American journal of hypertension
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Migraine, a common chronic-intermittent disorder of idiopathic origin characterized by severe debilitating headaches and autonomic nervous system dysfunction, and preeclampsia, a hypertensive disorder of pregnancy, share many common epidemiological and pathophysiological characteristics. Both conditions are associated with higher subsequent risk of ischemic stroke. Moreover, endothelial dysfunction, platelet activation, hyper-coagulation, and inflammation are common to both disorders. We assessed the risk for preeclampsia in relation to the maternal history of migraine before and during pregnancy in Peruvian women. ⋯ Our findings are consistent with previous reports and we have extended them to the Peruvian population. Prospective cohort studies, however, are needed to more rigorously evaluate the extent to which migraines and/or its treatments are associated with the occurrence of preeclampsia.
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To investigate the risk of stroke in subjects with isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and combined systolic and diastolic hypertension (SDH) in a Japanese general population, we used 24-h ambulatory blood pressure (ABP) and casual-screening blood-pressure (CBP) readings. ⋯ Isolated systolic hypertension, as determined by 24-h ABP measurements, was associated with a high risk of stroke, similar to that found in SDH subjects; this suggests that the prognosis of hypertensive patients would be improved by focusing treatment on 24-h systolic ABP.
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We previously reported that a high-sodium diet activates the local renin-angiotensin-aldosterone system (RAAS) in cardiovascular tissues of Dahl salt-sensitive hypertensive (DS) rats. Angiotensin-converting enzyme 2 (ACE2) is a novel regulator of blood pressure (BP) and cardiac function. The effect of blockade of aldosterone or angiotensin II (Ang II) on cardiac angiotensinogen and ACE2 in DS rats is unknown. ⋯ In DS rats, blockade of aldosterone or Ang II protects cardiac hypertrophy and fibrosis by inactivation of the local RAAS in the heart.
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Randomized Controlled Trial
Noninvasive pulse waveform analysis in clinical trials: similarity of two methods for calculating aortic systolic pressure.
Concerns persist about the validity of generalized transfer function-derived, aortic blood-pressure measurements during the administration of vasoactive agents in clinical trials. Hence, we compared this transfer-function method with another, which estimates aortic systolic pressure directly from the late systolic shoulder of the radial pressure wave, after administration of placebo, ramipril, or atenolol. ⋯ Central pressure derived from radial pressure waveforms using a generalized transfer function gave similar results for central pressure measured directly from radial waveforms. The hemodynamic benefits of angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, and calcium channel blocker over beta-blocker antihypertensive therapy in recent trials were confirmed by this study.