during the animal's active period. Pressure-induced hypertrophy is known to adversely affect the circadian clock in the heart and this study sets out to determine whether this alters the time-of-day variation in E-C coupling. : Hearts from juvenile (6-8 week) and adult (24-28 week) spontaneously hypertensive rats (SHRs) and normotensive Wistar-Kyoto (WKY) rats were isolated during the animals active and resting periods. Left ventricular developed pressure (LVDP) recorded from isolated perfused adult SHR hearts did not show the night-time dip in response to ISO that was present in normotensive hearts. Left ventricular myocytes isolated from juvenile WKY and SHRs during the resting period had a higher systolic [Ca]i and faster rate of decay of the Ca- transient, under basal conditions and in response to 10 nmol/l ISO, than the active period. LV-myocytes isolated from adult WKYs had a similar time-of-day variation in their Ca-transient. However, LV-myocytes from adult SHRs had lost this diurnal variation in both basal systolic [Ca]i and in response to ISO. Adult SHR hearts were hypertrophic in comparison to age-matched WKYs, had disrupted cycling of the circadian genes CLOCK and Per2, and this was matched by depressed nNOS cycling. : The dip in response of the heart to ISO stimulation during the animal's active period is absent in adult SHRs. This may result from disruption to the circadian clock mechanism, which depresses the cycling of nNOS expression.
  Journal of hypertension 06/2013; 31(6):1214-23.
• Article: Occult chronic kidney disease among persons with hypertension in the United States: data from the national health and nutrition surveys 1988-1994 and 1999-2002.

  Carmen A Peralta, Cristin C Weekley, Yongmei Li, Michael G Shlipak
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  ABSTRACT: : Hypertension guidelines recommend screening for chronic kidney disease (CKD) using serum creatinine and urine dipstick; this strategy may lead to misclassification. Persons with occult CKD [i.e. missed by creatinine but detected by cystatin C or albumin-to-creatinine ratio (ACR)] have higher risks for death, cardiovascular events, and end-stage renal disease. : We studied occult CKD prevalence among nondiabetic, hypertensive adults in National Health and Nutrition Examination Survey 1988-1994 (N = 2088) and 1999-2002 (N = 737). We defined occult CKD as estimated glomerular filtration rate by cystatin C (eGFRcys) less than 60 ml/min per 1.73 m and/or ACR at least 30 mg/g among persons with eGFRcreat more than 60 ml/min per 1.73 m. We studied occult CKD prevalence by either marker, stratified by age, race/ethnicity, and assessed clinical predictors associated with occult CKD presence. : In 1988-1994, occult CKD was prevalent among 25% of nondiabetic hypertensive persons, and it was 22% in 1999-2002. Each marker's ability to detect occult CKD varied by age and race. Cystatin C detected occult CKD among 8.9% of persons more than 65 years, and among 3.8% of whites. ACR detected occult CKD among 9.3% of persons less than 45 years, 16.6% of Blacks, and 20.6% of Mexican-Americans. In multivariate models, each decade of advancing age was associated with a higher occult CKD prevalence by cystatin C (OR 3.1, 95% CI 2.5-3.8) in 1988-1994 and 1999-2002 (OR 2.9, 1.8-4.6). : Current hypertension guidelines may fail to detect a large proportion of high-risk individuals with CKD who can be identified by cystatin C or ACR. Future studies are needed to evaluate targeted use of multimarker renal panels among hypertensives.
  Journal of hypertension 06/2013; 31(6):1196-202.
• Article: Blood pressure control in the hypertensive population. Is the trend favourable?

  Giuseppe Mancia
  Journal of hypertension 06/2013; 31(6):1094-5.
• Article: Prevalence, awareness and risk factors of hypertension in a large cohort of Iranian adult population.

  Masoud M Malekzadeh, Arash Etemadi, Farin Kamangar, Hooman Khademi, Asieh Golozar, Farhad Islami, Akram Pourshams, Hossein Poustchi, Behrouz Navabakhsh, Mohammad Naemi, Paul D Pharoah, Christian C Abnet, Paul Brennan, Paolo Boffetta, Sanford M Dawsey, Alireza Esteghamati, Reza Malekzadeh
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  ABSTRACT: BACKGROUND:: There is considerable variation in hypertension prevalence and awareness, and their correlates, across different geographic locations and ethnic groups. We performed this cross-sectional analysis on data from the Golestan Cohort Study (GCS). METHODS:: Enrollment in this study occurred in 2004-2008, and included 50 045 healthy individuals from Golestan Province in northeastern Iran. Hypertension was defined as a SBP at least 140 mmHg, a DBP at least 90 mmHg, a prior diagnosis of hypertension, or the use of antihypertensive drugs. Potential correlates of hypertension and its awareness were analyzed by logistic regression adjusted for sex, age, BMI, place of residence, literacy, ethnicity, physical activity, smoking, black and green tea consumption and wealth score. RESULTS:: Of the total cohort participants, 21 350 (42.7%) were hypertensive. Age-standardized prevalence of hypertension, using the 2001 WHO standard world population, was 41.8% (95% confidence interval: 38.3-45.2%). Hypertension was directly associated with female sex, increased BMI, Turkmen ethnicity, and lack of physical activity, and inversely associated with drinking black tea and wealth score. Among hypertensive patients, 46.2% were aware of their disease, 17.6% were receiving antihypertensive medication, and 32.1% of the treated patients had controlled hypertension. Hypertension awareness was greater among women, the elderly, overweight and obese patients, and those with a higher wealth score. CONCLUSION:: Hypertension is highly prevalent in rural Iran, many of the affected individuals are unaware of their disease, and the rate of control by antihypertensive medications is low. Increasing hypertension awareness and access to health services, especially among less privileged residents are recommended.
  Journal of hypertension 05/2013;
• Article: Use of electronic health records to evaluate the quality of care for hypertensive patients in Mexican family medicine clinics.

  Svetlana V Doubova, Héctor Lamadrid-Figueroa, Ricardo Pérez-Cuevas
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  ABSTRACT: OBJECTIVES:: Patients with hypertension require life-long care and should be monitored to identify whether they are receiving the appropriate healthcare and reach their expected health outcomes. Our objectives were to develop quality of healthcare indicators (QCI) and evaluate the quality of care that hypertensive patients receive in family medicine clinics at the Mexican Institute of Social Security. METHOD:: We used a two-stage mixed methods approach: development of QCIs following the RAND-UCLA method; quality of care evaluation using electronic health record (EHR) data from 47 150 hypertensive patients who received care in 2009. We developed 15 QCIs, which were possible to construct using EHR data. The QCIs evaluated the process of care and health outcomes. RESULTS:: Most hypertensive patients were women (64%) more than 60 years old; 79% were overweight/obese and 31% had diabetes. On average, these patients attended regularly to the family doctor (≥7 visits a year); however, they received only 27% of recommended care. Among the hypertensive patients without comorbidity, 62% had achieved blood pressure (BP) control, whereas in the group of hypertensive patients with diabetes or chronic kidney disease, only 7% had achieved BP control. CONCLUSION:: EHR can become a source of information to evaluate routinely quality of care in developing countries that are beginning to modernize their health information systems.
  Journal of hypertension 05/2013;
• Article: Effect of depression onset on adherence to medication among hypertensive patients: a longitudinal modelling study.

  Noora Sjösten, Hermann Nabi, Hugo Westerlund, Paula Salo, Tuula Oksanen, Jaana Pentti, Marianna Virtanen, Mika Kivimäki, Jussi Vahtera
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  ABSTRACT: OBJECTIVES:: Although a link between depression and poor adherence to antihypertensive medication (AHM) has been found, it is not known whether depression actually leads to poorer adherence or whether poor adherence only is a marker of depression. In this study we aimed to determine the time order between hypertension, depression and changes in adherence to AHM. METHODS:: The analyses were based on data gathered from a longitudinal cohort of Finnish employees (The Finnish Public Sector Study). A total of 852 chronically hypertensive men and women at baseline with a recorded onset of depression during the 9-year observation window and 2359 hypertensive control participants matched for age, sex, socio-economic status, time of study entry, employer and geographic area were included in the study. Individuals with any sign of depression during 4 years before the beginning of the study were excluded. To describe long-term trajectories (4 years before and 4 years after the recorded depression) of AHM adherence in relation to the onset of depression, annual data on reimbursed AHM prescriptions were gathered from the national Drug Prescription Register. Annual nonadherence rates (i.e. number of 'days-not-treated') were based on filled prescriptions. RESULTS:: Among male cases, the rate of 'days-not-treated' was 1.52 times higher (95% confidence interval 1.08-2.14) in the years after the onset of depression compared to preonset levels. In women and in male controls, no change in adherence to AHM was observed between these time periods. CONCLUSION:: In hypertensive men, the onset of recorded depression increases the risk of nonadherence to AHM.
  Journal of hypertension 05/2013;
• Article: Sex differences in noninvasive vascular function in the community.

  Renate B Schnabel, Moritz P Biener, Sandra Wilde, Christoph R Sinning, Francisco M Ojeda, Tanja Zeller, Edith Lubos, Karl J Lackner, Ascan Warnholtz, Tommaso Gori, Christine Espinola-Klein, Stefan Blankenberg, Thomas Munzel, Philipp S Wild
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  ABSTRACT: OBJECTIVE:: The relation of noninvasive vascular function to sex, sex hormones, and reproductive history in the general population is little understood. METHODS:: We simultaneously assessed flow-mediated dilation (FMD) and peripheral arterial tonometry in 454 women (mean age 40.4 ± 16.1 years, age range 19-78 years) and 100 men (mean age 44.7 ± 15.3 years) in a community-based cohort. Plasma estradiol, progesterone, luteinizing hormone, and follicle stimulating hormones were measured, and menstrual cycle and reproductive history were recorded. RESULTS:: Vascular function was blunted in men as compared to women irrespective of menopausal status and adjustment for classical cardiovascular risk factors and hormones. Vascular reactivity changed during the menstrual cycle and correlated with estradiol concentrations for FMD, r = 0.13 and inversely with progesterone for pulse amplitude, r = -0.14, and brachial artery diameter, r = -0.10. Multivariable-adjusted regressions showed a relation of estradiol with FMD, β 0.658, 95% confidence interval (CI) 0.084/1.232, P = 0.025 in women. Age at menarche (β 0.070, 95% CI 0.039/0.101, P < 0.0001) and breastfeeding duration (β -0.006, 95% CI -0.011/-0.001, P = 0.036) were related to brachial artery diameter, age at menarche also to FMD (β -0.455, 95% CI -0.886/-0.023, P = 0.039). CONCLUSION:: Sex differences in noninvasive conduit and peripheral arterial function with better vascular reactivity in women were not fully explained by female sex hormones and menopausal status. Age at menarche and duration of breastfeeding were also related to vascular function and need further investigation.
  Journal of hypertension 05/2013;
• Article: Prevalence, awareness, and control of hypertension among Asian Indians living in urban Singapore and rural India.

  Wanfen Yip, Tien Y Wong, Jost B Jonas, Yingfeng Zheng, Ecosse L Lamoureux, Vinay Nangia, Charumathi Sabanayagam
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  ABSTRACT: BACKGROUND:: Hypertension is a major modifiable risk factor associated with cardiovascular morbidity and mortality. We compared the epidemiology of hypertension in South Asian Indians living in two geographic regions with vastly different socioeconomic settings (urban Singapore and rural India). METHODS:: We analyzed data from two large population-based studies: the Singapore Indian Eye Study (SINDI, n = 3228, aged 40-80 years, 49.2% women) and the Central India Eye and Medical Study (CIEMS, n = 3591, aged ≥40 years, 52.6% women). Hypertension was defined as SBP at least 140 or DBP at least 90 mmHg or self-reported history/treatment for hypertension. RESULTS:: The age-adjusted prevalence of hypertension in SINDI and CIEMS were 58.6 and 25.3%. After adjusting for potential confounders, increasing age, overweight/obese, and diabetes status showed a positive association and 'never drinking alcohol' showed a protective association with hypertension in both populations. Current smoking and being female showed a protective association and no formal education showed a positive association with hypertension in SINDI. Among those with hypertension in SINDI and CIEMS, 72.4 and 25.3% were aware of their condition of whom 85 and 31.6% were on treatment for hypertension. The blood pressure control was similar between the two populations (48.7% in SINDI and 46.9% in CIEMS). CONCLUSION:: The prevalence of hypertension, the level of awareness, and treatment for hypertension was higher in Indians living in Singapore than in rural Indians. Socioeconomic and metabolic factors explain some of the observed differences between the two populations, which may provide insights to develop public health strategies.
  Journal of hypertension 05/2013;
• Article: Silencing of Atp2b1 increases blood pressure through vasoconstriction.

  Young-Bin Shin, Ji Eun Lim, Su-Min Ji, Hyeon-Ju Lee, So-Yon Park, Kyung-Won Hong, Mihwa Lim, Mark I McCarthy, Young-Ho Lee, Bermseok Oh
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  ABSTRACT: BACKGROUND:: Recent genome-wide association studies (GWASs) have identified 30 genetic loci that regulate blood pressure, increasing our understanding of the cause of hypertension. However, it has been difficult to define the causative genes at these loci due to a lack of functional analyses. METHOD:: In this study, we aimed to validate the candidate gene ATP2B1 in 12q21, variants near which have the strongest association with blood pressure in Asians and Europeans. ATP2B1 functions as a calcium pump to fine-tune calcium concentrations - necessary for repolarization following muscular contractions. We silenced Atp2b1 using an siRNA complex, injected into mouse tail veins. RESULTS:: In treated mice, blood pressure rose and the mesenteric arteries increased in wall : lumen ratio. Moreover, the arteries showed enhanced myogenic responses to pressure, and contractile responses to phenylephrine increased compared with the control, suggesting that blood pressure is regulated by ATP2B1 through the contraction and dilation of the vessel, likely by controlling calcium concentrations in the resting state. CONCLUSION:: These results support that ATP2B1 is the causative gene in the blood pressure-associated 12q21 locus and demonstrate that ATP2B1 expression in the vessel influences blood pressure.
  Journal of hypertension 05/2013;
• Article: Vascular and parenchymal lesions along with enhanced neurogenesis characterize the brain of asymptomatic stroke-prone spontaneous hypertensive rats.

  Lidia Cova, Paolo Gelosa, Elena Mura, Alessandro Mauro, Marco Stramba-Badiale, Georgios Michailidis, Alessandra Colonna, Nadia E L Assawy, Alice Pignieri, Giuseppe Busca, Elena Tremoli, Vincenzo Silani, Luigi Sironi, Alberto Zanchetti
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  ABSTRACT: BACKGROUND AND OBJECTIVES:: Spontaneously hypertensive stroke-prone rats (SHRSPs) develop hypertension, cerebrovascular abnormalities and a stroke phenotype in association with higher levels of proteinuria. Here, we focus on cerebral abnormalities preceding lesions detectable by MRI. METHODS:: Longitudinal assessment of brain histology was performed in salt-loaded male SHRSPs (n = 26) and Wistar-Kyoto (WKY) normotensive control animals (n = 27). Groups of rats were sacrificed at different time points: Time 0, before the salt diet administration; Time 1, when proteinuria achieved 40 mg/day; Time 2, when proteinuria exceeded 100 mg/day. RESULTS:: At Time 0, no brain lesions were observed. At Time 1, changes of the cortical penetrating arteries, vasogenic oedema, lacunae and focal cell loss appeared in SHRSPs and worsened at Time 2, although no lesions were yet detected by MRI. Staining for proliferation markers revealed a significant boost of cellular mitosis in the subventricular zone (SVZ) of SHRSPs. Moreover, we observed higher immunopositivity for nestin, glial fibrillary acidic protein and doublecortin (markers for neural stem cells, astrocytes and immature neurons, respectively). At Time 2, apoptotic caspase-3 as well as 4-hydroxynonenal-positive neurons were associated to decreased nestin and doublecortin staining. High expression levels of glial fibrillary acidic protein were maintained in the SVZ. No comparative alterations and SVZ activation were recorded in WKYs. CONCLUSION:: Appearance of vascular changes in SHRSPs, before any MRI-detectable brain lesion, is coupled to active neural proliferation in the SVZ. With disease progression, only newborn astrocytes can survive, likely because of the neurotoxicity triggered by brain oedema and oxidative stress.
  Journal of hypertension 05/2013;
• Article: Assessing sodium sensitivity in clinical practice: new insights from ambulatory blood pressure monitoring data.

  Paolo Castiglioni, Paolo Coruzzi, Gianfranco Parati
  Journal of hypertension 05/2013; 31(5):870-3.
• Article: The need for hospitalization still represents a major burden for hypertensive patients and healthcare systems.

  Bernard Waeber, François Feihl
  Journal of hypertension 05/2013; 31(5):880-1.