Search results for " Pressure"

Blood-pressure variability in patients with obstructive sleep apnea: current perspectives

2018

Obstructive sleep apnea (OSA) is often associated with hypertension and other cardiovascular diseases. Blood pressure (BP) variability is part of the assessment of cardiovascular risk. In OSA, BP variability has been studied mainly as very short-term (beat-by-beat) and short-term (24-hour BP profile) variability. BP measured on consecutive heartbeats has been demonstrated to be highly variable, due to repeated peaks during sleep, so that an accurate assessment of nocturnal BP levels in OSA may require peculiar methodologies. In 24-hour recordings, BP frequently features a "nondipping" profile, ie, <10% fall from day to night, which may increase cardiovascular risk and occurrence of major…

The Role of ABPM in Evaluation of Hypertensive Target-Organ Damage

2013

Casual blood pressure measurement has provided the basis for the present knowledge of the potential risk associated with hypertension and has guided patient management for many years. The possibility of carrying out repeated ambulatory blood pressure measurements using automatic or semiautomatic devices allows for the gathering of more representative values of blood pressure and for observing the behavior of blood pressure during both moments of activity as well as rest. Ambulatory blood pressure measurement is now increasingly recognized as being indispensable to the diagnosis and management of hypertension, and it has contributed significantly to our understanding of hypertension. Likewis…

Pulsatile and steady 24-h blood pressure components as determinants of left ventricular mass in young and middle-aged essential hypertensives

2003

In order to explore the relations between left ventricularmass (LVM) and the pulsatile (pulse pressure) andsteady (mean pressure) components of the bloodpressure (BP) curve, 304 young and middle-agedessential hypertensive patients were studied by meansof 24-h ambulatory BP monitoring and echocardio-graphy. In the overall study population, both the BPcomponents showed significant correlations with LVM.These correlations were unevenly distributed in thesubgroups of subjects younger and in those older than50 years. While in this latter subgroup, in multivariateanalysis, both 24-h mean BP (24-MBP) (b¼0.27;P¼0.008) and 24-h pulse pressure (24-h PP) (b¼0.23;P¼0.02) were associated with LVM, in th…

Relationship between aortic stiffness and albumin excretion rate in untreated essential hypertensive patients

2004

Ambulatory blood pressure monitoring is ready to replace clinic blood pressure in the diagnosis of hypertension: con side of the argument.

2014

The San Francisco experience with Perloff and Sokolow was the starting point for the clinical application of ambulatory blood pressure (ABP) measurement. Using a semiautomatic device, the superiority of ABP to office measurement was demonstrated in the relationship with hypertension-induced organ damage1 and in the risk for cardiovascular events.2 This seminal study impelled an issue with the largest production and impact in the field of hypertension in recent decades, boosting research and having an enormous influence on daily clinical practice. Initially restricted to specialized clinics, ABP monitoring (ABPM) has largely expanded to primary care in many countries. Similarly, scientific p…

Blood Pressure Measurement Before and After Intervention

2016

The complexity and the uncertainties about long-term effect of the invasive interventions to treat essential hypertension (HTN) require a precise diagnosis about the real “resistance” to the antihypertensive treatment given, and it is defined when a therapeutic strategy that includes appropriate lifestyle measures plus a diuretic and two other antihypertensive drugs belonging to different classes at adequate doses fails to lower systolic blood pressure (SBP) and diastolic blood pressure (DBP) values to <140 and 90 mmHg, respectively. Consequently, in the process of diagnosis and follow-up, blood pressure (BP) measurement is the first step that is not exempt of difficulties due to the variab…

Morning and smooth 24-h ambulatory blood pressure control is not achieved in general practice: results from the SURGE observational study.

2013

BACKGROUND The aim of this large-scale, practice-based observational study [Survey with HBPM and ABPM Under Real clinical conditions in General practice to Evaluate BP control in the early morning (SURGE)] was to ascertain the degree of morning and 24-h ambulatory blood pressure (ABP) control in hypertensive patients. METHODS Hypertensive patients [with uncontrolled clinic blood pressure (BP) >140/90 mmHg at screening] from nine different countries were included. Ambulatory BP monitoring was performed over 24 h at 15-min intervals during the day and at 20-min intervals during the night. Assessments included morning (0600-1159 h) and daytime ABP control (BP < 135/85 mmHg), and 24-h ABP contr…

Comparative effectiveness of an angiotensin receptor blocker, olmesartan medoxomil, in older hypertensive patients

2018

The efficacy and safety of olmesartan medoxomil (OM) vs active control (AC) monotherapy among elderly patients aged 60‐79 years (N = 4487) was evaluated by meta‐analysis (25 studies). In all patients, change from baseline to end point in blood pressure (BP) was significantly greater with OM vs AC (−19.5/−11.9 vs −16.8/−10.7 mm Hg). Greater proportions of OM‐ vs AC‐treated patients achieved BP goals. In patients with impaired renal function (estimated glomerular filtration rate <60 mL/min/1.73 m(2)), OM treatment resulted in a greater mean change from baseline in systolic BP vs AC (−21.2 vs −18.7 mm Hg, respectively) and a greater proportion of patients achieving BP goals. These parameters w…

The normal circadian pattern of blood pressure: implications for treatment

2004

Blood pressure fluctuates over 24 h following a circadian rhythm that reaches a peak in the morning shortly after awakening. The onset of many acute cardiovascular and cerebrovascular events shows a synchronous cyclical pattern, with the highest incidence of morbidity and mortality in the early morning hours. Strong, although circumstantial, evidence suggests that the early morning surge in blood pressure may contribute to the onset of acute cardiovascular episodes. Sustained blood pressure control that blunts the early morning blood pressure surge may help to reduce the incidence of these events. Antihypertensive agents are needed that provide smooth and sustained blood pressure control fo…

Angiotensin-Converting Enzyme 2 and Antihypertensives (Angiotensin Receptor Blockers and Angiotensin-Converting Enzyme Inhibitors) in Coronavirus Dis…

2020

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, is being defined as the worst pandemic disease of modern times. Several professional health organizations have published position papers stating that there is no evidence to change the use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in the management of elevated blood pressure in the context of avoiding or treating COVID-19 infection. In this article, we review the evidence on the relationship between the renin-angiotensin-aldosterone system and COVID-19 infection. In agreement with current guidelines, patients with hypertension should continue taki…