J Staessen

..We therefore undertook a quantitative overview of the trials to further evaluate the risks associated with systolic blood pressure in treated and untreated older patients with isolated systolic hypertension..

..Ambulatory blood pressure (ABP) monitoring is used increasingly in clinical practice, but how it affects treatment of blood pressure has not been determined...

..We aimed to investigate whether pharmacological properties of antihypertensive drugs or reduction of systolic pressure accounted for cardiovascular outcome in hypertensive or high-risk patients...

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..However, most studies in humans focused on single-gene effects and disregarded epistasis, the suppression or potentiation of a gene by other non-allelic genes...

..Chronic low-level exposure to cadmium may promote calcium loss via urinary excretion. We undertook a prospective population study to investigate whether environmental exposure to cadmium lowers bone density and increases risk of fractures...

..The clinical use of ambulatory blood pressure (BP) monitoring requires further validation in prospective outcome studies...

..In conclusion, the newer techniques of blood pressure measurement are now well established in the diagnosis and management of adult subjects with hypertension...

..To reach a consensus on the clinical use of ambulatory blood pressure monitoring (ABPM)...

..We hypothesise that this phenomenon may contribute to the rise in systolic pressure and pulse pressure in women beyond age 50 and, in turn, may lead to a slight dilatation of the common carotid artery...

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..Human exposure to chemicals is normally monitored by measurement of environmental pollutants in external media. We investigated whether biomarkers in adolescents can show exposure to, and health effects of, common environmental pollutants...

..However, the present proposal could guide clinicians who wish to use self-measurement to refine the diagnosis and the management of hypertension based on conventional sphygmomanometry...

..More moderate salt restriction may constitute a more realistic goal, but its influence on blood pressure in the community at large is probably trivial...

..Although apparently simple, this procedure is fraught with many potential sources of error. This review focuses on two alternative techniques of BP measurement: ambulatory monitoring and self measurement...

..Self-measurement of blood pressure is increasingly used in clinical practice, but how it affects the treatment of hypertension requires further study...

..In diabetic patients, nitrendipine reduced the risk of proteinuria, decreased total mortality, and markedly improved cardiovascular prognosis. Taken together, these findings emphasize the desirability of tight blood pressure control...

..Furthermore, we observed that in clinical trials in hypertensive or high-risk patients gradients in systolic pressure accounted for most differences in outcome...

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..To reach a consensus on the prognostic significance of new techniques of automated blood pressure measurement...

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..In a quantitative overview of published trials, we investigated whether some pharmacological properties of antihypertensive drugs, besides reduction in blood pressure, explain cardiovascular outcomes in hypertensive or high-risk patients...

..These findings emphasize the desirability of tight BP control. The hypothesis that angiotensin converting enzyme inhibitors or alpha-blockers might influence outcome beyond their BP lowering-effects was not confirmed...

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..Our data suggest that the changes in plasma renin, aldosterone, and alpha-atrial natriuretic peptide during xipamide administration may be related to diuretic-induced volume contraction...

..In conclusion, in TT homozygotes of both generations, early left ventricular relaxation was reduced. In TT homozygous parents, the latter observation might be because of the higher systolic pressure associated with the TT genotype...

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..As compared with nifedipine, celiprolol after 12-week therapy had a rather favorable plasma lipid profile. The clinical relevance of such findings, in terms of prevention of cardiovascular complications, has yet to be established...

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..03), non-cardiovascular (P = 0.03) and cancer (P = 0.04) mortality during follow-up on double-blind treatment. Total and non-cardiovascular mortality were also negatively correlated with haemoglobin and body weight at randomization...

..Changes in intra-erythrocyte cations in ADD2 1797CC homozygous men might lead to osmotic fragility of erythrocytes, but to what extent they reflect systemic changes or are possibly involved in blood pressure regulation remains unknown...

..Gender and renal function were the major determinants of serum uric acid in elderly hypertensive patients...

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..Thus, one 24 h recording is insufficient to fully characterize an individual's diurnal BP profile...

..However, a decrease in the Na+, K+-pump and the Na+, K+-cotransport activity and a rise in the passive permeability of the cell membrane was only observed starting from a concentration of 10(-4) M xipamide...

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..ADD1 and AT1R interactively determine the elastic properties of the femoral artery. There is a single-gene effect of the AGT promoter haplotypes on brachial properties and PRA...

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..Thus, blood pressure measurements during long-term CEI predict the curability by PTRA of renovascular hypertension and can be employed either alone or in association with the RVR...

..The increase of heart rate in response to the upright posture is less pronounced at older age, whereas the reflex control of the peripheral vasculature is preserved and blood pressure maintained...

..The changes in plasma renin, aldosterone, and alpha-atrial natriuretic peptide during xipamide administration may be related to diuretic-induced volume contraction...

..CONCLUSION: Stepwise antihypertensive drug treatment, starting with the dihydropiridine calcium-channel blocker nitrendipine, improves prognosis in elderly patients with isolated systolic hypertension...

..Few studies have addressed the effect of cadmium toxicity on arterial properties...

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..37 (CI: 1.16-1.69). These prospective data suggest that pulse pressure may improve the Framingham risk prediction among middle-aged and older individuals. Further studies, especially in the Framingham cohort, are warranted...

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..0003), -0.2 (-0.5 to -0.1, P = 0.13), 0.3 (-0.3 to 1.0, P = 0.28) and 0.5 (0.01 to 1.1, P = 0.047) mm Hg, respectively. In conclusion, there is no consistent relationship between blood pressure and blood lead in the NHANES III dataset...

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..The pooled results of 15,693 older patients with isolated systolic hypertension prove that antihypertensive drug treatment isjustified if on repeated clinic measurements SBP is 160 mm Hg or higher...

..To compare the results from autoregressive modelling (ARM) and from fast Fourier transform (FFT), the most commonly used methods for the analysis of short-term heart rate variability in the frequency domain...

..The latter 2 methods were applied in untreated subjects not selected on the basis of their blood pressure...

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..Finally, a meta-analysis partly based on Syst-Eur data showed that in older hypertensive patients pulse pressure and not mean pressure is the major determinant of cardiovascular risk...

..The goal of this study was to assess the prognostic power of the pulse pressure-to-stroke index (PP-to-SVi) ratio for cardiovascular events and mortality in patients with uncomplicated hypertension...

..5 to +1.4 mm Hg; P < 0.001) and with a 0.6 mm Hg increase in the diastolic pressure (95% CI +0.4 to +0.8 mm Hg; P < 0.001). On balance, this meta-analysis suggests that there can only be a weak association between BP and blood lead...

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..The pooled results of 15693 older patients with isolated systolic hypertension prove that antihypertensive drug treatment is justified if on repeated clinic measurements systolic blood pressure is 160 mmHg or higher...

..The hypothesis that angiotensin-converting enzyme inhibitors or alpha-blockers might influence outcome over and beyond that expected on the basis of their blood pressure lowering effects still remains to be proved...

..This relation was observed in Slavic male offspring. It was therefore dependent on gender, age and ecogenetic context, and in addition it appeared to be modulated by the trophic effects of salt intake on LVM...

..By contrast, blood pressure variability, as measured in the present study, was only to a minor extent influenced by life style...

..The pooled results of 15,693 older patients with isolated systolic hypertension prove that antihypertensive drug treatment is justified if systolic blood pressure on repeated clinic measurements is 160 mm Hg or higher...

..By using the procedures of linear multiple regression, commonly provided by software packages, the calculations can be readily implemented on microcomputers without requiring advanced skills in mathematics or programming techniques...

..The Framingham findings, which have informed several guidelines, can be extrapolated to a Western European population...

..Western Europeans have low blood levels of selenium (BSe), an antioxidant trace element. In a Flemish population, we investigated the cross-sectional and longitudinal association of blood pressure (BP) with BSe...

..We reviewed the randomized controlled trials that evaluated the effects of an antihypertensive drug versus placebo or another antihypertensive agent of a different class on carotid intima-media thickness...

..The ambulatory arterial stiffness index (AASI) can be computed from individual 24-h blood pressure recordings...

..Pending additional validation in outcome studies, normal values of AASI are probably <0.50 and 0.70 in young and older subjects, respectively...

..We investigated the prognostic value of AASI and PP in relation to fatal outcomes...

..The goal of our study was to assess the sex-specific intrafamilial aggregation of ultrasonographic carotid intima-media thickness (IMT) and brachial flow-mediated vasodilation (FMD) in a Siberian population...

..Current diagnostic thresholds for ambulatory blood pressure (ABP) mainly rely on statistical parameters derived from reference populations. We determined an outcome-driven reference frame for ABP measurement...

..The EPOGH therefore highlights the concept that phenotype-genotype relations can only be studied within a defined ecogenetic context...

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..We examined the role of blood pressure-lowering compared with class-specific properties of antihypertensive drugs in cardiovascular prevention...

..9% and 44.3%, respectively. In conclusion, the alpha-adducin Gly460Trp polymorphism, in combination with systolic blood pressure, is a strong predictor of cardiovascular mortality and morbidity...

..With the exception of the night:day heart rate ratio, heart rate did not add to the risk stratification for fatal combined with nonfatal cardiovascular events. Thus, heart rate adds little to the prediction of cardiovascular risk...

..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...

..The increased mortality in patients with higher NDR probably indicates reverse causality. Our findings support recording the ambulatory BP during the whole day...

..We investigated the possible association between left ventricular diastolic function and the ADD1 Gly460Trp and ADD3 IVS11 +386A>G polymorphisms alone and in combination...

..Whether the treatment of patients with hypertension who are 80 years of age or older is beneficial is unclear. It has been suggested that antihypertensive therapy may reduce the risk of stroke, despite possibly increasing the risk of death...

..In conclusion, population-based outcome-driven thresholds for optimal and normal ABP are lower than those currently proposed by hypertension guidelines...

..0%. Cardio-Sis is the first randomized study specifically designed to compare two different SBP goals. Results will be broadly applicable to subjects with uncontrolled SBP under anti-hypertensive treatment...

..We investigated to what extent anthropometric and lifestyle factors contributed to the classification of Chinese individuals into groups with white-coat, masked and sustained hypertension (HT)...

..The regulator of G-protein signalling-2 (RGS2) is a key factor in adipogenesis. We hypothesized that the metabolic syndrome, of which obesity is an important component, might be related to genetic variation in RGS2...

..We are constructing a new resource of longitudinal population studies to investigate with great precision to what extent the ambulatory blood pressure improves risk stratification...

..In conclusion, isolated nocturnal HT can only be diagnosed by ambulatory blood pressure monitoring, is prevalent among Chinese, and is associated with increased arterial stiffness...

..89; P=0.47 versus 0.40). AASI is a novel measure of arterial stiffness, which can be readily determined from ambulatory blood pressure recordings and which independently predicts cardiovascular mortality, even in normotensive subjects...

..The association between these measurements and mortality and morbidity in this age group will be addressed...

..The purpose of our study was to investigate whether the ADRA2B I/D polymorphism is associated with such phenotypes in a Chinese population...

..CONCLUSION: In the placebo group, but not the active treatment group, increased night-time systolic blood pressure variability on admission to the Syst-Eur trial was an independent risk factor for stroke during the trial...

..Genetic determinants of complex quantitative traits such as BP can only be investigated within their epidemiologic context...

..Subjects were genotyped for the beta-adducin C1797 T polymorphism. Both a population-based association study and a family-based analysis were performed...

..We studied the C825T polymorphism in relation to blood pressure, obesity and intermediate phenotypes in a Caucasian population...

..This genotype may slightly potentiate the structural and functional haematological disturbances associated with alcohol intake...

..In the present study, we investigated in multivariate analyses whether the risk of hypertension was associated with the C1797T polymorphism of the beta-adducin gene...