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  • Ovid Technologies (Wolters Kluwer Health)  (29)
  • 1
    Online Resource
    Online Resource
    Heat Tolerance and Occupational Heat Exposure Limits in Older Men with and without Type 2 Diabetes or Hypertension
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Medicine & Science in Sports & Exercise Vol. 53, No. 10 ( 2021-10), p. 2196-2206
    Details
    In: Medicine & Science in Sports & Exercise, Ovid Technologies (Wolters Kluwer Health), Vol. 53, No. 10 ( 2021-10), p. 2196-2206
    Abstract: To mitigate rises in core temperature 〉 1°C, the American Conference of Governmental Industrial Hygienists (ACGIH) recommends upper limits for heat stress (action limit values [ALV]), defined by wet-bulb globe temperature (WBGT) and a worker’s metabolic rate. However, these limits are based on data from young men and are assumed to be suitable for all workers, irrespective of age or health status. We therefore explored the effect of aging, type 2 diabetes (T2D), and hypertension (HTN) on tolerance to prolonged, moderate-intensity work above and below these limits. Methods Core temperature and heart rate were assessed in healthy, heat unacclimatized young (18–30 yr, n = 13) and older (50–70 yr) men ( n = 14) and heat unacclimatized older men with T2D ( n = 10) or HTN ( n = 13) during moderate-intensity (metabolic rate: 200 W·m −2 ) walking for 180 min (or until termination) in environments above (28°C and 32°C WBGT) and below (16°C and 24°C WBGT) the ALV for continuous work at this intensity (25°C WBGT). Results Work tolerance in the 32°C WBGT was shorter in men with T2D (median [IQR]; 109 [91–173] min; P = 0.041) and HTN (120 [65–170] min; P = 0.010) compared with healthy older men (180 [133–180] min). However, aging, T2D, and HTN did not significantly influence (i) core temperature or heart rate reserve, irrespective of WBGT; (ii) the probability that core temperature exceeded recommended limits ( 〉 1°C) under the ALV; and (iii) work duration before core temperature exceeded recommended limits ( 〉 1°C) above the ALV. Conclusion These findings demonstrate that T2D and HTN attenuate tolerance to uncompensable heat stress (32°C WBGT); however, these chronic diseases do not significantly impact thermal and cardiovascular strain, or the validity of ACIGH recommendations during moderate-intensity work.
    Type of Medium: Online Resource
    ISSN: 1530-0315 , 0195-9131
    URL: Article
    DOI: 10.1249/MSS.0000000000002698
    RVK:
    ZX 1000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2031167-9
    SSG: 31
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  • 2
    Online Resource
    Online Resource
    Sensitivity to ischaemic ATP breakdown in different models of cardiac hypertrophy in rats
    Ovid Technologies (Wolters Kluwer Health) ; 1994
    In:  Journal of Hypertension Vol. 12, No. 1 ( 1994-01), p. 49???58-
    Details
    In: Journal of Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 12, No. 1 ( 1994-01), p. 49???58-
    Type of Medium: Online Resource
    ISSN: 0263-6352
    URL: Article
    DOI: 10.1097/00004872-199401000-00008
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1994
    detail.hit.zdb_id: 2017684-3
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  • 3
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    Online Resource
    Effects of low-dose nifedipine GITS on sympathetic activity in young and older patients with hypertension
    Ovid Technologies (Wolters Kluwer Health) ; 2004
    In:  Journal of Hypertension Vol. 22, No. 5 ( 2004-05), p. 1039-1044
    Details
    In: Journal of Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 22, No. 5 ( 2004-05), p. 1039-1044
    Type of Medium: Online Resource
    ISSN: 0263-6352
    URL: Article
    DOI: 10.1097/00004872-200405000-00028
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2004
    detail.hit.zdb_id: 2017684-3
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  • 4
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    Online Resource
    Blood Pressure Control Should Focus on More Potassium: Controversies in Hypertension
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Hypertension
    Details
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health)
    Type of Medium: Online Resource
    ISSN: 0194-911X , 1524-4563
    URL: Article
    DOI: 10.1161/HYPERTENSIONAHA.123.20545
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2094210-2
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  • 5
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    Alpha-Blocker Use and the Risk of Hypotension and Hypotension-Related Clinical Events in Women of Advanced Age
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Hypertension Vol. 74, No. 3 ( 2019-09), p. 645-651
    Details
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 74, No. 3 ( 2019-09), p. 645-651
    Abstract: Alpha-blockers (ABs) are commonly prescribed as part of a multidrug regimen in the management of hypertension. We set out to assess the risk of hypotension and related adverse events with AB use compared with other blood pressure (BP) lowering drugs using a population-based, retrospective cohort study of women (≥66 years) between 1995 and 2015 in Ontario, Canada. Cox proportional hazards examined the association of AB use and hypotension and related events (syncope, fall, and fracture) compared with other BP lowering drugs matched via a high dimensional propensity score. The primary outcome was a composite of hospitalizations for hypotension and related events (syncope, fractures, and falls) within 1 year. From 734 907 eligible women, 14 106 were dispensed an AB (mean age, 75.7; standard deviation 6.9 years, median follow-up 1 year) and matched to 14 106 dispensed other BP lowering agents. The crude incidence rate of hypotension and related events was 95.7 (95% CI [confidence interval], 90.4–101.1, events 1214 [8.6%] ) with AB and 79.8 (95% CI, 74.9–84.7 per 1000 person-years, events 1025 [7.3%]) with other BP lowering medications (incident rate ratio, 1.20; 95% CI, 1.10–1.30). The risk was higher for hypotension (hazard ratio, 1.71; 95% CI, 1.33–2.20) and syncope (hazard ratio, 1.44; 95% CI, 1.18–1.75) with no difference in falls, fractures, adverse cardiac events, or all-cause mortality. Treatment of hypertension in women with ABs is associated with a higher risk of hypotension and hypotension-related events compared with other BP lowering agents. Our findings suggest that ABs should be used with caution, even as add on therapy for hypertension.
    Type of Medium: Online Resource
    ISSN: 0194-911X , 1524-4563
    URL: Article
    DOI: 10.1161/HYPERTENSIONAHA.119.13289
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2094210-2
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  • 6
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    Online Resource
    Behind the Mask : A Call for 24-Hour Blood Pressure Monitoring in Chronic Kidney Disease
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Hypertension Vol. 72, No. 4 ( 2018-10), p. 841-842
    Details
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 72, No. 4 ( 2018-10), p. 841-842
    Type of Medium: Online Resource
    ISSN: 0194-911X , 1524-4563
    URL: Article
    DOI: 10.1161/HYPERTENSIONAHA.118.11681
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2094210-2
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  • 7
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    Online Resource
    Longitudinal Blood Pressure in Late-Stage Chronic Kidney Disease and the Risk of End-Stage Kidney Disease or Mortality (Best Blood Pressure in Chronic Kidney Disease Study)
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Hypertension Vol. 70, No. 6 ( 2017-12), p. 1210-1218
    Details
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 70, No. 6 ( 2017-12), p. 1210-1218
    Abstract: Whether different methods of quantitating blood pressure (BP) in late chronic kidney disease better mimic pathophysiological processes and clinical outcomes remains unclear. In a retrospective study, we determined the association of BP with end-stage kidney disease (ESKD) and all-cause mortality with BP modeled at baseline versus longitudinally with time-varying Cox models as (1) current (most recent) clinic visit, (2) lag (visit immediately preceding the current), (3) cumulative (average of previous measurements), and (4) change from baseline to the most recent. Among 1203 (6913 visits) study patients, the mean age and baseline estimated glomerular filtration rate were 66 and 18 mL·min −1 ·1.73 m −2 ), and 40% were female. Patients had a mean of 6.7 BP measurements, 540 (44.8%) reached ESKD, and 141 (11.7%) died. For systolic BP 〉 160, current (hazard ratio [HR] , 1.67), cumulative (HR, 1.58), and a rise to 〉 160 from baseline 120 to 160 (HR, 1.60) were associated with ESKD. Similarly, diastolic BP 〉 85 was associated with ESKD when modeled as current (HR, 1.47), lag (HR, 1.63), cumulative (HR, 2.15), or change from baseline (rise to 〉 85 from a baseline of 60–85; HR, 1.62). Both low SBP ( 〈 120), when modeled as current (HR, 1.59), cumulative exposure (HR, 1.76), persistently 〈 120 (HR, 2.28), and high SBP ( 〉 140), when modeled as cumulative exposure, were associated with all-cause mortality. For diastolic BP, only cumulative 〉 85 was significantly associated with mortality (HR, 2.75). Thus, in late-stage chronic kidney disease, persistently high or rises in systolic BP or diastolic BP are associated with risk of ESKD, whereas baseline BP measures did not convey information on risk.
    Type of Medium: Online Resource
    ISSN: 0194-911X , 1524-4563
    URL: Article
    DOI: 10.1161/HYPERTENSIONAHA.117.09855
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 2094210-2
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  • 8
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    Online Resource
    Abstract P206: Interarm Difference in Blood Pressure: Prevalence, Risk Factors, and Relevance for Diagnosis of Disease of the Aorta Among Patients Referred to Specialized Regional Hypertension Center
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Hypertension Vol. 72, No. Suppl_1 ( 2018-09)
    Details
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 72, No. Suppl_1 ( 2018-09)
    Abstract: Background: Initial evaluation of hypertension (HTN) should include assessment of blood pressure (BP) in both arms. The prevalence of high interarm differ ranges from 3% in the general adult population to about 10% in the patients with HTN. However, we lack proper estimates of its prevalence, and existing practice of follow up for these patients in a referred population. Methods: We performed a retrospective chart review of all prevalent patients followed at the Hypertension Center at the Ottawa Hospital. BP data from the first visit were used for assessment for interarm BP difference. We considered interarm difference in either systolic or diastolic BP in excess of 10 mmHg for casual BP by mercury sphygmomanometry to be clinically significant. Results: 493 patients of 580 patients were included in this study based on available data. The prevalence of clinically significant interarm difference in systolic or diastolic BP was 16.2% and was similar among men and women. These patients were more likely to be smokers (current or previous; 53.5% vs 36.8%) with peripheral arterial disease (PAD, 15% vs 8%). None of these patients had undergone further investigations of ascending aorta/aortic arch. Conclusions: A significant proportion of referred patients have a high interarm difference in systolic or diastolic BP. No clinical investigations were ordered to evaluate for ascending aorta/aortic arch disease reflecting the physicians’ lack of understanding of its clinical relevance. The association with smoking and PAD suggests underlying aortic/large vessel disease as a potential mechanism in some patients.
    Type of Medium: Online Resource
    ISSN: 0194-911X , 1524-4563
    URL: Article
    DOI: 10.1161/hyp.72.suppl_1.P206
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2094210-2
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  • 9
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    Abstract P431: Renal Artery Stenosis Caused by a Bcr-Abl Tyrosine Kinase Inhibitor: Blood Pressure Response to Revascularization
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Hypertension Vol. 70, No. suppl_1 ( 2017-09)
    Details
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 70, No. suppl_1 ( 2017-09)
    Abstract: Introduction: Bcr-Abl tyrosine kinase inhibitors (TKI) are first line agents for management of chronic myelogenous leukemia (CML). Amongst the second generation TKIs, which have less resistance and improved side effect profile, nilotinib and ponatinib have also been reported to be associated with vascular adverse events (VAEs), including systemic and peripheral arterial stenosis. We report on a patient with CML treated with ponatinib, who developed bilateral renal artery stenoses, difficult to control hypertension, and responded to revascularization. Case: A 55 year old man, with CML due to a Bcr-Abl truncating mutation diagnosed in 2007, was treated with ponatinib 45 mg daily starting in 2011, which induced a complete remission. He subsequently developed hypertension. Hypertension appeared angiotensin II-dependent as BP normalized on combination of candesartan 32 mg once daily and hydrochlorothiazide 25 mg once daily. This treatment was however associated with an increase in serum creatinine from 1.4 to 2.6 mg/dL. Consistent with our clinical suspicion, a computed tomography angiogram revealed bilateral renal artery stenosis. He eventually required bilateral renal artery angioplasty and stenting as the BP could not be controlled without renin-angiotensin system blockers despite using up 5 classes of BP lowering drugs. Furthermore, follow up imaging of renal arteries showed progressive renal artery stenosis bilaterally. He underwent angioplasty and stenting in the left renal artery and angioplasty of both the branches of the right main renal artery, which could not be stented because of the early branching. After 6 months, BP is within target with 8 mg candesartan, amlodipine 10 mg and bisoprolol 2.5 mg daily, and the renal function is stable (creatinine 1.1 mg/dL). Overall, in this case, renal artery angioplasty and stenting stabilized renal function and improved control of hypertension. Discussion: Second generation TKIs are associated with VAEs, including renal artery stenosis. Renal artery angioplasty and stenting stabilized renal function and improved control of hypertension in this case. Future research should clarify the mechanisms of VAEs with TKIs, natural history, and long term response to revascularization in this setting.
    Type of Medium: Online Resource
    ISSN: 0194-911X , 1524-4563
    URL: Article
    DOI: 10.1161/hyp.70.suppl_1.p431
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 2094210-2
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  • 10
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    Online Resource
    Relevance of Blockade of Cardiac and Circulatory Angiotensin-Converting Enzyme for the Prevention of Volume Overload–Induced Cardiac Hypertrophy
    Ovid Technologies (Wolters Kluwer Health) ; 1995
    In:  Circulation Vol. 91, No. 1 ( 1995-01), p. 16-19
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 91, No. 1 ( 1995-01), p. 16-19
    Abstract: Background Angiotensin-converting enzyme (ACE) inhibitors show major differences in their affinity for cardiac and other tissue ACEs, and their effects on tissue ACE range from minimal to nearly complete blockade. Angiotensin II taken up from the circulation or generated in the heart may mediate the cardiac hypertrophic response to increased cardiac load. Thus, differences between the ACE inhibitors regarding their effects on cardiac ACE may determine their effects on prevention or regression of cardiac hypertrophy. Methods and Results In the present study, we assessed the effects of ACE inhibitors with low (enalapril) and high (quinapril) affinity for cardiac tissue ACE on prevention of volume overload–induced cardiac hypertrophy in relation to their hemodynamic effects. Both blockers were equipotent for circulatory ACE as assessed from the pressure response curve to angiotensin I. Both blockers partially (and similarly) prevented the increase in left ventricular end-diastolic pressure by aortocaval shunt. However, only quinapril prevented or attenuated the development of right ventricular hypertrophy and left ventricular hypertrophy and dilation. Conclusions The present findings further stress the involvement of the renin-angiotensin system as a trophic stimulus in the development of cardiac hypertrophy in this model. Moreover, the low affinity of enalapril for cardiac ACE appears to lead to continuous angiotensin II generation in the heart and can thus explain the failure of enalapril to attenuate hypertrophic response of the heart induced by shunt despite decreasing cardiac volume overload.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/01.CIR.91.1.16
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1995
    detail.hit.zdb_id: 1466401-X
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