Fifty years of Framingham Study contributions to understanding hypertension

Wb, Kannel

doi:10.1038/sj.jhh.1000949

Cited by 236 publications

(143 citation statements)

References 42 publications

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“…Despite new and efficient antihypertensive drugs, hypertension is still associated with significant morbidity and mortality, mainly due to stroke, renal failure and myocardial infarction. 1 In the care of hypertensive patients, fundus alterations have long been considered to give stable and easily detectable information about the vascular status in less accessible organs. 2 In the eye, arterial hypertension is considered to be a major systemic risk factor for retinal artery and vein occlusion.…”

Section: Introductionmentioning

confidence: 99%

Do angiographic data support a detailed classification of hypertensive fundus changes?

Pache

Kube²,

Wolf

et al. 2002

J Hum Hypertens

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Section: Introductionmentioning

confidence: 99%

Do angiographic data support a detailed classification of hypertensive fundus changes?

Pache

Kube²,

Wolf

et al. 2002

J Hum Hypertens

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“…3 Blood pressure decreases during weight loss and increases during weight gain. 1,4 The mechanism behind the association between weight and blood pressure is not understood 5 and is probably complex since both current weight and change in weight in the preceding period seem to have an effect independent of each other.…”

Section: Introductionmentioning

confidence: 99%

Blood pressure in relation to relative weight at birth through childhood and youth in obese and non-obese adult men

2002

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OBJECTIVE:To determine the influence on blood pressure of relative weight from birth through adulthood in non-obese and juvenile obese men. DESIGN: Case-cohort study of obesity in Danish men, identified at age (mean AE s.d.) 19.8 AE 1.6 y at draft board examination, who participated in at least one of two follow-up studies in adulthood (age 36.8 AE 6.7 and 47.9 AE 6.8 y at first and second followup, respectively). Birth weight and weight and height from the age of 7 -13 y were collected from school health records. SUBJECTS: Three hundred and twenty-seven non-obese men (controls) selected as 0.5% of the draft board population and 285 obese men with body mass index (BMI) ! 31 kg=m 2 at draft board examination. MAIN OUTCOME MEASURES: Systolic and diastolic blood pressure measured twice in adulthood adjusted for current age. RESULTS: Birth weight was inversely related to systolic blood pressure at first and second follow-up, but only significantly so when adjusted for current BMI (regression coefficients in mmHg per unit Z-score (95% confidence interval (CI))71.2 (72.3, 7 0.1) and 71.6 (73.1, 0.0)). Change in Z-score from birth weight to BMI at the age of 7 y was significantly positively related to systolic blood pressure, but the relationship weakened by adjustment for current BMI (0.8 (0.1, 1.6) and 0.6 ( 7 0.4, 1.6), respectively). If both birth weight and change until 7 y were included in the same model, their effects were both positive and significant, but they weakened and became not significant when adjusted for current BMI. BMI since the age of 7 y had no significant effect on blood pressure beyond that of current BMI. CONCLUSION: In a wide range of adult BMI in men, the birth weight was inversely related to systolic blood pressure, even when controlled for BMI since the age of 7 y. However, the effect may reflect the weight change between birth and 7 y of age. After that age BMI had no additional effect on blood pressure beyond the effect of current BMI.

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“…Hypertension, defined by the JNC VII guidelines [13] as stage 1: SBP 140-159 mmHg or DBP 90-99 mmHg; stage 2: SBP ≥ 160 mmHg or DBP ≥ 100 mmHg, is linked to cardiovascular disease [49][50][51], a leading cause of death in the western world [52]. In the Framingham Heart Study, a longitudinal 30-year survey, which examined data from normotensive and untreated hypertensive subjects, SBP increased linearly with age; if left untreated, elevated SBP can accelerate large artery stiffness, an independent determinant of cardiovascular risk [51].…”

Section: The Effect Of Drsp On Blood Pressurementioning

confidence: 99%

Advances in hormone replacement therapy with drospirenone, a unique progestogen with aldosterone receptor antagonism

2006

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Unlike other currently available progestogens, drospirenone (DRSP) has a pharmacological profile, which closely mimics that of endogenous progesterone, most notably potent anti-aldosterone and anti-androgenic effects. Consequently, DRSP, when combined with 17β-estradiol (E2) as hormone replacement therapy (HRT), offsets E2-related water and sodium retention by blocking the mineralocorticoid receptor. This review evaluates the potential benefits offered by DRSP as the progestin component of HRT with respect to its anti-aldosterone activity, which translates into positive effects on body weight and blood pressure in clinical trials of continuous, combined E2/DRSP in post-menopausal women. In a 1 -year, large-scale, randomised, controlled trial, E2 1 mg/DRSP 2 mg significantly decreased mean body weight by 1.2 kg versus baseline (P < 0.001), whereas patients receiving E2 1 mg gained weight. E2 1 mg/DRSP 2 mg also significantly lowered mean systolic blood pressure (SBP) by 9.0 mmHg from baseline (P < 0.05) versus 3.7 mmHg in the E2 1 mg group (P = 0.220) in a sub-group of hypertensive women. In addition, E2/DRSP was not associated with hyperkalemia (potassium ≥ 5.5 meq/L) irrespective of concomitant use of ACE inhibitors, angiotensin II receptor antagonists or non-steroidal anti-inflammatory drugs, and co-morbid diabetes mellitus. In summary, as well as effectively treating climacteric symptoms, DRSP 2 mg combined with E2 1 mg has shown positive effects on body weight and blood pressure in clinical trials, most likely due to DRSP's anti-aldosterone properties. This combination may therefore offer an alternative therapeutic option with additional benefits beyond current HRT agents for symptomatic postmenopausal women.

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Fifty years of Framingham Study contributions to understanding hypertension

Cited by 236 publications

References 42 publications

Do angiographic data support a detailed classification of hypertensive fundus changes?

Do angiographic data support a detailed classification of hypertensive fundus changes?

Blood pressure in relation to relative weight at birth through childhood and youth in obese and non-obese adult men

Advances in hormone replacement therapy with drospirenone, a unique progestogen with aldosterone receptor antagonism

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