Blood Pressure Distribution Research Articles

Trends of Blood Pressure Distributions in a Northeast Rural Japanese Population

In Japan recently there has been a rapid change in living and eating patterns along with accelerated urbanizations in rural communities. This provides an unique opportunity to observe a critical natural experiment of change in both risk factors and disease. Data on blood pressures and time trends were obtained in population-based surveys conducted in rural Japan ; the first survey from 1963-66, the second from 1972-75, and the third from 1980-83. This report describes the population trends over 20 years for blood pressure distributions and its related factors. Between the 1960s and the 1970s, the prevalence of a higher blood pressure level declined although no remarkable shift of the blood pressure distribution was observed. However, between the 1970s and the 1980s, there was a significant downward shift of the blood pressure distribution. The decline in blood pressure between the 1960s and 1970s was primarily related to a fall in the prevalence of elevated blood pressure, attributable in turn to the greater use of anti-hypertensive medications and improved blood pressure control. In contrast, the large downward shift in the whole blood pressure destributions between the 1970s and the 1980s was attributable partly to improved hypertension control and apparently also to changes in environmental factors of associated behaviors that affected the whole distribution. The correlation between blood pressure and relative weight index was weak in the 1960s but became stronger in the 1970s and the 1980s. The significant blood pressure trend in a whole population are consistent with the reported decline in stroke incidence in this population. J Epidemiol, 1993; 3 : 63-70.

Syndrome X

Using cross-sectional and longitudinal analysis of data from the San Antonio Heart Study, syndrome X (primary insulin resistance syndrome) has been redefined in terms of hyperinsulinaemia combined with changes in glucose tolerance, lipid pattern, blood pressure and body fat distribution. Syndrome X is itself an atherogenic cardiovascular risk factor, which interacts with environmental and genetic factors to lead to the eventual development of the endpoint of cardiovascular disease.

Dissociation of Hypertension and Genetically Enhanced Cell Growth Capacity in Skin Fibroblasts of F2 Hybrid Spontaneously Hypertensive Rats /Wistar-Kyoto Rats

Skin fibroblasts from newborn spontaneously hypertensive rats (SHR) grow faster in culture than Wistar-Kyoto rat (WKY) cells. Similar results have been described for vascular smooth muscle cells from prehypertensive and adult SHR. This suggests the existence of an intrinsic abnormality in vascular and nonvascular cells of mesodermal origin affecting cell growth control in those rats. In an attempt to determine the relation between high blood pressure and this trait, we cultured skin fibroblasts from adult SHR, WKY, F1, and F2 hybrid SHR/WKY populations by explant technique. Their growth capacity was determined by culture well DNA doubling time and by [3H]thymidine incorporation. Adult SHR fibroblasts grew more quickly (doubling time [DT] = 37.2 +/- 2.3 h, n = 8) than WKY ones (DT = 53.9 +/- 3.6 h, n = 6). Female SHR were crossed with male WKY to produce an F1 and an F2 hybrid generation presenting a Mendelian distribution of blood pressure. Skin fibroblasts were cultured from 21 rats belonging to the highest and the lowest blood pressure groups. No difference was observed between the two groups in either growth (DT = 47.5 +/- 4.1 h, n = 11 v DT = 44.6 +/- 3.2 h, n = 10) or epidermal growth factor-induced [3H]thymidine incorporation. These observations suggest that the increased growth capacity observed in SHR is not a determinant of high blood pressure initiation but may be involved in early cardiovascular enlargement.

Resting blood pressure and cardiovascular response to sympathetic stimulation in adolescents

The prevalence of significant hypertension in childhood may be higher than expected. We have measured sitting blood pressure in 168 11-yr-old children attending a pre-high school in the Neapolitan area on four occasions over a 3-month period. We have also measured blood pressure and heart rate during a mental arithmetic test and during isometric exercise. Prevalence of significant hypertension (diastolic blood pressure 82–90 mmHg) was 13% at the first visit and decreased to 6.5% at the last visit; prevalence of severe hypertension (diastolic blood pressure ≧ 90 mmHg) decreased from 5.4% to 1.2% from the 1st to the 4th visit. No sex-related difference was observed. A more frequently positive family history of hypertension (50% vs 30% in the fifth and first quintile of blood pressure, respectively) and higher body weight (body mass index = 21.4 vs 19.3 kg/m 2) were found in children in the 5th quintile of blood pressure distribution. Blood pressure increased during mental arithmetic by 10 13 % of the resting values in the first quintile and by 6 11 % in the last one during mental test; during handgrip the increase was of 20 37 % and 24 46 %, respectively: differences between quintiles did not reach statistical significance. These data show that about 8% of a Neapolitan sample of school population have high blood pressure levels, while no difference in vascular reactivity to sympathetic stimulation was detected in children with higher blood pressure.

Sex, cardiac hypertrophy and diurnal blood pressure variations in essential hypertension

To test the hypothesis of a difference between men and women in the left ventricular hypertrophic response to diurnal variations of ambulatory blood pressure in essential hypertension. Non-invasive ambulatory blood pressure monitoring and echocardiography in untreated hypertensive patients and healthy normotensive subjects. Community-based ambulatory population in tertiary care centers. Two hundred and sixty hypertensive patients and sixty-three healthy normotensive subjects. Patients with average daytime systolic blood pressure (SBP) and diastolic blood pressure (DBP) falling by less than 10% during the night were defined as non-dippers, the others as dippers. In the hypertensive group, dippers and non-dippers did not differ, in either gender, in several covariates possibly affecting left ventricular structure, including daytime ambulatory blood pressure, prevalence of white coat hypertension, age, body mass index, family history and known duration of hypertension, funduscopic changes, diabetes, alcohol consumption and renal function. Left ventricular mass (LVM) did not differ between dippers and non-dippers in hypertensive men whilst in hypertensive women it was significantly lower in dippers than in non-dippers. This sex difference held for all quartiles of the distribution of mean daytime blood pressure. In hypertensive women there was an inverse correlation between LVM and the per cent reduction of SBP and DBP from day to night, but this relationship was absent in hypertensive men. Other indices of left ventricular structure differed between dippers and non-dippers in both genders, as did LVM. For any level of daytime ambulatory blood pressure, a reduction of SBP and DBP by less than 10% from day to night identifies a subset of hypertensive patients at increased risk of left ventricular hypertrophy only in the female gender. These data suggest that, compared with men, hypertensive women require a longer duration of exposure to high blood pressure levels during the 24 h to develop left ventricular hypertrophy.

Dipyridamole-induced capillary growth in normal and hypertrophic hearts.

Chronic increases in myocardial blood flow have been shown to stimulate capillary proliferation in normal growing hearts. It is unknown, however, if elevated myocardial blood flow stimulates precapillary and/or capillary growth in hearts undergoing hypertrophy. Accordingly, renal hypertension was produced in rabbits (Page, 1-kidney, 1-wrap model) in which one group of Page (n = 9) and one group of normotensive sham (n = 10) rabbits were given dipyridamole (4.0 mg/kg sc) twice daily for 2 mo. Another group of Page (n = 7) and sham (n = 12) rabbits received vehicle injections. In separate acute studies performed on conscious rabbits, this does of dipyridamole increased myocardial blood flow 35-60% over time without altering transmural distribution of flow or systemic blood pressure. Two months later, minimal coronary vascular resistance (MCVR/100 g) was calculated from perfusion during maximal coronary vasodilation in conscious animals. Histomorphometric methods were then utilized to evaluate various indexes of capillarity in perfuse-fixed hearts. Systolic pressure and left ventricle weight-to-body weight ratios were significantly higher in Page vs. sham rabbits; dipyridamole treatment did not alter these parameters within either group. Similarly, dipyridamole treatment did not significantly alter MCVR/100 g values in either normotensive or hypertensive rabbits. In contrast, dipyridamole treatment increased endomyocardial capillary length density by 33% in the hypertensive group (P less than 0.05) and 11% in the sham group (P not significant) compared with the respective vehicle-treated rabbits. In addition, intercapillary distance was significantly reduced in the endomyocardial region of both groups receiving dipyridamole injections.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood pressure in first 10 years of life: the Brompton study.

To determine the normal range of blood pressure and its pattern of change in the first 10 years of life. To estimate at what age (if any) children consistently appear in one part of the blood pressure distribution and at what age familial correlations in blood pressure become significant. Longitudinal cohort study. South east England. 2088 children of both sexes born consecutively in Farnborough Hospital, Kent, and their parents. Blood pressure measured by Doppler ultrasonography and sphygmomanometry. Systolic blood pressure rose from a mean of 88.5 mm Hg at age 6 months to 96.2 mm Hg at 8 years measured with a 8 cm cuff and from 89.1 mm Hg at age 5 years to 94.3 mm Hg at age 10 years measured with a 12 cm cuff. The larger cuff gave blood pressure readings about 6 mm Hg lower. This effect was independent of body weight and arm circumference. Diastolic blood pressure rose from 57.8 mm Hg at 5 years to 61.8 mm Hg at 10 years (12 cm cuff). There was only about 1 mm Hg difference between sexes. Blood pressure was correlated with weight, weight adjusted for height, height, and arm circumference at all ages studied. The correlation coefficient of repeated yearly measurements increased steadily with age from 0.28 at 2 years to 0.59 at 10 years. The correlation coefficients between child's blood pressure and mother's average blood pressure increased from 0.1 at age 1 year to 0.23 at age 10. Blood pressure changes relatively little between the ages of 6 months and 10 years. Yet because of the increasing strength of between occasion and family correlations, children are more consistently occupying a specific part of the blood pressure distribution as they grow older. Studies in children should help determine why some adults have hypertension and others do not.

Microvascular network architecture in a mammary carcinoma.

The distribution of blood flow in a given tumor regulates the exchange and uptake of relevant molecules in chemo-, immuno-, and radiation therapy, thereby determining the efficacy of present day cancer treatments. Because it plays a significant role in heat transfer, the distribution of blood flow is also important in both thermographic detection and hyperthermia treatment [1, 2]. But what determines the distribution of blood flow in a microvascular network? In both normal and pathologic tissues, blood flow through a vascular bed is determined by several factors including the vascular network topology and the dimensions of the blood vessels. Previous workers have made qualitative comparisons of host and tumor vasculature including both animal tumors (for review see [3]) as well as human tumor xenotransplants [4]. To date, however, there exists no quantitative data describing the microvascular network architecture of any tumor type. If such data can be obtained, then a network model capable of predicting the blood pressure and flow distribution in a given tumor can be constructed, thus allowing insight into growth rate variability among tumors and the mechanisms governing current cancer therapies. Below is a brief presentation of the results of such a quantitative analysis of the vascular network topology in a mammary adenocarcinoma from Less et al. [5].KeywordsTumor VasculatureTumor Blood FlowVessel LengthBranch AngleVessel DimensionThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

157. Relationship of erythrocyte lithium-sodium counter-transport to blood pressure, adiposity and body fat distribution

157. Relationship of erythrocyte lithium-sodium counter-transport to blood pressure, adiposity and body fat distribution

91173444 Blood pressure, metabolic variables and adipose tissue distribution in pre- and post-menopausal women

91173444 Blood pressure, metabolic variables and adipose tissue distribution in pre- and post-menopausal women

Blood pressure and high blood pressure. Aspects of risk.

This report deals with three aspects of risk related to blood pressure and high blood pressure. The first aspect of risk concerns distributions of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the adult population and their relation to long-term risk of morbidity and mortality. By middle age, only a minority (about 20%) of Americans have optimal SBP and DBP levels, less than 120 mm Hg and less than 80 mm Hg, respectively. For the majority with higher levels, risks of major clinical events, including death from cardiovascular diseases and from all causes, are markedly increased. The relations of SBP and DBP with risk are strong, continuous, and graded. Risk is sizable not only for persons with high blood pressure by usual clinical criteria (SBP greater than or equal to 140 mm Hg or DBP greater than or equal to 90 mm Hg), but also for those with "high-normal" blood pressure (e.g., SBP 130-139 mm Hg or DBP 80-89 mm Hg). Thus, the blood pressure problem is a population-wide one and requires for its control a combined population-wide and high-risk strategy. A major component of this strategy must be nutritional-hygienic measures for the primary prevention of the rise in blood pressure during adulthood and of high blood pressure (i.e., primary prevention not only of the complications of high blood pressure but also of high blood pressure itself) through improved lifestyles having the potential to shift downward the blood pressure distribution of the whole population. The second aspect of risk concerns the known risk factors (i.e., aspects of modern lifestyle) leading to the mass occurrence of blood pressure rise during adulthood and of high blood pressure. These risk factors are high salt intake, high dietary sodium/potassium ratio, calorie imbalance and resultant obesity, and high alcohol intake. The extensive data base establishing the role of these common traits in the etiology of the blood pressure/high blood pressure problem is the scientific foundation for efforts to achieve the primary prevention of high blood pressure. The third aspect of risk relates to the combined impact of other risk factors along with blood pressure-high blood pressure in markedly increasing the probabilities of morbidity and mortality (e.g., "rich" diet, diet-dependent serum cholesterol and uric acid, smoking, diabetes, and target-organ damage). Prevention and control of lifestyle-related traits are essential components of the strategy for dealing with the blood pressure-high blood pressure problem.

The costs of treating hypertension — an analysis of different cut-off points

In this article the effects of different cut-off points for hypertension treatment are analysed, with respect to treatment costs. A theoretical blood pressure distribution is used to calculate the potential annual cost of treating all persons in Sweden above certain cut-off points for drug treatment. A lowering of the cut-off point from 105 mm Hg to 100 mm Hg diastolic blood pressure could potentially lead to an increase in annual costs of approximately £80m. Further lowering from 100 to 95 mm Hg in turn could increase annual costs by about £110m. The potential annual cost of treating all persons (roughly 1.6million) with a diastolic blood pressure of ≥95 mm Hg with drugs is calculated as being roughly £40 per inhabitant in Sweden. The Swedish cut-off point for treatment (95 mm Hg) can be expected to lead to roughly 50 per cent higher treatment costs than the British cut-off point (100 mm Hg).

Blood Pressure and Skin Color

To the Editor.— Klag et al1have presented interesting data about the distribution of blood pressure in US blacks. However, their analysis may have failed to consider the striking effect that the city of residence had on their blood pressure observations. The mean blood pressure in Savannah, Ga, for example, was 10/6 mm Hg higher than it was in Pueblo, Colo (Klag et al, Table 2, p 600). By way of comparison, there is a somewhat smaller difference in mean blood pressures, only 5/5 mm Hg, between subjects at the highest and lowest quartiles of skin color (unadjusted data; Table). Since the city of residence was associated both with skin color (the risk factor under examination) and with blood pressure (the outcome variable), it would have been appropriate for Klag et al to include the city of residence among the variables in their multivariate analysis. It is not clear

Normal and Elevanted Blood Pressure Among Gaziantep Residents

The goal of this study is to determine the normal distribution of blood pressure and prevalence of hypertension among Gaziantep residents with the collaboration of Gaziantep University Medical Faculty Department of lnternal Medicine and National Office of Health in Gaziantep, 1992. Blood pressure was measured totally 4874 persons in Gaziantep city and its towns, The prevelance of hypertension was found 23, 1 %. Among that hypertensive persons 57.4% of them had mild, 25.1 % of them had moderate and 17.4% of them had severe elevated of blood pressure. Obesity. dietary habit and smoking was the most important factors affected blood pressure at this region. it is thought that more investigation is necessary for lowering cardiovascular mortality.

Regression of Left Ventricular Hypertrophy with 1 Year of Antihypertensive Treatment in Type 1 Diabetic Patients with Early Nephropathy

M-mode echocardiograms were recorded in 22 Type 1 diabetic patients with microalbuminuria (n = 10) or early persistent proteinuria (n = 12). Eight (36%) had both an increased left ventricular mass (males greater than 131 g m-2; females greater than 100 g m-2) and a systolic blood pressure above the 75th centile of the normal blood pressure distribution. These eight patients were treated with antihypertensive drugs, predominantly enalapril, for 1 year. Echocardiograms were repeated after 3 and 12 months. Systolic blood pressure at recruitment was 155 +/- 14 (+/- SD) mmHg, and was significantly lower after 3 months (146 +/- 12 mmHg; p less than 0.05) and 12 months (139 +/- 8 mmHg; p less than 0.005). Diastolic blood pressure did not change significantly. Both intraventricular septal width and left ventricular posterior wall thickness fell progressively and were significantly lower after 12 months treatment (15.0 +/- 2.7 vs 13.0 +/- 2.6 mm, and 10.3 +/- 1.9 vs 8.8 +/- 1.3 mm; both p less than 0.05). Left ventricular mass index was 148 +/- 29 g m-2 at recruitment, but lower after 3 months (131 +/- 25 g m-2; p less than 0.05) and 12 months (132 +/- 26 g m-2; p less than 0.005) antihypertensive therapy.

157. Relationship of erythrocyte lithium-sodium counter-transport to blood pressure, adiposity and body fat distribution

Strazzullo, Pasquale; Trevisan, Maurizio; Cappuccio, Francesco P.; Barba, Gianvincenzo; Jossa, F.; Pagano, Ermenegilda; Mancini, Mario Author Information

Discriminant Analysis of Transmission of Elevated Blood Pressure in First Generation Offspring of African Green Monkeys

A linear discriminant analysis was applied to blood pressure data of 162 first generation colony-born offspring of normotensive (C), hypertensive (H), or borderline hypertensive (B) African green monkeys who were being selectively bred in an attempt to establish a strain of spontaneously hypertensive monkeys. The offspring were classified according to their parents' blood pressures as CC, HH, or Mixed (e.g. HC). Blood pressures were measured by indirect methods from unanesthetized offspring aged 0.5-6 years of age. The discriminant score was used to classify each of the 533 blood pressure measurements of the CC, Mixed, and HH offspring into one of three predicted groups: normotensive, borderline hypertensive, or hypertensive. The group means of the three predicted groups compared without regard to offspring type were significantly different (p less than .001). In addition, the percentage of blood pressure measurements predicted to be normal or elevated differed among the three offspring groups (p less than .001). 82% of the blood pressure measurements from CC offspring were classified as normotensive, compared with 58% and 40% of the blood pressure measurements from the Mixed and HH groups, respectively. In contrast, 25% of the blood pressure measurements from the HH groups were classified as hypertensive, compared with 10% and 4% from the Mixed and CC groups, respectively. Blood pressures of the normotensive, borderline hypertensive, and hypertensive subgroups derived from the CC group were consistently and significantly lower (p less than .001) than their respective counterparts in the Mixed and HH groups. The results of the discriminant analysis indicate a trimodal distribution of blood pressures in the first generation offspring and a significant separation of blood pressures among the offspring after a single generation.

Effect of age on the efficacy of blood pressure treatment strategies.

To study whether the proportion of excess cardiovascular events attributable to various levels of systolic blood pressure varies with age, we calculated the population-attributable risk of all-cause mortality, fatal and nonfatal cardiovascular events (stroke, coronary heart disease, angina, congestive heart failure, and peripheral vascular disease), and stroke incidence due to systolic blood pressure in men and women 45 years of age or older in the United States during 1980. Our estimates are based on US census counts, blood pressure prevalence distributions from the second National Health and Nutrition Examination Survey, and the annual risk of cardiovascular complications during 18 years of follow-up in the Framingham cohort. We then determined the impact of age on the relative efficacy of mass treatment and case-finding strategies in preventing systolic blood pressure-related events. At 45-54 years of age, only 30-40% of systolic blood pressure-related excess events occur in hypertensive individuals (systolic blood pressure greater than or equal to 160 mm Hg). With increasing age, however, the percentage of systolic blood pressure-related events that occur in hypertensive individuals rose substantially; in the older age group (greater than or equal to 75 years), 65-70% of fatal and nonfatal cardiovascular disease events occur in hypertensive persons. The pattern is similar for men and women. The potential impact of a mass treatment strategy designed to shift the distribution of blood pressure downward by a small amount is greater in younger than in older groups, whereas an opposite trend is seen for a high-risk, hypertensive case-finding and treatment approach.(ABSTRACT TRUNCATED AT 250 WORDS)

Reflections on the U.S. preventive services task force recommendations for screening for hypertension and hypercholesterolemia

The U.S. Preventive Services Task Force recommendations for screening for hypertension and high blood cholesterol are generally consistent with preexisting national guidelines promulgated by the Joint National Committee for Detection, Evaluation, and Treatment of High Blood Pressure and the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Cholesterol in Adults. While a welcome addition to the armamentarium of the clinician, the Task Force recommendations represent only a partial solution to our current epidemic of blood-pressure- and cholesterol-related cardiovascular disease. A meaningful reduction in society's burden of cardiovascular disease can be achieved only by complementing the Task Force recommendations with community-based mass treatment strategies aimed at shifting the distribution of blood pressure and cholesterol toward a biologically more normal pattern.

Blood pressure distribution in a school-age population aged 8-10 years: the Odense Schoolchild Study

This paper describes the distribution of systolic and diastolic blood pressures in a homogeneous population of 1330 schoolchildren (81% of the eligible population) aged 8-10 years in Odense, Denmark. A single blood pressure measurement was made. No significant difference in mean blood pressure between the sexes could be demonstrated. A significant age-related increase in systolic blood pressure of 4.4 mmHg/year and in diastolic blood pressure of 3.4 mmHg/year was observed. Weight and the heart rate were important determinants of blood pressure level. Other positive determinants were age and triceps skinfold thickness. There was a significant association between diastolic blood pressure and sexual maturation, which seemed to depend on body weight.