广东省不同个体特征人群血压差别的调查分析

目的 了解广东省不同个体特征人群的血压水平差别及影响血压升高的主要因素。方法 对1991年广东省高血压抽样调查15岁及以上研究对象共42894人的资料进行分析。个体特征包括：年龄、性别、职业、化程度、吸烟、饮酒及体重指数。结果 收缩压和舒张压均随年龄的增长而增长;男性的高血压患病率较女性高;在不同职业人群中经年龄标化后机关工作人员的高血压患病率最高,达12．9％;随着化程度的长高、高血压患病率增加,大学以上化程度高血压患病率达13．1％;吸烟较不吸烟患病率高;饮酒较不饮酒患病率高;体重指数高,高血压患病率明显升高。结论 在广东省不同个体特征人群中年龄、职业、化程度、吸烟、饮酒及体重指数均为升高血压的危险因素提示对这类人群需要减少社会精神压力,吸烟等致高血压危险因素。     

自然人群血糖、体重指数、腰臀比与血压的关系

目的：探讨自然人群中血糖、体重指数（BMI）、腰臀比（WHR）的水平对血压的影响及作用的大小。方法：应用1998年广东省糖尿病流行病学调查资料，采用分层整群抽样方法，调查对象年龄在20-74岁。血糖值为早晨空腹口服75g葡萄糖2h后的血糖值。糖悄病及糖耐量低减（IGT）的诊断标准采用1999年WHO糖尿病诊断标准。高血压诊断标准采用1999年中国高血压防治指南。结果：共调查11377人，其中男性5183人，女性6194人，平均年龄43岁，平均收缩压、舒张压、血糖、体重指数、腰臀比分别为117mmHg、74mmHg、104mg/dL、22kg/m^2和0.84。糖尿病高血压患病率明显高于血糖正常，为45.3％比14.4％，糖耐量低减高血压患病率明显高于糖耐量正常，为32.2％比14.5％，肥胖高血压患病率明显高于非肥胖，为21.5％比10.4％。多重线性回归模型分析显示，年龄、血糖体重指数、腰臀比对男女性收缩压和舒张压有显影响。结论：广东省自然人群的分析结果显示，血糖、体重指数和腰臀比是影响血压的重要因素，在控制我省高血压患病率不断增加的同时，尚须要注意控制血糖、体重指数和腰臀比的升高。     

北京地区2740人的血压水平10年（1992-2002）变化情况

目的探讨北京地区人群个体血压水平10年的变化情况。方法采用前瞻性队列研究的方法，于1992年对北京大学社区和首钢地区35～64岁人群，进行了基线心血管病危险因素调查，并持续10年对心血管病的发病情况进行了随访。在2002年对相同人群再次进行了危险因素调查，对两次调查结果中血压水平的变化情况进行了流行病学分析。结果(1)10年间平均收缩压水平随年龄的增长而持续增加；平均舒张压水平在55岁以前呈上升变化，在55～64岁组呈轻度下降；(2)1992年与2002年相同年龄组间比较(例如1992年45～54岁与2002年45～54岁)．平均收缩压水平、平均舒张压水平及高血压患病率均明显增加；(3)10年间总的高血压患病率由27．6％增加到48．8％，55～64岁组高血压患病率最高，35～44岁组高血压患病率增加的幅度最大；单纯收缩期高血压(ISH)在全部高血压患者中所占比例随年龄的增长明显增加，65～岁组的ISt{所占比例最高，达61．8％；(4)1992年血压在120／80mmHg以下、120～129／80～84mmHg、130～139／85～89mmHg3个亚组的人群到2002年成为高血压患者的比例分别为22．2％、44．7％和64．3％。结论收缩压和舒张压随年龄的增长呈现不同的变化；目前45～64岁年龄组人群的平均收缩压水平、平均舒张压水平及高血压患病率，均较10年前45～64岁年龄组人群高；随年龄的增长单纯收缩期高血压在全部高血压患者中所占比例增加；血压在120～139／80～89mmHg的亚组人群10年后的高血压发病率，与血压在120／80mmHg以下的亚组人群相比明显增加。     

脉压水平与冠心病的相关性研究

目的 探讨体检人员脉压水平与冠心病之间的关系。方法 根据计划方案对1071例参检人员按年龄分为两组，并进行询问病史和测量血压。结果 高血压患者，年龄≤50岁，患病率为2．95％；年龄〉51岁，患病率为12．36％。脉压≤40mmHg，冠心病患病率为0．24％；脉压41～80mmHg，冠心病患病率为3．26％；脉压≥81mmHg，冠心病患病率为9．73％。结论 当收缩压（SBP）相同脉压不同时，随着脉压的增加，冠心病发病率增加（P〈0．05）。当SBP逐渐增高，舒张压（DBP）逐渐下降，冠心病发病率也增加（P〈0．01）。在50岁以上人群中，无论SBP正常还是增高，只要脉压增宽，冠心病的患病率就增加。     

重庆地区人群体重指数腰围与血压水平及高血压关系的分析

目的 探讨重庆地区人群体重指数（BMI）、腰围（WC）与血压水平及高血压的关系。方法 采用分层整群抽样的方法,抽取重庆地区15岁以上城乡人口5246人进行血压、脉搏、身高、体重、腰围、臀围的测量,并问卷调查。结果 重庆地区人群收缩压、舒张压水平及高血压患病率均随着BMI的增加呈明显的线性上升趋势（线性趋势检验P〈0．01）。腹型肥胖的人群收缩压、舒张压水平及高血压患病率均高于腰围正常的人群,差异均有统计学意义（线性趋势检验P〈0．01）。按BMI分组[〈18．5、18．5～23．9、24．0～27．9、≥28．0（kg／m。）]的高血压患病率分别为9．39％、13．51％、26．23％、32．21％;按WC分组（男〈85cm或女〈80cm,男≥85cm或女≥80cm）的高血压患病率分别为12、39％、28．81％。结论 重庆地区人群血压水平及高血压患病率均与BMI、WC密切相关。BMI、WC是高血压的重要危险因素,对于高血压的发生有着重要的预测作用。     

社会地位和教育水平较高人群的血压和血脂水平

背景随着社会经济的发展和生活方式的变化，我国高血压发病率及相关危险因素均有增加趋势，不健康的生活方式和膳食不平衡是导致高血压患病率上升的主要原因，知识水平较高的高校教师人群高血压患病率及其危险因素存在特殊性。目的探讨一组高校教师人群血压和血脂水平及其高血压与高血脂症的关系。方法采用整群抽样的方法对1028例信阳师范学院教师（高校教师人群）的血压、身高、体质量、体质量指数、血脂进行测定，并将其结果与862例当地的市直企事业单位健康体检人群（普通人群）作比较。结果高校教师人群收缩压[（125．2±18．4）VS（121．8±15．9）mmHg]和脉压[（48．5±13．9）VS（44．8±11．2）mmHg]水平显著高于普通人群（P〈0．05），单纯收缩期高血压（10．2％比6．4％）和高血压（21．5％比15．6％）的患病率也明显高于普通人群（P〈0．05）；而总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇水平则显著低于普通人群（P〈0．05～0．001），高胆固醇血症（24．5％比28．9％）患病率也显著低于普通人群（P〈0．05），但高密度脂蛋白胆固醇水平值则显著高于普通人群（P〈0．01）。高校教师人群高血压患病率与TG呈显著正相关（r=0．423，P〈0．05），而普通人群高血压患病率则与TC呈显著正相关（r=0．618，P〈0．01）。结论高校教师人群的血压和血脂水平与普通人群存在显著差异，其高血压防治具有特殊性。     

我国老年人群单纯性收缩期高血压患病率及影响因素

目的　了解我国老年人群单纯性收缩期高血压的患病率及影响因素。方法　使用1991年全国高血压抽样调查资料 ,以≥ 6 0岁为老年人 ,单纯性收缩期高血压诊断标准按照 1999年WHO/ISH的规定 :收缩压≥ 14 0mmHg(1mmHg =0 133kPa)和舒张压 <90mmHg ,其亚型为收缩压 14 0～ 14 9mmHg和舒张压 <90mmHg ,分析患病率及其相关的影响因素。结果　 (1)我国 6 0岁及以上人群单纯性收缩期高血压患病率为 2 1 5 0 % ,亚型患病率为 9 0 4 % ;如按收缩压≥ 16 0mmHg和舒张压 <90mmHg计算患病率则为 6 83%。 (2 )年龄增长是影响患病率最为明显的因素 ,35岁始患病率随年龄增长而显著升高 ;每增长 10岁患病率约增高一倍。性别差异则表明 35岁前男性患病率高于女性 ,但此后女性随年龄增长单纯性收缩期高血压上升幅度则高于男性。 (3)体重指数的大小与患病率成正比。结论　我国老年单纯性收缩期高血压患病率为 2 1 5 0 % ,占老年高血压总人数的5 3 2 1%。在老年高血压患者中防治单纯性收缩期高血压是降低人群高血压致死致残的重要组成部分。     

中国人群低血压患病率及影响因素研究

方法：利用1991年全国血压抽样调查的资料，进行低血压的横断面分析。低血压的定义为：收缩压（SBP）≤98mmHg并且舒张张压（DBP）≤60mmHg。结果：男性和女性的低血压患病率分别为2．70％和7．36％，女性明显高于男性（P＜0．01）。从低年龄组一高年龄组（15－、25－、35－、45－、55－、65－岁），低血压的患病率分别为7．62％、6．97％、4．40％、3．22％、2．65％、1．94％，随年龄的增加，低血压的患病率呈下降趋势。不同民族低血压患病率变异大。低血压患病率在地区分布上呈现南高北低的现象。Logistic回归分析显示，年龄，体重体数、饮酒、心率与低血压状态呈负相关，女性比男性更易低血压。低血压人群的脑卒中和心肌梗死患病率明显低于正常血压和高血压人群。提示：我国人群低血压的患病率变异较大，影响因素较多；低血压可能是一种正常的生理现象，但它对于健康的确切影响需要进行前瞻性才能证实。     

驻穗部队老年干部高血压患病情况的调查

目的探讨部队老年干部高血压患病率和现患因素，为进行健康教育寻求科学依据。方法对驻穗部队的中老年干部进行健康检查以及生活习惯的调查，按统一标准测量2269例老干部，另500例中年干部做对照。结果老年组高血压的患病率为35．3％，中年组为14．2％。老年组单纯收缩期岛血压（ISH）的患病率为20．8％，中年组为3．2％（P〈0．05）。该人群高血压控制达标率为59．6％，对高血压相关危险因素的知晓率较低（36％）。对老年组收缩压进行多元逐步回归表明，收缩压与年龄、体重指数（BMI）、高血压家族史和吸烟相关，多元逐步回归方程为Y SBP=115．71＋7．35 Xage＋4．97BMI＋2．01 Xhistory＋0．73 Xsmoking。结论戒烟和控制体重对血压的控制有帮助。     

钢铁厂男性工人高血压及其危险因素综合性干预效果的初步 …

目的 评价在工厂人群中采取综合性措施干预高血压及基危险因素的效果；初步总结开展人群高血压预防和治疗的经验。方法 对干预厂（组）进行为期３年（１９９２年１月至１９９５年４月）设对照厂（组）的综合性干预，对比两厂干预前后２次整群随机抽样调查结果。结果 干预后干预组人群年龄调整的收缩压水平，体重指数，高血压患病率和饮酒率较对照组人群分别净下降２．４ｍｍＨｇ、０．４３ｋｇ／ｍ＾２，５．２％和１９．２％，除     

Prevalence and association of snoring, anthropometry and hypertension in Korea

OBJECTIVES: There is little data on the relationships between hypertension and snoring in Asians, whose anthropometrics and prevalence of diseases are different from Western populations. This study evaluated the prevalence and the factors associated with snoring in an adult Korean population (18 years). METHODS: The questions on snoring were divided into five Likert scales ["never" to "severe"(everyday)]. Subjects were divided into two mutually exclusive groups: moderate and severe groups of snorers considered habitual snorers, and never, sometimes and mild snorers considered the non-snoring group. We classified the severity of hypertension according to JNC 6. Independent variables included demographic and baseline characteristics, hypertension, anthropometrics, current medical history, medications and substance use. RESULTS: Overall prevalence of habitual snoring is 15.58% in males and 8.40% in females. The mean age, body mass index (BMI), both systolic and diastolic blood pressure, and anthropometric data, including neck, chest and abdominal girth, were significantly associated with the snoring group in both men and women. Neck length was only significantly shorter in females, not in males. Alcohol consumption rate was significantly higher in the snoring group of the men, but was lower in the snoring group in women. Smoking did not show any significant relationship with snoring and non-snoring groups in both genders. Snoring was significantly higher in the menopause group (odds ratio 2.8) than the premenopausal group. Fifty per cent in the snoring group and 33.08% in the non-snoring group were diagnosed as having hypertension. The prevalence of hypertension was significantly higher in the snoring group aged<40 years and was weakly significant in those subjects aged between 40 and 60 years in males. The prevalence of hypertension was significantly higher in the snoring group in those both aged<40 years and those aged between 40 and 60 years in females. Those aged>60 years old in both genders showed no significant differences in the prevalence of hypertension between snorers and non-snorers. The relationship between hypertension and snoring after adjustments for age, BMI, age, smoke and alcohol usage showed a dose-response relationship in both genders. CONCLUSIONS: This study showed the dose-response relationship between hypertension and snoring, even after adjustments for age, BMI, age, smoke and alcohol usage. Snoring significantly increased after menopause in women. Snoring had a significant relationship with neck length in females but not in males. There is a dose-response relationship between snoring and hypertension in both genders in those subjects aged<60 years old.     

Comparison of blood pressure measurements in children with and without habitual snoring

Higher or similar systolic and/or diastolic blood pressure has been recorded in children with sleep apnea compared to subjects with primary snoring or in those with primary snoring compared to controls. To investigate the association between blood pressure and habitual snoring, we studied children in four randomly selected schools in central Greece. A symptom questionnaire was answered by parents, and children's weight, height, and blood pressure were measured. Seven hundred and sixty children (4-14 years old; 352 female) were recruited. Fifty of 760 (6.6%) participants were snoring more than 3 nights/week (habitual snorers). Mean (+/- SD) systolic blood pressure was 106.9 (+/-10.6) mmHg in habitual snorers vs. 107 (+/- 12) in nonhabitual snorers (P > 0.05). Mean diastolic blood pressure was 61.9 (+/- 7.6) in the former vs. 61.8 (+/- 6.8) in the latter (P > 0.05). While age, gender, and body mass index were significant predictors of systolic blood pressure in a general linear model, snoring was not. Similarly, that gender and body mass index but not snoring were significant predictors of diastolic blood pressure. In a community sample of children, habitual snorers do not have higher morning systolic or diastolic blood pressure than nonhabitual snorers.     

Trends in the prevalence of isolated systolic hypertension in the middle-aged population in 1972-1992.

We described the trends in the prevalence of isolated systolic hypertension during 1972 to 1992 in five independent population-based cross-sectional random samples in eastern Finland. A total of 15,155 men and 16,126 women aged 30-59 in 1972 and 30-64 years during 1977 to 1992 were included in this study. Standardised methods and measurements of the first screening blood pressure value were used, the size of the cuff bladder changed between 1977 and 1982. We defined isolated systolic hypertension as systolic blood pressure (SBP) > or =160 mm Hg and diastolic blood pressure (DBP) <95 mm Hg and diastolic hypertension as DBP > or =95 mm Hg. The normotensive group comprised subjects whose SBP <160 mm Hg and DBP <95 mm Hg. Subjects on antihypertensive medication were classified as having diastolic hypertension. The prevalence of isolated systolic hypertension increased in both sexes and in all age groups except among the youngest women, whereas the prevalence of diastolic hypertension decreased. The proportion of subjects with isolated systolic hypertension out of all hypertensive subjects increased from 11% in 1972 to 24% in 1992 among men and from 15% to 27% among women. The overall decrease in blood pressure, particularly the disproportionate decrease in diastolic over systolic blood in mean pressure may have resulted in the increase in the prevalence of isolated systolic hypertension.     

Arterial hypertension difficult to control in the elderly patient. The significance of the "white coat effect"]

OBJECTIVE: Previous studies have revealed a high prevalence of white coat effect among treated hypertensive patients. The difference between clinic and ambulatory blood pressure seems to be more pronounced in older patients. This abnormal rise in blood pressure BP in treated hypertensive patients can lead to a misdiagnosis of refractory hypertension. Clinicians may increase the dosage of antihypertensive drugs or add further medication, increasing costs and producing harmful secondary effects. Our aim was to evaluate the discrepancy between clinic and ambulatory blood pressure in hypertensive patients on adequate antihypertensive treatment and to analyse the magnitude of the white coat effect and its relationship with age, gender, clinic blood pressure and cardiovascular or cerebrovascular events. POPULATION AND METHODS: We included 50 consecutive moderate/severe hypertensive patients, 58% female, mean age 68 +/- 10 years (48-88), clinic blood pressure (3 visits) > 160/90 mm Hg, on antihypertensive adequate treatment > 2 months with good compliance and without pseudohypertension. The patients were submitted to clinical evaluation (risk score), clinic blood pressure and heart rate, electrocardiogram and ambulatory blood pressure monitoring (Spacelabs 90,207). Systolic and diastolic 24 hour, daytime, night-time blood pressure and heart rate were recorded. We considered elderly patients above 60 years of age (80%). We defined white coat effect as the difference between systolic clinic blood pressure and daytime systolic blood pressure BP > 20 mm Hg or the difference between diastolic clinic blood pressure and daytime diastolic blood pressure > 10 mm Hg and severe white coat effect as systolic clinic blood pressure--daytime systolic blood pressure > 40 mm Hg or diastolic clinic blood pressure--daytime diastolic blood pressure > 20 mm Hg. The patients were asked to take blood pressure measurements out of hospital (at home or by a nurse). The majority of them performed an echocardiogram examination. RESULTS: Clinic blood pressure was significantly different from daytime ambulatory blood pressure (189 +/- 19/96 +/- 13 vs 139 +/- 18/78 +/- 10 mm Hg, p < 0.005). The magnitude of white coat effect was 50 +/- 17 (8-84) mm Hg for systolic blood pressure and 18 +/- 11 (-9 +/- 41) mm Hg for diastolic blood pressure. A marked white coat effect (> 40 mm Hg) was observed in 78% of our hypertensive patients. In elderly people (> 60 years), this difference was greater (50 +/- 15 vs 45 +/- 21 mm Hg) though not significantly. We did not find significant differences between sexes (males 54 +/- 16 mm Hg vs 48 +/- 17 mm Hg). In 66% of these patients, ambulatory blood pressure monitoring showed daytime blood pressure values < 140/90 mm Hg, therefore refractory hypertension was excluded. In 8 patients (18%) there was a previous history of ischemic cardiovascular or cerebrovascular disease and all of them had a marked difference between systolic clinic and daytime blood pressure (> 40 mm Hg). Blood pressure measurements performed out of hospital did not help clinicians to identify this phenomena as only 16% were similar (+/- 5 mm Hg) to ambulatory daytime values. CONCLUSIONS: Some hypertensive patients, on adequate antihypertensive treatment, have a significant difference between clinic blood pressure and ambulatory blood pressure measurements. This difference (White Coat Effect) is greater in elderly patients and in men (NS). Although clinic blood pressure values were significantly increased, the majority of these patients have controlled blood pressure on ambulatory monitoring. In this population, ambulatory blood pressure monitoring was of great value to identify a misdiagnosis of refractory hypertension, which could lead to improper decisions in the therapeutic management of elderly patients (increasing treatment) and compromise cerebrovascular or coronary circulation.     

Reproducibility of blood pressure response to hydrochlorothiazide

Few studies have investigated the reproducibility of responses to antihypertensive therapies. The purpose of this study was to assess the reproducibility of the blood pressure response to a thiazide diuretic, a preferred initial treatment for hypertension. Twenty-two subjects who underwent monotherapy with hydrochlorothiazide as part of a study to identify predictors of blood pressure response agreed to undergo the same protocol a second time, 26.6+/-11.8 (range, 4-52) months after their first participation. The mean systolic and diastolic blood pressure responses to hydrochlorothiazide did not differ significantly between the first and second participation (systolic response, -14.2+/-16.4 mm Hg vs. -16.0+/-16.5 mm Hg; diastolic response, -7.1+/-11.8 mm Hg vs. -6.6+/-8.6 mm Hg), and these responses were significantly correlated between the two trials (systolic response, r=0.61 and p<0.01; diastolic response, r=0.64 and p<0.01). However, both the direction and magnitude of responses for individual subjects varied considerably, with the limits of agreement between the first and second participations (i.e., 2 standard deviations above and below the mean difference between responses) ranging from 27.4 mm Hg to -23.8 mm Hg for systolic blood pressure response and from 17.4 mm Hg to -18.4 mm Hg for diastolic blood pressure response. These results show that the average systolic and diastolic blood pressure responses to hydrochlorothiazide for a group of subjects are reproducible; however, the responses for individual subjects are unpredictable.     

Prevalence of overweight and obesity in Turkey

The objectives of this study were to determine the prevalence of overweight and obesity in Turkey, and to investigate their association with age, gender, and blood pressure. A crosssectional population-based study was performed. A total of 20,119 inhabitants (4975 women and 15,144 men, age > 20 years) from 11 Anatolian cities in four geographic regions were screened for body weight, height, and systolic and diastolic blood pressure between the years 1999 and 2000. The overall prevalence rate of overweight was 25.0% and of obesity was 19.4%. The prevalence of overweight among women was 24.3% and obesity 24.6%; 25.9% of men were overweight, and 14.4% were obese. Mean body mass index (BMI) of the studied population was 27.59 +/- 4.61 kg/m(2). Mean systolic and diastolic blood pressure for women were 131.0 +/- 41.0 and 80.2 +/- 16.3 mm Hg, and for men 135.0 +/- 27.3 and 83.2 +/- 16.0 mm Hg. There was a positive linear correlation between BMI and blood pressure, and between age and blood pressure in men and women. Obesity and overweight are highly prevalant in Turkey, and they constitute independent risk factors for hypertension.     

Hypertension and its determinants among adults in high mountain villages of the Northern Areas of Pakistan

We studied the prevalence and determinants of hypertension among adults in mountainous rural villages in the Ghizar district Northern Areas of Pakistan, an area that recently has undergone substantial economic development. We selected a stratified random sample of 4203 adults (age > 18 years) from 16 villages in Punial Valley of Ghizar district where the number of study subjects from each village was proportionate to the size of the village. We obtained blood pressure (BP) records by taking the mean of the second and third BP measurement, using a standard mercury sphygmomanometer, and assessed risk factors for hypertension in the study subjects. The mean +/- s.d. blood pressures (mm Hg) were 125 +/- 19 systolic and 80 +/- 12 diastolic in men and 125 +/- 22 systolic and 78 +/- 14 diastolic in women. The 125 +/- 22 systolic and 78 +/- 14 diastolic in women. The mm Hg, or systolic BP > or = 140 mm Hg or currently taking antihypertensive medication) was 15%, increasing from 4% in the 18-29 year age group to 36% among persons 60 years of age or older. The age-standardised prevalence of hypertension was 14% (12.5% among men and 14% among women). There was no significant difference in prevalence of hypertension in males, and in females. Multivariate analysis revealed that age, and higher body mass index (overweight and obesity) were independently associated with higher prevalence of hypertension. People with hypertension were more likely to have a first-degree relative with physician-diagnosed hypertension (OR = 1.90, 95% CI 1.49, 2). Hypertension is a significant health problem in rural northern Pakistan. The primary health care programme in the Northern Areas of Pakistan needs to address this problem, especially identifying people at risk.     

Simultaneous measurements of blood pressures in right and left brachial arteries

The most recent guidelines do not mention which arm to use to measure blood pressure or interarm blood pressure differences. In 357 women and 171 men, mean age 79 +/- 10 years, 2 geriatricians simultaneously measured brachial artery blood pressure (BABP) with the patient in the sitting position. All blood pressure measurements were performed using the same 2 machines, which were calibrated and marked 1 and 2. The machines and cuffs were transferred to the opposite arm for a repeat measurement in all patients and the results of the 2 blood pressures averaged. Patients with conditions that may cause a disparity in blood pressure between the right and left arms were not included in this study. The right systolic BABP was >/= 10 mm Hg higher than the left systolic BABP in 35 of 528 patients (7%), and the left systolic BABP was >/= 10 mm Hg higher than the right systolic BABP in 35 of 528 patients (7%) (P = not significant). The right diastolic BABP was >/= 10 mm Hg higher than the left diastolic BABP in 16 of 528 patients (3%), and the left diastolic BABP was >/= 10 mm Hg higher than the right diastolic BABP in 12 of 528 patients (2%) (P = not significant). There was no significant difference in prevalence of hypertension, atherosclerotic vascular disease, diabetes mellitus, or hypercholesterolemia in patients with or without a >/= 10-mm Hg difference in right and left systolic BABP and in right and left diastolic BABP. Interarm differences of >/=10 mm Hg in systolic BABP were found in 14% of elderly patients and of >/= 10 mm Hg in diastolic BABP in 5% of elderly patients. The higher blood pressure should be used for the diagnosis of hypertension, and the blood pressure in that arm used for all follow-up blood pressure-evaluating therapy.     

Is sublingual nifedipine administration superior to oral administration in the active treatment of hypertension?

Nifedipine, a calcium-channel-blocking agent, was administered orally to 44 untreated patients (Group A) and sublingually to 51 untreated patients (Group B) who had a diastolic blood pressure more than 90 mm Hg and systolic blood pressure more than 140 mm Hg. The mean pretreatment systolic and diastolic blood pressure values were 185.3 +/- 26.0 and 115.1 +/- 13.4 mm Hg in Group A patients and 193.6 +/- 23.1 and 118.1 +/- 14.1 mm Hg in Group B patients respectively (p greater than 0.05). The hypotensive activity of nifedipine was observed at the tenth minute in both groups. Mean systolic and diastolic pressures were 168.9 +/- 23.7 and 101.9 +/- 14.2 mm Hg in Group A and 170.6 +/- 26.2 and 103.0 +/- 15.8 mm Hg in Group B, (p less than 0.001) Diastolic blood pressures dropped under 100 mm Hg at the twentieth minute in both groups. Maximal reduction of blood pressure was observed at the fortieth minute in both groups and the degree of reduction in blood pressure was also the same (mean systolic and diastolic blood pressures: 143.7 +/- 22.1 and 86.9 +/- 11.7 in Group A and 148.7 +/- 21.4 and 91.7 +/- 17.0 in Group B (p less than 0.05). The authors conclude that sublingual nifedipine administration is not superior to oral nifedipine administration (in capsular form) in the acute treatment of hypertension.     

Effects of antihypertensive therapy on blood pressure and left ventricular hypertrophy in patients with severe hypertension

The mechanisms responsible for regression of left ventricular (LV) mass with antihypertensive therapy in patients with severe hypertension remain unclear. This study was designed to examine whether systolic and diastolic blood pressures are associated with changes in LV mass. Eighteen patients with essential hypertension whose average seated diastolic blood pressure was >or = 110 mm Hg were enrolled in the study. All patients were administered antihypertensive therapy and underwent M-mode echocardiography before and after 6 months of treatment. In all patients, antihypertensive treatment significantly reduced systolic blood pressure from 175 +/- 21 mm Hg at baseline to 143 +/- 22 mm Hg at 6 months (p < 0.001), and diastolic blood pressure from 116 +/- 7 mm Hg at baseline to 92 +/- 20 mm Hg at 6 months (p < 0.001). LV mass index at 6 months was significantly reduced compared to its baseline value (p < 0.05). Change (value at 6 months-value at baseline) in systolic and diastolic blood pressures correlated positively with the change in LV mass index (r = 0.61, p < 0.01 and r = 0.71, p < 0.001, respectively). The patients were divided into responders. whose LV mass regressed by > or = 10% (n = 9), and nonresponders, whose LV mass regressed by < 10% (n = 9). Systolic (p < 0.001) and diastolic (p < 0.001) blood pressures. interventricular septal thickness (p< 0.05), posterior wall thickness (p < 0.001), and LV mass index (p < 0.001) were significantly decreased in the responders, but not in the nonresponders, at 6 months compared with those at baseline. Systolic (p < 0.05) and diastolic (p < 0.05) blood pressures in nonresponders were significantly higher than those in the responders at 6 months. The changes in systolic and diastolic blood pressures did not correlate with the change in LV mass index in the responders or the nonresponders. The regression of LV mass is strongly affected by reducing blood pressure. This is the first study using antihypertensive therapy to demonstrate that a change in blood pressure correlates positively with changes in LV mass index in severely hypertensive patients.