Active clinical trials for "Hypertension"

Wintertime is associated with increased morbidity and mortality and a majority is related to cardiovascular causes, such as myocardial infarctions, heart failures, and strokes. It is also known, that both acute and long-term cold exposure increase blood pressure and cardiac workload, and this may contribute to the observed excess morbidity and mortality during the cold season. Although the effects of cold on blood pressure are known among healthy people, these responses among risk groups, such as hypertensive people, are not established. In addition, changes in cardiac electrical activity or autonomic regulation are largely unknown. The cardiovascular responses in the cold could be different among hypertensive people because of disturbances in the circulatory regulation or function, such as aortic stiffening and increased vasomotor tone of peripheral arteries due to endothelial dysfunction associated with the disease. To assess this, a controlled experiment employing a cold exposure similar to everyday winter circumstances in a subarctic climate was performed.

This study is a prospective, observational study of changing from any IOP-lowering treatment to a prostaglandin analogue-containing IOP-lowering medication for patients with Primary Open Angle Glaucoma (POAG) or Ocular Hypertension (OHT). The decision to change medications lies with the physician according to their standard practice.

Previous studies have demonstrated that single nucleotide polymorphisms (SNPs) of the sodium-bicarbonate co-transporter gene (SLC4A5) are associated with hypertension. We tested the hypothesis that SNPs in SLC4A5 are associated with salt sensitivity of blood pressure in 185 whites consuming an isocaloric constant diet with a randomized order of 7 days of low sodium (Na+) and 7 days of high Na+ intake. Salt sensitivity was defined as a ≥7-mm Hg increase in mean arterial pressure during a randomized transition between low and high Na+ diet. A total of 35 polymorphisms in 17 candidate genes were assayed, 25 of which were tested for association. Association analyses with salt sensitivity revealed 3 variants that associated with salt sensitivity. Of these, 2 SNPs in SLC4A5 (rs7571842 and rs10177833) demonstrated highly significant results and large effects sizes, using logistic regression. These 2 SNPs had P values of 1.0×10-4 and 3.1×10-4 with odds ratios of 0.221 and 0.221 in unadjusted regression models, respectively, with the G allele at both sites conferring protection. These SNPs remained significant after adjusting for body mass index and age (P=8.9×10-5 and 2.6×10-4 and odds ratios 0.210 and 0.286, respectively). Furthermore, the association of these SNPs with salt sensitivity was replicated in a second hypertensive population. Meta-analysis demonstrated significant associations of both SNPs with salt sensitivity (rs7571842 [P=1.2×10-5]; rs1017783 [P=1.1×10-4]). In conclusion, SLC4A5 variants are strongly associated with salt sensitivity of blood pressure in 2 separate white populations.

Introduction: Daily stress levels of population are increasing over the last decades. Frequent spouse to stress is considered an important risk factor for development of cardiovascular diseases. Other well documented risk factor for cardiovascular diseases is systemic hypertension which, in turn, has been related to elevated blood pressure reactivity (BPR) to stress. The exacerbated BPR may suggest a poor autonomic modulation due to an elevated sympathetic tone, condition that has been associated with medium to long-term cardiovascular complications. Also, some reports have demonstrated that individuals hyper-reactive to stress chronically increase their risk for psychological disorders such as anxiety, irritability and frustration. These feelings are associated to increased sympathetic tone induced chronic elevation in BP. Although the hemodynamic benefits of aerobic and resistance exercises had been documented in a variety of reports5, the acute effects of the aforementioned exercise modes combined in a circuit method on post-exercise BP, including the responses to cardiovascular stressor test need further investigations. Objective: To investigate the blood pressure (BP) responses to cardiovascular stressor test after a combined exercise circuit session at moderate intensity. Methods: Twenty individuals (10male/10fem; 33.4±6.9years; 70.2±15.8kg; 170.4±11.5cm; 22.3±6.8 %body fat) volunteered to randomly perform on different days: 1) Exercise session consisting of 3-laps in a circuit model in the following sequence: knee extension, bench press, knee flexion, rowing in the prone, squat, shoulder press and 5-min of aerobic exercise at 75-85% of age-predicted maximum heart rate and/or 13 in the Borg-Scale [6-20]. The sets of resistance exercise were composed by 15 repetitions with ~50% of one repetition maximum test and; 2) a control session without exercise. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured at resting and during 1h of recovery in both experimental sessions. After that, blood pressure reactivity (BPR) was evaluated using the Cold Pressor Test (a test with hand in the cold water during one minute). The hypotheses are that after doing the exercise session occur attenuation of blood pressure increase during the Cold Pressor Test compared to sitting without exercise (control session).

The study will evaluate patients diagnosed with POAG or OHT who are switched to GANFORT® UD (unit dose of fixed combination bimatoprost and timolol) therapy for medical reasons in accordance with physician standard clinical practice. All treatment decisions lie with the physician.

The study objective is to develop and test a Measure of Drug Self-Management for use in clinical settings among patients with hypertension and diabetes. While medication non-adherence is a highly recognized public health and patient safety concern, it is rarely assessed in a routine and consistent manner in clinical settings. With the aging of the US population and rising rates of chronic disease, an increasing number of adults are being prescribed multi-drug regimens that require greater self-management skills. Despite the complexity of medication use, adherence has most commonly been measured as a limited set of behaviors (i.e., filling a prescription, taking doses). This emphasis has, over time, simplified how we think of prescription (Rx) medication use and directed attention away from the full range of tasks associated with effective Rx self-management. The field of health literacy research has deconstructed these tasks in considerable detail in recent years, and can offer insight into a more comprehensive measurement of patients' outpatient Rx use. There is a clear need for a brief, yet inclusive, measure of adherence that can be used in clinical settings to routinely assess patients' use of complex Rx regimens. Such an assessment could be used to guide clinicians in addressing specific patient challenges to safe and appropriate medication use. In response to this need, our study proposes to develop a new assessment of medication self-management. This unique measure will utilize health literacy best practices to promote patient comprehension and ease-of-use; it will also be tailored to patients' actual regimens via electronic health record (EHR) data. Finally, the tool will be available in both English and Spanish to support use among diverse patient populations. Our study aims are to: Develop and refine a Measure of Drug Self-Management (MeDS) prototype. Inform the content, structure and delivery of the MeDS through targeted discussions with patients, providers and information technology specialists. Test the reliability and validity of the MeDS among patients with diabetes and hypertension H1: The MeDS will strongly correlate with other self-report adherence measures.

Observational evidence indicates that intradialytic hypertension is associated with high morbidity & mortality. The investigators impression is that this problem may be more prevalent than initially suspected. To the investigators knowledge, there are no studies on intradialytic hypertension in the South African haemodialysis population.

Objectives: To analyze the influence on the presence of target organ damage renal, cardiac and vascular of peripheral and central blood pressure, retinal vessels caliber, oxidative stress and polymorphisms of genes VAV-2-3 in hypertensive subjects. Methodology: A cross- sectional design we will performed . Population: 486 hypertensive patients. Target organ damage will be assessed by tests recommended in 2013 European guidelines of hypertension. Blood pressure office and ambulatory, retinal caliber vassels,oxidative stress and polymorphisms VAL -2-3 will be measurement.

An observational study comparing changing from an IOP-lowering treatment to a bimatoprost-containing IOP treatment in primary open-angle glaucoma (POAG) or ocular hypertension (OHT). Visits and treatment are per normal clinical practice.

This single center study will monitor the developmental progress of PPHN patients who received iv sildenafil in study A1481276. Two visits will be conducted, at 12 and 24 months following the end of study drug infusion.