Journal of hypertension
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Journal of hypertension · Jun 2015
4D.04: TIMING OF THE CAROTID PRESSURE WAVE INFLECTION POINT IS COUPLED TO SYSTOLIC MYOCARDIAL MOTION IN OLDER PATIENTS WITH CARDIOVASCULAR RISK FACTORS.
Cardiac motion during systole has been shown to be closely associated with carotid pressure wave inflection point timing in young, healthy volunteers. In these individuals the inflection point occurred following the systolic pressure peak (Murgo Type C). The relationship between myocardial motion and the timing of inflection point in older patients with cardiovascular risk factors where the inflection point precedes peak systolic pressure remains unknown. ⋯ : Peak systolic mitral annular motion timing (representing the commencement of myocardial deceleration in systole) always precedes and remains coupled to carotid pressure wave inflection point timing in older patients with established cardiovascular risk factors. This data suggests that the morphology of the central blood pressure waveform may relate more strongly to local ventricular-vascular interactions, rather than wave reflections.
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Journal of hypertension · Jun 2015
6A.09: DIAGNOSIS OF SODIUM SENSITIVITY FROM MEAN ARTERIAL PRESSURE MEASURED AT THE ARM OR AT THE FINGER.
The severity of sodium sensitivity is quantified or 1) by the difference in mean arterial pressure (MAP) between high- and low-sodium diets (δMAP), or 2) by the sodium-sensitivity index (SSI), i.e. ratio between δMAP and the difference in urinary sodium excretion rates at the end of the two diets. MAP is usually measured with an arm cuff but the use of finger blood pressure monitors is rapidly increasing. Thus, our aim is to evaluate whether finger measures of MAP can be reliably used for assessing sodium sensitivity. ⋯ : The assessment of sodium sensitivity depends strongly on the MAP measurement site, with important discrepancies between brachial and finger measures.
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Journal of hypertension · Jun 2015
4A.09: SAFETY AND PERFORMANCE OF THE ENLIGHTN RENAL DENERVATION SYSTEM IN PATIENTS WITH SEVERE UNCONTROLLED HYPERTENSION: 12 MONTH RESULTS FROM THE ENLIGHTN II STUDY.
Percutaneous sympathetic renal artery denervation is available for the treatment of patients with resistant hypertension. We further investigated the safety and efficacy of a multi-electrode renal denervation system (EnligHTN™) in patients with severe uncontrolled hypertension. ⋯ In this real world, post-marketing study we demonstrate that multi-electrode renal denervation results in durable, highly significant and safe lowering of both office BP and ambulatory BP parameters in patients with severe uncontrolled hypertension up to 12 months following treatment.
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Journal of hypertension · Jun 2015
5A.01: CORONARY ATHEROSCLEROSIS AND ADVERSE OUTCOME IN HYPERTENSIVE PATIENTS WITH RECENT-ONSET ATRIAL FIBRILLATION AND TROPONIN RISE.
Atrial fibrillation (AF), the most common cardiac-arrhythmia in critical-care, has reached a high prevalence in hypertensive patients. Prevention of systemic-embolism is mandatory; unfortunately, evidence to support the treatment of comorbidities as coronary artery disease (CAD) that contribute to excess mortality is lacking, and the mechanism underlying the troponin-rise during AF without acute coronary syndrome (ACS) is unclear. This study investigates the relationship between CAD, stroke and outcomes in patients with troponin-rise and AF. ⋯ Patients with a recent-onset AF and troponin-rise showed a high prevalence of CVE but not stroke, thus CAD might have a role in poor outcomes.
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Journal of hypertension · Jun 2015
Principles of cerebral hemodynamics when intracranial pressure is raised: lessons from the peripheral circulation.
The brain is highly vascular and richly perfused, and dependent on continuous flow for normal function. Although confined within the skull, pressure within the brain is usually less than 15 mmHg, and shows small pulsations related to arterial pulse under normal circumstances. Pulsatile arterial hemodynamics in the brain have been studied before, but are still inadequately understood, especially during changes of intracranial pressure (ICP) after head injury. ⋯ The findings emphasize importance of reducing ICP, when raised, and on the additional benefits of reducing wave reflection from the lower body.