American journal of hypertension
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Hypertensive patients with retinal arteriolar abnormalities are at increased risk for cardiovascular events. However, the extent of retinal microvascular changes in naïve, never-treated patients with hypertension of short duration has not been established. In addition to this, the lack of relevant data about other phenotypes of hypertension (masked and white-coat hypertension) determined by ambulatory blood-pressure measurement (ABPM) is notable, despite their relationship to increased cardiovascular risk mediated by underlying target-organ and vascular damage. ⋯ Subtle retinal microvascular signs of pathology are observed in hypertensive patients at early stages of hypertension and in patients with both masked and white coat hypertension. These changes may be indicative or may mediate the differences in cardiovascular mortality in persons with masked and white-coat hypertension, and relevant information about this can be easily accessed with retinal photography.
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Hyperuricemia and left ventricular (LV) hypertrophy are prevalent in chronic kidney disease (CKD), but the association of uric acid (UA) and left ventricular mass index (LVMI) with renal outcomes in patients with CKD is unclear. We conducted a study to assess whether the combination of UA and LVMI is associated with renal outcomes in patients with CKD of stages 3-5. ⋯ Our findings show that the combination of a higher UA and LVMI is a risk factor for progression to dialysis and rapid progression of decline in renal function in patients with CKD of stages 3-5.
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The superiority of prognostic value of blood pressure (BP) measured at central aorta (CBP) over conventional brachial BP measured by cuff-based BP monitors has reignited the development of new noninvasive techniques for estimating CBP. The present study validated the accuracy of CBP measured by a newly developed stand-alone CBP monitor. ⋯ Central SBP, PP, and DBP can be measured accurately by a stand-alone automatic BP monitor.
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Multicenter Study
Evolution of target organ damage by different values of self-blood pressure measurement in untreated hypertensive patients.
To determine the prognostic value of various self-blood pressure (BP) monitoring (SBPM) cutoff at the time of diagnosis. ⋯ Baseline SBPM values <130/80 mm Hg is associated with better evolution of amount of TOD than SBPM values <135/85 mm Hg. These results would support a clinical trial to test a SBPM threshold <130/80 as an optimal pressure not needing pharmacological treatment among those with CBP ≥ 140/90.
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Randomized Controlled Trial
Effect of cholecalciferol supplementation during winter months in patients with hypertension: a randomized, placebo-controlled trial.
Low 25-hydroxy-vitamin D (25(OH)D) levels are inversely related to blood pressure (BP) and have been associated with incident hypertension. In people living at northern latitudes diminished cholecalciferol synthesis in the winter increases the risk of vitamin D deficiency. We wanted to test the hypothesis that daily cholecalciferol supplementation in the winter lowers BP in patients with hypertension. ⋯ Cholecalciferol supplementation, by a dose that effectively increased vitamin D levels, did not reduce 24-h BP, although central systolic BP decreased significantly. In a post-hoc subgroup analysis of 92 subjects with baseline p-25(OH)D levels <32 ng/ml, significant decreases in 24-h systolic and diastolic BP occurred during cholecalciferol supplementation.