K Kario

..Here I review the recent evidence, possible mechanism and the management of "disaster HT" for effective prevention of disaster-induced cardiovascular events...

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..Anti-hypertensive medication that normalizes the diurnal blood pressure variation might improve the cardiovascular prognosis in high-risk hypertensive patients...

..Cardiovascular events occur most frequently in the morning hours. We prospectively studied the association between the morning blood pressure (BP) surge and stroke in elderly hypertensives...

..The impact on microalbuminuria of strict treatment aimed at lowering of self-measured morning blood pressure using an adrenergic blockade is unclear...

..In conclusion, brain damage is advanced in DHTs. ARB partly improved the impaired cerebral microvascular function in DHTs...

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..This "bronchoantihypertensive" therapy seems to be more effective for reducing sleep blood pressure in hypertensive patients with COPD and sleep hypoventilatory/hypoxemic syndromes...

..The study investigated the clinical significance and mechanism of orthostatic blood pressure (BP) dysregulation in elderly hypertensive patients...

..Blood pressure also increased after the earthquake, and was prolonged for several weeks in patients with microalbuminuria...

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..Individualized antihypertensive medication targeting disrupted diurnal BP variation might thus be beneficial for such high-risk hypertensive patients...

..It remains uncertain which is the stronger predictor for stroke in older hypertensives, ambulatory pulse pressure (PP) or mean blood pressure (MBP)...

..The morning surge of blood pressure (BP) is associated with alpha-adrenergic activity. We studied the association between the alpha-adrenergic morning surge in BP and silent cerebrovascular disease in elderly patients with hypertension...

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..Increased VP after tilting in extreme dippers might counteract reduced circulating blood volume, whereas nondippers appear to have alpha- and beta-adrenergic subsensitivity that may be induced by their chronic exposure to high NE levels...

..To study the impact of the dosing time of an angiotensin II receptor blocker (ARB) titrated by self-measured home blood pressure (HBP) on cardiorenal damage in hypertensives...

..In conclusion, congenital protein C deficiency may accelerate the progression of silent cerebral infarct formation in hypertension, particularly in the basal ganglia, and may be a potential risk for stroke or vascularly induced dementia...

..In addition, they also show that among employed women who perceive greater stress at home than at work, higher home stress levels may also elevate sleep BP levels...

..Understanding the characteristics of OSAS-related hypertension is essentially important to achieve perfect BP control over a 24-h period, including the sleep period, for more effective prevention of cardiovascular disease...

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..27, P=0.006). In conclusion, depression is associated with disrupted diurnal BP variation independent of ambulatory physical activity in working men, whereas anxiety is associated with awake SBP and pulse rate in women...

..However, their combined impact on the risk of a stroke remains unknown...

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..CONCLUSIONS: Exaggerated MBPS, adjusted for physical activity, is associated with cardiac hypertrophy independent of ambulatory BP level in a community-dwelling population...

..01-2.26), and beta-blocker use (OR 1.50, P=.02, 95% CI 1.06-2.12). CONCLUSIONS: Older age, beta-blocker use, and regular alcohol drinking were significant determinants of the exaggerated ME difference in medicated hypertensive patients...

..Moreover, a reduction in the microalbuminuria may have occurred concomitant with a reduction in clinic systolic BP level...

..We sought to study the association of the silent cerebral infarct (SCI), a predisposing condition of stroke, with hyperinsulinemia and hemostatic abnormalities in older hypertensive subjects...

..The improvement in endothelial cell function brought about by lipid-lowering therapy might contribute to the reduction in cardiac events within a relatively short time period in hyperlipidemic patients...

..To examine the relationship between serum insulin and lipoprotein (a) [Lp(a)] concentrations in both sexes in a large population...

..In the very old (older than 75 years), however, there were no consistent associations between pulse pressure measures and BNP. More studies are needed in the evaluation of cardiac risk with hemodynamic measures in the very old...

..The lack of any such association in older hypertensives can be explained by both the plateau in the values of carotid AIx, and the fact that LVM increased with age...

..The most important determinants of the effect of doxazosin were the absolute BP levels, both day and night, rather than dipping status per se...

..It is clinically important to distinguish WCHT from SHT even after assessment of target organ damage in the elderly...

..The correlation with white-coat hypertension suggests that both phenomena are related to sympathetic activation...

..Clinical and awake BPs were similarly reduced by each drug therapy. In conclusion, BRS was increased by azelnidipine therapy, but not by amlodipine therapy. This differential effect may be important in cardiovascular risk reduction...

..Cardiovascular prognostic significance of relative wall thickness (RWT) in patients with diabetes has not been reported although concentric hypertrophy is common in diabetic patients...

..Our study objective was to examine atherosclerotic profiles in HT and DM patients in both countries...

..Doxazosin is reported to increase the incidence of congestive heart failure. The benefits of doxazosin, for controlling morning blood pressure as well as its effect on the left ventricular structure and function, are herein examined...

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..6] pg/mL, p=0.003). Evaluation of orthostatic hypertension at home might be a high-risk factor for cardiovascular events in hypertensive subjects with increased levels of BNP and a higher UAR, independent of the home sitting BP level...

..Antihypertensive medication that normalize the disrupted circadian BP variation might improve cardiovascular prognosis in high-risk hypertensive patients...

..33, p < .0001). In conclusion, in hypertensive elderly patients, endothelial cell damage increases with systolic BP and fibrinogen levels, indicating a prethrombotic condition...

..Of greatest interest is the potential benefit of a chronotherapeutic approach, involving, for example, long-acting chronoformulations, which has not yet been extensively studied...

..Background: There have been few reports on the relationship between variation in the diurnal pulse rate (PR) in relation to a nondipper blood pressure (BP) pattern and cardiovascular events in elderly hypertensives...

..It has been demonstrated that insulin resistance is associated with morning hypertension. We investigated the hypothesis that the lowering of morning blood pressure (BP) can improve insulin resistance in patients with morning hypertension...

..We previously reported that morning blood pressure (BP) surge (MBPS) was an independent risk factor for stroke. We evaluated the determinants of MBPS in hypertensive patients...

..The negative white-coat effect (WCE), a phenomenon in which out-of-office blood pressure (BP) is higher than clinic BP, has not been well examined, unlike the WCE...

..Thus, when we controlled using daytime office BP, amlodipine might not further reduce nocturnal BP to the extent that it accelerates the brain ischemia in some hypertensive patients with marked nocturnal BP reduction...

..4 vs 10.1 mg/gCr, P<.05). Depressive hypertensive patients required a larger number of antihypertensive drugs to control HBP, and showed a smaller reduction in UACR than nondepressive hypertensives...

..To break the vicious circle, not only the management of risk factors such as diabetes, obesity, or smoking, but also the intervention with antihypertensive agents is considered as a useful and effective procedure...

..Both high blood pressure (BP) and inflammatory processes have been reported to be involved in cognitive impairment via cerebrovascular atherosclerosis or neuronal cell damage...

..70-0.94, chi2=7.70, d.f.=1, P=0.006] but not of cardiac events. It should not be assumed that one summary measure of ambulatory blood pressure would be the best predictor of different clinical outcomes...

..The CAD-atherosclerosis and hypertension may be independently involved in the pathologic process of SCI...

..Antihypertensive drug treatment can normalize the non-dipping pattern, but the therapeutic consequences of this are unknown...

..Patients with WCHT also showed no benefit...

..We assessed the hypothesis that changes in PP during antihypertensive therapy correlate with changes in surrogate markers of target-organ damage...

..We tested the reproducibility of ambulatory blood pressure (ABP), BP variability, and BP reduction in hypertensive patients...

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..Systolic hypertension in the elderly has been found to be a risk factor for cognitive impairment. We studied the relationship of ambulatory blood pressure with brain atrophy and cognitive function...

..The purpose of this study was to investigate the subclinical arterial damage in unmedicated subjects with MHT detected by home BP measurement...

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..It is clinically important to distinguish WCHT from SHT even after assessment of target organ damage in the elderly...

..Treatment with these agents that modify BP may benefit even normotensive patients after a myocardial infarction, although the benefit is greater in hypertensives...

..The present study investigated whether the morning-evening difference in self-measured blood pressure (BP) (MEdif) can be an independent determinant of cardiac damage in untreated hypertensive patients...

..27, p<0.05). N-type calcium channel blockade by cilnidipine may not cause reflex tachycardia, and may be useful for hypertensive treatment...

..The aim of this study was to assess the association of the change in pulse wave velocity (PWV) with that in urinary albumin excretion as a measure of renal damage...

..In conclusion, increased HR variability during sleep was a predictor for incident CVD in T2DM, but not in non-diabetics. Increased HR variability at night would reflect pathophysiological mechanism of T2DM...

..The aim of this study was to evaluate the prevalence and determinants of SCI in hypertensives with or without diabetes mellitus (DM)...

..Diabetic patients with MHT showed evidence of brain and kidney damage. Hence, out-of-office monitoring of BP may be indicated in diabetics whose BP is normal in the clinic...

..The cell-to-cell interaction between monocytes and HUVECs induces AM production by HUVECs, which may play an important role in the pathogenesis of vascular disorders...

..Elderly women with a history of falls and with lower SBP levels should have more attention paid to the prevention of falls and related accidents...

..A subgroup with higher levels of CRP who had an aggregation of cardiovascular risk factors was identified by the 2 measurements...

..Whether the incidence of cerebrovascular stroke increased after the 1995 Hanshin-Awaji earthquake (EQ) in Japan and whether seismic intensity affected stroke risk dose-dependently was examined...

..In conclusion the abnormal patterns of circadian BP rhythm were frequently observed during the acute phase of stroke. The cause of this abnormality may result from the diminished circadian rhythms of neurohumoral factors...

..The objective of this study was to investigate the relationship between nocturnal hypoxia and silent cerebral infarct (SCI) in the general population...

..Japanese adults have very low hs-CRP levels. An aggregation of metabolic risk factors is associated with elevated hs-CRP levels among overweight individuals, particularly in women...

..In conclusion, WCH was not associated with a definitely increased risk of stroke during the total follow-up period. However, WCH might not be a benign condition for stroke in the long term...

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..We investigated the relationships and the differences between ambulatory BP variability and cognitive function or QOL in younger elderly and very elderly...

..21-1.47) and 1.23 (95% CI 1.06-1.37), respectively. Home BP measurements were associated with good hypertensive management. Our findings suggest that it is important that physicians recommend home BP measurements to their patients...

..However, the predictor of high PR at home in treated hypertensives is unknown. In this study, we studied the predictor of high PR and evaluated pulse rate variability (PRV)...

..9% for diastolic BP (kappa coefficient = 0.43). The present study showed that the prevalence of masked hypertension was underestimated when the diagnosis of masked hypertension was made on the basis of evening home BP...

..Using 24-h ambulatory blood pressure monitoring, we studied the repeatability of the morning blood pressure in older (> or =60 years) patients with isolated systolic hypertension...

..These results indicate that amlodipine is effective at lowering BP in older hypertensives, although it may increase VEB, especially when given at a high dose...