Increase In DBP Research Articles

Effects of Acute Consumption of Noni and Chokeberry Juices vs. Energy Drinks on Blood Pressure, Heart Rate, and Blood Glucose in Young Adults.

The purpose of this study has been to determine the effect of acute consumption of noni and chokeberry juices vs. energy drinks on blood pressure, heart rate, and blood glucose. The subjects divided into 4 groups, which consumed three portions of noni or chokeberry juices (30 mL or 200 mL, respectively) and energy drink (ED) or water (200 mL) at one-hour intervals. All participants had their blood pressure (BP), both systolic and diastolic BP (SBP and DBP), as well as heart rate (HR) and blood glucose (BG), measured. Consumption of noni juice caused a significant decrease in SBP and DBP of 5.0% and 7.5%, respectively, while, the consumption of chokeberry juice slightly decreased only DBP by 3.6%. On the contrary, consumption of three portions of EDs caused a significant increase in DBP by 14.7%. The BG of participants consuming noni juice decreased by 7.3%, while the consumption of EDs increased BG by as much as 15.8%. Acute consumption of noni juice contributed to a significantly decreased SBP, DBP, and HR as well as a mild reduction of BG. Consumption of chokeberry juice caused only a slight reduction of DBP. Contrary to juices, EDs consumption resulted in an increase of blood pressure (especially DBP) and blood glucose. The results of the study showed that noni juice may be effective in lowering blood pressure and blood sugar levels, but there is a need to continue research on the long-term effect of this juice.

Protective effects of Gαq‐RGS2 signalling inhibitor in aminophylline induced cardiac arrhythmia

An over activation of GPCR mediated Gαq dependent signalling pathway is widely associated with the development of cardiovascular abnormalities. The objective of study was to evaluate the effects of (1-(5-chloro-2-hydroxyphenyl)-3-(4-(trifluoromethyl)phenyl)-1H-1,2,4-triazol-5(4H)-one) Gαq-RGS2 signalling inhibitor on aminophylline induced cardiac arrhythmia in rats. Rats were divided into four groups; normal rats, disease control (DC, aminophylline treated 100mg/kg/d, i.p., 7days), Gαq-RGS2 signalling inhibitor (1 and 10mg/kg/d, p.o., 7days) treated arrhythmic rats. Gαq-RGS2 signalling inhibitor was administered 1hour prior to the administration of aminophylline from 1st day. At the end of study, heart rate (HR), QRS complex, QT and RR interval were measured by electrocardiogram (ECG) of anesthetized rats. Systolic and diastolic blood pressure (SBP, DBP) by invasive method, cardiac damage markers (CK-MB, LDH) in the serum, antioxidant enzymes (SOD, catalase, glutathione) and cAMP level were measured. The treatment of Gαq-RGS2 signalling inhibitor (10mg/kg) significantly abolished the aminophylline induced increase of heart rate, prolongation of RR and QT interval as compared to DC rats. Gαq-RGS2 signalling inhibitor (1 and 10mg/kg) significantly attenuated the prolongation in QRS complex, increase of SBP, DBP and cardiac damage markers as compared to DC. Gαq-RGS2 signalling inhibitor treatment (10mg/kg) significantly reduced the cAMP level and increased the antioxidant enzyme level as compared to DC. Gαq-RGS2 signalling inhibitor (10mg/kg) showed the protective effect against the aminophylline induced cardiac arrhythmia and it might be due to improvement in cAMP level and antioxidant enzymes.

OFFICE, HOME AND AMBULATORY BLOOD PRESSURE LONG-TERM CHANGES IN THE GENERAL POPULATION

Objective: The PAMELA is an epidemiological study performed on a population sample, including office, home and 24 h ambulatory blood pressure (BP) measurements. Measurements were made at baseline, after 11 years, and repeated in a 3rd survey 26 years later. Design and method: 3200 subjects were randomly selected to represent the population of Monza (North Italy) aged 25–74 years. In each subject body mass index (BMI), office (sphygmomanometer), home (semiautomatic validated device), 24 h (validated automatic oscillometric device) systolic (S) and diastolic (D) BP measurements, heart rate (HR) and biochemical variables were obtained. All values were measured at baseline (1st survey, 1990–91), 11 years later (2nd survey, 2001–02) and after further 15 years (3rd survey, 2016–17). Results: 562 subjects (279/283 males/females, mean age 41 ± 10 yrs) participated at the 3 surveys. Baseline average office, home and 24 h SBP/DBP were respectively 122/81 ± 14/9, 116/73 ± 15/10, 116/73 ± 9/7 mmHg and increased respectively of 5/1 ± 14/9, 4/1 ± 14/9 and 4/2 ± 10/7 mmHg at the 2nd survey. At the 3rd survey a further increase of 11/2 ± 7/11, 8/3 ± 16/10 and 13/2 ± 15/9 mmHg was observed in office, home and 24 h BP respectively. The baseline-3rd survey office, home and 24 h SBP difference was unrelated to age, while the DBP increase was inversely related to age (r = −0.32, −0.39 and −0.38, respectively, P < 0.0001). The baseline-3rd survey increase in office, home and 24 h DBP was significantly directly related to the concomitant BMI increase (r = 0.23, 0.17 and 0.14, respectively, P < 0.005). Office and home HR was similar in the 3 surveys. A reduction in 24 h HR was detected between the 1st and 3rd survey (−4.0 ± 8.2 b/min). At baseline hypertensive subjects were 22.2% (office BP), 19.3% (home BP) and 20.7% (24 h BP), and increased to 37.7%, 33.8% and 43.5% at the 2nd survey and to 68.7%, 65.8% and 80.8% at the 3rd survey respectively. Conclusions: The PAMELA 26-year follow-up represents the longest survey ever done describing the long-term changes of BP measurements in general population. It shows a long-term increase in office, home and 24 h BP only partially accompanied by HR changes, and an increase in the prevalence of hypertension, particularly pronounced when defined with 24 h measurements.

ATTENUATION OF LOW AMBIENT TEMPERATURE-INDUCED ELEVATION OF BLOOD PRESSURE BY SPECIAL HYPERTENSIVE MEDICINES

Objective: It is well documented that elevated blood pressure is associated with low ambient temperature, which is related with increase of sympathetic nervous system and renin-angiotensin system activities. In the current study, we aim to determine whether hypertension medicine, such as angiotensin converting enzyme inhibitor(ACEI), beta-blocking agent is effective in the prevention of cold-induced elevation of blood pressure and to shed light on underlying mechanism.Design and method: A stratified multistage random sampling method was used in The China Hypertension Survey study from 2012 to 2016, aimed to obtain nationally representative sample of the general Chinese population aged greater than 15 years in 31 provinces of mainland China, finally, a total of 466,670 was eligible and enrolled into our analysis. generalized linear model was applied to explore the estimates of ambient temperature on blood pressure after adjustment for potential confounders. Results: Among 46513 individuals taking hypertensive drugs, those taking beta-blocking agent, and medicine decreasing renin-angiotensin system activities were observed to mitigate the adverse effects of cold weather on blood pressure. Individuals taking beta-blocking agent was showed to have lower effect of cold weather on blood pressure, with 3.4 mmHg increase in SBP with per 10°C decrease in ambient temperature, while, those not taking beta-blocking agent had a average 5.7mmHg increment in SBP with per 10°C decrease in ambient temperature. Furthermore, individuals taking ACEI or angiotensin receptor blocker(ARBs) could completely counteract the adverse effect of cold weather on blood pressure. Hypertensive patients taking ACEI and ARB were found to had a average 1.4 and 1.5 mmHg increase in SBP and DBP, respectively, which did not have statistical significance. Conclusions: Hypertensive medicines such as ACEI, ARB and beta-blocking agent attenuated adverse effect of blood sympathetic nervous system and renin-angiotensin system activities. With the widely awareness of extreme weather on human health, it may provide a novel strategy for low temperature-induced blood pressure, aimed to decrease the prevalence of hypertension in cold weather.

THE RELATIONSHIP BETWEEN BODY COMPOSITION AND BLOOD PRESSURE DIFFERS IN THOSE WITH AND WITHOUT CHRONIC KIDNEY DISEASE

Objective: Thought it is generally accepted that measures of adiposity are related to cardiovascular disease risk, this relationship may not be consistent in disease states, particularly chronic kidney disease (CKD). This study aimed to investigate the relationship between measures of adiposity and blood pressure indices in a community-based sample of adults with and without prevalent CKD. Design and method: Mixed-ancestry South Africans residing in Cape Town (n = 1621) were examined between February and November 2015. Glomerular filtration rate (GFR) was estimated using the Modification of Diet in Renal Disease (MDRD) equation, without ethnicity correction. CKD was defined as an estimated GFR (eGFR) <60 ml/min/1.73m2. Body composition was assessed using anthropometry [body mass index (BMI) and waist circumference (WC)] and dual-energy x-ray absorptiometry (DXA) (in a sub-sample, n = 152). Blood pressure was recorded using a semi-automated digital monitor. Pulse pressure (PP) and mean arterial pressure (MAP) were calculated from mean systolic and diastolic blood pressure (SBP and DBP). Results: In bivariate correlation analysis, in those without CKD, an increase in anthropometric and DXA-derived measures of body composition correlated with an increase in SBP, DBP and MAP (all, p < 0.02); with BMI, WC and visceral adipose tissue also having a positive association with PP (all, p < 0.004). Contrary, in those with CKD (6%, n = 96), measures of body composition and fat distribution were not associated with blood pressure indices, accept for PP where the anthropometric-derived measures were inversely associated with PP (rho: -0.21 and -0.19 respectively, both p < 0.004). In multivariable analysis, only BMI and WC were positively associated with SBP [β (95 %CI): 0.27(0.13–0.41), p < 0.0001; 0.13(0.06–0.19), p < 0.0001], DBP [β (95% CI): 0.27(0.18–0.36), p < 0.0001; 0.13(0.09–0.17), p < 0.0001] and MAP [β (95% CI): 0.25(0.16–0.35), p < 0.0001; 0.12(0.08–0.17), p < 0.0001], independent of age, gender and CKD status. However, this association differed by CKD status, such that BMI and WC were only associated with SBP in those without CKD and inversely associated with PP in those with CKD (interaction, p < 0.098). Conclusions: In those without CKD there are parallel increases in brachial blood pressure as BMI, WC and fat depots increases, but these relationships were not observed in the presence of CKD.

Limited contribution of left ventricular mass and remodelling to the impact of blood pressure on diastolic function in a community sample.

Although the development of left ventricular (LV) dysfunction in hypertension has traditionally been viewed as a transition process from a phase of structural LV remodelling to dysfunction, the extent to which LV mass (LVM) and remodelling account for blood pressure (BP)-associated alterations in LV diastolic function is uncertain. In product of coefficient mediation analysis, we aimed to determine the extent to which LVM index (LVMI) or relative wall thickness (RWT) account for relations between BP and LV diastolic function. In 709 randomly selected participants from a community sample with a high prevalence of hypertension (49.6%), we determined BP and LVMI, RWT and several indices of diastolic function from transmitral blood flow and myocardial tissue Doppler (E/A, e'/a', e' and E/e') and left atrial volume using standard echocardiographic techniques. With adjustments for confounders, LVMI (P < 0.001-0.0001) and RWT (P < 0.05-0.001) were independently associated with E/A, e'/a', e' and E/e'. However, in product of coefficient mediation analysis, LVM and RWT failed to account for most BP-associated changes in diastolic function. Indeed, whilst a one SD increase in DBP or SBP (13 and 22 mmHg, respectively) translated into a 0.07, 0.13 and 0.53 decrease in E/A, e'/a', e' and a 0.73 increase in E/e', respectively, in mediation analysis LVMI accounted for only 0.0005, 0.0017, 0.05 and 0.08 of the impact of a one SD effect of LVMI on E/A, e'/a', e' and E/e', respectively. Similar contributions of RWT as for LVMI to BP-associated LV diastolic functional changes were noted and the contribution of LVMI or RWT to BP-related alterations in diastolic function was similar in those participants not receiving antihypertensive therapy. Although structural LV remodelling is independently associated with changes in LV diastolic function, LVMI and RWT account for only a minor proportion of the impact of BP on diastolic function. Thus, most BP-associated decreases in LV diastolic function are likely to be a transition process independent of LV hypertrophy or concentric remodelling.

Blackberry and Raspberry Attenuate the Increase in Blood Pressure Elicited by Angiotensin II in Mice (P06-054-19)

ObjectivesTo examine whether diet supplementation with blackberry or raspberry attenuate angiotensin (Ang) II-induced increase in blood pressure (BP) and decrease oxidative stress in the kidneys of mice. MethodsTwelve-week male C57BL/6 J mice were fed AIN-93 M diets alone (control and Ang II groups) or supplemented with 10% w/w freeze-dried blackberry (BL + Ang II) or raspberry (RB + Ang II) powder for eight weeks. At week 4, mice were implanted with subcutaneous osmotic minipumps that delivered 0.9% saline (Control) or Ang II (1 μg/kg body weight/day) for another four weeks. BP was measured weekly by tail-cuff plethysmography and validated by direct measurement at endpoint using a BP catheter. Kidney expression of pro-oxidant enzymes such as NADPH oxidases (Nox) and antioxidant enzymes such as superoxide dismutates (SOD) were also measured. Results were analyzed using ANOVA followed by Tukey-Kramer post-hoc test. ResultsAs expected, Ang II significantly increased systolic BP (SBP; 185 ± 4, n = 6, vs 132 ± 2 mmHg, n = 5, P < 0.001) and diastolic BP (124 ± 4, n = 6, vs 96 ± 2 mmHg, n = 4, P < 0.001) compared to control. Supplementation with BL and RB significantly attenuated this increase in SBP (143 ± 7 mmHg, n = 5, P < 0.0001 and 137 ± 4 mmHg, n = 5, P < 0.0001, respectively) and DBP (100 ± 6 mmHg, n = 5, P < 0.003 and 90 ± 3 mmHg, n = 5, P < 0.0001, respectively). Regarding the expression of NADPH oxidases in the kidney, Nox2 was significantly decreased by supplementation with BL (0.68 ± 0.07-fold, n = 5, P = 0.0005) and RB (0.70 ± 0.03-fold, n = 5, P = 0.0008) compared to Ang II (1.15 ± 0.12-fold, n = 5). Nox1 expression was up-regulated by Ang II compared to control (2.03 ± 0.16 vs 1.00 ± 0.00-fold, n = 5, P = 0.0001), but this was not prevented by supplementation with either berry. Nox4 expression was not affected by any of the treatments. Lastly, Ang II did not change the expression of SOD1 and SOD2 in the kidney, however, supplementation with RB significantly increased SOD1 (P = 0.02) and SOD2 (P = 0.005) expression compared to the other groups. ConclusionsOur findings indicate that supplementation with BL and RB decrease BP in mice which may be related to a decrease in oxidative stress in the kidney. Studies are underway to further elucidate the mechanism by which BL and RB exert their antihypertensive effects. Funding SourcesArkansas Biosciences Institute and Lewis Foundation Grant Program.

SUN-451 A Randomized-Withdrawal, Placebo-Controlled, Phase 3 Study to Assess the Efficacy and Safety of Selective Glucocorticoid Receptor Antagonist, Relacorilant, in Patients with Cushing Syndrome (GRACE Study)

Relacorilant is a highly selective glucocorticoid receptor antagonist (GRA) that modulates the effects of excess cortisol while showing no affinity for progesterone, mineralocorticoid, androgen, or estrogen receptors. In a phase 2 study, treatment with relacorilant showed improvement in glycemic and hypertension endpoints as well as other manifestations of cortisol excess in patients with endogenous Cushing syndrome (CS). Relacorilant was well tolerated, with no instances of drug-related hypokalemia or antiprogesterone effects. A multicenter phase 3 clinical trial of relacorilant is underway (GRACE Study: NCT03697109) that uses a randomized withdrawal (RW) design to evaluate efficacy and safety. Based on the mechanism of action of GRAs, clinical efficacy endpoints are being used. The study includes a 6-week (6wk) screening phase, followed by a 22wk open-label (OL) treatment phase, where eligible patients 18-80 years old with a confirmed biochemical diagnosis of endogenous CS, clinical signs and symptoms of CS, and either diabetes mellitus/impaired glucose tolerance (DM/IGT) or hypertension will receive relacorilant (100 mg/day, titrated to 400 mg/day, as tolerated). Those patients who complete the OL phase and meet clinical response criteria (assessed at OL wk22) are eligible to enter the blinded RW phase, where they will receive either placebo or relacorilant at the same dose they received at the end of the OL phase. During the RW phase, increases in antidiabetic and/or antihypertensive agents are allowed if there is a loss of response compared to OL wk22. Criteria for RW entry in the DM/IGT group include one of the following: ≥0.5% decrease in HbA1c from baseline, normalization or ≥50 mg/dL decrease in 2-hour OGTT glucose from baseline, or decrease in daily insulin or sulfonylurea dose and HbA1c unchanged or decreased. Criteria for RW entry in the hypertension group include one of the following: ≥5 mmHg decrease in mean systolic and/or diastolic blood pressure (SBP/DBP) without worsening of either, or a reduction in the number/dose of antihypertensives and no worsening of SBP/DBP. The primary efficacy endpoint in the DM/IGT group is the mean change from OL wk22 to RW wk12 in 2-hour OGTT glucose as compared between treatment groups. In the hypertension group, the primary endpoint is the proportion of patients with a loss of response with respect to hypertension from OL wk22 to RW wk12 as compared between treatment groups. Loss of response is defined as an increase in SBP or DBP ≥5 mmHg or any increase in dose or number of antihypertensive medications. Secondary efficacy endpoints include the proportion of patients meeting any DM/IGT and/or hypertension RW entry criteria at the end of the OL phase. Cushing Quality-of-Life and Global Clinical Response scores are also assessed. In conclusion, GRACE is enrolling participants in the first RW trial to assess relacorilant in the treatment of CS.

Influence of subclinical hypothyroidism on indicators of 24-hour arterial blood pressure monitoring in hypertensive patients with high additional risk

Significant prevalence of arterial hypertension (40 % of the adult population) and unsatisfactory level of high blood pressure adequate control (only 14 % of the urban and 8 % of the rural population in Ukraine) underlines the need to study the factors influencing AH course and contributing to a lack of antihypertensive therapy efficacy. One of such factors is subclinical hypothyroidism (SH). Aim. To study Influence of subclinical hypothyroidism on indicators of 24-hour arterial blood pressure monitoring in hypertensive patients with high additional risk. Materials and methods. After signing of written informed consent for the study, 124 patients with arterial hypertension (AH) and 16 practically healthy people (control group) were involved. The main group included 32 AH patients (women 87.5 % (n = 28), men 12.5 % (n = 4)) with moderately elevated thyroid stimulating hormone level (TSH) (4.0–15.6 μD/ml) and normal levels of thyroid hormones. The comparison group consisted of 92 AH patients (women 81.52 % (n = 75), men 18.48 % (n = 17)) with normal levels of TSH (0.4–4.0 μD/ml). The groups of patients were matched for age (54.16 ± 10.16) years versus (57.69 ± 9.76) years, (P = 0.093), sex (P = 0.4319), height (P = 0.993), weight (P = 0.719), body surface area (P = 0.901), body mass index (P = 0.669). All patients underwent a combined 24-hour blood pressure monitoring and ECG using a “Cardiology-04-AD-3” device (St. Petersburg, RF). Results. AH patients with or without concomitant SH were of comparable mean daytime and nighttime indices of SBP and DPB, indicators of SBP and DBP variability, PBP, indices for hypertension and hypotension, circadian indices, indices of percentage SBP and DBP increases, SBP and DBP load (with the exception of daytime SBP load). Patients with AH and SH, in contrast to AH patients without SH, tended to have 8.5 % (P < 0.05) higher indices of daytime SBP load, and 19.3 % (P < 0.05) lower daytime DBP hypotension index. Conclusions . AH patients with or without concomitant SH are comparable by the vast majority of ABPM indicators. However, in AH patients with concomitant SH, unlike those without SH, a larger daytime SBP load and a lower daytime DBP hypotension index were detected.

Effect of Sex on Cardiovascular Responses to Acute Sympathoexcitatory Stressors

Over the past twenty years, an increasing number of studies have compared baseline cardiovascular regulation between men and women. These studies have provided strong support for an effect of sex on cardiovascular outcomes, and implicate the sympathetic nervous system as a mediator of many of these differences. However, many of these studies have been conducted under baseline conditions, despite the fact that humans are seldom in a true “baseline” state (i.e., quiet, supine rest). Therefore, the purpose of this study was to investigate the effect of sex on cardiovascular responses to sympatho‐excitatory stimuli in young healthy individuals. We examined cardiovascular responses to the cold pressor test (CPT) and a voluntary end‐expiratory apnea (APN) in 5 women and 4 men. We hypothesized that women would demonstrate a reduced change in total peripheral resistance (TPR) and therefore blood pressure (BP) responses to these stimuli compared with men. Men and women were of similar age (men: 24 ± 2 y, women: 24 ± 1; p=0.8) and BMI (men: 26 ± 6 kg/m2, women: 22 ± 1; p=0.2). Baseline mean arterial pressure (MAP) was higher in men than women (87 ± 7 vs77 ± 4 mmHg, respectively; p=0.03), while baseline TPR (men: 25.7 ± 2.7 vs women: 23.2 ± 6.6 mmHg/L/min; p=0.5) and cardiac output (3.4 ± 0.4 vs 3.5 ± 0.9 L/min; p=0.9) were similar between the sexes. CPT was associated with a significant increase in MAP from baseline which was not different between the sexes (men: 90 ± 3 vs women: 92 ± 13mmHg; main effect of condition: p=0.03, effect of sex: p=0.7). Likewise, TPR increased in response to CPT, but again this response did not differ between the sexes (men: 27.0 ± 7.1, vs women: 25.8 ± 5.4 mmHg/L/min; main effect of condition: p=0.04, effect of sex: p=0.3). APN‐EX was associated with a similar increase in DBP (men: 83 ± 6 vs women: 69 ± 25 mmHg; main effect of condition: p=0.03, effect of sex: p=0.3) as well as TPR (men: 33.0 ± 4.8 vs women: 29.0 ± 13.9 mmHg/L/min; main effect of condition: p=0.01, effect of sex: p=0.6). In conclusion, cardiovascular responses to the CPT, a generalized sympathetic stressor, as well as to APN, which activates the chemoreflex, were similar between the young healthy men and women. These data refute our hypothesis, and suggest that cardiovascular responsiveness during these sympatho‐excitatory stimuli does not differ between the sexes.Support or Funding InformationThis project was supported by a Natural Sciences and Engineering Research Council Discovery Grant (CWU). TEA and YC were supported by the McGill Department of Kinesiology and Physical Education Graduate Excellence Fellowship.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

The ocular cardiac reflex effect study on cardiac hemodynamic parameters in healthy young mans

Purpose of the study. Investigate changes of cardiac hemodynamic parameters caused by ocular cardiac reflex triggering in healthy men’s in youthful age.&#x0D; Material and methods. 120 healthy male volunteers in youthful age were examined. The mean age was (19,2 ± 0,93 years). For ocularcardiac reflex (OCR) triggering we used a patented model «Device for dosed compression effects on the eyeballs» and «The method of ocular cardiac reflex triggering». On the basis of the obtained parameters of systolic (SBP) and diastolic (DBP) blood pressure, by arithmetic operations, pulse pressure (PP) and average flow pressure (AFP) and integrative parameters of cardiohemodynamics (CHD) – systolic blood volume (SBV), minute blood flow volume (MBFV), volumetric blood flow rate (V), total peripheral resistance (TPR) were determined.&#x0D; Results. Three main types of cardiovascular system response on OCR triggering were identified. The first type – hypertensive (n = 30 (25%) of the total number of examined subjects) was characterized by a significant (p &lt; 0,05) increase in heart rate, SBP, DBP, PP, AFP and other integrative parameters of CHD. The second, hypotonic type of the response (62 subjects; 51,7%) was characterized by a significant (p &lt; 0,05) decrease in SBP, DBP, PP, AFP. Patients with third, dystonic type, of response (n = 28 (23,3%) of the total number examined subjects) showed significant bilateral changes of blood pressure parameters in a nonlinear dependence of compression power on the eyeballs. Determination CHD parameters directly after and 3 and 5 minutes after decompression of the air in the compression device we enabled to determine the subtype of the mobility of the nervous centers as a feature that complements the basic type. The subtype of normal mobility was revealed in 63,3% (n = 19) of subjects with the main hypertensive type of response, 69,3% (n = 43) of subjects with the main hypotonic and 60,7 % (n = 17) with the main dystonic type of response of the cardiovascular system. The inert subtype in the mobility of the cardiovascular system were identified in 36,7% (n = 11) individuals with hypertension is the main type of response, at 30,7% (n = 19) of individuals with primary hypotonic type of response and 39,3 % (n = 11) – distancing. The obtained typological changes in blood pressure parameters caused by OCR triggering allowed to reveal predisposition to hypertension, hypotension, dystonia and to predict the development of hypertension in patients with hypertensive type of response usin appropriate primary prevention changes in life style. The highest risk of hypertension development may be in persons with hypertensive inert type of reaction of the system of regulation of blood pressure on OCR triggering. Further studies are being conducted to confirm this assumption.

Effect of sympathetic autonomic stress from the cold pressor test on left ventricular function in young healthy adults.

There is a dearth of studies investigating the effect of sympathetic activation on left ventricular function. This study aimed to investigate the effect of sympathetic autonomic stress on left ventricular function in young healthy adults. Fifty‐six normotensive healthy participants (age 23.55 ± 3.82 years) took part in the study after giving informed consent. After obtaining baseline measurements, heart rate (HR), blood pressure (BP), peripheral saturation of oxygen (SpO2) and left ventricular function (assessed by means of ejection fraction (EF) obtained by transthoracic 2‐D echocardiography) were determined before and following sympathetic activation using cold pressor test (CPT). Exposure to CPT led to significant increase (P < 0.0001) in HR (70.4 ± 10.7 bpm to 91.6 ± 14.8 bpm), SBP (118 ± 8 mmHg to 138 ± 14 mmHg) and DBP (71 ± 7 mmHg to 91 ± 11 mmHg). Participants’ EDV (101.1 ± 15.8 ml to 104.2 ± 19.3 mL), ESV (38.7 ± 9.1 mL to 40.3 ± 11.6 mL), SpO2 (99.5 ± 0.79% to 99.5 ± 0.77%) and EF (61.9 ± 5.9% to 60.9 ± 6.4%) were only slightly changed (P > 0.05). However, cardiac output (4.3 ± 0.9 L/min to 5.4 ± 1.4 L/min) and cardiac index (3.7 ± 0.8 L/min per m2 to 4.5 ± 1.4 L/min per m2) increased significantly (P < 0.0001). We conclude that sympathetic stress induced by cold pressor test has marginal effect on ejection fraction and fractional shortening while increasing cardiac output and cardiac index in young healthy adults.

ADJUSTMENT OF BLOOD PRESSURE DURING EXERCISE STRESS TEST IN ELITE RUNNERS FROM MANIPUR, INDIA

Objectives : Adjustment is a short term response in the body that is associated with exercise. The objective of the study was to observe the adjustment in blood pressure during rest, exercise and recovery in Manipuri elite long distance runners. Design : Observational study. Methods : 12 Manipuri elite long distance runners underwent a 12 minutes treadmill stress test following the standard Bruce protocol. Blood pressure monitoring was done at resting (supine, standing, and hyperventilation), during exercise, and recovery stages during treadmill test by mercury sphygmomanometer with auditory confirmation. Descriptive analysis was used to interpret the data and Mann-Whitney U test to compare the mean. Results : In male runners, the mean resting blood pressure (BP rest ) was SBP/DBP (±SD); 118/70 (±7/6) mmHg and rose up-to maximum blood pressure (BP max ) of SBP/DBP (±SD); 163/90 (±8/0.0) mmHg whereas, in the female runners, mean resting blood pressure was SBP/DBP (±SD); 110/70 (±6/6) mmHg rose up-to maximal blood pressure of 148/86 (±9/5) mmHg. In male runners, DBP increases slightly during exercise and becomes plateau at steady stage at 6 minutes of exercise. The mean recovery blood pressure (BP rec. ) value at 3 minutes in male runners indicated higher chances of future hypertension. Rate of perceived exertion of the runners’ measure through Borg CR10 scale rating ranges from 3-5. Conclusions : SBP and DBP value did not change at resting phase i.e. supine, standing, and hyperventilation position. However, SBP increases rapidly with the onset of exercise and the increase in the DBP is slow and steady yet reaches the plateau faster than the SBP. Regular blood pressure monitoring is recommended for athletes to diagnose hypertension and prevent from sudden cardiac arrest during physical training and competition. Article visualizations:

A brief submaximal isometric exercise test 'unmasks' systolic and diastolic masked hypertension.

An exaggerated blood pressure (BP) response during dynamic exercise testing has been proposed as an additional screening tool to identify systolic masked hypertension (masked-HYP). However, masked-HYP in young people is often characterized by an elevated DBP. Static/isometric exercise elicits augmented sympathetic stimulation causing greater increases in both SBP and DBP than dynamic exercise. To examine whether individuals with masked-HYP exhibit exaggerated BP responses during a submaximal handgrip vs. normotensive individuals and individuals with sustained hypertension (true-HYP), and the possible associations of exercise BP with total peripheral resistance (TPR), central/aortic BP, and 24-h-ambulatory BP (24-h BP). Eighty-six participants [untreated, newly diagnosed, masked-HYP (n = 27), true-HYP (n = 31), and normotensive individuals (n = 28); 46.3 ± 10.7 years], following evaluation of office BP, central/aortic BP, pulse wave velocity, carotid intima-media thickness, echocardiocardiography, and 24-h BP, underwent a 3-min handgrip (30% maximal voluntary contraction) with beat-by-beat BP and hemodynamics assessment (Finapres Medical Systems). Despite similar baseline-BP in masked-HYP and normotensive individuals, during exercise masked-HYP exhibited a markedly greater (P < 0.01) SBP and DBP vs. normotensive individuals, and similar BP to true-HYP. TPR significantly increased (P < 0.001) during exercise, in masked-HYP and true-HYP. The exaggerated BP responses in masked-HYP were evident from the 1st minute of exercise and correlated (P < 0.05) with central/aortic-BP, aortic stiffness, 24-h BP, day-BP, night-time-BP, and interventricular septum thickness. During handgrip, masked-HYP exhibited exaggerated BP and TPR responses, similar to those of true-HYP. These responses were evident from the 1st minute of exercise and correlated with 24-h BP, suggesting that systolic and diastolic masked-HYP can be 'unmasked' during a brief, submaximal, handgrip test.

Analysis of risk factors and the effect of comprehensive nursing intervention in middle-aged patients with atherosclerosis

Objective To understand the occurrence and risk factors of middle-aged people with atherosclerosis and explore the application effect of comprehensive nursing intervention in middle-aged patients with atherosclerosis. Methods Arteriosclerosis screening was conducted in the middle-aged population who had a health examination in the hospital in 2015 by detecting pulse wave conduction velocity (PWV). The risk factors, cognitive level of disease and compliance behavior with atherosclerosis were analyzed.A total of 580 cases of patients were randomly divided into the control group and the observation group, 290 cases of each group.The control group was treated with the routine nursing, and the observation group was treated with the comprehensive nursing intervention on the basis of the routine nursing. After 1 year, the changes of cognition level, medical behavior and arteriosclerosis of the two groups were analyzed. Results Among the 1 765 middle-aged patients, 580 cases of arteriosclerosis were screened out.The positive rate was 32.86%.Age, BMI, SPB, DBP, HCY and TG were associated with arteriosclerosis. The awareness rate of the two groups of patients on the causes, clinical manifestations, treatment methods, risk factors, complications, preventive measures of arteriosclerosis, as well as the following medical behaviors such as diet control, weight control, aerobic exercise, blood pressure/blood glucose monitoring and psychological adjustment was higher than that before the intervention, and the observation group was higher than the control group, with statistically significant differences (P<0.05). The PWV level of the two groups was lower than that of the control group and the observation group was lower than that of the control group.The difference was statistically significant (P<0.05). There were 64 and 14 cases of arteriosclerosis improvement in the two groups, and the difference was statistically significant (P<0.05). Conclusion The occurrence rate of arteriosclerosis in middle-aged people in this region is relatively high, with the increase of age, BMI, SPB, DBP, HCY and TG as the risk factors.Comprehensive nursing intervention can effectively improve the cognition level of atherosclerosis patients, follow medical behavior and prevent the progression of arteriosclerosis. Key words: Middle-aged people; Atherosclerosis; Risk factor; Comprehensive nursing

Everyday Discrimination Prospectively Predicts Blood Pressure Across 10 Years in Racially/Ethnically Diverse Midlife Women: Study of Women's Health Across the Nation.

Interpersonal discrimination is linked to greater risk for cardiovascular disease (CVD) and this association varies by race/ethnicity. To examine whether exposure to everyday discrimination prospectively predicts elevated blood pressure (BP), whether this association differs by race/ethnicity, and is mediated by adiposity indices. Using data for 2,180 self-identified White, Black, Chinese, Japanese, and Hispanic participants from the Study of Women's Health Across the Nation, we examined associations among exposure to (higher vs. lower) everyday discrimination at baseline and BP and hypertension (HTN; systolic blood pressure [SBP] ≥ 140 mmHg; diastolic blood pressure [DBP] ≥ 90 mmHg; or self-reported HTN medication use) risk over a 10 year period. Additionally, we used the bootstrap method to assess repeated, time-varying markers of central and overall adiposity (waist circumference and body mass index [BMI] (kg/m2), respectively) as potential mediators. Exposure to everyday discrimination predicted increases in SBP and DBP over time, even after adjusting for known demographic, behavioral, or medical risk factors. However, greater waist circumference or BMI (examined separately) mediated these observations. Notably, there were no racial/ethnic differences in the observed association and HTN risk was not predicted. The current findings suggest that everyday discrimination may contribute to elevated BP over time in U.S. women, in part, through increased adiposity. These findings demonstrate the complexity of the linkage of discrimination to CVD risk and raise the need to closely examine biobehavioral pathways that may serve as potential mediators.

RATIONAL CONTROL OF ARTERIAL PRESSURE DURING LABOUR IN WOMEN WITH ARTERIAL HYPERTENSION

Arterial hypertension can significantly impair the health of the pregnant woman and often causes complications in childbirth and perinatal complications.The purpose of the study: to identify the advantages and disadvantages of various antihypertensive regimens in women with hypertension during the labor process and their effect on the course of labor and perinatal outcomes.Materials and methods: There were surveyed for the period of 2013-2018 years 228 women who had labour in the Ternopil perinatal center “Mother and Child”. Arterial hypertension was verified in 172 women, 56 women were healthy and formed a control group. The study included delivery time of 40 ± 2 weeks of gestation. According to the treatment program, the women in labour were divided into 4 groups: the first group - 58 women who neglected the treatment of chronic arterial hypertension before pregnancy, and during pregnancy there was insufficient compliance; The second group - 57 women in labour with AH, which were used dopegit and classic beta-blockers, (metoprolol, bisoprolol) during pregnancy; The third group - 57 women in labour who received high selective beta-blocker with vasodilating effect nebivolol for treatment of hypertension; The fourth group - 56 healthy women in labour without hypertension and / or other somatic pathology.Results of the research and their discussion. The recommended program of treatment for hypertension (with nebivolol hydrochloride) proves the sufficient control of blood pressure and avoiding of high blood pressure spikes or excessive increase of SBP, DBP, and heart rate during childbirth, which could endanger the mother’s health.Conclusions. The therapy with nebivolol hydrochloride for laboring women with chronic arterial hypertension allows to normalize the course and duration of childbirth, to reduce the percentage of such complications as a prolonged labour or unsatisfactory progress of labour, and to reduce the level of blood loss during child-birth

Abstract P195: Blood Presure is Related to Glucose Fluctuation in Longstanding Type 1 Diabetes

Mechanisms underlying relationship between hypertension and metabolic abnormalities are well established in type 2 diabetes. Much less is known about this link in type 1 diabetes. None of the previous studies has assessed relationship between glucose variability and diurnal blood pressure profile in patients with longstanding type 1 diabetes (DM1). The Aim: to investigate the possible association of glucose fluctuation with BP levels in longstanding DM1. Design and Methods: We examined 36 patients with longstanding (&gt;20 years) history of DM1 (without overt cardiovascular disease, including hypertension) and episodes of hyperglycemia &gt;160 mg/dL during 24-hour continuous glucose monitoring (CGM). In all patients simultaneous 24-hour CGM and ambulatory blood pressure monitoring (ABPM) were performed. Intima-media thickness (IMT) of the common carotid artery was also assessed. Patients were divided into two groups: with and without severe hypoglycemia &lt;50 mg/dL (n=18 in each group). Results: Compared to patients with hypoglycemia, patients without hypoglycemia had a significantly lower day-time SBP variability expressed as standard deviation (12.6 ± 2.5 and 10.9 ± 3.0 mmHg, respectively, p&lt;0.05). In patients without hypoglycemia, mean amplitude of glycemic excursion both up and down was associated with increase in DBP (r=0.49, p&lt;0.05 and r=0.59, p&lt;0.05, respectively), whereas in patients with hypoglycemia it was associated with increase in SBP (r=0.53, p&lt;0.05). In patients without hypoglycemia, time of hyperglycemia was associated with increase in DBP (r=0.57, p&lt;0.05) and in patient with hypoglycemia – with increase in SBP (r=0.67, p&lt;0.05). Furthermore, in patients with short hypoglycemic episodes, time of hypoglycemia was associated with increase in SBP (r=0.57, p&lt;0.05). In patients with hypoglycemia, SBP level had also positive correlation with IMT (r=0.50, p&lt;0.05). Conclusions: In patients with longstanding DM1, BP is related to glucose fluctuation. While the change in glucose levels towards hypoglycemia is associated with an increase in SBP, hyperglycemia is linked to an increase in DBP. The mechanisms underlying these associations remain to be determined.

Effect of anticipation and cuff inflation on blood pressure during self-measurement.

Self-measurement of blood pressure (BP) is increasingly being used for the diagnosis of hypertension and to monitor BP at home. Whenever compared with ambulatory BP measurements, home BP values are frequently higher and less predictive for incident cardiovascular events. We hypothesized that this could be caused by a pressor response elicited by the self-measurement of BP. A total of 50 patients (mean age 62.0 ± 11.2 years, 44% women) were included, 25 with and 25 without at least 10/5 mmHg higher home BP compared with daytime ambulatory BP. All patients performed 10 consecutive oscillometric BP measurements after 10 min of rest, followed by another resting period of 10 min, while continuously monitoring BP and central hemodynamics using finger photoplethysmography. Baseline BP before the start of the self-measurements was compared with the average BP during the first 10 s of inflation of the cuff. In both groups, we observed a significant increase in SBP and DBP during cuff inflation. The mean rise in average BP was 6.9 ± 6.3/4.5 ± 4.3 mmHg in the group with and 4.4 ± 9.4/2.7 ± 5.3 mmHg in the group without a BP difference between home and daytime ambulatory BP compared with baseline, whereas the maximum increase in average BP was 17.4/8.4 mmHg and 17.7/7.5 mmHg (P < 0 01). The increase in BP coincided with an increase in heart rate and cardiac output. BP differences attenuated after multiple readings, but did not disappear. Our results support the existence of a pressor response during self-BP measurement that remains present after multiple BP readings.

Abstract 121: Endothelial Cullin3 Mutation Causes Vascular Dysfunction, Arterial Stiffening, and Hypertension

Mutations in CULLIN3 gene (causing in-frame deletion of exon 9) cause human hypertension (HT), which is likely to be driven by a combination of renal tubular and vascular mechanisms. We have recently shown that smooth muscle expression of Cul3Δ9 mutant causes vascular dysfunction and HT via augmented RhoA/Rho-kinase signaling, strongly supporting a vascular role of Cul3 in BP regulation. To test the importance of endothelial Cul3 in vivo , we bred the conditionally activatable Cul3Δ9 mice with tamoxifen-inducible Tie2-CRE ERT2 mice. The resultant mice (E-Cul3Δ9) developed nocturnal hypertension (Night time peak systolic BP, E-Cul3Δ9: 138±3 vs Control: 121±4 mmHg, p&lt;0.01) and arterial stiffening (pulse wave velocity, 3.7±0.3 vs 2.7±0.1 m/s, p&lt;0.01). No difference was seen in daytime BP. Nitric oxide synthase (NOS) inhibitor L-NAME induced smaller increases in nocturnal peak SBP and DBP in E-Cul3Δ9 mice (15±1 vs 27±3 mmHg, p&lt;0.01), suggesting their NOS activity is low. Of note, E-Cul3Δ9 mice exhibited impaired endothelial-dependent relaxation in carotid artery (Max ACh relaxation: 69% vs 84%, p&lt;0.05) and cerebral resistance basilar artery (41% vs 77%, p&lt;0.01). No difference in smooth muscle function was observed. To determine the molecular mechanisms, we isolated primary aortic endothelial cells from mice carrying the inducible Cul3Δ9 construct and induced Cul3Δ9 expression in vitro using adenovirus carrying Cre recombinase gene. Expression of Cul3Δ9 resulted in marked decreases in wild type Cul3 protein, phosphorylated eNOS, and nitric oxide production. Because protein phosphatase 2A (PP2A) is a known Cul3 substrate which dephosphorylates eNOS, we determined whether impaired eNOS activity was attributable to PP2A. Cul3Δ9-induced impairment of eNOS activity was rescued by a selective PP2A inhibitor Okadaic Acid (4 nM), but not by a Protein Phosphatase 1 inhibitor Tautomycetin (4 nM). These data define a novel regulatory pathway involving Cullin3/PP2A/phospho-eNOS in the endothelium. Selective endothelial expression of Cul3Δ9 partially phenocopies the hypertension observed in Cul3Δ9 patients, suggesting that mutations in Cullin-3 cause human hypertension in part through a vascular mechanism characterized by endothelial dysfunction.