Ambulatory Central Blood Pressure Research Articles

Reduction of central blood pressure after bathing in hot water-results of 24-hr ambulatory central blood pressure monitoring

Reduction of central blood pressure after bathing in hot water-results of 24-hr ambulatory central blood pressure monitoring

24 Hour central ambulatory blood pressure: usual values and relationship with markers of cardiovascular risk

24 Hour central ambulatory blood pressure: usual values and relationship with markers of cardiovascular risk

Cardiovascular and metabolic characteristics 40 years after hypertensive pregnancies

Maternal cardiovascular morbidity is increased after hypertensive pregnancies (HTP). The pathways from complicated pregnancies to future cardiovascular disease are complex. The aim of the present study was to test the hypothesis that different cardiovascular mechanisms are changed in women who experienced HTP four decades earlier in comparison to women with normotensive pregnancies. One hundred and five women (50 with hypertensive and 55 with normal pregnancies) were examined with anthropometric measurements; office blood pressure, ambulatory blood pressure and central blood pressure, pulse wave velocity, augmentation index, intimal-media thickness, echocardiography and laboratory measurements. In addition another 204 women were followed-up by a questionnaire regarding their pregnancy 40 years ago, as well as their present health status and medications. Women with HTP had more often diagnosed hypertension when compared with women with normal pregnancies (50 vs. 31%, respectively; P = 0.046), but the groups did not differ in any blood pressure levels. HTP were associated with higher pulse wave velocity (8.8 m/s vs. 7.8 m/s, P = 0.021), and higher levels of P-glucose (5.7 mmol/l vs. 5.2 mmol/l, P = 0.022), P-HbA1c (4.4% vs. 4.2%, P = 0.010) and noradrenaline (2.45 mmol/l vs. 2.11 mmol/l, P = 0.040) when compared with normotensive pregnancies. Women followed up with a questionnaire reported deteriorated cardiovascular health compared to women attending the clinical investigations of the study. HTP are associated with impairment in vascular function and metabolic status 40 years postpartum despite well controlled blood pressure levels.

Effect of Amiloride and Spironolactone on Renal Tubular Function and Central Blood Pressure in Patients with Arterial Hypertension during Baseline Conditions and after Furosemide: A Double-Blinded, Randomized, Placebo-Controlled Crossover Trial

This study demonstrates that the increased potassium content in the body seems to change both the blood pressure and renal tubular function. We wanted to test the hypotheses that amiloride and spironolactone induced potassium retention reduces ambulatory blood pressure (ABP) and central blood pressure (CBP) during baseline conditions and after furosemide and that the tubular transport via the epithelial sodium channels (ENaCs) and aquaporin-2 (AQP2) water channels was increased by furosemide in arterial hypertension. Each of three 28-day treatment periods (placebo, amiloride, and spironolactone) was completed by a 4-day period with standardized diet regarding calories and sodium and water intake. At the end of each period, we measured pulse wave velocity (PWV), central systolic blood pressure (CSBP), central diastolic blood pressure (CDBP), glomerular filtration rate (GFR), free water clearance (CH2O), fractional excretion of sodium (FENa) and potassium (FEK), urinary excretion of AQP2 (u-AQP2), urinary excretion of γ-fraction of the ENaC (u-ENaCγ), and plasma concentrations of renin (PRC), angiotensin II (p-Ang II), and aldosterone (p-Aldo) at baseline conditions and after furosemide bolus. Ambulatory blood pressure and CBP were significantly lowered by amiloride and spironolactone. During 24-hour urine collection and at baseline, GFR, CH2O, FENa, FEK, u-AQP2 and u-ENaCγ were the same. After furosemide, CH2O, FENa, FEK, u-AQP2, u-ENaCγ, PRC, p-Ang II, p-Aldo, PWV and CDBP increased after all treatments. However, during amiloride treatment, FEK increased to a larger extent than after spironolactone and during placebo after furosemide, and CSBP was not significantly reduced. The increases in water and sodium absorption via AQP2 and ENaC after furosemide most likely are compensatory phenomena to antagonize water and sodium depletion. Amiloride is less effective than spironolactone to reduce renal potassium excretion.Trial registration: ClinicalTrials.gov identifier: NCT0138088.

Relationship between 24 h ambulatory central blood pressure and left ventricular mass – Rationale and design of a prospective multicenter study

The prognostic superiority of ambulatory over clinic blood pressure has been repeatedly proven. However, due to the mechanical properties of the arterial system, systolic and pulse pressures are higher in the brachial artery than in the ascending aorta. It seems logical that central pressures are more relevant to cardiovascular disease than peripheral (brachial) pressures, and indeed, using clinic blood pressures, it has been shown that central systolic and pulse pressures are more closely associated with hypertensive end-organ damage than their brachial counterparts. Moreover, antihypertensive drugs can have differential effects on central versus brachial blood pressures. All these effects have been described on the basis of clinic blood pressure measurements. Recent advances in technology allow the estimation of central systolic blood pressure from brachial pulse waves recorded with a regular brachial oscillometric blood-pressure cuff, using a transfer-function like algorithm (ARCSolver). This method has been invasively validated and allows the recording of 24 h ambulatory central blood pressure profiles. Our multicenter study now aims for the first time to investigate the relationship between central ambulatory blood pressure monitoring and hypertensive end-organ damage (left ventricular mass) in untreated adults.

2.8 In Patients with Isolated Ambulatory Hypertension Central Blood Pressure and Augmentation Index are Increased: the VOBARNO Study

2.8 In Patients with Isolated Ambulatory Hypertension Central Blood Pressure and Augmentation Index are Increased: the VOBARNO Study

Randomised, Controlled, Cross-Over Trial of Soy Protein with Isoflavones on Blood Pressure and Arterial Function in Hypertensive Subjects

Objective: To examine the effects of dietary soy/isoflavones on 24 hr blood pressure profiles and arterial function [systemic arterial compliance (SAC), pulse wave velocity (PWV) and brachial arterial flow mediated vasodilation (FMD)] compared to non legume-based plant protein without isoflavones, in hypertensive subjects.Design: In a 6 month double-blind, placebo controlled, cross-over trial, 41 hypertensive subjects (26 men, 15 postmenopausal women), 30–75 years, received soy cereal (40 g soy protein, 118 mg isoflavones) and gluten placebo cereal, each for 3 months.Results: Thirty-eight subjects completed protocol with results expressed as mean or mean change (±SEM) with each intervention. Soy increased urinary isoflavones (daidzein: 8-fold; genistein: 8-fold; equol: 9-fold; ODMA: 18-fold) with no change during gluten placebo. There was no difference in the change in individual 24 hr ambulatory BP parameters (SBP: 2 ± 2 vs −1 ± 1 mmHg, p = 0.21; DBP: 1 ± 1 vs −1 ± 1 mmHg, p = 0.06) central BP (cSBP: −4 ± 2 vs 0 ± 2 mmHg, p = 0.2) or the change in arterial function (FMD: 0.3 ± 0.5 vs −0.2 ± 0.5%, p = NS; SAC: 0.02 ± 0.02 vs −0.02 ± 0.02 U/mmHg, p = NS; PWV central: −0.2 ± 0.2 vs 0.0 ± 0.2 m/sec, p = NS; PWV peripheral: 0.01 ± 0.3 vs −0.4 ± 0.4 m/sec, p = NS) noted between interventions. Analysis of the area under curve of 24 hr BP outputs demonstrated that soy protein compared to gluten protein resulted in higher 24 hr systolic BP by 2.3 mmHg (p = 0.003), a higher daytime systolic BP by 3.4 mmHg (p = 0.0002) and a higher daytime diastolic BP by 1.4 mmHg (p = 0.008). Overall 24 hr diastolic BP, night systolic BP and night diastolic BP were not significantly different between groups. Furthermore, soy protein compared to gluten protein resulted in higher 24 hr heart rates by 3.5 bpm (p < 0.0001).Conclusions: In hypertensive subjects, compared to gluten placebo, soy dietary supplementation containing isoflavones had no effect on arterial function, on average 24 hr ambulatory blood pressure parameters or central blood pressure in men and women with hypertension. Area under the curve of 24 hr profiles demonstrated that daytime BP was higher after soy compared to gluten.