The role of blood pressure variability in end-organ damage

Mancia, Giuseppe; Parati, Gianfranco

doi:10.1097/00004872-200307006-00004

Cited by 148 publications

(108 citation statements)

References 27 publications

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“…Impaired baroreflex is believed to lead to significant dysregulation of BP; leading to increased BP variability, orthostatic hypotension, aberrant pressure rises with major risk of fatal events such as myocardial infarction (MI) and stroke (Tozawa et al, 1999;Mancia & Parati, 2003;Di Rienzo et al, 2009); and has been reported in several models of HTN such as SHR, 2KIC hypertensive model and Lyon hypertensive rat. Angiotensin II inhibits baroreceptor function (Huang & Leenen, 1998;Huang et al, 2006;Xie et al, 2006;Parsons & Coffman, 2007;Carlson & Wyss, 2008;Cravo et al, 2009).…”

Section: Baroreceptorsmentioning

confidence: 99%

Effect of Tulbaghia violacea on the blood pressure and heart rate in male spontaneously hypertensive Wistar rats

Raji

Mugabo

Obikeze

2012

Journal of Ethnopharmacology

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Effect of Tulbaghia violacea on the blood pressure and heart rate in male spontaneously hypertensive Wistar rats I. A. RAJITulbaghia violacea Harv. (Alliaceae) is a small bulbous herb which belongs to the family, Alliaceae, most commonly associated with onions and garlic. In South Africa (SA), this herb has been traditionally used in the treatment of various ailments, including fever, colds, asthma, paralysis, hypertension (HTN) and stomach problems. The aim of this study was to evaluate the effect of methanol leaf extracts (MLE) of T. violacea on the blood pressure (BP) and heart rate (HR) in anaesthetized male spontaneously hypertensive rats; and to find out the mechanism(s) by which it acts.The MLE of T. violacea (5 -150 mg/kg), angiotensin I (ang I, 3.1 -100 µg/kg), captopril (10 mg/kg), angiotensin II (ang II, 3.1 -50 µg/kg), losartan (30 mg/kg), phenylephrine T. violacea (60 mg/kg) and captopril (10 mg/kg) were injected intraperitoneally into iii some SHR for 21 days to investigate the chronic effect of these agents on plasma levels of aldosterone. The mean change, the mean of the individual percentage changes and the percentage difference (in mean) observed with each intervention was calculated and statistically analyzed using the Student's t test for significant difference (p < 0.05). The Microsoft Excel software was used for statistical analysis.T. violacea significantly (p < 0.05) reduced the systolic, diastolic, and mean arterial BP;and HR dose-dependently. In a dose-dependent manner, ang I, ang II, phenylephrine significantly (p < 0.05) increased the BP, while propranolol, muscarine and atropine reduced the BP. The increases in BP due to dobutamine were not dose-dependent. In a dose dependent manner, phenylephrine and propranolol reduced the HR, while dobutamine increased the HR. The effect of ang I, ang II, muscarine and atropine on HR were not dose-dependent; with both increases as well as decreases observed with ang I, and II and atropine, while decreases were seen with muscarine. Captopril produced significant (p < 0.05) reduction in BP which were not associated with any change in HR.The co-infusion of ang I with the MLE produced significant (p < 0.05) reduction in BP, which were not associated with significant changes in HR. The co-infusion of ang II with the MLE did not produce any significant changes in BP or HR when compared to the infusion of the standard drug alone. The co-infusion of phenylephrine with the MLE did

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Section: Baroreceptorsmentioning

confidence: 99%

Effect of Tulbaghia violacea on the blood pressure and heart rate in male spontaneously hypertensive Wistar rats

Raji

Mugabo

Obikeze

2012

Journal of Ethnopharmacology

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“…2,3 The clinical relevance of establishing a non-dipping BP pattern lies in its proven association with more severe hypertensive target organ damage and increased cardiovascular risk both in hypertensive and normotensive subjects. [4][5][6] Left ventricular hypertrophy, carotid intima-media thickening, microalbuminuria and cerebrovascular disease are more prevalent in non-dippers than in dippers. 7,8 In normal pregnancy, the circadian rhythm of BP is similar to that in the non-pregnant state.…”

Section: Introductionmentioning

confidence: 99%

Melatonin secretion is impaired in women with preeclampsia and an abnormal circadian blood pressure rhythm

et al. 2014

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Non-dipping circadian blood pressure (BP) is a common finding in preeclampsia, accompanied by adverse outcomes. Melatonin plays pivotal role in biological circadian rhythms. This study investigated the relationship between melatonin secretion and circadian BP rhythm in preeclampsia. Cases were women with preeclampsia treated between January 2006 and June 2007 in the University Hospital of Larissa. Volunteers with normal pregnancy, matched for chronological and gestational age, served as controls. Twenty-four hour ambulatory BP monitoring was applied. Serum melatonin and urine 6-sulfatoxymelatonin levels were determined in day and night time samples by enzyme-linked immunoassays. Measurements were repeated 2 months after delivery. Thirty-one women with preeclampsia and 20 controls were included. Twenty-one of the 31 women with preeclampsia were non-dippers. Compared to normal pregnancy, in preeclampsia there were significantly lower night time melatonin (48.4 ± 24.7 vs. 85.4 ± 26.9 pg/mL, p50.001) levels. Adjustment for circadian BP rhythm status ascribed this finding exclusively to non-dippers (p50.01). Two months after delivery, in 11 of the 21 non-dippers both circadian BP and melatonin secretion rhythm reappeared. In contrast, in cases with retained non-dipping status (n ¼ 10) melatonin secretion rhythm remained impaired: daytime versus night time melatonin (33.5 ± 13.0 vs. 28.0 ± 13.8 pg/mL, p ¼ 0.386). Urinary 6-sulfatoxymelatonin levels were, overall, similar to serum melatonin. Circadian BP and melatonin secretion rhythm follow parallel course in preeclampsia, both during pregnancy and, at least 2 months after delivery. Our findings may be not sufficient to implicate a putative therapeutic effect of melatonin, however, they clearly emphasize that its involvement in the pathogenesis of a non-dipping BP in preeclampsia needs intensive further investigation.

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“…BP exhibits a circadian periodic variation with lower values during the night and higher values during the day [11][12][13][14]. This rhythmicity is also present throughout pregnancy [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

“…An altered circadian pattern has been reported in pregnancy-induced hypertension [18] and in severe preeclamsia, where a complete reversal of the BP variation has been reported [19,20]. Single BP measurements are then only a poor indicator of the complex adaptation of the maternal circulation, while BP variability needs to be considered [7][8][9][10][11]13,[21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Circadian rhythm of maternal blood pressure and fetal growth

Maggioni¹,

Cornelissen²,

Otsuka³

et al. 2005

Biomedicine & Pharmacotherapy

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This study aimed at examining any relation between the circadian variation in blood pressure (BP) in human pregnancy and fetal growth. A prospective study included 52 pregnant women monitored during the third trimester of pregnancy. There were 33 uncomplicated pregnancies with normal fetal growth (Group 1) and 19 pregnancies complicated by intrauterine growth retardation (IUGR), confirmed at birth (Group 2). Ten women (five in each group) had pregnancy-induced hypertension. All women were hospitalized and followed a similar daily routine. BP was recorded with an automatic wearable device. Measurements were obtained every 20 min for 24 ± 1 h. BP profiles were analyzed by conventional statistical methods and by cosinor, involving the least squares fit of cosine curves with an anticipated period (24 h) to the data. BP parameters, fetal outcome, demographic and obstetric characteristics were compared between the two groups. Logistic regression and multivariate analyses were used to assess factors putatively associated with fetal outcome. The circadian amplitude of diastolic BP was found to be larger in normotensive women with IUGR. As gauged by odds ratios (OR), the circadian amplitude of diastolic BP (OR = 1.7, 95% CI: 1.1-2.8; P = 0.03) and hematocrit (OR = 1.4, 95% CI: 1.0-1.9; P = 0.04) were the only variables positively and independently associated with IUGR. In the presence of maternal hypertension, the circadian amplitude of systolic BP was negatively associated with IUGR (OR = 0.7, 95% CI: 0.5-1.0; P = 0.03). A larger circadian variation in diastolic BP, rather than a difference in the mean value of systolic or diastolic BP, was found to be statistically significantly associated with IUGR. This study adds another condition in which the circadian BP amplitude constitutes a harbinger of elevated risk, apart from an association with a shortened lifespan in the absence or presence of malignant hypertension and with an increased risk of stroke and nephropathy reported earlier.

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The role of blood pressure variability in end-organ damage

Cited by 148 publications

References 27 publications

Effect of Tulbaghia violacea on the blood pressure and heart rate in male spontaneously hypertensive Wistar rats

Effect of Tulbaghia violacea on the blood pressure and heart rate in male spontaneously hypertensive Wistar rats

Melatonin secretion is impaired in women with preeclampsia and an abnormal circadian blood pressure rhythm

Circadian rhythm of maternal blood pressure and fetal growth

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