Higher Diastolic Pressure Levels Research Articles

CLINICAL AND GENETIC DETERMINANTS OF PERINATAL PATHOLOGY IN NEWBORNS

One of the pressing issues of healthcare nowadays is applying methods of molecular genetics aimed at identifying and assessing genetic risk factors and early diagnosis of perinatal pathology. Numerous studies have contributed to identifying risk factors that affect the health of newborns. The aim of this work is to investigate the associations between the development of perinatal pathology in premature and full-term infants with polymorphism of genes of the glutathione transferase family (GSTT1, GSTM1, GSTP1), renin-angiotensin system (ACE, AGT2R1). Materials and methods. The study included 110 full-term infants with asphyxia, 30 healthy full-term infants for the control group, and 125 preterm infants with perinatal infections, 21 preterm infants with broncho-pulmonary dysplasia, and 70 conditionally healthy preterm infants. A set of routine clinical and laboratory methods of research and determining gene polymorphism was performed. Results. The presence of a non-functional allele of the GSTT1 gene and DD variant of the ACE gene in newborns is associated with the development of severe perinatal asphyxia (p = 0.006 and p = 0.003, respectively). Children with GSTT1 "-" and AC AG2TR1 genotypes have significantly higher levels of diastolic pressure in the first day after birth than children with functional genotypes of these genes (p <0.05). The median mean duration of mechanical ventilation and CPAP in children with GSTT1 genotype "-" was significantly higher than that in children with GSTT1 genotype "+" (p = 0.01 and p = 0.001, respectively). Conclusion. Polymorphism studies of glutathione transferase and renin-angiotensin genes can be used to predict the severity of a child's condition after birth.

Health-Related Quality of Life, Blood Pressure, and Biochemical and Anthropometric Profile in Vegetarians and Nonvegetarians.

Several studies have been carried out which mainly focus on the analysis of the lipid profile in vegetarians and nonvegetarians. However, few studies have been undertaken in this population oriented to quality of life and health. This study aimed to compare health-related quality of life, blood pressure, and biochemical and anthropometric profile in vegetarians and nonvegetarians. The study included 149 participants out of an initial sample of 162: 62 vegetarians and 87 nonvegetarians. Health-related quality of life was assessed with the SF-12 Health Questionnaire version 2 and was related with the lipid profile, glucose, blood pressure, anthropometric measures, and sociodemographic characteristics. Vegetarians presented better Body Mass Index (BMI) and waist circumference (WC), as well as higher LDL levels. No significant differences in HDL and TG concentrations were found. Serum glucose concentrations were significantly lower among vegetarians. Nonvegetarian males had higher diastolic pressure levels. Vegetarian women had significantly higher levels of systolic pressure. As for the physical health and mental health components of quality of life, no significant differences were found in vegetarian and nonvegetarian women and men. In conclusion, vegetarians presented a better anthropometric profile, lower glycaemia, and higher LDL levels but no significant differences in health-related quality of life compared with nonvegetarians.

The Benefit, Risks and Cost of Primary Stroke Prevention with Antihypertensive Drugs

The benefits of treatment with anti-hypertensive drugs not only include a reduction in stroke incidence of 40% but also a reduction in cardiac deaths, severe congestive heart failure, severe retinal changes and almost certainly a reduction in the incidence of angina. The risks depend on the drug employed and include gout and diabetes mellitus for diuretics and symptom side effects with all drugs. Certain drugs have been proven to impair the quality of life of treated patients. The cost of an extra year of life gained is lower in men, in the elderly and at higher levels of diastolic pressure. It is desirable to adjust the years of life gained by their quality (a cost-utility analysis) but such methods await good data. (Hypertens Res 1994; 17 Suppl. I: S115-S119)

Influence of age on the outcome of percutaneous angioplasty in atheromatous renovascular disease

We compared the efficacy and safety of percutaneous transluminal renal angioplasty for the treatment of renovascular disease in 66 patients. Thirty-four were aged less than 60 years, and 32 more than 60 years. The younger patients had a shorter known duration of hypertension and higher levels of diastolic pressure (6.4 +/- 9 years and 109 +/- 15 mmHg) than the older patients (12.8 +/- 8 years and 101 +/- 11 mmHg, P less than 0.01 for both comparisons). They also had higher creatinine clearance rates (78 versus 46 ml/min, P less than 0.01) and less severe renal artery disease. A total of 70 percutaneous transluminal renal angioplasties were performed in 70 arteries with a technical success rate of 100% in the younger group versus 67% in the older group (P less than 0.01); complications occurred more frequently in the older group. Our data indicate that, when technically successful, percutaneous transluminal renal angioplasty improves blood pressure to a similar extent in both younger and older patients. However, in patients over 60 years, the safety of the procedure is limited by more severe age-associated atheroma of renal and extrarenal arteries.

6 Hypertension

The awareness of hypertension as one of the major risk factors for mortality and morbidity in NIDDM has increased greatly in the past few years. It is now accepted practice to measure BP at least yearly in all such patients. Unfortunately, one cannot yet be sure to what extent diabetics benefit from anti-hypertensive therapy, and the simple assumption that treatment of the increased risk reduces that risk must be constantly questioned. No specific data are yet available for NIDDM, though it would be remarkable if the benefits of decreased cerebrovascular mortality and probable reduced total mortality (Sleight, 1987) did not apply to the higher-risk diabetic subject, at least at the higher levels of diastolic pressure (greater than 105 mm Hg). There is, though, no evidence that mortality or morbidity of coronary artery disease, the major killer in NIDDM, is reduced even in non-diabetics and the present author does not consider there to be any evidence suggesting that thresholds for treatment of hypertension in uncomplicated patients with NIDDM should be lower than those for non-diabetics, unless progressive nephropathy is present. Current advice in the non-diabetic is that levels of blood pressure in adults consistently above 95 mm Hg warrant therapy, aiming to reduce it below 90 mm Hg (World Health Organization, 1986). While the importance of hypertension should not be underestimated, it should not deflect attention from the other risk factors. Cessation of smoking, and by implication its reduction, will, for all smoking patients but the most hypertensive, produce a greater reduction in cardiovascular and total mortality risk than will anti-hypertensive therapy. There are also early signs that effective dietary and/or drug treatment of significant hyperlipidaemia lowers cardiovascular mortality. Choice of anti-hypertensive therapy is especially important, not only for efficacy but also for quality of life, in patients who already suffer major restrictions on diet, freedom and life expectancy. While controlled trials in the subject are of immense importance in determining optimum therapy, there is currently no evidence to favour any particular group of drugs, and an individual patient's therapy should be decided on the basis of their own circumstances.

The relation of social support and working environment to medical variables associated with elevated blood pressure in young males: A structural model

The object of the present study was to examine the interaction of working environment factors and the individual social support network with medical variables related to blood pressure elevations in young (mean age = 28 years) hypertensives. The results of path analyses reveal that the medical variables which explained a significant amount of the variation in systolic blood pressure were blood hemoglobin, plasma adrenaline and relative weight. High relative weight was associated with a low level of employment security and high plasma adrenaline with a poor self-reported social network as well as a job providing few possibilities for learning new things. High levels of diastolic pressure were associated with elevated hemoglobin levels, increased heart rate and low plasma renin activity. Increased heart rate was influenced by a lack of ‘anger’ coping in conflict situations at work and a low number of contacts with acquaintances. Working environment and social support are hypothesized to assert their influence through increased sympathetic stimulation mediated by limbic-hypothalamic discharge.