American journal of hypertension
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Randomized Controlled Trial
Effects of low-dose atorvastatin on arterial stiffness and central aortic pressure augmentation in patients with hypertension and hypercholesterolemia.
Experimental and clinical data suggest that statins exert anti-inflammatory and antiproliferative actions on vasculature beyond their lipid-lowering properties. Whether these pleiotropic effects of statins translate into a beneficial effect on arterial stiffness is not clear. This study aimed to evaluate the potential effects of low-dose atorvastatin treatment on arterial stiffness and central arterial pressure waveforms in patients with mild hypertension and hypercholesterolemia. ⋯ ClinicalTrials.gov Database Identifier Number: NCT01126684.
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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.
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Randomized Controlled Trial Comparative Study
Effects of ACE inhibitors on cardiac angiotensin II and aldosterone in humans: "Relevance of lipophilicity and affinity for ACE".
Angiotensin-converting enzyme (ACE) inhibitors differ in their lipophilic/hydrophilic index that determines their tissue bioavailability and affinity to ACE, which may result in major differences in the degree of blockade of cardiac ACE. We evaluated the hypothesis that in patients with chronic heart failure (CHF) and activated cardiac renin-angiotensin-aldosterone system (RAAS), lipophilic ACE inhibitors with high affinity for ACE (perindopril and quinapril) will cause marked blockade of cardiac angiotensin (Ang) II and aldosterone generation, but not a hydrophilic ACE inhibitor with low affinity for ACE (lisinopril). ⋯ These findings do not support the concept that a hydrophilic ACE inhibitor is less effective in blocking the cardiac RAAS as compared to lipophilic ACE inhibitors.
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Randomized Controlled Trial Multicenter Study Comparative Study
Cluster-randomized controlled trial of oscillometric vs. manual sphygmomanometer for blood pressure management in primary care (CRAB).
Although mercury sphygmomanometers are seen as the gold standard instrument for blood pressure (BP) measurement, they are being withdrawn due to safety concerns. CRAB was a cluster-randomized controlled trial in 24 family practices in Tasmania, Australia, which aimed to determine the effect of an oscillometric device on BP management. ⋯ Although digit preference was largely eliminated by oscillometric measurement, prescribing behavior was mediated by SBP.
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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.