American journal of hypertension
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Randomized Controlled Trial Multicenter Study
Should Blood Pressure Targets After Lacunar Stroke Vary by Body Size? The SPS3 Trial.
It is unknown whether the physiological impact of a given blood pressure (BP) varies by body size. We explored interactions between higher vs. lower systolic BP (SBP) targets and anthropometric measures (body mass index (BMI), body surface area (BSA), height, weight) and recurrent stroke and death in the Secondary Prevention of Small Subcortical Strokes (SPS3) Trial. ⋯ Trial Number NCT00059306.
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Vascular calcification, a regulated process in chronic kidney disease (CKD), requires vascular smooth muscle cell (VSMC) differentiation into osteoblast-like cells. This phenomenon can be enhanced by inflammatory cytokines and production of reactive oxygen species (ROS). In CKD rats with vascular calcification, we investigated whether inflammatory cytokines, ROS generation, and downstream signaling events are associated with CKD-related vascular calcification. ⋯ This study demonstrates a relationship between inflammation/ROS and arterial calcification in CKD and contributes to understanding of the complex pathways that mediate arterial calcification in CKD patients.
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Central blood pressure (CBP) betters conventional clinical BP (cuff BP) in predicting cardiovascular outcomes. Noninvasive CBP monitoring has emerged as a new technology for management of hypertension. This study aimed to analyze the cost-effectiveness of noninvasive CBP compared to cuff BP monitoring for confirming a diagnosis of hypertension. ⋯ Early evidence on the diagnostic accuracy of noninvasive CBP monitoring suggests significant improvements in the confirmation of suspected hypertension, compared to cuff BP. This paper suggests that the long-term benefits of improved diagnostic performance justify the supplementary purchase costs of new, noninvasive CBP monitors. The results highlight the potential value of CBP, and hence the value of further research to confirm the diagnostic and prognostic role of CBP for the management of hypertension.
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The cardio-renal interaction occurs via hemodynamic and humoral factors. Noninvasive assessment of renal hemodynamics is currently possible by assessment of renal resistive index (RRI) derived from intrarenal Doppler arterial waveforms as ((peak systolic velocity - end-diastolic velocity)/peak systolic velocity). Limited information is available regarding the relationship between RRI and cardiac hemodynamics. We investigated these associations in randomly recruited subjects from a general population. ⋯ We demonstrated that in unselected subjects RRI was significantly associated with central pulse pressure and left ventricular systolic and diastolic Doppler blood flow indexes. Our findings imply that in addition to the anthropometric characteristics, cardiac hemodynamic factors influence the intrarenal arterial Doppler waveform patterns.
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Randomized Controlled Trial Multicenter Study Observational Study
Biological correlates of blood pressure variability in elderly at high risk of cardiovascular disease.
Visit-to-visit variability in blood pressure is an independent predictor of cardiovascular disease. This study investigates biological correlates of intra-individual variability in blood pressure in older persons. ⋯ In an elderly population at risk of cardiovascular disease, inflammation (as evidenced by higher levels of interleukin-6) is associated with higher intra-individual variability in systolic, diastolic, and pulse pressure.