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  • 1
    Electronic Resource
    Electronic Resource
    ISOLATED SYSTOLIC HYPERTENSION: DOES IT REALLY EXIST ON AMBULATORY BLOOD PRESSURE MONITORING? (1990)
    Oxford, UK : Blackwell Publishing Ltd
    Clinical and experimental pharmacology and physiology 17 (1990), S. 0 
    Details
    ISSN: 1440-1681
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: 1. The diagnosis of isolated systolic hypertension, diastolic hypertension and normotension in elderly subjects, as defined by casual office blood pressure measurement, was compared with 24 h ambulatory blood pressure monitoring using an Accutracker II.2. Mean day-time ambulatory blood pressure monitoring underestimated the casual systolic blood pressure in all three clinical groups. Diastolic pressure was not underestimated to the same extent.3. Ambulatory blood pressure monitoring best reflected casual blood pressure determination for normotensive subjects. In subjects with isolated systolic hypertension ambulatory blood pressures were only consistent with that diagnosis for 8% of the day time period. For 34% of the day time, their ambulatory blood pressures were consistent with diastolic/ mixed hypertension.4. It is concluded that isolated systolic hypertension may not be a sustained condition, but rather an isolated response to office measurement of blood pressure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1440-1681.1990.tb01306.x
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  • 2
    Electronic Resource
    Electronic Resource
    IS ISOLATED SYSTOLIC HYPERTENSION A WHITE COAT’ PHENOMENON IN THE ELDERLY? (1992)
    Oxford, UK : Blackwell Publishing Ltd
    Clinical and experimental pharmacology and physiology 19 (1992), S. 0 
    Details
    ISSN: 1440-1681
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: 1. Repeated clinic blood pressure measurement was compared with non-invasive ambulatory blood pressure (ABP) monitoring in 10 elderly subjects with isolated systolic hypertension (ISH) and 11 normotensive controls (NT).2. Subjects were assessed on four occasions at weekly intervals. None was receiving antihypertensive or vasoactive medication.3. Mean clinic blood pressure was consistently higher than mean daytime ABP in both clinical groups. This effect was greater for systolic (SBP) than diastolic blood pressure (DBP) and in the ISH group compared with the NT group. The reproducibility of the clinic minus ABP difference was high in both groups; the mean±s.d. of the differences was 26± 15/9 ± 2 mmHg in the ISH group and 7 ± 18/8 ± 9 mmHg in the controls.4. ABP readings were normally distributed for both SBP and DBP in both groups. In the ISH group, the frequency distribution of SBP readings was shifted to the right whilst the distribution of DBP readings overlapped that of the NT subjects.5. These results suggest a pressor response may largely account for the elevated SBP seen in elderly subjects with sustained ISH based on casual readings.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1440-1681.1992.tb00454.x
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    SAMPLE SIZE REQUIREMENTS FOR CLINICAL TRIALS OF ISOLATED SYSTOLIC HYPERTENSION (1992)
    Oxford, UK : Blackwell Publishing Ltd
    Clinical and experimental pharmacology and physiology 19 (1992), S. 0 
    Details
    ISSN: 1440-1681
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: 1. This study investigated components of blood pressure variability in elderly subjects with isolated systolic hypertension (ISH) using both ambulatory blood pressure monitoring (ABPM) and casual clinic blood pressure measurement. These were then used to determine sample size requirements for clinical trials of different designs.2. Eleven elderly subjects not receiving antihypertensive medication were seen on four occasions at weekly intervals. On each occasion blood pressure was measured in the clinic and then for 24 h using a non-invasive ABPM device. Nested analysis of variance was used to calculate the ‘between subject’ and ‘between subject within occasion’ components of blood pressure variability.3. Increasing the number of readings or occasions where measurement was performed in a parallel group trial only reduced the variability substantially when the number of subjects involved was less than 50. Use of a cross-over design substantially reduced the sample size required.4. ABPM appears most useful as a strategy for reducing sample size in parallel group trials in ISH involving small numbers of subjects measured on one occasion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1440-1681.1992.tb00455.x
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Hypertension in the elderly: Epidemiology and pathophysiology (1991)
    Springer
    Cardiovascular drugs and therapy 4 (1991), S. 1197-1201 
    Details
    ISSN: 1573-7241
    Keywords: hypertension ; elderly ; epidemiology ; drug therapy ; pathophysiology ; environment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In all but a few remote and unacculturated tribes, blood pressure rises with advancing age. By the time Western adult males or females reach their 70s their probability of being hypertensive (BP〉140/90 mmHg) exceeds 50%. Unlike various other risk factors for vascular disease, hypertension retains its predictive power as age increases, but since the baseline risk is higher, the number of cases of disease attributable to hypertension is much higher in the elderly than in the young. The reason for the rise in blood pressure with aging is not well established, although a high lifetime intake of sodium may be a contributing factor. It now appears that the major hemodynamic abnormality is an increased peripheral resistance. It is possible that an accentuation of changes that take place with normal aging might be responsible for this phenomenon. They include a reduction in renal function, decreased haroreceptor sensitivity, or increased sympathetic activity. Up until the present time studies have been unable to isolate the mechanisms involved.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00114219
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    Paper (German National Licenses)
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