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BP Reduction (bp + reduction)
Selected AbstractsQT interval prolongation in association with impaired circadian variation of blood pressure and heart rate in adolescents with Type 1 diabetesDIABETIC MEDICINE, Issue 11 2007K. Karavanaki Abstract Aims, The aim of our study was to assess diurnal blood pressure (BP) and heart rate variability and their possible relationship to the duration of the QT interval in adolescents with Type 1 diabetes. Methods, In 48 normotensive, normoalbuminuric diabetic adolescents, with a mean (± sd) age of 17.3 (± 4.1) years and a mean (± sd) diabetes duration of 8.5 (± 3.3) years, 24-h ambulatory BP was recorded. In addition, 24-h heart rate (HR) monitoring was performed and QT and corrected QT (QTc) intervals were estimated as indices of autonomic function. The patients were divided into two groups according to the absence of a decrease (non-dippers) or the presence of a decrease (dippers) in nocturnal diastolic BP (DBP). Results, In comparison with the dippers, the non-dippers showed reduced mean 24-h HR (79.6 vs. 84.0 beats/min, P = 0.05) and reduced mean daytime HR (81.3 vs. 86.0 beats/min, P = 0.05). The QT interval was prolonged in the non-dippers (366.3 vs. 347.5 ms, P = 0.015), and end systolic (28.7 vs. 25.9 mm, P = 0.004) and end diastolic left ventricular diameters (47.8 vs. 45.5 mm, P = 0.037) were greater. In stepwise multiple regression, HR variables were the most important factors affecting DBP ratio or the duration of the QT interval. Conclusions, In conclusion, normotensive diabetic adolescents with impaired nocturnal BP reduction also have impaired autonomic function tests, in association with prolonged QT interval and increased left ventricular diameters. These findings suggest that diabetic adolescents who have the ,non-dipper' phenomenon may need close follow-up for the possible development of vascular complications, such as cardiac arrhythmias and left-ventricular hypertrophy. [source] Effect of cilnidipine vs losartan on cerebral blood flow in hypertensive patients with a history of ischemic stroke: a randomized controlled trialACTA NEUROLOGICA SCANDINAVICA, Issue 1 2010K.-S. Hong Objectives,,, The aim of this study was to compare the effects of antihypertensive agents on cerebral blood flow (CBF) in hypertensive patients with previous ischemic stroke. Materials and methods,,, In this double-blind, multi-center, non-inferiority trial, 196 patients were randomized to cilnidipine 10,20 mg or losartan 50,100 mg once daily for 4 weeks. Baseline and follow-up CBF as measured by single photon emission computed tomography were obtained in 167. The primary endpoint was the global CBF change. The secondary endpoints were the CBF change in the hemisphere ipsilateral to the index stroke, non-impairment of global CBF and blood pressure (BP) reduction. Results,,, Global CBF increased significantly in the cilnidipine arm (9.0 ± 29.6%, P = 0.0071) and the losartan arm (11.4 ± 31.4%, P = 0.0012), and these changes were not different between the two groups (P = 0.607). However, the estimated difference in percentage global CBF change between the two groups was ,2.43% (97.5% CI, ,13.06% to 8.21%), which crossed the predetermined non-inferiority margin of ,8.6%. Ipsilesional hemispheric CBF change, non-impairment of global CBF and BP reduction were similar in the two groups. Conclusions,,, This trial failed to prove the non-inferiority of cilnidipine to losartan regarding global CBF change. Both the treatments, however, increase the global CBF despite BP lowering. [source] The patient with cardiovascular disease: Treatment strategies for preventing major eventsCLINICAL CARDIOLOGY, Issue S2 2006Michael Cuffe M.D. Abstract An abundance of clinical data exists to support the ability of pharmacologic interventions to reduce risk for vascular events significantly; however, there remains a gap between this evidence and current clinical practice. Recent data from large-scale, placebo-controlled statin trials demonstrate that these agents dramatically reduce risk for cardiovascular events, even in moderate-risk patients with normal to moderately elevated cholesterol levels. Data from trials of a broad range of antihypertensives reinforce the value of blood pressure (BP) management and indicate that some of these agents may have additional benefits beyond BP reduction. Similarly, meta-analyses of randomized trials confirm that antiplatelet therapy prevents serious cardiovascular events in a wide range of high-risk patients. Each of these interventions alone has been demonstrated to reduce the risk for vascular events by approximately 25 to 30%. A combination approach utilizing intensive risk-reducing therapy with more than one of these agents has the potential to reduce the risk for vascular events by as much as 75%. Combined with nonpharmacologic risk reduction strategies, including exercise, diet, and smoking cessation, an opportunity exists to reduce the incidence of both first and recurrent cardiovascular events dramatically. [source] Optimizing blood pressure reduction: predicting success in the home environmentCLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 1 2001A. R. Craig Transferring skills to non-clinic contexts remains a challenge for clinical psychologists. Research is needed that investigates strategies of transferring clinic skills as well as factors that are associated with successful transfer. This paper presents research that involved training clients to reduce blood pressure (BP) in the home environment and isolating factors related to successful BP reduction. Subjects diagnosed with mild hypertension participated in a controlled trial investigating the efficacy of continuous BP feedback in helping to reduce systolic BP in the clinic and home environment. While the benefits of learning BP feedback in the clinic was not shown to be beneficial over a control, training in the home environment was shown to reduce BP significantly in comparison to controls. Factors shown to be associated consistently and reliably with reduction of BP in the home were those that involved beliefs or expectations of self-control. Expectations (self-efficacy) and an internal locus of control consistently predicted the ability to reduce both systolic and diastolic BP in the home environment. Implications for the behavioural treatment of hypertension are discussed. Copyright © 2001 John Wiley & Sons, Ltd. [source] | ||||||||||