hypertensive

摘要： Spontaneous intracerebral hemorrhage(ICH)represents the second most common type of stroke,with high mortality and disability rates.^([1,2])In 2010,there were approximately 5.3 million ICH cases,with 3 million deaths worldwide.^([1])However,there is still no validated medical treatment for ICH,with the role of surgery remaining controversial.^([2,3])Cusack et al^([4])demonstrated that lowering blood pressure rapidly in hypertensive ICH patients may be safe and at least partially effective in inhibiting hematoma expansion.

摘要： BACKGROUND Masked diastolic hypotension is a new blood pressure(BP)pattern detected by ambulatory blood pressure monitoring(ABPM)in elderly hypertensives.The aim of this study was to relate ABPM and comorbidity in a cohort of fit elderly subjects attending an outpatient hypertension clinic.METHODS Comorbidity was assessed by Charlson comorbidity index(CCI)and CHA_(2)DS_(2)VASc score.All subjects evaluated with ABPM were aged≥65 years.CCI and CHA_(2)DS_(2)VASc score were calculated.Diastolic hypotension was defined as mean am-bulatory diastolic BP<65 mmHg and logistic regression analysis was carried out in order to detect and independent relationship between comorbidity burden and night-time diastolic BP<65 mmHg.RESULTS We studied 174 hypertensive elderly patients aged 72.1±5.2 years,men were 93(53.4%).Mean CCI was 0.91±1.14 and mean CHA_(2)DS_(2)VASc score of 2.68±1.22.Subjects with night-time mean diastolic values<65 mmHg were higher in females[54.7%vs.45.3%,P=0.048;odds ratio(OR)=1.914,95%CI:1.047−3.500].Logistic regression analysis showed that only CHA_(2)DS_(2)-VASc score was independently associated with night-time mean diastolic values<65 mmHg(OR=1.518,95%CI:1.161−1.985;P=0.002),but CCI was not.CONCLUSIONS ABPM and comorbidity evaluation appear associated in elderly fit subjects with masked hypotension.Com-orbid women appear to have higher risk for low ambulatory BP.

摘要： BACKGROUND The cardiovascular hazards of total homocysteine(tHcy)are long known.In addition,despite the acknow-ledgment on the importance of low ankle-brachial index(ABI)(<0.9),borderline ABI(0.91-0.99)was once commonly overlooked.This study aims to explore the independent and joint effect of tHcy level and borderline ABI on all-cause death in hypertensive population.METHODS This study included 10,538 participants from China H-type Hypertension Registry Study.ABI was described into two groups:normal ABI(1.00-1.40)and borderline ABI.tHcy level was also divided into two groups:<15.02 and≥15.02μmo/L.Four groups were analyzed,using COX proportional hazard regression model,separately and pairwise to observe the independ-ent and joint effect on all-cause death.RESULTS A total of 126(1.2%)deaths were observed in the 1.7 years follow-up time.Borderline ABI has a higher predicted risk of death than normal ABI(HR=1.87,95%CI:1.17-3.00)after adjusting for potential covariates.Compare with tHcy level<15.02μmo/L(low tHcy),those with tHcy≥15.02μmo/L(high tHcy)had higher risk to event outcome(HR=1.99,95%CI:1.30-3.05).According to the cumulative hazard curve,group with borderline ABI and high tHcy level has significantly higher altitude and larger increasing rate over follow-up period compare to other groups.Among those with borderline ABI,participants with high tHcy had higher death risk than those with low tHcy,nevertheless,no significant different between borderline and normal ABI among those with low tHcy levels.CONCLUSIONS Borderline ABI and tHcy level both have independent predictive value on all-cause death.The combined group of borderline ABI and high tHcy has highest risk factor of outcomes,which suggested the mutual additive value of border-line ABI and tHcy.More attention should be given to the importance of borderline ABI in hypertensive population,especially with elevated tHcy level.

摘要： BACKGROUND While studies have suggested the association between triglyceride-glucose(TyG)index,a reliable surrogate for insulin resistance and hypertension data are limited to the correlation of TyG and central blood pressure.This study aims to test the hypothesis that a higher TyG index is associated with elevated central systolic blood pressure(cSBP).METHODS A total of 9249 Chinese hypertensive adults from the H-type Hypertension and Stroke Prevention and Control Project were analyzed in this study.cSBP was measured noninvasively using an A-Pulse CASPro device.TyG index was calculated as ln[fasting triglycerides(mg/dL)×fasting glucose(mg/dL)/2].Smoothing curve and multivariate linear regression models[beta coefficient(β)with 95%CI]were applied to analyze the association between TyG index and cSBP.Subgroup analyses were conducted to explore potential modifications to such a correlation.RESULTS The overall mean TyG index is 8.8±0.7,and the total mean cSBP is 131.3±12.8 mmHg.TyG index was observed to be independently and positively associated with cSBP among the total population(β=0.92,95%CI:0.53–1.31,P<0.001),and participants who do not use antihypertensive drugs(β=1.03,95%CI:0.46–1.60,P<0.001),which is in accordance with the result of the smoothing curve.The association between TyG index and cSBP appears robust in all tested subgroups.CONCLUSIONS TyG index is positively and independently associated with cSBP among hypertensive adults.Our study result suggests that TyG index might serve as an effective marker for vascular function.

摘要： Many general conditions have an impact on the fundus. The purpose of our work was to study the epidemiological profile of patients referred to our service for a review of the fundus and analyze the results. It was a retrospective study description of the examinations of the fundus during the period from January 2016 to December 2017. In the ophthalmology department of the Lomé University Hospital Center, during the study period, 1019 consultations were recorded, of which 727 were for fundus 6.84%. There were 336 men and 391 women, a sex ratio of 0.85. The age group 40 - 69 years accounted for 61.9%. The frequency of the main reasons for the request was hypertension 54.2% (N = 394);hypertension complicated or associated with other conditions (CKI, CKD, pregnancy and diabetes) accounted for 21.6% (N = 157), headache associated with a decrease in visual acuity 8.25% (N = 60), diabetes 6.46% (N = 47) and sickle cell disease 0.69% (N = 5). Hospitalized patients 52.41% (N = 381). The fundus was abnormal in 546 patients or 75.11%. Hypertensive retinopathy was found 80.21% cases in hypertensive patients, diabetic retinopathy 43.42 in diabetic patients. Diabetics Fundus examination in hospital practice found a retinal lesion in three-quarters of cases. It so important to ask the examination of the fundus most often in the current pactise.

摘要： Objective To investigate the effects of simvastatin compared with standard treatment on cardiovascular outcomes and all-cause mortality in high-risk hypertensive patients with a high–normal level of total cholesterol(TC).Methods In a randomized,open-label,blinded-endpoint trial,hypertensive patients at high risk for cardiovascular events from 180 clinical centers in China were assigned to receive treatment with amlodipine plus amiloride/hydrochlorothiazide(n=6,776)or telmisartan(n=6,766).

摘要： In case of hypertension, hypertensive retinopathy is normally an indicator of target organ damage. This sign can be frequently detected even in normotensive subjects. Among 94 normotensive volunteers chosen with regard of the hypertensive status of their parents, we could report the case of 3 black women who had hypertensive retinopathy. As changes in retinal microvasculature precede other signs of damage, we suggest fundus photography routine to be performed more frequently in assessing cardiovascular risks in hypertensive individual and their offspring, especially in black African population, where hypertension is severe.

摘要： Objective To explore the effectiveness of renal denervation (RDN) on blood pressure with the appropriate dosage of phenol/ethanol solution in spontaneously hypertensive rats (SHRs). Methods RDN was performed on the bilateral renal artery. Forty SHRs were divided into four groups according on the dosage of phenol (10% phenol in absolute ethanol): sham group, 0.5 mL phenol group, 1 mL phenol group and 1.5 mL phenol group (n = 10 in each group). Blood pressure was measured by tail-cuff plethysmography. Plasma creatinine was determined four weeks after the treatment. The kidneys and renal arteries were collected and processed for histological examination. Results A sustained decrease in systolic blood pressure (SBP) was only observed after the application of 1 mL phenol for four weeks, while SBP was lowered during the first week after RDN and increased in the following three weeks in the 0.5 mL and 1.5 mL phenol groups compared with the sham group. Renal norepinephrine (NE) was significantly decreased four weeks after RDN in the 1 mL and 1.5 mL phenol group compared with the sham group, but not in the 0.5 ml group. RDN with 1 mL phenol obviously reduced glomerular fibrosis. Histopathological analysis showed that tyrosine hydroxylase immunoreactivity was lower in the 1 mL and 1.5 mL phenol groups compared with the sham group. Moderate renal artery damage occurred in the 1.5 mL phenol group. Conclusion Chemical denervation with 1 ml phenol (10% phenol in absolute ethanol) effectively and safely damaged peripheral renal sympathetic nerves and contributed to the sustained reduction of blood pressure in SHRs.

摘要： Objective Telomere length, as an emerging marker of biological age,isrelatedwithhypertension.Ouraimistoinvestigatethe relationship between telomere trajectory and blood pressure change as well as the incident cardiovascular events in a longitudinal hypertensive cohort in China.

摘要： Cardiovascular diseases (CVDs) are increasingly emerging as a major health problem in sub-Saharan Africa, but information on the epidemiology, clinical characteristics and spectrum of the diseases are scanty. Epidemiological data regarding the incidence and prevalence of CVDs in different geographical regions are essential to our understanding of global distribution and evolution of CVDs. We conducted a retrospective observational study to determine the prevalence and spectrum of cardiovascular diseases in patients seen at the out-patient cardiac clinic of the Directorate of Medicine, Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. Medical records of 432 patients selected from the cardiac clinic using simple random sampling. The medical history, including the socio-demographic information, was examined. The results of the patients’ laboratory tests, chest X-ray, electrocardiography, M-mode and two-dimensional echocardiography with Doppler and colour flow imaging of the patients were also examined. The patients were aged between 13 - 97 years with the mean age (±standard deviation) of 55.35 (±19) years. There were more females (53%;n = 229) than males (47%;n = 203). The main cardiovascular diseases seen included: hypertensive heart disease (35.6%;n = 154), valvular heart disease (19.7%;n = 85), cardiomyopathies (18.5%;n = 80), arrhythmias (6.3%;n = 27) and coronary artery disease (4.2%;n = 18). The most common causes of valvular heart disease, cardiomyopathies and arrhythmias were rheumatic heart disease, dilated cardiomyopathy and complete heart block respectively. In conclusion, our study has shown that hypertensive heart disease, rheumatic heart disease and cardiomyopathies were the main cardiovascular diseases,seen in 73.8% of the patients in this study.