Cardiovascular risk factors in a French-Canadian population: resolution of genetic and familial environmental effects on blood pressure by using extensive information on environmental correlates.

Genetic and environmental influences on systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure (MBP) were examined in 371 French-Canadian families by using path analysis. Familial environment was estimated with environmental indices constructed from as many as 14 (of a pool of more than 100) correlates of blood pressure (BP). Approximately 20% of the variance in BP can be accounted for by the composite index, and the types of variables and the direction of their effects vary as a function of age and of the multivariate context. Path analysis of the family data suggests that genetic heritability is relatively high in children (from 0.49 for SBP to 0.56 for MBP) but much smaller in adults (from 0.08 for DBP to 0.18 for SBP). The proportion of variability explained by familial environment is estimated to be the same in children and adults and is much higher than reported to date (from 0.30 for SBP to 0.42 for DBP). In addition, sibships share significant nontransmitted environmental effects, and there is no evidence to suggest specific maternal effects in the aggregation of BP. Two unique findings emerge from this study. First, unlike in most earlier studies, we were able to arrive at the same parsimonious model for each of the BP variables. Second, the familial environment accounts for a substantial proportion of the variability in BP, which has been considerably underestimated in earlier studies.     

Inbreeding effects on metrical phenotypes among North Indian Children

This study aimed to examine the effects of inbreeding on 12 quantitative phenotypes like body weight, height, sitting height, head circumference, head length, head breadth, chest circumference, verbal, performance and full scale intelligence quotients, systolic and diastolic blood pressures among North Indian Children. The sample consisted of 3,253 subjects (1,683 males and 1,570 females) including offspring of first cousins, first cousins once removed, second cousins, (inbred part of samples) and unrelated spouses (non-inbred part of samples) ranging in age from 6 to 14 years from the Aligarh district, Uttar Pradesh in North India. Samples were selected purposively to estimate the average inbreeding coefficients based on 3 ancestral generations and using Wright's path method. The average inbreeding coefficient of the present inbred part of sample is 0.04609. The mean ages of males and females were almost equal for both inbred and non-inbred individuals. A significant reduction of means (p < 0.05) or inbreeding depression has been observed in inbred series for all anthropometric and psychometric traits for both the sexes. A significant elevation of mean with inbreeding is observed for systolic and diastolic blood pressure. The average inbreeding depression per 10% inbreeding appeared very high in verbal IQ (> or =23), performance IQ (> or =40), full scale IQ (> or =28), systolic blood pressure (> or =10) and diastolic blood pressure (> or =12) among both sexes. On the whole, relatively greater amount of inbreeding effects are apparent among all measures of intelligence quotient and blood pressures compared to the anthropometric traits. The results of the present work have thrown light on the nature and mechanism of genetic effects of inbreeding on certain quantitative traits in human.     

Familial resemblance of blood pressure with residual household environmental effects in consanguineous and nonconsanguineous families from Andhra Pradesh, India.

Familial aggregation of blood pressure (BP), both systolic (SBP) and diastolic (DBP), was examined in consanguineous and nonconsanguineous families from southern India. Path analysis of BP suggests inbreeding effects, with the genetic variance for SBP being lower in the sample that included inbred families. Specifically, genetic heritability for SBP was 38% in the nonconsanguineous sample but only 23% in the combined sample. Genetic heritability for DBP (30%) did not vary by sample, nor were sample differences in cultural heritability detected for either SBP (over 35%) or DBP (about 18%). These findings are remarkably similar to those in a French-Canadian population of Quebec; both reports found a considerably larger effect of the home environment on BP than previous studies.     

Blood pressure levels of the Suruí and Zoró Indians of the Brazilian Amazon: group- and sex-specific effects resulting from body composition, health status, and age

Two related Tupí-Mondê-speaking tribes of the Aripuan? Indian Park of western Brazil are compared in terms of their recent contact with Western culture, subsistence patterns, general health, and blood pressure levels. Age, weight, height, sex, and tribal affiliation for Suruí and Zoró adults over age 18 are included in an analysis of covariance to test regression models of both diastolic and systolic blood pressure. Because of significant interaction effects between sex and other covariates, sex-specific models were developed. The relationship between body mass and blood pressure level in males conforms with Western data, but the direction and magnitude of effects for the age and body mass covariates in both sexes conflict with data from other modernizing societies. With age, weight/height ratio, and sex differences controlled for, Suruí males show a lower mean systolic blood pressure (SBP) level and diastolic blood pressure (DBP) level than Zoró males. Intertribal differences were smaller among females: Suruí females SBP and DBP differences were similar but did not reach significance. Other sex-specific differences include a greater inverse relationship between age and SBP level among the 104 male subjects than among the 98 female subjects (with similar trends in DBP) and a small but significant effect of the weight/height ratio on both SBP and DBP in males but not in females. Health status data for these groups suggest that hypothesized increases in mean blood pressure levels following the Suruí's acceptance of a Western diet and social stratification may be modified by their health status, particularly prevalent infectious disease.     

Time Course Study of Blood Pressure in Term and Preterm Infants Immediately after Birth

Objective

To describe temporal changes in systolic, diastolic, and mean blood pressure (SBP, DBP, and MBP, respectively) in term and preterm infants immediately after birth.

Methods

Prospective observational two-center study. In term infants SBP, DBP, and MBP were assessed non-invasively every minute for the first 15 minutes, and in preterm infants every minute for the first 15 minutes, as well as at 20, 25, 30, 45, and 60 minutes after birth. Regression analyses were performed by gender and respiratory support in all neonates; and by mode of delivery, cord clamping time, and development of ultrasound-detected brain injury in preterm neonates.

Results

Term infants (n = 54) had a mean (SD) birth weight of 3298 (442) g and gestational age of 38 (1) weeks, and preterm infants (n = 94) weighed 1340 (672) g and were 30 (3) weeks gestation. Term infants’ SBP, DBP and MBP within the first 15 minutes after birth were independent of gender or respiratory support. Linear mixed regression analysis showed that preterm infants, who were female, born vaginally, had delayed cord clamping and did not require positive pressure ventilation nor develop periventricular injury or ventriculomegaly, had significantly higher SBP, DBP, and MBP at some measurement points within the first hour after birth.

Conclusions

We present novel reference ranges of BP immediately after birth in a cohort of term and preterm neonates. They may aid in optimization of cardiovascular support during early transition at all gestations.     

Non-invasive measurement of blood pressures in the Yucatan micropig (Sus scrofa domestica), with and without midazolam-induced sedation

Current literature suggests that the effects of midazolam, a water-soluble benzodiazepine, on blood pressure in swine are minimal. The hypothesis of the study reported here was that a light sedative dose would induce a decrease in blood pressure in this species. Healthy female Yucatan Micropigs (n = 20), 16 to 30 (mean, 22) kg, aged four six months, were individually placed in a humane restraint sling and allowed to acclimate. Systolic (SBP), diastolic (DBP), and mean (MBP) blood pressures (mmHg) and heart rate (HR; beats per min [bpm]) were measured by use of oscillometry. The pressure cuff was placed at the base of the tail, and five sets of values were recorded at five-min intervals, beginning at 10 and ending 30 min after cuff placement. Following a three- to four-day rest period, this procedure was repeated with the addition of a dose of 0.5 mg of midazolam HCl/kg of body weight given intramuscularly at the time of cuff placement. A paired one-way Student's t-test was used to compare the means of the five measures between control and midazolam treatment. Mean (+/- SD) differences for SBP, DBP, MBP, and HR were 18.9 (+/- 3.97), 17.8 (+/- 5.27), and 18.6 (+/- 5.09) mmHg and 20.7 (+/- 3.73) bpm, respectively. All four parameters were significantly reduced in the midazolam-sedated group (P < 0.001). The maximal decrease in SBP, DBP, and MBP occurred at 15 and 20 min after dosing. Mean values based on the means of the five measures were 128 (+/- 12.6), 80 (+/- 9.4), and 99 (+/- 9.2) mmHg and 135 (+/- 17.4) bpm, and 109 (+/- 15.4), 63 (+/- 12.6), and 80 (+/- 13.6) mmHg and 115 (+/- 15.5) bpm for SBP, DBP, MBP, and HR in the control (n = 20) and midazolam (n = 20) groups, respectively. The control values can serve as normal oscillometric values for this age, sex, and breed of Micropig. We conclude that midazolam, given intramuscularly at a sedative dosage, negatively affects cardiovascular parameters measured by use of a blood pressure cuff, in sexually mature female Micropigs, compared with values in untreated pigs, which is similar to reports for humans.     

How many sphygmomanometric cuff inflations are necessary to obtain a hemodynamic baseline?

The purpose of this study was to determine the minimum number of consecutive blood pressure cuff inflations required to obtain seated stable resting baseline measurements of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP). Sixty male college students aged 18 to 31 years volunteered as study subjects. Thirteen observations of HR, SBP, DBP, and MAP were recorded at 90-second intervals for each subject using a Critikon-Dinamap monitor. Stable readings for SBP and MAP were obtained in 6.5 minutes or 3 to 5 cuff inflations in the population tested. Using this procedure, additional age- and gender-specific norms could be established for normal and hypertensive subjects. Knowing the approximate quantity and frequency of blood pressure cuff inflations needed to generate baseline minimum measurements of HR, SBP, DBP, and MAP will be helpful in studies of cardiovascular reactivity, as well as for clinical and psychophysiologic treatment of hypertension.     

湘西地区农村7-15 岁儿童体重指数、血压及其相关性研究

目的:探讨湘西地区农村7-15岁儿童体重指数、血压及其相关性。方法:随机抽取湘西地区怀化市,吉首市,张家界市农村地区,于2011年1月到3月对7-15岁儿童进行调查。我们采用问卷调查法和体格检查法收集资料,采用中国肥胖问题工作组(WGOC)推荐的"中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准"。高血压诊断采用文献中国儿童青少年血压参照标准评价肥胖和高血压。结果:1755名7-15岁儿童中,男性938人、占53.4%,女性817人占46.6%。男性BMI正常组838人、超重组7人和肥胖组30人,SBP分别为101.1±23.5 mmHg、103.9±12.0 mmHg、106.9±8.8 mmHg,DBP分别为66.7±9.0 mmHg、69.8±7.4 mmHg、71.7±9.1 mmHg。女性BMI正常组768人、超重组43人和肥胖组17人;SBP分别为101.3±35.1 mmHg、104.5±18.0 mmHg、109.1±9.8 mmHg,差异显著,有统计学意义(P<0.05),DBP分别为66.2±8.1 mmHg、71.1±8.8 mmHg、72.0±7.9 mmHg,差异显著,有统计学意义(P<0.05)。制年龄和性别后,BMI与收缩压(SBP)和舒张压(DBP)成独立正相关关系(P<0.05);BMI正常组、超重组和肥胖组的高SBP发生率分别是1.3%、7.1%和15.2%,高DBP发生率分别是4.5%、9.2%和17.4%,高SBP发生率分别是5.3%、13.3%和32.6%,差异显著,有统计学意义(P<0.05)。结论:儿童BMI与SBP和DBP密切相关,儿童超重和肥胖增加高血压的发生风险,且高血压发生率随肥胖程度的增加呈现成倍上升趋势。     

Genetic epidemiological study of blood pressure in a sedentary rural agricultural population of West Bengal, India

To study the genetic epidemiology of blood pressure (BP), data on 78 families were collected from a sedentary agricultural population of eastern India. The general levels of both systolic (SBP) and diastolic (DBP) blood pressures are found to be low (mean SBP = 106.41 mm Hg; mean DBP = 63.94 mm Hg). Trends of blood pressures with age are similar to those reported earlier (e.g., in the Framingham study). Environmental variables--e.g., occupation and tobacco use--do not have any direct significant effect on blood pressure variability in this population. Path analysis of family data shows a highly significant familial aggregation and yields a genetic heritability (maximum) estimate of 0.3 for both SBP and DBP. Sib-sib and mother-child correlation estimates are, respectively, 0.3 and 0.25. Father-child correlation estimates are 0.13 for SBP and near zero for DBP. A pseudopolygenic model yields the best fit to the data on SBP, while for DBP a proper resolution of various models considered could not be obtained.     

树鼩血压和心率的无创测定

目的建立健康树鼩的心率、血压正常值参考范围,并探讨不同来源、不同性别、不同年龄树鼩心率、血压的差异。方法随机挑选实验树鼩180只,按来源分为野生成年组、F1代自繁成年组和青幼年组三个组,每组雌雄各半,共60只。采用智能无创血压计（鼠仪）逐只测定HR（心率）、SBP（收缩压）、DBP（舒张压）和MBP（平均动脉压）。结果野生成年树鼩、自繁成年树鼩和青幼年树鼩心率分别为394.33±37.74 BPM、351.61±72.76 BPM和378.19±69.04 BPM,野生和自繁成年树鼩组差异有显著性（P〈0.05）。自繁成年树鼩收缩压、舒张压和平均动脉压均明显低于青幼年树鼩,差异有极显著性（P〈0.01）。野生成年树鼩和自繁成年树鼩相比,收缩压、舒张压和平均动脉压差异均无显著性（P〉0.05）。结论大鼠无创血压计适合于树鼩的血压、心率的测量。通过测定,获得了野生成年树鼩、F1代自繁成年树鼩和青幼年树鼩的心率和血压参考值范围,丰富了树鼩基础生理数据,可为相关研究提供科学参考。     

Evaluation of Cardiovascular Risk With Arterial Stiffness in Patients With Nonfunctioning Pituitary Adenoma

Objective: Nonfunctioning pituitary adenoma (NFPA) accounts for 30% of all pituitary adenomas, and its incidence has been increasing compared to previous years. Increased risk of cardiovascular effects shown in recent studies is noteworthy in patients with NFPA diagnosis, but the number of studies on the subject is limited. In this study, we aimed to assess possible cardiovascular effects and risk via arterial stiffness measurements in patients diagnosed with NFPA.Methods: We performed arterial stiffness measurements for 30 patients diagnosed with NFPA and 30 healthy volunteers and compared the results to explore the relationship between arterial stiffness parameters, hormone levels, and adenoma size.Results: Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), central SBP, central DBP, augmentation index corrected for a heart rate of 75 beats per minute (AIx@75), and pulse wave velocity (PWV) values of the patients with NFPA diagnosis were significantly higher than the control group. PWV was found to have a significant and negative correlation with growth hormone and insulin-like growth factor 1 (IGF-1). A significant and positive correlation was found between adenoma median short-axis length and PWV. IGF-1 was found to have a significant and negative correlation with adenoma median long- and short-axis length. In multivariate linear regression analysis, we found that IGF-1 was an independent predictor of PWV.Conclusion: Both arterial stiffness parameters such as AIx@75 and PWV and peripheral SBP, DBP, and MBP values were found to be high in NFPA patients with no cardiovascular risk factors. Our findings suggest increased cardiovascular effect and risk in patients with NFPA diagnosis, and therefore, we recommend that patients are monitored closely in this respect.Abbreviations: ACTH = adrenocorticotropic hormone; AIx@75 = augmentation index corrected for a heart rate of 75 beats per minute; BMI = body mass index; CVD = cardiovascular disease; DBP = diastolic blood pressure; FSH = follicle-stimulating hormone; GH = growth hormone; HT = hypertension; IGF-1 = insulin-like growth factor 1; LH = luteinizing hormone; MBP = mean blood pressure; MRI = magnetic resonance imaging; NFPA = nonfunctioning pituitary adenoma; PP = pulse pressure; PWA = pulse wave analysis; PWV = pulse wave velocity; SBP = systolic blood pressure; TSH = thyroid-stimulating hormone     

Circadian Rhythm of Blood Pressure and Heart Rate in Healthy Persons and Kidney Transplant Patients: Correlations with Activity

Fourteen diurnally active (07: 00–22: 39 h) normotensive healthy control subjects and 14 kidney transplant patients were studied by ambulatory blood pressure monitoring and wrist actigraphy simultaneously during one 24-h period. In the control group, circadian rhythms in systolic (SBP), diastolic (DBP), and mean arterial (MAP) blood pressure, heart rate (HR), and wrist activity were documented by cosinor analysis with comparable afternoon peak times. In contrast, circadian rhythms with afternoon acrophases were detected only in HR and wrist activity in the patient group. The correlation of wrist activity with HR in controls and patients was comparable. Wrist activity and blood pressure were associated (r = 0.65 DBP and 0.54 SBP; p < 0.05) in controls, while in patients the relationship was weak or absent (r ranging from 0.02 SBP to 0.22 DBP). In 6 of 14 patients, BP and wrist activity were negatively correlated, reflecting the existence of nocturnal hypertension. In eight others, the correlation was small but positive. The 24-h pattern in BP and wrist activity in controls was comparably phased; however, this was not the case for the transplant patients, indicating the day-night pattern in blood pressure in this group is strongly dependent on pathologic phenomena rather than activity level and pattern.     

人参皂苷Rg2对异丙肾上腺素诱导的大鼠心室重构的保护作用

目的：探讨人参皂苷Rg2对异丙肾上腺素诱导的心室重构模型大鼠的保护作用。方法：将60只雄性Wistar大鼠随机分为对照组、心室重构模型组、人参皂苷Rg2（20、40、80 mg/kg）组和普萘洛尔（propranolol,15 mg/kg）组,n=10。采用多点皮下注射异丙肾上腺素85 mg/（kg·d）,连续7 d,建立大鼠心室重构模型;对照组皮下注射等体积的生理盐水。此后按分组灌胃给药,每天1次,连续给药6 w后,使用八道生理记录仪测定血流动力学参数,并测定心脏重量和左心室重构指数。结果：与对照组相比,注射异丙肾上腺素后第7周时模型组大鼠颈动脉收缩压、舒张压、平均动脉压、心率、LVSP、+dp/dt_max、-dp/dt_max显著降低（P<0.01）;而HW/BW和LVW/BW、LVDP显著升高（P<0.01）。与模型组相比,人参皂苷Rg2低、中、高剂量组和普萘洛尔组大鼠颈动脉收缩压、舒张压、平均动脉压、心率、LVSP、+dp/dt_max、-dp/dt_max显著升高（P<0.05,P<0.01）;LVDP显著降低（P<0.01）,而人参皂苷Rg2中、高剂量组和普萘洛尔组大鼠HW/BW和LVW/BW显著降低（P<0.01）。与普萘洛尔组相比,人参皂苷Rg2低剂量组收缩压、舒张压、平均动脉压显著降低（P<0.05,P<0.01）;人参皂苷Rg2低剂量组LVDP和高剂量组LVSP和+dp/dt_max显著升高（P<0.05,P<0.01）。结论：人参皂苷Rg2对异丙肾上腺素所致的心室重构模型大鼠具有改善作用。     

Non-invasive blood pressure measurement in Yucatan miniature swine using tail cuff sphygmomanometry

A relatively new non-invasive method using a photo-electric flow sensor in non-heated animals, was evaluated for its accuracy in measuring systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) in 40-90 Kg normotensive and hypertensive Yucatan miniature swine. Directly measured SBP, DBP and electronically averaged MAP were recorded from chronic arterial catheters simultaneously with indirect pressures, cuff pressure and tail blood flow under various conditions. In all of the tests tail cuff SBP estimation averaged within 5% of directly measured SBP. The correlation of the two methods was significant (r = .95, P less than 0.01). Over a 60 to 202 mmHg range of blood pressure induced pharmacologically or due to DOCA hypertension, the tail cuff SBP was within 4-10% of directly measured SBP. The tail cuff method was also used to determine DBP and MAP. DBP determined from the tail cuff record was found consistently to underestimate the direct measured DBP by approximately 17%. The two methods were correlated (r = .87 P less than 0.01). The measured tail cuff MAP generally underestimated the direct MAP by approximately 5%. The correlation of directly measured MAP and tail cuff methods was significant (r = .72, P less than 0.01). These results indicated that this system may be used to accurately assess blood pressure in miniature swine.     

Validity of auscultatory and Penaz blood pressure measurements during profound heat stress alone and with an orthostatic challenge

Despite frequent reporting of blood pressure (BP) during profound passive heat stress, both with and without a hypotensive challenge, the method by which BP is measured often varies between laboratories. It is unknown whether auscultatory and finger BP measures accurately reflect intra-arterial BP during dynamic changes in cardiac output and peripheral resistance associated with the aforementioned conditions. The purpose of this investigation was to test the hypothesis that auscultatory BP measured at the brachial artery, and finger BP measured by the Penaz method, are valid measures of intra-arterial BP during a passive heat stress and a heat-stressed orthostatic challenge, via lower body negative pressure (LBNP). Absolute (specific aim 1) and the change in (specific aim 2) systolic (SBP), diastolic (DBP), and mean BPs (MBP) were compared at normothermia, after a core temperature increase of 1.47 ± 0.09°C, and during subsequent LBNP. Heat stress did not change auscultatory SBP (6 ± 11 mmHg; P = 0.16), but Penaz SBP (-22 ± 16 mmHg; P < 0.001) and intra-arterial SBP (-11 ± 13 mmHg P = 0.017) decreased. In contrast, DBP and MBP did not differ between methods throughout heat stress. Compared with BP before LBNP, the magnitude of the reduction in BP with all three methods was similar throughout LBNP (P > 0.05). In conclusion, auscultatory SBP and Penaz SBP failed to track the decrease in intra-arterial SBP that occurred during the profound heat stress, while decreases in arterial BP during an orthostatic challenge are comparable between methodologies.     

Consanguineous marriages in Afghanistan

The present cross-sectional study was done in order to illustrate the prevalence and types of consanguineous marriages among Afghanistan populations. Data on types of marriages were collected using a simple questionnaire. The total number of couples in the study was 7140 from the following provinces: Badakhshan, Baghlan, Balkh, Bamyan, Kabul, Kunduz, Samangan and Takhar. Consanguineous marriages were classified by the degree of relationship between couples: double first cousins, first cousins, first cousins once removed, second cousins and beyond second cousins. The coefficient of inbreeding (F) was calculated for each couple and the mean coefficient of inbreeding (α) estimated for each population. The proportion of consanguineous marriages in the country was 46.2%, ranging from 38.2% in Kabul province to 51.2% in Bamyan province. The equivalent mean inbreeding coefficient (α) was 0.0277, and ranged from 0.0221 to 0.0293 in these two regions. There were significant differences between provinces for frequencies of different types of marriages (p<0.001). First cousin marriages (27.8%) were the most common type of consanguineous marriages, followed by double first cousin (6.9%), second cousin (5.8%), beyond second cousin (3.9%) and first cousin once removed (1.8%). There were significant differences between ethnic groups for the types of marriages (χ2=177.6, df=25, p<0.001). Tajiks (Soni) and Turkmens (also Pashtuns) showed the lowest (α=0.0250) and highest (α=0.0297) mean inbreeding coefficients, respectively, among the ethnic groups in Afghanistan. The study shows that Afghanistan's populations, like other Islamic populations, have a high level of consanguinity.     

The relationship between body mass index, blood pressure and pulse rate among normotensive and hypertensive participants in the third National Health and Nutrition Examination Survey (NHANES).

Obesity is associated with high insulin and leptin levels. Studies also suggest that high levels of insulin and leptin increase sympathetic nervous system (SNS) activity and engender increased chronotropy, vasoconstriction and antinatriuresis that may contribute to the pathogenesis of obesity related hypertension. Sympathetic modulation of cardiovascular responses requires good baroreceptor sensitivity and optimal vascular compliance. The vascular changes associated with isolated systolic hypertension (ISH) have been shown to modify baroreceptor sensitivity and vascular compliance and may mitigate sympathetic modulation of cardiovascular responses and attenuate the hypertensive effect of obesity. The purpose of this study is to examine the differences in the relationship between body mass index, pulse rate (PR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) among participants with normal blood pressure and ISH using data from the third National Health and Nutrition Examination Survey. Data from 13,761 non-institutionalized adults 18 years and older not receiving antihypertensive therapy were analyzed. Results showed that PR, SBP and DBP increase with increasing BMI. The rise in PR, SBP and DBP with BMI is higher among participants with normal blood pressure than among those with ISH. We concluded that increasing level of obesity is associated with a rise in pulse rate and blood pressure but the effect of obesity on blood pressure and pulse rate might be weaker among participants with ISH.     

Blood pressure and heart rate effects, weight loss and maintenance during long-term phentermine pharmacotherapy for obesity

There is a perception that phentermine pharmacotherapy for obesity increases blood pressure and heart rate (HR), exposing treated patients to increased cardiovascular risk. We collected data from phentermine‐treated (PT) and phentermine‐untreated (P0) patients at a private weight management practice, to examine blood pressure, HR, and weight changes. Records of 300 sequential returning patients were selected who had been treated with a low‐carbohydrate ketogenic diet if their records included complete weight, blood pressure, and HR data from seven office examinations during the first 12 weeks of therapy. The mean time in therapy, time range, and mode was 92 (97.0), 12–624, and 52 weeks. 14% were normotensive, 52% were prehypertensive, and 34% were hypertensive at their first visit or had a previous diagnosis of hypertension. PT subjects systolic blood pressure/diastolic blood pressure (SBP/DBP) declined from baseline at all data points (SBP/DBP ?6.9/?5.0 mm Hg at 26, and ?7.3/?5.4 at 52 weeks). P0 subjects' declines of SBP/DBP at both 26 and 52 weeks were ?8.9/?6.3 but the difference from the treated cohort was not significant. HR changes in treated/untreated subjects at weeks 26 (?0.9/?3.5) and 52 (+1.2/?3.6) were not significant. Weight loss was significantly greater in the PT cohort for week 1 through 104 (P = 0.0144). These data suggest phentermine treatment for obesity does not result in increased SBP, DBP, or HR, and that weight loss assisted with phentermine treatment is associated with favorable shifts in categorical blood pressure and retardation of progression to hypertension in obese patients.     

The relationship of family income,family size,age and circumferences with blood pressure in the female students of the Bahauddin Zakariya University,Multan, Pakistan

In a randomly selected sample of 600 female students of the Bahauddin Zakariya University, Multan, Pakistan, belonging to different socioeconomic groups, age, family income and family size were recorded and measurements were made of arm, waist, neck and total circumferences, systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP). The correlation coefficients between different independent (age, family income, family size, arm, waist, neck and total circumference) and dependent variables (SBP, DBP and MAP) showed that age had a strong association (p < 0.001) with all types of blood pressure, whereas the correlation coefficient of family income and family size was significant with SBP (p < 0.05) and non-significant with DBP and MAP. Moreover, all the circumferences had strong relationship (p 0.05 at least) with blood pressure. The regression coefficients of age were highly significant for SBP, DBP and MAP, whereas these were non-significant (p > 0.05) for family income and family size. The regression coefficients for arm and waist were significant (p < 0.05), whereas these were highly significant (p < 0.01 at least) for neck and total circumferences. The neck had a 0.46 mm Hg/cm with SBP, 0.41 mm Hg/cm for DBP and 0.44 Hg/cm for MAP, and these were highest among the circumferences.     

Age-Related Differences of Blood Pressure Profile in Essential Hypertension

The purpose was to assess age-related circadian changes of blood pressure profile (BPP) employing a truncated Fourier series with four harmonics (tFs) in patients with essential hypertension. The study was performed on 32 patients with essential hypertension divided in two groups: (A) 15 patients younger than 55 years and (B) 17 patients older than 60 years. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were monitored every 20 minutes for 24h with a noninvasive portable device (SpaceLabs 90202). To evaluate the existence of SBP and DBP circadian rhythms a one-sample runs-test was performed and the mesor, amplitude, and acrophase from the overall curve of each patient were obtained by tFs. In both groups, SBP and DBP profiles showed a first peak in the late morning and a second peak in the early evening around the same hours. The two peaks in the SBP profile were higher and the two peaks in the DBP profile were lower in older patients than in younger ones (p. 01, p <. 05, p>. 3, p>. 05). The truncated Fourier series with four harmonics evidences different age-related BP profiles characterized by two peaks with higher SBP and lower DBP in elderly patients. These changes of BPP are in accordance with the reported higher risk of cardiovascular events observed around the same hours. (Chronobiology International, 14(4), 397–407, 1997)