Blood pressure effects of CPAP in nonresistant and resistant hypertension associated with OSA: A systematic review of randomized clinical trials.

Obstructive sleep apnea (OSA) is a rather common chronic disorder, associated with increased prevalence of hypertension. The pathophysiological mechanisms for hypertension in OSA are at least in part linked to intermittent hypoxia developed during nightly hypopneas and apneas. Hypoxemia stimulates sympathetic overactivity, systemic inflammation, oxidative stress, and endothelial dysfunction.

Abundance of live ²⁴⁴Pu in deep-sea reservoirs on Earth points to rarity of actinide nucleosynthesis.

Half of the heavy elements including all actinides are produced in r-process nucleosynthesis, whose sites and history remain a mystery. If continuously produced, the Interstellar Medium is expected to build-up a quasi-steady state of abundances of short-lived nuclides (with half-lives ≤100 My), including actinides produced in r-process nucleosynthesis. Their existence in today's interstellar medium would serve as a radioactive clock and would establish that their production was recent.

Lowering blood pressure to prevent stroke recurrence: a systematic review of long-term randomized trials.

Albeit hypertension is a leading risk factor for an initial stroke, the role of blood pressure (BP) lowering to prevent a subsequent stroke is controversial. The present systematic review searched randomized trials published from January 1990 to January 2014 with the aim to assess antihypertensive treatment effects on recurrent stroke prevention. Seven randomized placebo-controlled trials enrolling 49,518 patients, two randomized trials not placebo controlled comparing antihypertensive drugs, and one randomized trial that compared the effects of intensive systolic BP lowering with a more conservative systolic BP management, were identified.

Early treatment of hypertension in acute ischemic and intracerebral hemorrhagic stroke: progress achieved, challenges, and perspectives.

Hypertension is the leading risk factor for ischemic and intracerebral hemorrhagic subtypes of stroke. Additionally, high blood pressure (BP) in the acute cerebrovascular event is associated with poor outcome, and a high percentage of stroke survivors have inadequate control of hypertension. The present is a systematic review of prospective, randomized, and controlled trials carried out on safety and efficacy of antihypertensive treatment of both subtypes of acute stroke.

Nocturia in arterial hypertension: a prevalent, underreported, and sometimes underestimated association.

Nocturia is a risk factor for morbidity and mortality but is frequently overlooked and underreported by patients and unrecognized by physicians. Epidemiologic studies reported that nocturnal voiding is associated not only with aging and benign prostatic hyperplasia, but also with many other clinical conditions. The majority of epidemiologic studies reported a significant relationship between nocturia and hypertension.

Association between chronic blood pressure changes and development of Alzheimer's disease.

Epidemiological studies suggest an association between chronic blood pressure (BP) changes and Alzheimer's disease (AD). In particular, there is growing evidence that hypertensive people that do not have their BP adequately treated and controlled in midlife are more likely to develop AD in late-life. It has been hypothesized that cerebrovascular disease is a common pathway which connects hypertension and AD in individuals with apolipoprotein E genotype through brain hypoperfusion and hypoxia.

Orthostatic hypotension: a common, serious and underrecognized problem in hospitalized patients.

Orthostatic hypotension (OH) is strongly age-dependent, with a prevalence ranging from 5% to 11% in middle age to 30% or higher in the elderly. It is also closely associated with other common chronic diseases, including hypertension, congestive heart failure, diabetes mellitus, and Parkinson's disease. Most studies of OH have been performed in population cohorts or elderly residents of extended care facilities, but in this review, we draw attention to a problem little studied to date: OH in hospitalized patients.

Establishing targets for hypertension control in patients with comorbidities.

Most current guidelines recommend tighter blood pressure (BP) control in hypertensive patients with comorbidities. These recommendations are based on epidemiologic data indicating that cardiovascular risk increases at lower BP levels in hypertensive patients with comorbidities than in those without comorbidities. Hypertension guidelines usually reflect outcomes from previous studies, but current recommendations for patients with comorbidities have preceded the evidence.

Effects of blood pressure changes on Alzheimer's disease.

Alzheimer's disease is the most frequent cause of dementia. Whereas other major causes of death have been decreasing, the number of deaths due to Alzheimer's disease is rising. As there is no cure for this type of dementia at present, preventive measures have assumed great importance.

The complex interaction between overweight, hypertension, and sympathetic overactivity.

There is ample evidence in the epidemiological and clinical literature that hypertension and overweight are closely and causally interrelated. Sympathetic nervous system (SNS) overactivity has been well documented in both hypertension and overweight, but it is not clear whether this is a coincidental finding or whether the association reflects a mechanistic role of SNS in these two interrelated clinical conditions. Whereas in this review we focus on the evidence for a primary role of SNS in the development of hypertension and overweight, it is clear that the process can be initiated from other starting points such as primary overeating or sleep apnea.

Primary care survey of awareness and control of hypertension: a hospital-based study.

The objectives of this cross-sectional study were to determine awareness degree, treatment status, and control of hypertension and its predictors in a consecutive group of attendees at a Buenos Aires University School Hospital primary care setting from April 2003 to May 2006. Results for 1733 hypertensive subjects, all of them white (578 men and 1155 women), were available for analyses. Mean age of hypertensive subjects was 66.

Statins in hypertension: are they a new class of antihypertensive agents?

High blood pressure is a very common disease in hypercholesterolemic and diabetic patients and contributes to the increase in cardiovascular risk. Inhibitors of 3OH-3methyl-glutaryl-coenzyme A reductase are the most effective and widely used cholesterol-lowering drugs. They significantly reduce the risk of cardiovascular events and death in both primary and secondary prevention of cardiovascular disease.

[Resistant hypertension].

Resistant hypertension, defined as a persistent blood pressure over 140/90 mmHg despite the use of three antihypertensive drugs including a diuretic, is unusual. The diagnosis requires ruling out initially pseudoresistance and a lack of compliance with treatment. Ambulatory blood pressure recording allow the recognition of white coat hypertension.

Statins as antihypertensives.

The beneficial effects of statins in hypertension stem from their effects on endothelial function, their interactions with the renin-angiotensin system, and their influence on large artery compliance. Substantial evidence has recently accumulated showing that statins exert pleiotropic effects in vascular function. These include an increase in the synthesis of NO, inhibition of vascular smooth muscle cell proliferation and migration, anti-inflammatory actions, downregulation of angiotensin II type 1 receptor expression, and anti-oxidative effects.

Role of endothelins in hypertension.

There are three peptides of endothelial origin, called endothelins (ETs), having different receptors that mediate a potent vasoconstrictor effect and also a mild vasodilation. Their renal effects are characterized by natriuresis in spite of the renal vasoconstriction. This effect, along with the stimulation of ETs by high sodium intake, suggests that ETs may be responsible for maintaining sodium balance when the renin angiotensin system is depressed.

Management of hypertensive crises.

Hypertensive emergencies are life-threatening conditions because their course is complicated with acute target organ damage. They can present with neurological, renal, cardiovascular, microangiopathic hemolytic anemia, and obstetric complications. After diagnosis, they require the immediate reduction of blood pressure (in <1 hour) with intravenous drugs such as sodium nitroprusside, administered in an intensive care unit.

[Treatment of hypertension in type 2 diabetes: importance of therapeutic selection].

Background: Type 2 diabetes and essential hypertension are the most common causes of end-stage renal disease in Argentina. Over 887 organ transplantations performed in the year 2004, 577 were kidney transplants. In urban and rural populations hypertension was more prevalent in type 2 diabetics, in particular systolic hypertension.

Sibrafiban (Genentech).

Sibrafiban (G-7453) is an orally active non-peptide GPIIb/IIIa antagonist, under development by Genentech and Hoffmann-La Roche, and in phase III trials as an antithrombotic. Roche intends to file for marketing approval in 1999. Merrill Lynch predicts a product launch in 2001.

A comparison of body mass index and waist-to-hip ratio as indicators of hypertension risk in an urban Argentine population: a hospital-based study.

Background And Aim: To examine the relationship between 24-h ambulatory blood pressure monitoring (ABPM) and three commonest anthropometric measurements for obesity [body mass index (BMI), waist circumference (WC) and waist-hip ratio (WHR)] in patients with essential hypertension never treated or after a 3 week placebo period, living in Buenos Aires.

Methods And Results: Cross-sectional survey among outpatients at the Hypertension Program of Buenos Aires University Hospital de Clinicas. Three-hundred seventy-seven essential hypertensives, aged 18-86 years, of either sex, were consecutively recruited.

Role of endothelin in the pathogenesis of hypertension.

In 1985, investigators characterized a potent vasoconstrictor of endothelial origin called endothelin (ET). Subsequently, 3 peptides were recognized that had a comparable molecular structure but different receptors that mediate potent vasoconstrictive and mild vasodilative effects. The renal effects are characterized by natriuresis despite renal vasoconstriction.

Insulin resistance and hypertension in postmenopausal women.

The aim of the study was to elucidate the role of hyperinsulinaemia/insulin resistance in hypertension of lean postmenopausal women. Twenty-four women with essential hypertension (systolic/diastolic > or =140/90 mm Hg) and a body mass index (BMI) less than 26 kg/m(2) not receiving antihypertensive treatment or who had been without treatment for a 4-week washout period, and 10 normotensive postmenopausal weight- and aged-matched controls were compared. Both groups were not receiving hormone replacement therapy.