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The relationship between blood pressure and carotid haemodynamics in normotensive carotid stenosis patients
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Abstracts
plaque biology. The purpose of the present study is to evaluate additive effects of telmisartan (ARB) and Rosuvastatin (HMG-CoA reductase inhibitor) to endothelial function, insulin sensitivity and arterial stiffness in essential hypertension. Subjectives and methods: Thirty-nine patients with essential hypertension were to receive telmisartan, which was administered at doses of 80 mg once daily using an open-labeled, prospective protocol for 8 weeks. And then twenty of them were to continue telmisartan therapy alone and nineteen were to receive rosuvastatin at doses of 30 mg once daily added to telmisartan. The patients were examined at baseline, 8 weeks, 16 weeks to assess changes of flow mediated-vasodilation (FMD), QUICKI (quantitative insulin-sensitivity check index), HOMA (homeostasis model assessment), adiponection and pulse wave velocity (PWV). Results: Telmisartan therapy improved FMD (from 7.6 ± 3.5 to 9.0 ± 2.8%, p < 0.01) and PWV (Rt 17.3 ± 3.1 to 15.9 ± 2.6, Lt. 17.5 ± 2.8 to 16.1 ± 2.6 m/s, p < 0.01) at 8 weeks. But, it was not changed in QUICKI, HOMA level, and plasma adiponectin (p = NS, respectively). At 16 weeks, FMD and PWV of both group didn't increase (p = NS) compared to 8 weeks' result. Conclusion: These results suggest that telmisartan is effective at improving endothelial function and arterial stiffness in hypertensive patients in Korea. But adding rosuvastatin to telmisartan had little additive effect on that.
Objective: To explore the relationship between blood pressure and carotid haemodynamics in normotensive carotid stenosis patients by color duplex ultrasonography. Methods: The blood pressure and carotid haemodynamics indexes of 80 mortotensive carotid stenosis patients were checked, including systolic blood pressure (SBP), diastolic blood pressure (DBP) and the heamodynamics parameters (peak systolic velocity, PSV; end diastolic velocity, EDV; pulsatility indexes, PI; resistant indexes, RI; and inside diameters, D, respectively) of bilateral carotid arteries (common carotid artery, CCA; internal carotid artery, ICA; vertebral artery, VA, respectively). Results: 1) The stenosis grades would accelerate blood velocity of the stenosis internal carotid artery. 2) The vertebral artery blood flow velocity were faster in SBP of 90 to 120 mm Hg and DBP of 60 to 79 mm Hg, while the blood flow resistance was smaller in the same blood pressure level. Then the vertebral artery blood flow velocity would go down and the blood flow resistance would raise, with the increase of blood pressure especially SBP of >120 mm Hg, DBP of ≥80 mm Hg. Conclusions: Lowering blood pressure could help promote the carotid blood flow velocity and increase cerebral blood flow and SBP of 90 to 120 mm Hg and DBP of 60 to 79 mm Hg may help to maintain the better cerebral haemodynamics. doi:10.1016/j.ijcard.2009.09.119
doi:10.1016/j.ijcard.2009.09.117 CT000296 The effect of anxiety depression on morning blood pressure surge and heart rate variability in patients with hypertension XIN-JUAN XU, HONG-YUN XING, YONG-ZHI WANG The First Affiliated Hospital of Xinjiang Medical University, China Department of Cardiovascular Medicine, The Fifth Affiliated Hospital of Xinjiang Medical University, China Objective: To investigate the effect anxiety depression on MBPS and heart rate variability (HRV) in patients with EH, MBPS and HRV. Methods: To evaluate in 106 EH patients, to divided into anxiety depression group (n = 52) and non-anxiety non-depression group (n = 54) according to anxiety depression. To compare related clinic information between anxiety depression group and non-anxiety nondepression group, Holter ECG monitoring, ambulatory blood pressure and MBPS. Results: (1) The 24 hours average blood pressure, the average blood pressure of daytime, the average blood pressure of night, the blood pressure of morning and MBPS in anxiety depression group are all higher than non-anxiety non-depression group (P <0.01), and then the blood pressure of morning improve obviously (P <0.01), MBPS(+) in anxiety depression group are higher than non-anxiety non-depression group (67.3% to 31.5%, P < 0.01).(2) The HRV index (SDNN, SDANN, RMSSD, PNN50) in anxiety depression group are lower than non-anxiety nondepression group (P< 0.01). (3) The logistic regression analysis indicate that the dangerous MBPS(+) occurred in EH patients are related with age increasing ,with anxiety depression and SDNN decreasing (OR are 2.524, 2.699, 3.867, P <0.05). Conclusion: Anxiety depression increase the MBPS(+) in EH patients related with the damage of autonomic nerves. doi:10.1016/j.ijcard.2009.09.118 CT000297 The relationship between blood pressure and carotid haemodynamics in normotensive carotid stenosis patients XIN-JUAN XU, RONG REN, KAI-PING FAN Department of Hypertension, The First Affiliated Hospital of XinJiang Medical University, China
CT000326 Pharmacist interventions to enhance patient adherence to self-administered antihypertensive medication: a systematic review M. MORGADOa,b, S. MORGADOb, L. CASTANHEIRAa, I. VERDEa, M. CASTELO-BRANCOa,c a Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal b Pharmacy Department, Hospital Centre of Cova da Beira E.P.E., Covilhã, Portugal c Emergency Department, Hospital Centre of Cova da Beira E.P.E., Covilhã, Portugal Objective: Some studies have assessed pharmacist interventions in hypertensive patients in order to enhance adherence to medication. Our aim is to review published data on pharmacist interventions targeting antihypertensive medication adherence and reporting blood pressure (BP) outcomes in adults with high BP. Design and methods: A systematic literature review was conducted. A search in MEDLINE, The Cochrane Library and the ISI Web of Knowledge was performed from January 1999 to May 2009, to identify relevant articles of pharmacist interventions intended to improve adherence to antihypertensive medications. We also hand searched bibliographies in articles on patient adherence to identify relevant articles. Studies were included if they reported a pharmacist intervention to improve adherence with antihypertensive drugs, with adherence to medication and BP control as outcomes. Two authors selected studies and extracted the data independently. Results: We included 15 studies testing 18 different interventions and containing data on 3,280 patients. The duration of follow-up ranged from 2 weeks to 12 months. Studies were too heterogeneous in terms of the interventions and methods used to measure adherence to warrant meta-analysis. Although 83% of the interventions reported statistically significant improvements in treatment outcomes, only 50% of the interventions tested were associated with significant increases in medication adherence, with a relative increase in adherence of 12.0% to 26.4%. Almost all the interventions that were effective in increasing adherence to BP-lowering medication were complex, including combinations of simplifying doses regimes, educational strategies directed to the patient, reminders, BP self-monitoring, scheduling
Abstracts
plaque biology. The purpose of the present study is to evaluate additive effects of telmisartan (ARB) and Rosuvastatin (HMG-CoA reductase inhibitor) to endothelial function, insulin sensitivity and arterial stiffness in essential hypertension. Subjectives and methods: Thirty-nine patients with essential hypertension were to receive telmisartan, which was administered at doses of 80 mg once daily using an open-labeled, prospective protocol for 8 weeks. And then twenty of them were to continue telmisartan therapy alone and nineteen were to receive rosuvastatin at doses of 30 mg once daily added to telmisartan. The patients were examined at baseline, 8 weeks, 16 weeks to assess changes of flow mediated-vasodilation (FMD), QUICKI (quantitative insulin-sensitivity check index), HOMA (homeostasis model assessment), adiponection and pulse wave velocity (PWV). Results: Telmisartan therapy improved FMD (from 7.6 ± 3.5 to 9.0 ± 2.8%, p < 0.01) and PWV (Rt 17.3 ± 3.1 to 15.9 ± 2.6, Lt. 17.5 ± 2.8 to 16.1 ± 2.6 m/s, p < 0.01) at 8 weeks. But, it was not changed in QUICKI, HOMA level, and plasma adiponectin (p = NS, respectively). At 16 weeks, FMD and PWV of both group didn't increase (p = NS) compared to 8 weeks' result. Conclusion: These results suggest that telmisartan is effective at improving endothelial function and arterial stiffness in hypertensive patients in Korea. But adding rosuvastatin to telmisartan had little additive effect on that.
Objective: To explore the relationship between blood pressure and carotid haemodynamics in normotensive carotid stenosis patients by color duplex ultrasonography. Methods: The blood pressure and carotid haemodynamics indexes of 80 mortotensive carotid stenosis patients were checked, including systolic blood pressure (SBP), diastolic blood pressure (DBP) and the heamodynamics parameters (peak systolic velocity, PSV; end diastolic velocity, EDV; pulsatility indexes, PI; resistant indexes, RI; and inside diameters, D, respectively) of bilateral carotid arteries (common carotid artery, CCA; internal carotid artery, ICA; vertebral artery, VA, respectively). Results: 1) The stenosis grades would accelerate blood velocity of the stenosis internal carotid artery. 2) The vertebral artery blood flow velocity were faster in SBP of 90 to 120 mm Hg and DBP of 60 to 79 mm Hg, while the blood flow resistance was smaller in the same blood pressure level. Then the vertebral artery blood flow velocity would go down and the blood flow resistance would raise, with the increase of blood pressure especially SBP of >120 mm Hg, DBP of ≥80 mm Hg. Conclusions: Lowering blood pressure could help promote the carotid blood flow velocity and increase cerebral blood flow and SBP of 90 to 120 mm Hg and DBP of 60 to 79 mm Hg may help to maintain the better cerebral haemodynamics. doi:10.1016/j.ijcard.2009.09.119
doi:10.1016/j.ijcard.2009.09.117 CT000296 The effect of anxiety depression on morning blood pressure surge and heart rate variability in patients with hypertension XIN-JUAN XU, HONG-YUN XING, YONG-ZHI WANG The First Affiliated Hospital of Xinjiang Medical University, China Department of Cardiovascular Medicine, The Fifth Affiliated Hospital of Xinjiang Medical University, China Objective: To investigate the effect anxiety depression on MBPS and heart rate variability (HRV) in patients with EH, MBPS and HRV. Methods: To evaluate in 106 EH patients, to divided into anxiety depression group (n = 52) and non-anxiety non-depression group (n = 54) according to anxiety depression. To compare related clinic information between anxiety depression group and non-anxiety nondepression group, Holter ECG monitoring, ambulatory blood pressure and MBPS. Results: (1) The 24 hours average blood pressure, the average blood pressure of daytime, the average blood pressure of night, the blood pressure of morning and MBPS in anxiety depression group are all higher than non-anxiety non-depression group (P <0.01), and then the blood pressure of morning improve obviously (P <0.01), MBPS(+) in anxiety depression group are higher than non-anxiety non-depression group (67.3% to 31.5%, P < 0.01).(2) The HRV index (SDNN, SDANN, RMSSD, PNN50) in anxiety depression group are lower than non-anxiety nondepression group (P< 0.01). (3) The logistic regression analysis indicate that the dangerous MBPS(+) occurred in EH patients are related with age increasing ,with anxiety depression and SDNN decreasing (OR are 2.524, 2.699, 3.867, P <0.05). Conclusion: Anxiety depression increase the MBPS(+) in EH patients related with the damage of autonomic nerves. doi:10.1016/j.ijcard.2009.09.118 CT000297 The relationship between blood pressure and carotid haemodynamics in normotensive carotid stenosis patients XIN-JUAN XU, RONG REN, KAI-PING FAN Department of Hypertension, The First Affiliated Hospital of XinJiang Medical University, China
CT000326 Pharmacist interventions to enhance patient adherence to self-administered antihypertensive medication: a systematic review M. MORGADOa,b, S. MORGADOb, L. CASTANHEIRAa, I. VERDEa, M. CASTELO-BRANCOa,c a Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal b Pharmacy Department, Hospital Centre of Cova da Beira E.P.E., Covilhã, Portugal c Emergency Department, Hospital Centre of Cova da Beira E.P.E., Covilhã, Portugal Objective: Some studies have assessed pharmacist interventions in hypertensive patients in order to enhance adherence to medication. Our aim is to review published data on pharmacist interventions targeting antihypertensive medication adherence and reporting blood pressure (BP) outcomes in adults with high BP. Design and methods: A systematic literature review was conducted. A search in MEDLINE, The Cochrane Library and the ISI Web of Knowledge was performed from January 1999 to May 2009, to identify relevant articles of pharmacist interventions intended to improve adherence to antihypertensive medications. We also hand searched bibliographies in articles on patient adherence to identify relevant articles. Studies were included if they reported a pharmacist intervention to improve adherence with antihypertensive drugs, with adherence to medication and BP control as outcomes. Two authors selected studies and extracted the data independently. Results: We included 15 studies testing 18 different interventions and containing data on 3,280 patients. The duration of follow-up ranged from 2 weeks to 12 months. Studies were too heterogeneous in terms of the interventions and methods used to measure adherence to warrant meta-analysis. Although 83% of the interventions reported statistically significant improvements in treatment outcomes, only 50% of the interventions tested were associated with significant increases in medication adherence, with a relative increase in adherence of 12.0% to 26.4%. Almost all the interventions that were effective in increasing adherence to BP-lowering medication were complex, including combinations of simplifying doses regimes, educational strategies directed to the patient, reminders, BP self-monitoring, scheduling