Preliminary study of abnormal increase of postexercise systolic blood pressure in the diagnosis of coronary artery disease

Objectives This study sought to evaluate the diagnostic value of abnormal increase of postexercise systolic blood pressure (SBP) for detecting coronary artery disease (CAD) in patients with or without hypertension. Methods Treadmill exercise testing (TET) was conducted in 88 patients (40 CAD patients, 48 control subjects) with or without hypertension, each of whom underwent selective coronary angiography (CAG). The abnormal increase of postexercise SBP was defined as 10mmHg higher than earlier periods during the recovery phase (6 minutes) of exercise testing. Results The abnormal increase of postexercise SBP had higher sensitivity, specificity, and accuracy for detecting CAD than those of ST - segment depression in patients with or without hypertension. Its accuracy increased with the severity of CAD while decreased in patients with hypertension, and the increase value of SBP had a positive correlation with the extent of coronary artery lesion. The combination of ST - segment depression and abnormal increase of postexercise SBP diagnosed CAD most accurately in patients with hypertension. Conclusions Abnormal increase of postexercise SBP may be a useful index for diagnosing CAD.

THE CIRCADIAN ALTERATIONS OF BLOOD PRESSURE IN PATIENTS WITH SECONDARY HYPERTENSION

Objective To study the pattern of circadian blood pressure changes in patients with se-condary hypertension. Methods The 24h ambulatory blood pressure monitoring was performed in 80 patients with secondary hypertension (SH) including primary aldosteronism in 44, pheochromocytoma in 11, renovas-cular hypertension in 10, renoparenchymal hypertension in 15 and compared with 80 patients with essential hy-pertension (EH) matched by age and sex. Results The diurnal rhythm in patients with SH was different from that of patients with EU. The diurnal curves in SU and EU was overlapped in daytime and separated from each other at nighttime. The nocturnal blood pressure fall was less and average blood pressure at nighttime was higher in patients with SH than those in patients with Eli (P <0. 01). The nighttime blood pressure loading and non-dipper phenomenon were much more frequently seen in patients with SH than those in patients with Eli (P <0. 01). The nighttime blood pressure/daytime blood pressure ratio was significantly higher in patients with SH than that in patients with Eli (P <0. 01). Conclusion The non-invasive 24h ambulatory blood pressure monitoring may be a useful method in screening for

Impact of blood pressure control on coronary flow reserve in hypertensive patients

Objective To investigate the impacts of blood pressure control on coronary flow reserve(CFR)in hypertensive patients.Methods A total of 236 patients without significant coronary stenosis(defined as<50%luminal narrowing confirmed by coronary angiography or coronary artery CT scan)between January 2011 and July 2015were retrospectively enrolled in this study.CFR

Impact of classic massage on blood pressure in patients with clinically diagnosed hypertension

OBJECTIVE: To assess the impact of classic massage on the changes in the values of blood pressure in women with previously diagnosed hypertension.METHODS: The study involved a group of ten women aged 60-68, who had previously been diagnosed with hypertension. Ten sessions of classic massage of the lower limbs were performed on the subjects. The massage sessions were conducted every day over ten consecutive days. Throughout the treatment, the subjects' blood pressure was measured using a manometer with a stethoscope TRO-CARDIO KIT 2 MONO. Their blood pressure was taken 1 min before the massage, as well as 1 min and5 min after each session. The study took place between March and June 2013 in Szpital Specjalistyczny im. J?drzeja ?niadeckiego(J?drzej ?niadecki Specialist Hospital) in Nowy S?cz, at the Department of Internal Diseases.RESULTS: For ten consecutive days, the blood pressure values in the examined women were decreasing, with the exception of the diastolic blood pressure measured 5 min after the massage.CONCLUSION: The drops in blood pressure by several percent, noted in the majority of the female subjects over the time of the study. Classic massage might provide a safe supportive measure in pharmacologic treatment of hypertension.

Nigerian Population Research on Environment,Gene and Health (NIPREGH)-objectives and protocol

Sub-Saharan Africa is currently undergoing an epidemiological transition from a disease burden largely attributable to communicable diseases to that resulting from a combination of both communicable and chronic non-communicable diseases.Data on chronic disease incidence,lifestyle,environmental and genetic risk factors are sparse in this region.This report aimed at providing relevant information in respect to risk factors that increase blood pressure and lead to development of intermediate cardiovascular phenotypes.We presented the rationale,objectives and key methodological features of the Nigerian Population Research on Environment,Gene and Health（NIPREGH） study.The challenges encountered in carrying out population study in this part of the world and the approaches at surmounting them were also presented.The preliminary data as at 20 November 2013 showed that out of the 205 individuals invited starting from early April 2013,160（72 women） consented and were enrolled;giving a response rate of 78%.Participants＇ age ranged from 18 to 80 years,with a mean（SD） of 39.8（12.4） years and they were of 34 different ethnic groups spread over 24 states out of the 36 states that constitute Nigeria.The mean（SD） of office and home blood pressures were 113.0（15.2） mm Hg systolic,73.5（12.5） mm Hg diastolic and 117.3（15.0） mm Hg systolic,and 76.0（9.6） mm Hg diastolic,respectively.Forty-three（26.8%） participants were hypertensive and 8（5.0%） were diabetic.In addition to having the unique potential of recruiting a cohort that is a true representative of the entire Nigerian population,NIPREGH is feasible and the objectives realisable.

Clinical Study of Western Medicine Combined with Chinese Medicine Based on Syndrome Differentiation in the Patients with Polarized Hypertension

Objective： To investigate the effects and safety of Western medicine combined with Chinese medicine （CM） based on syndrome differentiation in the treatment of elderly polarized hypertension （PHPT）, or isolated systolic hypertension with low diastolic blood pressure （DBP）. Methods： A total of 125 elderly patients with PHPT were randomly assigned to two groups： 59 in the control group treated by Western medicine and 66 in the intervention group treated by Western medicine combined with CM treatment. Based on syndrome differentiation, the patients in the intervention group were further divided into subgroups of yang-qi deficiency and yin-qi deficiency. All subjects were treated with Western medicine of Amlodipine Besylate Tablets and Irbesartan Tablets （or Irbesartan and Hydrochlorothiazide Tablets）, to decrease their systolic blood pressure （SBP） slowly to 125-135 mm Hg in 2-6 weeks. In the intervention group, Shiyiwei Shenqi Capsule （十一味参芪） was given additionally to the subgroup of yang-qi deficiency at the dosage of 3-5 capsules, thrice a day, while Dengzhan Shengmai Capsule （灯盏生脉胶囊） was given additionally to the subgroup of yin-qi deficiency at the dosage of 2 capsules, 2-3 times per day. For all subjects, SBP, pulse pressure （PP）, and DBP were measured before treatment and at the terminal of a 6-week treatment. For subjects in the intervention group, left ventricular ejection fraction （LVEF） was also recorded. Results： After a 6-week treatment, the SBP in the two groups and the PP in the intervention group decreased significantly compared to those before treatment （P〈0.05）, while the PP in the control group showed no significant difference between prior and post-treatment （P〉0.05）. After treatment, the DBP in the control group decreased （P〉0.05）, while the DBP and LVEF in the intervention group showed an increase tendency although it had no statistical significance （P〉0.05）. When subjects in the intervention group were classified further by the course of disease, the DBP and LVEF of subjects whose course of disease were less than 2 years, increased significantly after treatment （P〈0.05）. Conclusion： Western medicine combined with CM treatment based on syndrome differentiation was safer and more effective than Western medicine alone in the treatment of elderly PHPT, because it not only reduced SBP but also improved DBP, which might lower the incidence of the cardiovascular and cerebrovascular events.