Average daily blood pressure, not office blood pressure, determines cardiac function in patients with hypertension

Article Abstract:

It has long been known that for some individuals, a visit to the doctor's office is such an emotionally charged event that it can significantly raise blood pressure. Occasionally, the degree of elevation can be great enough to lead to an improper diagnosis of high blood pressure (hypertension). Over a period of four years, patients suspected of having high blood pressure were assessed by an ambulatory blood pressure monitoring laboratory. Over this period, 720 patients were evaluated, 77 of whom had never been treated with blood pressure reducing drugs (hypotensive agents). Twenty-six of this group of 77 were found to have blood pressures greater than 140 over 90 mmHG (a hypertensive reading) during an office visit, but had ambulatory readings less than 130 over 80 away from the physician's office. They were classified as potential office hypertensives (that is, those who only have high blood pressure under the anxiety of the office visit), and they were evaluated by other physiological and anatomical means. These measurements were similar in all respects to a group on who have elevated blood pressure only in the stressful environment of the doctor's office have normal heart size and function. Ambulatory blood pressure measurements are therefore important for discriminating hypertensive patients from those who may only be responding to a stressful environment.

Analysis, Measurement, Heart diseases, Blood pressure, Function tests (Medicine), Aldosterone assay, Blood pressure measurement

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Can we prevent end-stage renal disease due to hypertension or to diabetes mellitus?

Article Abstract:

Most cases of end-stage renal (kidney) disease (ESRD) are caused by hypertension or diabetes mellitus, especially diabetes mellitus type II. The development of ESRD is higher among African Americans with diabetes or high blood pressure than among patients of other ethnic groups. A research study found that the development of ESRD may be prevented in black patients with type I diabetes by good diabetic control. Another research study found that good blood pressure control may not prevent ESRD in black patients with hypertension. Only one-third of diabetes patients develop kidney damage that eventually progresses to ESRD. More knowledge about the risk factors for kidney disease may prevent some patients with diabetes or hypertension from developing ESRD. Black patients with hypertension have a higher risk of developing ESRD than other patients and should receive special treatment. African Americans should also undergo frequent screening for hypertension to enable early treatment.

Editorial, Prevention, Diabetes, Diabetes mellitus, Chronic kidney failure

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Association of serum lipoprotein(a) levels and apolipoprotein(a) size polymorphism with target-organ damage in arterial hypertension

Article Abstract:

Blood lipoprotein(a) (Lp(a)) levels appear to be the most important risk factor for target-organ damage in patients with hypertension. Lipoprotein(a) is low-density lipoprotein (LDL) attached to a protein called apolipoprotein(a). Researchers analyzed Lp(a) levels in 277 patients with untreated hypertension and 102 people with normal blood pressure. Lp(a) was the best predictor of target-organ damage. Blood pressure, duration of hypertension and LDL cholesterol levels were also associated with target-organ damage. Low molecular weight forms of apolipoprotein(a) were also associated with target-organ damage.

Physiological aspects, Lipoprotein A

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