American journal of hypertension
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Left atrial systolic force (LASF) has been recently reported to be associated with prolonged left ventricular (LV) relaxation and concentric LV geometry in a clinical setting. This study analyzes the association of increased LASF to LV geometry and function in hypertensive patients from a population study. ⋯ Enhanced LASF is associated with LV hypertrophy, normal LV chamber function, increased cardiac output, and prolonged relaxation. The LASF is a preload-dependent measure.
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Morning blood pressure (BP) surge in ambulatory BP monitoring was a risk factor for stroke in our previous study. We studied the determinants of the morning minus evening systolic BP difference (ME difference) in self-measured BP monitoring, as a possible risk factor for stroke in medicated hypertensive patients. ⋯ Older age, beta-blocker use, and regular alcohol drinking were significant determinants of the exaggerated ME difference in medicated hypertensive patients.
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Vasoconstrictive, proliferative and oxidative effects of angiotensin II (Ang II) are mediated by Ang II type 1 (AT1) receptors. The effects of Ang II via the Ang II type 2 (AT2) receptor subtype (AT2R) are less well defined. Growing evidence shows the existence of cross-talk between the Ang II receptor subtypes, which is revealed by AT1R blockade. Hence, under certain conditions, AT2R may act as an antagonistic system with respect to the AT1R. ⋯ The losartan-unmasked AT2R-vasorelaxation could significantly contribute to the beneficial hemodynamic effects of AT1R blockade. In view of this, our study highlights the importance of the integrated Ang II receptor network, which may help to define further the mechanisms of the well-established vascular protective effects of AT1R blockers.
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Hypertension is a disease state characterized by increased blood pressure (BP) associated with hemodynamic abnormalities, including elevated systemic vascular resistance index (SVRI); and altered cardiac index (CI). The objective of this study was to use noninvasive impedance cardiography (ICG) to evaluate hemodynamic characteristics of subjects with and without hypertension. ⋯ Hemodynamic parameters from ICG displayed significantly different hemodynamic profiles between hypertensive and nonhypertensive subjects. However, significant individual variation of hemodynamic status exists. Hemodynamic measurements with ICG characterize hemodynamic status and may be helpful in diagnostic, prognostic, and therapeutic decision making in hypertensive subjects.
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Impedance cardiography (ICG), a noninvasive method of hemodynamic monitoring, is a useful tool in the care of critically ill patients. Use of this technology shows promise in the hemodynamic assessment of hypertensive stroke patients. This study describes the different ICG findings of patients with hypertensive stroke and correlates parameters with patient outcome. ⋯ In this population of hypertensive stroke patients admitted to the ICU, ICG showed an elevated SVRI and SVR and depressed CO, SV, and SI. In the ischemic stroke group, higher SVR and SVRI were associated with in-hospital death, whereas in the hemorrhagic stroke group, lower SVR and SVRI were associated with in-hospital death. The ICG may provide significant prognostic information in patients admitted with hypertensive stroke.