In China, automated blood pressure monitors have been readily available for home use. Home blood pressure monitoring has been indispensable in the management of hypertension. There is therefore a need to establish guidelines for home blood pressure monitoring on the basis of the 2012 consensus document. In this guidelines
Background: The b1-adrenergic receptor (ADRB1) plays a pivotal role in mediating signal transduction of the sympathetic-adrenal system, which is involved in the regulation of cardiac output and peripheral resistance. Our goal was to determine whether the polymorphisms Arg389Gly (rs1801253) and Ser49Gly (rs1801252) of the ADRB1 gene were associated with essential hypertension in Chinese. Methods: We tested our hypothesis in two independent case-control studies, one comprised 481 patients with hypertension and 529 control subjects, and the other study comprised 212 patients and 325 control subjects. All subjects were genotyped for Arg389Gly and Ser49Gly polymorphisms. Results: The first study showed that the Arg389Arg genotype of the ADRB1 gene was associated with risk of hypertension wodds ratio (OR) 1.77, 95% confidence interval (CI) 1.09-2.98; ps0.008x, and the association was replicated in the second independent population (OR 1.65, 95% CI 1.07-2.89, ps0.01). The patients with the Arg389Arg genotype had significantly higher diastolic blood pressure (DBP) than did those with Arg389Gly genotype as well as those with Gly389Gly genotype (100.29"11.01 mm Hg vs. 95.33"13.10 mm Hg and vs. 96.17"12.18 mm Hg, respectively, ps0.01, ps0.02). The association was replicated in the second study (103.7"13.3 mm Hg vs. 97.31"12.9 mm Hg and vs. 96.29"13.4 mm Hg, respectively, ps0.03, ps0.02). Heart rate also showed an association (in first study : 79.43"9.90 bpm vs. 74.87" 8.96 bpm, vs. 73.92"8.18 bpm, respectively, ps0.02, ps0.014; in the second study: 81.12"8.99 bpm vs. 74.85"7.97 bpm and vs. 73.89"9.12 bpm, ps0.007, ps0.006, respectively). No association was seen between systolic blood pressure (SBP) and any of the three genotypes at amino acid position 389 in hypertensive patients, neither between the Ser49Gly polymorphisms and hypertension, nor between the Ser49Gly genotypes and DBP and heart rate.
The aim of the present study was to investigate inflammatory cytokine release and the interaction with platelets in patients with unstable angina (UA) after coronary angioplasty. In 50 patients with stable angina (SA) and 58 patients with UA, serial venous blood samples were obtained immediately before, and 30 minutes, 4, 12, 24, 48 and 72 hours, and 7 days after coronary angioplasty. Plasma concentrations of IL-8 and vWF were determined by immunoassay, while the expression of CD11 b/CD18 on monocytes and the expression of CD41 on platelets were assessed by flow cytometry. Differences in the baseline plasma concentrations of IL-8, vWF and CD11b/CD18, CD41 were found in the UA and SA groups before angioplasty (101.1 +/- 31.28 pg/mL to 55.8 +/- 17.24 pg/mL, 137.67 +/- 38.14% to 107.40 +/- 28.67% and 318.67 +/- 36.85 MFI to 240.72 +/- 28.43 MFI, 147.5 +/- 23.18 MFI to 104.43 +/- 26.68 MFI all p < 0.05). The peak plasma levels of IL-8 (172.24 +/- 37.82 pg/mL at 12 hours) and vWF (256 +/- 42.32% at 4 hours) significantly increased after coronary angioplasty (both p < 0.01), and were associated with significant time course increases in surface expression of CD11b/CD18 (p < 0.01) and CD41 (p < 0.01). The levels of plasma IL-8 and vWF were significantly higher pre- and post-procedure in UA patients with lesion type C compared to types A or B (p < 0.05), but there were no differences for pre-procedure in the SA group patients with different lesion types (p > 0.05). There were significant correlations between plasma IL-8 and monocyte CD11b/CD18, vWF and CD41 in the UA group (r = 0.5248, r = 0.6240 both p < 0.01, respectively). The findings demonstrate increases in plasma IL-8 and CD11b/CD18 as inflammatory mediators, vWF and CD41 as the abnormal coagulation activity may therefore yield a rationale for pharmacological anticytokines in patients with UA after coronary angioplasty.
Although the importance of elevated circulating plasma catecholamines on cardiac structural and functional remodelling of hypertension is well documented, it is unclear whether the catecholamine-beta-adrenoreceptor (beta AR)-cAMP system can predict different cardiovascular events. 2. A total of 601 identified hypertensive patients with baseline and follow-up plasma levels of noradrenaline (NA) and adrenaline (Adr), lymphocyte beta AR density (B(max)) and intra-lymphocyte cAMP levels in peripheral blood (last examination 60+/-26 months apart) were followed up for an additional 24+/-12 months. 3. After the last follow up, a composite end-point of cardiovascular death, non-fatal myocardial infarction (MI) and stroke occurred in 139 patients (23.1%). In Cox analyses, adjusting for other standard factors as well as treatment effect, NA (hazard ratio 1.22; 95% confidence interval (CI) 1.17-1.28; P=0.0008), Adr (hazard ratio 1.53; 95% CI 1.18-2.00; P=0.002), beta AR (hazard ratio 1.12; 95% CI 1.06-1.17; P=0.007) and cAMP (hazard ratio 1.15; 95% CI 1.09-1.21; P=0.005) separately predicted cardiovascular mortality. Noradrenaline, Adr, beta AR and intra-lymphocyte cAMP separately predicted fatal/non-fatal MI; NA and Adr predicted fatal/non-fatal stroke, whereas B(max) and intra-lymphocyte cAMP levels were not a significant predictor of fatal/non-fatal stroke. When stratifying the study population by NA or Adr (median 4 nmol/L), B(max) (median 600 fmol/10(7) cells) and cAMP (median 5.0 pmol/mg protein) above and below the median values in both parameters categories, patients above the median had composite cardiovascular end-point (all P<0.001) and high cardiovascular death (all P<0.01, log-rank test). 4. These results suggest that plasma NA and Adr are significant predictors of cardiovascular mortality, MI and stroke. The B(max) and intra-lymphocyte cAMP levels are significant predictors of cardiovascular mortality and MI, but not stroke.
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