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Isolated Systolic Hypertension Among the Bhotia of Uttaranchal  [PDF]
C.R. Mandal,D.K. Adak,S. Biswas,P. Bharati
Human Biology Review , 2012,
Abstract: Prevalence of isolated systolic hypertension (ISH) was examined among the Bhotia of Chamoli district, Uttaranchal. Occurrence of ISH was found to be 4.92% among the Bhotia. This prevalence was 2.5% in men and 2.42% in women. The study revealed an increasing trend of occurrence of ISH with increasing age. The determinants like age, abdominal obesity, tobacco chewing and education of the subjects emerged as important risk factors of ISH among the Bhotia of Uttaranchal.
Fosinopril and amlodipine in the treatment of isolated systolic hypertension  [PDF]
Pavlovi? Katica,Benc Dragan,Kmezi?-Grujin Jasna,Stojiljkovi? Jadranka
Medicinski Pregled , 2004, DOI: 10.2298/mpns0402045p
Abstract: The aim of this study was to assess the therapeutic effects of fosinopril (F) and amlodipine (A) on regulation and circadian rhythm of blood pressure, and to evaluate left ventricle mass index (LVMI) in patients over 60 years of age with isolated systolic hypertension, after three months of administration period. After one-week placebo run-in period, 60 patients were randomized into two groups, each including 30 patients, to receive either fosinopril or amlodipine for three months. Clinical, echocardiographic examinations and 24h ambulatory blood pressure measurements were performed at baseline, and after 3 months of therapy. The goal blood pressure was £ 140/90 mmHg. It was accomplished in more than two thirds of cases (F 76.6%, and A 79.9%), with lower drug doses needed in the group treated with F. In 13 patients goal values were not accomplished, therefore the therapy was prolonged for one additional month, with combination of two drugs. In 10 of these patients (76.9%), adequate regulation of blood pressure was achieved. Both fosinopril and amlodipine efficiently control blood pressure by once-a-day administration, both significantly influencing its circadian rhythm and resulting in regression of myocardial hyperthrophy. Adequate control of blood pressure and beneficial effects on circadian rhythm of blood pressure are achieved with lower doses of fosinopril.
Isolated systolic hypertension and its determinants - A cross-sectional study in the adult population of Lucknow district in North India  [cached]
Midha Tanu,Idris M,Saran R,Srivastava A
Indian Journal of Community Medicine , 2010,
Abstract: Objectives: 1) To determine the prevalence of isolated systolic hypertension (ISH) in the adult population of Lucknow district. 2) To study the determinants of ISH especially the relationship with age. Materials and Methods: A community-based cross-sectional study was conducted in four randomly selected areas of Lucknow district. A total of 800 subjects, aged 20 years and above, 400 from urban and 400 from rural area of Lucknow district were included in the study. The statistical tools used for analysis were Pearson′s Chi-square test and multiple logistic regression. Results: The prevalence of ISH according to JNC-7 criteria was 4.3%, which was 5.1% in men and 3.6% in women. A significant increase in the prevalence of ISH was seen with an increase in age. Multivariate logistic regression analysis of the determinants showed that age, BMI and smoking were significant independent risk factors of ISH. Conclusions: Given the risk of cardiovascular disease associated with ISH, the findings of this study emphasize the need for further research to document the impact of modifiable risk factors of ISH and the effect of hypertension screening and specific health promotion in bringing down the burden of ISH and related cardiovascular morbidity.
Isolated systolic hypertension: primary care practice patterns in a Nigerian high-risk subpopulation
Ono, Agbani Ejaife;Oyekigho, Erhun Wilson;Adeleke, Ojo Araoye;
Sao Paulo Medical Journal , 2006, DOI: 10.1590/S1516-31802006000200011
Abstract: context and objective: hypertension management and risk prediction based on diastolic blood pressure may be of little value for older people and people with isolated systolic hyper-tension (ish). this study investigated primary care practice patterns in ish management in a nigerian high-risk subpopulation. design and setting: three-year retrospective cohort review of outpatient medical records at a state primary health care facility in southwestern nigeria. methods: ish was defined according to international guidelines. treatments were graded as relatively non-aggressive, mildly aggressive and moderately aggressive. data were collected using a data abstraction form and statistically analyzed. results: the drug/regimen choice controlled systolic blood pressure (sbp) in only 46.90% of the population after the first visit to the clinic. sbp control among treated patients was significantly inadequate. group mean sbp was consistently > 150 mmhg in 28.13% of the patients for 3 six weeks after enrollment and for at least two additional visits. data analysis revealed an increasing tendency to place patients on monotherapy or "no drug treatment" with successive visits to the clinic, even in cases of uncontrolled systolic blood pressure, as well as declining prescription of moderately aggressive combination therapy. conclusion: aggressive ish management needs to be further emphasized at primary care levels, which for many low-income patients may be the first and last orthodox port of call.
A cost-minimization analysis of diuretic-based antihypertensive therapy reducing cardiovascular events in older adults with isolated systolic hypertension
G John Chen, Luigi Ferrucci, William P Moran, Marco Pahor
Cost Effectiveness and Resource Allocation , 2005, DOI: 10.1186/1478-7547-3-2
Abstract: Using the Systolic Hypertension in the Elderly Program (SHEP) and other data, a cost-minimization analysis was performed. The cost was presented as the cost of number-needed-to treat (NNT) of patients for 5 years to prevent one adverse event associated with cardiovascular disease (CVD).It was found that the cost of 5 year NNT to prevent one adverse CVD event ranged widely from $6,843 to $37,408 in older patients with ISH. The incremental cost of the 5 year NNT was lower to treat older patients in the very high CVD risk group relative to patients in the lower CVD risk group, ranging from $456 to $15,511. Compared to the cost of the 5 year NNT of other commonly prescribed antihypertensive drugs, the cost of SHEP-based therapy is the lowest. The incremental costs of the 5 year NNT would be higher if other agents were used, ranging from $6,372 to $38,667 to prevent one CVD event relative to SHEP-based drug therapy.Antihypertensive therapy that is diuretic-based and that includes either low-dose reserpine or atenolol is an effective and relatively inexpensive strategy to prevent cardiovascular events in older adults with isolated systolic hypertension. Use of the diuretic-based therapy is the most cost-effective in patients at high risk for developing cardiovascular disease.Hypertension is among the most common chronic conditions in middle-aged and older adults. Approximately 50 million Americans are currently diagnosed with this condition, and more than $18.7 billion is spent on hypertension management, including $3.8 billion for medications[1].Treatment of hypertension can significantly decrease the risk of developing CVD [2,3]. The SHEP and other studies have demonstrated the great potential of antihypertensive treatments to significantly reduce the number of cardiovascular events in elderly patients [4-10]. This, in turn, may reduce the costs associated with this chronic condition. Based on the SHEP study, it is estimated that 24,000 strokes, 44,000 major cardiovascu
Traditional Chinese versus integrative treatment in elderly patients with isolated systolic hypertension: a multicenter, randomized, double-blind controlled trial  [cached]
Hao LI
Zhong Xi Yi Jie He Xue Bao , 2010,
Abstract: Background: Isolated systolic hypertension (ISH) is a common disease in elderly people, threatening their health. Traditional Chinese medicine (TCM) treatment or integrative treatment had advantages in improving quality of life and protecting target organs, but need to be proved by large evidence-based researches.Objective: To observe the effects of TCM treatment (Jiangya Capsule) or integrative treatment (combination of Jiangya Capsule and nimodipine) on blood pressure and vasoactive agents, and their safety in elderly ISH patients.Design, setting, participants and interventions: A multicenter, randomized, double-blind controlled trial was adopted. A total of 270 elderly ISH patients recruited from Xiyuan Hospital, and TCM Hospital and Community Health Service Centers of Yanqing County of Beijing were randomly divided into 3 groups: TCM group (Jiangya Capsule plus nimodipine simulation, 90 cases), integrative group (Jiangya Capsule plus nimodipine, 90 cases) and Western medicine (WM) group (nimodipine plus Jiangya Capsule simulation, 90 cases). They were all treated for 4 weeks.Main outcome measures: Before and after 4-week treatment, office blood pressure, 24-hour ambulatory blood pressure, serum nitric oxide (NO), and plasma endothelin-1 (ET-1), thromboxane B2 (TXB2) and 6-keto-prostaglandin 1α (6-keto-PGF1α) were detected, and safety evaluation was conducted.Results: After 4-week treatment, 5 patients in TCM group were lost to follow-up and another 5 patients were excluded, and 80 patients finished the trial; 7 patients in integrative group were lost to follow-up and another 7 patients were excluded, and 76 patients finished the trial; 2 patients in WM group were lost to follow-up and another 3 patients were excluded, and 85 patients finished the trial. After treatment, systolic blood pressure (SBP) decreased in each group (P<0.05), and integrative treatment was superior to TCM or WM treatment in decreasing SBP (P<0.05). Twenty-four hour average SBP and day average SBP decreased significantly in each group, and night average SBP decreased in integrative group, and integrative treatment was superior to TCM or WM treatment in decreasing day average SBP. Serum NO and plasma 6-keto-PGF1α levels were elevated and plasma ET-1 and TXB2 levels were reduced after treatment, and integrative treatment was superior to TCM or WM treatment in reducing plasma TXB2 level.Conclusion: TCM treatment or integrative treatment has affirmative effects and safety in treating elderly ISH patients, and integrative treatment has superiority in improving some indexes, and dese
Correlation of structural and functional features of left ventricle with ambulatory blood pressure monitoring data in patients with essential hypertension  [cached]
O.M. Khromtsova,M.V. Arkhipov
Rational Pharmacotherapy in Cardiology , 2009,
Abstract: Aim. To evaluate the relationship of 24-hour blood pressure (BP) monitoring data with myocardial mass and type of left ventricle hypertrophy (LVH) in non-treated patients with essential hypertension (HT).Patients and methods. We reviewed echocardiograms and BP monitoring data of 500 patients (250 females and 250 males; aged 53,1 }12,2 y.o.).Results. Normal geometry of left ventricle (LV) was found in 143 patients (28,6%), concentric remodeling of LV – in 73 (14,6%), concentric LVH - in 138 (27,6%) and eccentric LVH – in 146 patients (29,2%). The least disturbances of 24-hour BP profile were observed in patients with normal LV geometry; 60,1% of patients had normal reduction of night BP. More than a third of patients had disturbances of circadian BP profile. Mostly severe disturbances of 24-hour BP profile were observed in patients with concentric and eccentric LVH. Circadian BP disturbances were revealed in two thirds of patients. Inadequate night BP reduction and inverted type of circadian BP profile predominated. Negative correlation between 24-hour systolic BP index and LV myocardial mass index was observed. Some LV structural disturbances as well as systolic dysfunction were revealed in patients with LV concentric remodeling. Besides HT of 3 grade and excessive night BP reduction were observed more often in these patients.Conclusion. The relationships between LV structural disturbances and 24-hour BP profile allow to reveal patients with unfavorable course of HT.
PREVALENCIA DE LA HIPERTENSION ARTERIAL SISTOLICA AISLADA Y FACTORES DE RIESGO ASOCIADOS EN DOS BARRIOS DEL MUINICIPIO INDEPENDENCIA ESTADO TACHIRA Prevalence of the isolated systolic arterial hypertension and factor of risk associated in the municipality Independence, Táchira State, Venezuela  [cached]
Agustín Paramio Rodríguez,Dayand Marín Hernández
Revista Habanera de Ciencias M??dicas , 2007,
Abstract: Se realizó un estudio observacional descriptivo de corte transversal con el objetivo de determinar la prevalencia, distribución y factores de riesgos asociados a la hipertensión arterial sistólica aislada; se estudiaron a pacientes mayores de 60 a os pertenecientes a la población de los barrios Centenario y San Rafael del municipio Independencia, Estado Táchira, Venezuela. En el período de junio del 2004 a febrero del 2005. El universo del estudio lo constituyeron 211 pacientes, a quienes se les aplicó el modelo de recolección del dato primario del CIRAH modificado para este estudio y la muestra quedó constituida por 84 pacientes, que tenían diagnóstico de Hipertensión Arterial o se diagnosticaron durante el estudio. Los resultados obtenidos mostraron 39.81% de pacientes con hipertensión arterial; predominó el sexo femenino y el grupo de edad de 60 a 69 a os. Predominó el color de la piel blanco, el factor de riesgo más frecuente fue el hábito de fumar. La hipertensión arterial sistodiastólica se presentó en 65.48 %, con predominio en el grupo de 60 a 69 a os de edad, al igual que la hipertensión sistólica aislada. El 55.95 % de los pacientes hipertensos desconocían su enfermedad por lo que constituyó diagnóstico de Novo. Se encontró un alto porciento de pacientes hipertensos con cardiopatía isquémica (23.81%) de los cuales solo 15.48% conocían su enfermedad. Recomendamos enfatizar en los programas de prevención y control de la Hipertensión arterial por el alto riesgo de muerte cardiovascular que ésta representa. A Observational study of cross section was made descriptive, with the objective to determine the prevalence, distribution and factor of risk associated of the isolated systolic arterial hypertension, studying to greater patients of 60 years pertaining to the population districts Centenario and San Rafael of the municipality Independence, Táchira State, Venezuela. In the period of June of the 2004 to February of the 2005. Universe of the study constituted 211 patients to who the model of harvesting of the primary data of the CIRAH modified for this study was applied to them and the sample was constituted by 84 patients that had diagnostic of Arterial Hypertension or they were diagnosed during the study. The obtained results showed 39.81% of patients with arterial hypertension, predominated feminine sex and the group of age of 60 to 69 years. I predominate the color of the white skin; the risk factor but it frequents was the habit to smoke. The sistodiastolica arterial hypertension appeared in 65.48%, with predominance in the group of 60 to 69 ye
A.A. Svistunov,T.P. Denisova,E.G. Volkova,L.I. Malinova
Saratov Journal of Medical Scientific Research , 2008,
Abstract: The article is devoted to the study of systolic blood pressure features in the population of large industrial center. On the basis of measurement of blood pressure in adult population of three city regions there were revealed the following age-related changes in systolic blood pressure in men: three periods of rise and two periods of stabilization. The principal difference in women is the absence of the periods of rise and stabilization, lower level of blood pressure in young and middle aged people and authentically higher level of blood pressure - in elderly women. The increase of haemodynamical loading for one year of life in men of the middle (2 times) and elder ages (3 times) was revealed, that was not typical forwomen.
Isolated Systolic Hypertension among Office Workers in North IndianTown  [cached]
Gupta A,Negi P,Gupta B,Bhardwaj A
Indian Journal of Community Medicine , 2006,
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