BLOOD PRESSURE A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2003 by ICON Group International, Inc. Copyright ©2003 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Blood Pressure: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83588-8 1. Blood Pressure-Popular works. I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on blood pressure. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.
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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.
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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes & Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health
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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON BLOOD PRESSURE...................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Blood Pressure............................................................................... 8 E-Journals: PubMed Central ....................................................................................................... 97 The National Library of Medicine: PubMed .............................................................................. 102 CHAPTER 2. NUTRITION AND BLOOD PRESSURE .......................................................................... 209 Overview.................................................................................................................................... 209 Finding Nutrition Studies on Blood Pressure ........................................................................... 209 Federal Resources on Nutrition ................................................................................................. 215 Additional Web Resources ......................................................................................................... 216 CHAPTER 3. ALTERNATIVE MEDICINE AND BLOOD PRESSURE ................................................... 223 Overview.................................................................................................................................... 223 The Combined Health Information Database............................................................................. 223 National Center for Complementary and Alternative Medicine................................................ 224 Additional Web Resources ......................................................................................................... 234 General References ..................................................................................................................... 266 CHAPTER 4. DISSERTATIONS ON BLOOD PRESSURE ..................................................................... 267 Overview.................................................................................................................................... 267 Dissertations on Blood Pressure ................................................................................................ 267 Keeping Current ........................................................................................................................ 275 CHAPTER 5. CLINICAL TRIALS AND BLOOD PRESSURE ................................................................ 277 Overview.................................................................................................................................... 277 Recent Trials on Blood Pressure ................................................................................................ 277 Keeping Current on Clinical Trials ........................................................................................... 290 CHAPTER 6. PATENTS ON BLOOD PRESSURE ................................................................................ 293 Overview.................................................................................................................................... 293 Patents on Blood Pressure.......................................................................................................... 293 Patent Applications on Blood Pressure...................................................................................... 420 Keeping Current ........................................................................................................................ 486 CHAPTER 7. BOOKS ON BLOOD PRESSURE .................................................................................... 487 Overview.................................................................................................................................... 487 Book Summaries: Federal Agencies............................................................................................ 487 Book Summaries: Online Booksellers......................................................................................... 488 The National Library of Medicine Book Index ........................................................................... 505 Chapters on Blood Pressure ....................................................................................................... 507 Directories.................................................................................................................................. 507 CHAPTER 8. MULTIMEDIA ON BLOOD PRESSURE ......................................................................... 509 Overview.................................................................................................................................... 509 Video Recordings ....................................................................................................................... 509 Bibliography: Multimedia on Blood Pressure ............................................................................ 518 CHAPTER 9. PERIODICALS AND NEWS ON BLOOD PRESSURE ...................................................... 521 Overview.................................................................................................................................... 521 News Services and Press Releases.............................................................................................. 521 Newsletters on Blood Pressure................................................................................................... 524 Newsletter Articles .................................................................................................................... 525 Academic Periodicals covering Blood Pressure.......................................................................... 526 CHAPTER 10. RESEARCHING MEDICATIONS................................................................................. 527 Overview.................................................................................................................................... 527 U.S. Pharmacopeia..................................................................................................................... 527
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Commercial Databases ............................................................................................................... 533 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 537 Overview.................................................................................................................................... 537 NIH Guidelines.......................................................................................................................... 537 NIH Databases........................................................................................................................... 539 Other Commercial Databases..................................................................................................... 543 APPENDIX B. PATIENT RESOURCES ............................................................................................... 545 Overview.................................................................................................................................... 545 Patient Guideline Sources.......................................................................................................... 545 Associations and Blood Pressure................................................................................................ 560 Finding Associations.................................................................................................................. 566 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 569 Overview.................................................................................................................................... 569 Preparation................................................................................................................................. 569 Finding a Local Medical Library................................................................................................ 569 Medical Libraries in the U.S. and Canada ................................................................................. 569 ONLINE GLOSSARIES................................................................................................................ 575 Online Dictionary Directories ................................................................................................... 578 BLOOD PRESSURE DICTIONARY .......................................................................................... 579 INDEX .............................................................................................................................................. 681
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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with blood pressure is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about blood pressure, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to blood pressure, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on blood pressure. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to blood pressure, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on blood pressure. The Editors
1
From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. STUDIES ON BLOOD PRESSURE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on blood pressure.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and blood pressure, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “blood pressure” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •
Blood Pressure and the U.K. Prospective Diabetes Study Source: Diabetes Spectrum. 14(4): 235-240. October, 2001. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: Control of blood pressure is important to people with diabetes. This article provides background information on the design and results of the United Kingdom Prospective Diabetes Study blood pressure study and the potential difficulties of translating this landmark study into practice. The authors address the practical and quality assurance issues surrounding blood pressure and offers information about potential pitfalls that can lead to errors of measurement. The authors also explore methods of patient participation in the measurement of blood pressure and in decision
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making about control of high blood pressure and explain why a participatory approach is needed. The authors comment on the failure of medical practice to achieve the substantial potential among patients with coronary heart disease (CHD) to reduce the risk of recurrent disease and death. For example, when the second study, conducted in 1999 and 2000, was compared to the first study, conducted in 1995 and 1996, the prevalence of smoking was unchanged, obesity had increased, and the proportion with hypertension was unchanged, although aspirin continued to be widely used and cholesterol was substantially reduced. This shows that there is substantial room for patients, nurses, and educators to be influential in reducing blood pressure and cardiovascular risks. Patient educational, empowerment, and self-management roles will be needed, with health care professionals encouraging patients to be active participants in their care. Sharing information, skills, and tools between patients and providers will be key. 2 figures. 19 references. •
Blood Pressure in Young Adulthood and the Risk of Type 2 Diabetes in Middle Age Source: Diabetes Care. 26(4): 1110-1115. April 2003. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: Hypertension (high blood pressure) is known to accompany type 2 diabetes in middle age, but it is unknown how early in life blood pressure (BP) begins to rise among individuals who later develop diabetes. This study evaluated elevated BP as a long-term predictor of type 2 diabetes. The prospective cohort study included 1,152 white male medical students; incident (new) diabetes was identified by self-report through mailed questionnaires verified by medical record review. During a median follow up of 38 years, 77 cases of incident diabetes occurred. The mean age of diabetes diagnosis was 58 years. As early as age 30 years, mean systolic BP and diastolic BP were significantly higher in men who developed diabetes during follow up than in those who remained nondiabetic. After adjustment for body mass index (BMI) and other risk factors for diabetes, systolic BP and diastolic BP at age 30 years remained significantly higher in individuals who developed diabetes than in their nondiabetic counterparts. The authors conclude that BP elevations precede the development of type 2 diabetes in middle age by 20 to 25 years. Higher BP in the prediabetic state might contribute to the presence of vascular disease at the time of diagnosis of type 2 diabetes. 1 figure. 2 tables. 38 references.
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Increase in Nocturnal Blood Pressure and Progression To Microalbuminuria in Type 1 Diabetes Source: New England Journal of Medicine. 347(11): 797-805. September 12, 2002. Contact: Available from New England Journal of Medicine. 860 Winter Street, Waltham, MA 02451-1413. (781) 893-3800. Website: www.nejm.org. Summary: Patients with type 1 diabetes mellitus and microalbuminuria (microscopic protein in the urine) often have elevated blood pressure while they are asleep, but it is not known whether the elevation develops concomitantly with microalbuminuria or precedes it. This article reports on a study of 75 adolescents and young adults with type 1 diabetes with normal urinary albumin excretion and blood pressure for more than five years. Ambulatory blood pressure monitoring was used to assess blood pressure at the initial evaluation and about two years later, at which time all subjects had normal urinary albumin excretion. Subsequently, subjects were monitored for the development of microalbuminuria. Microalbuminuria developed in 14 subjects, whereas the other 61
Studies
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continued to have normal urinary albumin excretion. The mean systolic pressure during sleep increased significantly in the subjects who ultimately had microalbuminuria, but not in the subjects with normal albumin excretion. The authors conclude that in persons with type 1 diabetes, an increase in systolic blood pressure during sleep precedes the development of microalbuminuria. In those whose blood pressure during sleep decreases normally, the progression from normal albumin excretion to microalbuminuria appears to be less likely. 4 figures. 2 tables. 37 references. •
15-Year Longitudinal Study of Blood Pressure and Dementia Source: Lancet. 347: 1141-1145. April 27, 1996. Summary: This journal article describes a 15-year study of the association between blood pressure and the development of dementia in older people. Residents of Goteborg, Sweden, who were 70 years in 1970-1972 participated in this study. A random subsample of 382 residents who did not have dementia on psychiatric evaluation at age 70 years were followed for 15 years with repeated neuropsychiatric examination and physical examination, electrocardiogram, chest radiograph, and blood tests. The results suggest that participants who developed dementia at age 79-85 years had significantly higher systolic blood pressure at age 70 years and significantly higher diastolic blood pressure at ages 70 and 75 years than did those who did not develop dementia. A significant association was found between higher diastolic blood pressure at age 70 years and subsequent development of Alzheimer's disease, and between higher diastolic blood pressure at age 75 years and subsequent development of vascular dementia. Participants with white matter lesions on computed tomography at age 85 years had higher blood pressure at age 70 than those without such lesions. In participants who developed dementia, blood pressure declined just before dementia onset and was then similar to or lower than that in participants without dementia. The authors conclude that increased blood pressure at age 70 years may increase the risk of developing dementia 10 to 15 years later. 4 figures, 1 table, 30 references.
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Midlife Blood Pressure and Dementia: The Honolulu-Asia Aging Study Source: Neurobiology of Aging. 21: 49-55. 2000. Summary: This journal article examines the association between mid-life blood pressure and late-life dementia. Data are from the sample of 3,703 Japanese-American men who were followed in the Honolulu Heart Program and reexamined for dementia. Researchers determined the risk for dementia associated with categories of systolic (SBP) and diastolic (DBP) blood pressure, stratified by treatment with anti-hypertensive medication. Among those never treated for hypertension, the odds ratio for dementia was 3.8 for men with DBP of 90-94, and 4.3 for DBP of 95 and over. Compared to those with SBP of 110-139, the risk for dementia in men with SBP 160 and higher was 4.8. Blood pressure was not associated with risk for dementia in treated men. The findings suggest that elevated blood pressure in mid-life can increase risk of late-life dementia in men never treated with anti-hypertensive medication. 3 tables, 42 references. (AA-M).
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Cross-Sectional Association Between Blood Pressure and Alzheimer's Disease in a Biracial Community Population of Older Persons Source: Journal of Gerontology. 55A(3): M130-M136. 2000. Summary: This journal article examines the cross-sectional association of blood pressure and Alzheimer's disease (AD) in a biracial community population of older people. Inhome interviews were completed with 6,162 residents age 65 years or older. A stratified
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random sample of 729 participants was clinically evaluated and 243 were diagnosed with AD. In logistic regression models adjusted for age, sex, education, and race, there was no association between blood pressure measured as a continuous variable and AD. In categorical analyses, however, prevalence of AD was significantly higher among persons with low systolic pressure compared with the referent group of 130-139 mmHg, and with low diastolic pressure compared to the referent of 70-79 mmHg. High systolic and diastolic categories were not statistically different from the referent group, although there was some evidence that the associations differed by race. The odds ratios changed little with further adjustment for apolipoprotein E genotype, antihypertensive medications, body mass, stroke, diabetes, or heart disease. 1 figure, 3 tables, 39 references. •
Current and Remote Blood Pressure and Cognitive Decline Source: JAMA. Journal of the American Medical Association. 281(5): 438-445. February 3, 1999. Summary: This journal article examines the possibility that blood pressure (BP) in middle age predicts later cognitive decline. A total of 3,657 residents of East Boston, Massachusetts, aged 65 years and older, had baseline BP measurements as part of the Established Populations for the Epidemiologic Study of the Elderly in 1982 and 1983. The Short Portable Mental Status Questionnaire and the East Boston Memory Test were administered at baseline and at 3 and 6 years. Nine years before the baseline assessment, 2,068 study participants also had their BP measured as part of the Hypertension Detection and Follow-up Program. Results of analyses adjusted for age, sex, and education showed no strong linear association between BP and cognition, but raised the possibility of more complex associations. These associations were fairly small in magnitude, and varied according to whether level of cognitive function or change in cognitive function was assessed, and according to which test was used to measure cognition. The evidence suggested a U-shaped association between BP and level of performance on the mental status questionnaire, but no effect of BP on memory function or change in cognitive function on either test. 4 figures, 4 tables, 34 references.
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Low Blood Pressure and Incidence of Dementia in a Very Old Sample: Dependent on Initial Cognition Source: JAGS. 47(6): 723-726. June 1999. Summary: This population-based study of 304 nondemented people in Sweden, aged 75 to 96 years at baseline, examined whether initially low blood pressure is related to the incidence of dementia. DSM-III-R criteria were used for dementia with Hachinski's scale being used for a differential diagnosis between Alzheimer's disease (AD) and vascular dementia. Criteria for AD were similar to those of the NINCDS-ADRDA criteria. The diagnosis of dementia was given after consensus among three independent physicians. Arterial blood pressure, antihypertensive drug use, and medical histories were determined. The Cox proportional hazards regression model was used to calculate the relative risk of developing dementia in relation to baseline blood pressure levels. After an average of 3 years, 81 dementia cases were identified. Those with systolic pressure equal to or greater than 140 mm Hg had a significantly higher risk of dementia and AD. A baseline Mini-Mental State Examination (MMSE) of less than 24 significantly predicted the occurrence of dementia, and systolic pressure equal to or greater than 140 mm Hg was significantly related to MMSE scores of less than 24 at baseline. These results suggest that low blood pressure may be an early correlate of a dementing
Studies
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process, although researchers believe a causative effect cannot be definitely ruled out. 2 tables, 21 references. (AA-M). •
Relationship Between Ethnicity and Glycemic Control, Lipid Profiles, and Blood Pressure During the First 9 Years of Type 2 Diabetes: U.K. Prospective Diabetes Study (UKPDS 55) Source: Diabetes Care. 24(7): 1167-1174. July 2001. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This review article describes a study that assessed the relationship among self reported ethnicity, metabolic control, and blood pressure during treatment of type 2 diabetes. The study population consisted of 2,999 people newly diagnosed with type 2 diabetes recruited to the United Kingdom Prospective Diabetes Study (UKPDS) who were randomized to conventional or intensive glucose control policies if their fasting plasma glucose levels remained greater than 6 mmol per liter after a dietary run in. Among the patients, 2,484 were white Caucasian (WC), 265 patients were AfroCaribbean (AC), and 250 patients were Asian of Indian origin (IA). Variables were assessed at 3, 6, and 9 years. During the 9 year study period, body weight increased more in WC patients than in AC and IA patients. After adjusting for age, gender, baseline value, treatment allocation, and change in weight, there were no consistent ethnic differences in mean change in fasting plasma glucose or glycosylated hemoglobin. After adjustment for antihypertensive therapy, increase in systolic blood pressure at 9 years was greatest in AC patients. Mean diastolic blood pressure, total cholesterol, and low density lipoprotein cholesterol decreased progressively during the 9 years in each group. In AC patients, the mean increase in high density lipoprotein cholesterol at 3 years, which was maintained at year 9, and the mean decrease in plasma triglyceride level at 9 years were greater than in WC and IA patients. The article concludes that the study shows important ethnic differences in body weight, lipid profiles, and blood pressure, but not glycemic control, during 9 years after diagnosis of type 2 diabetes. AC patients maintained the most favorable lipid profiles, but hypertension developed in more AC patients than WC or IA patients. Ethnicity specific glycemic control of type 2 diabetes seems unnecessary, but other risk factors need to be addressed independently. 1 appendix. 4 figures. 2 tables. 31 references. (AA-M).
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Association Between Midlife Blood Pressure Levels and Late-Life Cognitive Function: The Honolulu-Asia Aging Study Source: JAMA. Journal of the American Medical Association. 274(23): 1846-1851. December 20, 1995. Summary: This study assessed the long-term relationship of midlife blood pressure levels to late-life cognitive function. The study involved 4,678 surviving members of the prospective Honolulu Heart Program from which 3,735 Japanese-American men, aged 78 years, living in a Hawaiian community or in institutions were selected. Researchers used the 100-point Cognitive Abilities Screening Instrument to measure cognitive function. Midlife systolic blood pressure (SBP) and diastolic blood pressure (DBP) values were measured in 1965, 1968, and 1971. Results, when controlled for age and education, suggest that the risk for intermediate and poor cognitive function increased progressively with increasing level of midlife SBP category. For every 10 mm Hg increase in SBP there appeared to be an increase in risk for intermediate cognitive function of 7 percent and for poor cognitive function of 9 percent. According to the
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authors, adjustment for prevalent stroke, coronary heart disease, and subclinical atherosclerosis reduced the strength of the relationship between midlife SBP and poor cognitive function to 5 percent. The level of cognitive function did not appear to be associated with midlife DBP. The results suggest that midlife SBP may help predict reduced cognitive function in later life. Early control of SBP levels may reduce the risk for cognitive impairment in old age. 4 tables, 43 references. (AA-M).
Federally Funded Research on Blood Pressure The U.S. Government supports a variety of research studies relating to blood pressure. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to blood pressure. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore blood pressure. The following is typical of the type of information found when searching the CRISP database for blood pressure: •
Project Title: 20-HETE AND ITS INTERACTION WITH NO IN PREGNANT RATS Principal Investigator & Institution: Wang, Mong-Heng; Pharmacology; New York Medical College Valhalla, NY 10595 Timing: Fiscal Year 2002; Project Start 19-JUL-2002; Project End 30-NOV-2002 Summary: (provided by applicant): This is a proposal to investigate the mechanisms regulating renal vascular and tubular (medullary thick ascending limb; mTAL) synthesis of 20-hydroxyeicosatetraenoic acid (20-HETE) during pregnancy. 20-HETE is a major cytochrome P450 (CYP) 4A-derived eicosanoid in the rat kidney whose potent effects on vascular tone and tubular ion transport implicate it in the regulation of renal function and in the control of blood pressure. Normal pregnancy in humans and rats is associated with increases in the glomerular filtration rate and renal blood flow along with a significant decrease in arterial pressure and total peripheral resistance. The exact mechanisms mediating these physiological changes are not fully understood. Preliminary studies demonstrated distinct patterns of CYP4A isoform expression and 20-HETE synthesis in renal microvessels and mTAL during pregnancy and a transient reduction in systolic blood pressure and urinary sodium excretion following administration of an inhibitor of 20-HETE synthesis in pregnant rats. We hypothesize that renal 20-HETE synthesis is affected during gestation and that 20-HETE is involved in the regulation of renal function and blood pressure during pregnancy. Experiments will be performed in Aim 1 to characterize vascular and mTAL 20-HETE synthesis and CYP4A expression in pregnant rats at different gestational days, and in Aim 2 to
2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
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determine the consequence of inhibition and over-expression of CYP4A proteins in pregnant rats on renal 20-HETE synthesis, vascular reactivity, mTAL potassium channel activity, urinary electrolyte levels, and blood pressure. It has been shown that nitric oxide (NO) inhibits CYP4A activity and expression; inhibition of its production results in signs similar to preeclampsia. Experiments in Aims 3 and 4 will examine the possibility that NO presents a mechanism that regulates CYP4A expression and 20HETE synthesis during pregnancy. The present proposal sets the basis for understanding mechanisms that regulate 20-HETE synthesis in the kidney during pregnancy. Ultimately, this knowledge can uncover new therapeutic targets and provide novel loci for the control and treatment of pregnancy-induced hypertension. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: AFRICAN HYPERTENSION
AMERICAN
STUDY
OF
KIDNEY
DISEASE
&
Principal Investigator & Institution: Randall, Otelio S. Professor of Medicine; Medicine; Howard University 2400 6Th St Nw Washington, DC 20059 Timing: Fiscal Year 2001; Project Start 30-SEP-1992; Project End 30-JUN-2003 Summary: Hypertension is considered one of the major causes of end stage renal disease (ESRD) in the general population, and the number one cause in African Americans. Despite the availability of potent antihypertensive drugs, the number of hypertensive African Americans progressing to ESRD continues to rise. This disproportionately high prevalence of ESRD in African Americans cannot be explained by the higher prevalence of hypertension. Whether this is due to more susceptibility of the kidney of African Americans to hypertensive injury or due to concurrent existence of unidentified renal factors is not known. There is preliminary evidence suggesting that antihypertensive drugs may retard the progression of hypertensive renal disease, but no clinical trial has been conducted to test this hypothesis in African Americans. This proposed multi-center project is designed to study the following: if the pathological lesion in "hypertensive renal disease" is purely a result of persistent hypertension; if one anti-hypertensive drug is better than another in terms of preservation of renal function; and the level of blood pressure suitable for the survival of the kidney. Hypertensive African Americans, 18-70 years of age with no other known disease that can affect the kidney, will be screened for blood pressure qualification, and will undergo glomerular filtration rate (GFR) tests. Those who qualify, based on blood pressure levels and the GFR results will then be randomized in a double-masked fashion to one of the three major antihypertensive classes (converting enzyme inhibitor, calcium channel blocker, or beta blocker) and to one of two pressure levels: mean blood pressure greater than 92 millimeter of mercury (mmHg), or 102 to 107 mmHg. Other antihypertensive drugs will be added to keep the blood pressure at the desired level. The blood pressure of the randomized subjects will then be monitored on a monthly basis and compliance to medication(s) will be checked at the same time. Their renal function will also be tracked with periodic GFR tests throughout the study period, which will last approximately four years. All data will be collected and sent to the Data Coordinating Center (DCC) for analyses and interpretation. The goal of the African American Study of Kidney Disease and Hypertension (AASK) full- scale trial is to better understand the physiopathology of hypertensive renal disease in an effort to develop guidelines to prevent the increasing prevalence of ESRD in African Americans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: AFRICAN HYPERTENSION
AMERICAN
STUDY
OF
KIDNEY
DISEASE
IN
Principal Investigator & Institution: Rostand, Stephen G. Medicine; University of Alabama at Birmingham Uab Station Birmingham, AL 35294 Timing: Fiscal Year 2001; Project Start 19-AUG-1994; Project End 30-JUN-2003 Summary: The first goal of this application is to initiate a Clinical Center for the Full Scale phase of the "African-American Study of Kidney Disease and Hypertension". This study is a cooperative, multicenter, prospective, double-masked, randomized study that will follow a three by two factorial design. This study will be limited to about 900 African-Americans recruited from 14 Clinical Centers. Eligibility for participation will be determined by strict inclusion and exclusion criteria. Only those with seated diastolic blood pressure equal to or more than 95 mmHg and with glomerular filtration rate (GFR) 25 - 70 mmHg/1.73m2, without malignant hypertension or systemic disease and who are willing to cooperate will be considered. This study will consist of three phases: (l) Recruitment (24 months); (2) Intervention and follow-up (45 months); (3) Data analysis, close-out, results reporting (12 months). The second goal of this study is to test whether one of three different initial randomized drugs: angiotensin converting enzyme inhibitor (ACEi), calcium channel blocker (CCB) or beta blocker. better reduces the rate of decline of UFR in African-Americans with renal insufficiency attributed to hypertension. A third goal is to examine if one of two levels of blood pressure control (equal to or less than 92 mmHg vs. 102-107 mmHg, mean arterial pressure) is better at preserving renal function. Assignment to treatment and blood pressure groups will be randomized and the treatment regimen will be double-masked. Subsequent to assignment. no other ACEis, CCBs or beta- blockers will be used. If a blood pressure goal is not reached in a participant on maximal doses of the assigned drugs, additional antihypertensives will be used in the following order: (l) diuretics (furosemide); (2) alpha-blocker (doxazosin); (3) central alpha2 agonist (clonidine); (4) minoxidil or hydralazine. This study has major health related implications for disease prevention in that it will try to examine if renal failure due to hypertension that occurs in an extremely high risk African-American population can be slowed or prevented, thereby reducing the need for dialysis and renal transplantation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ANG II AND AVP ISORECEPTORS IN BLOOD PRESSURE Principal Investigator & Institution: Ruiz-Opazo, Nelson; Asociate Professor; Medicine; Boston University Medical Campus 715 Albany St, 560 Boston, MA 02118 Timing: Fiscal Year 2001; Project Start 15-DEC-1998; Project End 30-NOV-2002 Summary: Vasopressin (AVP) and angiotensin II (AngII) hormonal systems modulate a variety of physiologic functions affecting multiple organ systems. Of singular importance, is their role in blood pressure regulation. Our long term objective is to dissect the specific contribution of novel AngII and AVP receptors in blood pressure regulation in normal and pathophysiological states. Several isoreceptors for both AngII and AVP have been recently characterized. Of these, the dual AngII/AVP receptor, isolated by us, elucidates novel information providing the bases for new hypotheses and questions. In this research proposal, we will test the following hypotheses: 1) Based on the detected abundance and assignment by immunocytochemical localization of the AngII/AVP receptor polypeptide to renal epithelial cells of the outer medullary thick ascending limb tubules and inner medullary collecting ducts, we hypothesize that the AngII/AVP receptor is a prominent renal physiologic target for AngII and AVP, and
Studies 11
therefore plays an important role in salt- water balance and blood pressure regulation; 2) Based on the elucidation of functional significant mutations in the Dahl Salt-Sensitive rat AngII/AVP receptor, we hypothesize that the AngII/AVP receptor is a genetic determinant for salt-sensitive hypertension in the Dahl Salt- Sensitive hypertensive rat. Accordingly, the following specific aims are prioritized: I) Dissection of potential pathophysiologic involvement of the AngII/AVP receptor in hypertension 1A) Assessment of the specific contribution(s) of N119S and C163R substitutions to the increased sensitivity to Ang II and AVP and enhanced Gs-coupling observed in the Dahl S AngII/AVP receptor; 1B) Genetic cosegregation analysis of the AngII/AVP receptor with blood pressure and renal pathology in an F2 (Dahl S male x Dahl R female) cohort comprised of male and female rats in order to determine whether the mutant AngII/AVP receptor cosegregates with high blood pressure and/or with hypertensive renal disease. II) Dissection of physiologic role of the AngII/AVP receptor: 2A) Tissue specific, spatial and temporal expression patterns in development of the AngII/AVP receptor gene, establishing a foundation for assessing its function in an integrated biologic experimental system as in the gene targeting experiments proposed below. 2B) Targeted disruption of the AngII/AVP receptor gene in mice in order to define its physiologic role in an integrated biologic experimental system. These studies will elucidate the physiologic role of the AngII/AVP receptor and will define the status of the AngII/AVP receptor as a candidate hypertension susceptibility gene, thus paving the way for the direct assessment of the mechanistic role of this receptor in salt-sensitive hypertension and its role in the development of hypertension in selective human populations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ANGIOTENSIN RECEPTORS IN CENTRAL OSMONSENSITIVITY Principal Investigator & Institution: Morris, Mariana; Professor and Chair; Pharmacology and Toxicology; Wright State University Colonel Glenn Hwy Dayton, OH 45435 Timing: Fiscal Year 2002; Project Start 12-JUL-2002; Project End 30-JUN-2006 Summary: (provided by applicant): Angiotensin (Ang) AT1 receptors are critical in the control of blood pressure and fluid/electrolyte balance. AT1 receptors exist in two forms, AT1a and AT1b, which are homologous in gene and protein structure, making it impossible to distinguish pharmacologically. Genetic engineering techniques have produced models which allow for the investigation of gene/function interactions. Removal of AT1 a receptors appears to activate central Ang receptors, particularly in osmosensitive brain regions. The net result is an enhancement of the blood pressure and central neuroendocrine responses to stimuli which alter fluid/electrolyte balance. We propose to test the hypothesis that Ang receptors in specific brain regions are critical in the regulation of osmotic balance. Using the AT1 aKO model, we will determine the nature of the central nervous system changes with a focus on Ang/vasopressin (VP) interactions. The problem will be addressed at the level of the whole animal and. the individual neuron. For in vivo studies, we will use a method for chronic cardiovascular monitoring and blood sampling in the conscious mouse. The goal is to determine the role of Ang receptors in osmosensitivity, studying the regulation of blood pressure, heart rate, peptide secretion and neural activation. Markers for CNS activation include c-Fos, Ang receptors, Ang receptor mRNA and VP mRNA. Cellular studies aim at elucidating the mechanisms by which Ang modulates osmosensitivity in VP neurons. In vitro studies will use perfused brain slices for determination of electrophysiological properties underlying osmosensitivity. The specific aims are: 1. Are osmotic-induced
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peptide and cardiovascular responses altered in AT1 aKO? This will address the issue of whether acute or chronic osmotic stimulation alters the central and peripheral VP system, the central Mg receptor system, and cardiovascular and fluid balance. Experiments will further test the effect of Ang receptor blockade and enzymatic inhibition to document the extent and specificity of Mg input. 2. What are the cellular mechanisms underlying osmosensitivity in AT1aKO? The basic question relates to the nature of the cellular changes and whether these are mediated by intrinsic mechanisms. 3. What is the relationship between the central Ang system and the alterations in osmosensitivity? This will address the issue of whether there are changes in responses to Ang II or other Mg peptides and whether these are important in osmotic responsiveness. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ANTIHYPERTENSIVE THERAPY IN AUTOSOMAL DOMINANT PKD Principal Investigator & Institution: Schrier, Robert W. Professor; Medicine; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, CO 800450508 Timing: Fiscal Year 2001; Project Start 01-APR-2001; Project End 31-MAR-2006 Summary: (the applicant's description verbatim): The long-term objective of this research is to reduce the morbidity and mortality of autosomal dominant polycystic kidney disease (ADPKD). This project is an on-going 5-year clinical trial to test the hypothesis that intensive blood pressure control with angiotensin converting enzyme inhibitors (ACEI) as first-line drugs will slow the progression of ADPKD in children. Progression in children will be measured by increase in renal volume as determined by ultrasound imaging, reflecting increased number and size of renal cysts. Secondary aims are to evaluate the effect of intensive blood pressure control on left ventricular mass index, on microalbuminuria and proteinuria, and on the activation level of several growth-related and inflammatory cytokines. Three groups of children and young adults, age 4 to 21 years, will be randomized to different treatments: 1. Hypertensive subjects with blood pressures above the 95th percentile for age-, gender- and height-matched children will be randomized to intensive or standard blood pressure control, with intensive control defined as lowering blood pressure to the 45th to 50th percentile and standard control as lowering blood pressure to the 85th to 90th percentile. 2. Borderline hypertensive subjects with blood pressures between the 75th and 95th percentile will be randomized to treatment to lower the blood pressure to the 45th to 50th percentile versus no treatment. 3. Normotensive subjects (blood pressure between the 25th and 75th percentile) will be randomized to treatment with ACEI as long as blood pressure stays above the 25th percentile versus no treatment. The first-line drug for all groups is enalapril, second-line drugs for groups 1 and 2 are amlodipine and hydrochiorothiazide. The primary outcome variable is the increase in renal volume per year, compared between the different treatment levels or between treatment and no treatment. If intensive blood pressure control can be shown to reduce progressive renal enlargement, it would change screening and treatment recommendations for children from ADPKD families, and would have a major impact on the morbidity associated with large kidneys and with end-stage renal disease in ADPKD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ANTIHYPERTENSIVE THERAPY IN CHILDREN WITH ADPKD Principal Investigator & Institution: Fick-Brosnahan, Godela M.; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, CO 800450508
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Timing: Fiscal Year 2001; Project Start 01-APR-1985; Project End 30-JUN-2006 Summary: The long-term objective of this research is to reduce the morbidity and mortality of autosomal dominant polycystic kidney disease (ADPKD). This Project is a 5-year clinical trial to test the hypothesis blood pressure control with angiotensin converting enzyme inhibitors (ACEI) as first- line drugs will slow the progression of ADPKD in children. Progression in children will be measured by the increase in renal volume, which reflects an increased number and size of renal cysts, as determined by magnetic resonance imaging. Secondary aims are to evaluate the effect of intensive blood pressure control on left ventricular mass index, on microalbuminuria and proteinuria, and on the activation level of several growth-related and inflammatory cytokines. Three groups of children and young adults, age 4 to 21 years, will be randomized to different treatments: 1. Hypertensive subjects with blood pressure above the 9th percentile for age-, and gender- and height-matched children will be randomized to intensive or standard blood pressure control, with intensive control defined as lowering blood pressure to the 45th or 50th percentile and standard control as powering control defined as lowering blood pressure to the 85th to 90th percentile. 2. Borderline hypertensive subjects with blood pressures between the 75th and 95th percentile will be randomized to treatment to power the blood pressure to the 45th to 50th percentile or not treatment. 3. Normotensive subjects (blood pressure between the 25th and 75th percentile) will be randomized to treatment with ACEI or to no treatment. The first-line drug for all groups is enalapril, second-line drugs for groups 1 and 2 are amlodipine and hydrochlorothiazide. The primary outcome variable is the increase in renal volume per year, compared between the different blood pressure levels or between ACEI treatment and no treatment. If intensive blood pressure control or treatment with ACEI can be shown to reduce progressive renal enlargement, it would change screening and treatment recommendations for children from ADPKD families, and would have a major impact on the morbidity associated with large kidneys and with end-stage renal disease in ADPKD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ARTERIAL BAROREFLEX CONTROL OF BLOOD PRESSURE-EXERCISE Principal Investigator & Institution: Raven, Peter B. Professor and Chairman; Integrative Physiology; University of North Texas Hlth Sci Ctr Fort Worth, TX 761072699 Timing: Fiscal Year 2001; Project Start 01-JUL-1994; Project End 30-JUN-2003 Summary: (Applicant's abstract): Previously, we have demonstrated that the carotid baroreflex control of blood pressure during dynamic exercise is classically reset to the prevailing blood pressure of the dynamic exercise. Aortic baroreflex control of heart rate was also reset to the prevailing blood pressure without a change in maximal gain. Additionally, our findings suggest that at rest the arterial baroreflex function is modulated by aerobic fitness, cardiopulmonary baroreceptor load and increases in the intramuscular pressure. However, the mechanisms by which 1) the arterial baroreflexes are reset during exercise, 2) the interaction between increases in muscle pressure and the arterial baroreflex function, and 3) the effect of aerobic fitness on arterial and cardiopulmonary baroreflex function remain to the defined. We hypothesize that the feed forward mechanism of central command resets the baroreflexes in parallel with the induction of motor activity and continuous modulation of this resetting is provided by activation of intramuscular mechanoreceptors within the active tissue. We further hypothesize that increases in aerobic fitness results in an increased blood volume and a resetting of the aortic and cardiopulmonary baroreflex. In order to test these hypotheses
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we will use a historically unique experimental paradigm in which muscle tendon vibration will be used to selectively increase or decrease central command. During steady state exercise (a constant exercise pressor reflex input) with and without muscle tendon vibration, carotid arterial baroreflex function will be determined using procedures developed in our laboratory. Using a similar experimental paradigm and increasing intramuscular pressure by using lower body positive pressure, the interactions between central command and intramuscular pressure will be examined. Additionally, using techniques developed in our laboratory and measures of MSNA, NE spill-over and leg vascular conductance we will selectively model the aortic and cardiopulmonary baroreflexes of high and low fit endurance exercise trained subjects. A unique aspect of this investigation is that the data obtained is immediately relevant to the healthy human and will provide significant fundamental information for the investigation of blood pressure regulation during physical activity of patients with heart failure, hypertension and intermittent claudication. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: AT2 RECEPTORS IN BLOOD PRESSURE AND RENAL FUNCTION Principal Investigator & Institution: Carey, Robert M. Professor and Dean; General Clinical Research Ctr; University of Virginia Charlottesville Box 400195 Charlottesville, VA 22904 Timing: Fiscal Year 2001; Project Start 27-AUG-2001; Project End 31-JUL-2005 Summary: (provided by applicant): The overall objective is to test the hypothesis that the angiotensin type-2 (AT2) receptor plays an important role in the control of blood pressure and kidney function through the generation of bradykinin (BK), nitric oxide (NO) and guanosine cyclic 3', 5' monophosphate (cGMP). The specific aims are (1) to test the hypothesis that AT2 receptor stimulation mediates renal and systemic vasodilation and hypotension by increasing the production of BK, NO and cGMP and (2) to test the hypothesis that AT2 receptor stimulation, through increased renal production of BK, NO and cGMP, induces natriuresis. The investigators have demonstrated that the AT2 receptor is expressed in the kidney, heart and peripheral vasculature and stimulates renal BK, NO and cGMP. The principal investigator's recent studies in mice lacking the AT2 receptor (AT2-Null) demonstrate a sustained pressor and antinatriuretic hypersensitivity to angiotensin II (ANG II), accompanied by a marked reduction in BK, NO, cGMP. These results suggest that the AT2 receptor may function as an opponent of the actions of ANG II at the AT1 receptor. The principal investigator has recently demonstrated that valsartan-infused rats without functioning AT1 receptors have hypotensive respoflses to Ang II that are fully blocked by the AT2 receptor antagonist, PD 123319.The proposed experiments represent a systematic approach to the role of the AT2 receptor in vasodilation and natriuresis and the renal mechanisms of these actions in the valsartan-infused (AT1 receptor-blocked) rat model. This model will allow evaluations of the role of the AT2 receptor and its signalling mechanisms in the absence of interference by functional AT1 receptors. The proposed studies will clarify the role of the AT2 receptor in the control of blood pressure and kidney function. An understanding of the function of the AT2 receptor is necessary for an assessment of its potential role in the pathophysiology of hypertension and as a target for antihypertensive therapy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: AUTOREGULATION OF CEREBRAL BLOOD FLOW IN ACUTE ISCHEMIA Principal Investigator & Institution: Powers, William J. Professor of Neurology & Radiology; Washington University Lindell and Skinker Blvd St. Louis, MO 63130 Timing: Fiscal Year 2003; Project Start 15-AUG-2003; Project End 31-MAY-2008 Summary: Hypertension is one of the most significant risk factors for ischemic stroke. Long term treatment of hypertension after stroke has been shown to reduce the incidence of recurrent stroke by 28% and major cardiovascular complications by 26%. However, in the setting of acute ischemic stroke it has been difficult to determine the appropriate treatment of elevated blood pressure due to the overwhelming concern that lowering blood pressure in this setting might worsen cerebral ischemia. These concerns are based primarily on studies of CBF in animal models. Very few studies of the effect of pharmacological reduction of elevated blood pressure on CBF following acute ischemic stroke in humans have been done and they do not provide adequate data to settle this issue. The goal of this research project is to determine the effect of controlled, graded pharmacologic reduction of blood pressure on rCBF following acute ischemic stroke using positron emission tomography (PET) and to carefully monitor the clinical effects and safety of treatment. This specific null hypothesis will be tested: Pharmacological reduction of mean arterial blood pressure (MAP) by 15 +/- 5 mm Hg in patients with a recent cerebral infarction and elevated blood pressure does not produce a statistically significant reduction in regional cerebral blood flow. This Specific Aim will be carried out: Between day 3-14 after onset, sixty patients with a hemispheric cerebral infarction and mean arterial blood pressure of 120-150 mm Hg will undergo a detailed neurological examination and measurements of rCBF, regional cerebral metabolic rate (rCMRO2), and regional oxygen extraction fraction (rOEF) using PET. Blood pressure will then be lowered pharmacologically in two steps of 7.5 +/- 5 mm Hg each using intravenous labetalol. The neurological examination and CBF measurements will be repeated after each step. This study is not designed to provide data on whether blood pressure in the acute setting improves outcome. This can only be done by randomized treatment trials with clinical outcome measures. These data can, however, be used to help design such a trial and, in the meantime, provide helpful guidelines when reduction in arterial pressure is deemed to be necessary for other reasons. This study will provide esssential information necessary to translate data from animal studies into treatment for human cerebrovascular disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BEHAVIORAL TREATMENT OF HYPERTENSION Principal Investigator & Institution: Blumenthal, James A. Professor; Duke University Durham, NC 27706 Timing: Fiscal Year 2001; Project Start 01-DEC-2000; Project End 30-NOV-2001 Summary: Purpose: The study which we have now completed was a single, randomized clinical trial of exercise and weight management with three long term objectives. The first was to evaluate the efficacy of two behavioral interventions--aerobic exercise and weight management--in reducing blood pressure (BP) in people with mild HTN; the second was to examine the mechanisms by which BP was reduced; and the third was to investigate the effects of behavioral treatment on cognitive performance and related aspects of quality of life. Methods: We recruited 144 individuals with mild HTN. Individuals who were eligible but unable to participate in the intervention were initially assigned to a non-random control group (N=11). However, this practice was stopped
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and we are only including the 133 fully randomized subjects in our data analysis. Volunteers were randomly assigned to 6 months of exercise alone, exercise with weight management, or a control group. Subjects underwent evaluations at baseline and at 6 months, in addition to an eligibility screening--physical exam and blood and urine samples. Measurements of BP were obtained in the clinic, during ambulatory BP monitoring, and during physical exercise and mental stress testing. BPs were also obtained at 1 year follow-up. To examine potential mechanisms responsible for BP changes, subjects underwent glucose tolerance testing, lipid analysis, studies of heart rate variability, and hemodynamic and neuroendocrine assessments. Because hypertension has been shown to be associated with measurable changes in cognitive function, which may be reversible when BP is normalized, subjects also completed neuropsychological assessments along with psychometric testing. Finally, the clinical significance of the BP changes were determined by repeat cardiac echocardiography, as well as by repeated BP testing at baseline, 6 months, and 1 year follow-up. Results: Results indicate that while exercise alone is effective in reducing both systolic and diastolic blood pressure, the addition of a behavioral weight loss program augments significantly the efficacy of exercise alone. The magnitude of the resting clinic blood pressure reductions were 4-5 mm in the Exercise alone condition, but increased to 5-8 mm in the combined exercise and weight loss condition. Larger BP reductions also were observed for the combined condition relative to exercise alone with ambulatory blood pressure monitoring during routine activities of daily living, particularly for DBP, and during mental stress testing in the laboratory setting. In terms of potential mechanisms that may be responsible for the BP changes, changes in glucose metabolism and increased vagal tone were associated with BP reductions. Exercise alone was not associated with significant weight loss or changes in body composition. In addition exercise alone did not improve insulin sensitivity (as assessed indirectly by fasting plasma insulin), insulin secretory response, or plasma glucose. While the FPG in the present sample of hypertensive patients was normal, they did demonstrate substantial insulin resistance, as indicated by the presence of fasting and post prandial hyperinsulinemia. Consistent with this other research, the present findings did not show a substantial effect of exercise alone on glucose or insulin parameters unless the exercise was combined with diet. It would appear that a weight loss, over and above exercise alone, is necessary to induce favorable metabolic changes. Increased heart rate variability was also associated with exercise training, particularly among patients who also lost weight. Aerobic endurance training was associated with an increase in mean RR interval (bradycardia) at rest and that this bradycardia was accompanied by an increase in the standard deviation of R-R interval. This improvement was even greater among patients who lost weight in the Combination group. In contrast to findings from other studies, no treatment effects were observed for lipids or catecholamines in this project. Significance: Hypertension (HTN) is a major health problem in the U.S. placing some 58 million Americans at increased risk for stroke, myocardial infarction, kidney failure, and peripheral vascular disease. The information obtained from this study will have important practical significance by determining the efficacy of exercise and weight reduction in lowering BP in men and women with mild hypertension, and by assessing the clinical importance of these changes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BLOOD PRESSURE CANDIDATE GENE SCREENING--A NEW PARADIGM Principal Investigator & Institution: Cicila, George T. Physiology/Molecular Medicine; Medical College of Ohio at Toledo Research & Grants Admin. Toledo, OH 436145804 Timing: Fiscal Year 2001; Project Start 01-JUL-1999; Project End 30-JUN-2003 Summary: (Adapted from the Investigator's Abstract) The essential mechanisms (and the genes underlying them) leading to hypertension need identification for better understanding and treatment of this complex disorder. The most direct way of accomplishing this is to identify genes regulating blood pressure in animal models of genetic hypertension. The applicants have linked loci on rat chromosomes 3 and 7 to blood pressure quantitative trait loci (BP QTL) in a segregating population bred from inbred Dahl salt-sensitive (S) and salt-resistant (R) rats fed a high salt diet. Introgression of R-rat derived chromosomal regions containing these two QTLs into S rats resulted in congenic strains with significantly lower blood pressure and cardiac mass compared to S rats, confirming the presence of BP QTL in the introgressed regions of chromosomes 3 and 7. Similar methodology has been used by others to develop congenic strains carrying BP QTLs located on six other chromosomes, resulting in a panel of eight congenic strains derived from the Dahl rat model of blood pressure salt-sensitivity. The applicant hypothesizes that gene(s) underlying a given BP QTL may be differentially expressed in target organs/tissues. If so, such a gene should also be differentially regulated in congenic strains carrying different BP QTL. Gene(s) responsible for a QTL's effect should show a congenic strain-specific differential-pattern of expression in a target organ(s) and should map to the chromosomal interval carried by that particular congenic strain. Therefore, genes having such characteristics will be superior candidates as genes responsible for, at least in part, a specific BP QTL. The applicant proposes to identify candidate genes for BP QTL as follows: Differentially expressed genes will be identified in the kidneys of S and R rats, on both low NaCl (genetic-differences) and high NaCl diets (salt-responsive). Renal RNA expression of such differentiallyexpressed genes will be examined in a panel of congenic strains carrying Dahl rat BP QTL, where each strain carries a low blood pressure allele for a different BP QTL on a background of S-rat alleles. Genes having a congenic strain-specific pattern of differential gene expression will be mapped to determine their genomic location. Genes with a 1) congenic strain-specific pattern of differential gene expression and 2) mapping to the introgressed chromosomal region containing a specific BP QTL, will be considered strong candidates for the gene(s) responsible for blood pressure differences associated with this QTL. This new approach should accelerate the identification of strong candidate genes for particular BP QTL and, potentially, of new blood pressure regulatory mechanisms. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BLOOD PRESSURE IN POSTMENOPAUSAL WOMEN: A GCRC STUDY Principal Investigator & Institution: Seely, Ellen W. Professor; Brigham and Women's Hospital 75 Francis Street Boston, MA 02115 Timing: Fiscal Year 2003; Project Start 15-JUL-2003; Project End 31-MAY-2008 Summary: (provided by applicant): This is a Mid-Career Investigator (K 24) proposal for Ellen Seely, MD. The goal of this proposal is threefold. First, it would increase the depth of Dr. Seely's research by enabling the investigator to receive further advanced training in human genetics. Second, it would give the investigator the supported time to
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formally train young investigators in patient-oriented research in the field of hormonal control of blood pressure. Third, it would allow the investigator to use her experience as Associate Program Director of the General Clinical Research Center (GCRC) to teach the next generation of patient-oriented researchers about the use of a GCRC for the study of human pathophysiology using varied GCRC-based investigative techniques. Dr. Seely's research topic "Blood Pressure in Postmenopausal Women: a GCRC Study" serves as fertile ground for a K24. Hypertension affects over 20 million women in the United States and the majority of these women are postmenopausal. Although there is clearly a genetic component to hypertension in both men and women, its incidence increases dramatically in women following menopause superceding that in men and suggests that the hormonal milieu of the premenopausal state may be protective against the manifestation of hypertension. The overall goal of Dr. Seely's research plan is to utilize the GCRC for detailed studies of the pathophysiology of hypertension in postmenopausal women. Dr. Seely plans to determine how polymorphisms of genes of the renin-angiotensin-aldosterone system (RAAS), a major regulator of blood pressure, are influenced by estradiol. An understanding of the interaction of estradiol with specific polymorphisms of the RAAS that lead to blood pressure lowering may enable the development of selective estrogen receptor modulators that have antihypertensive effects. Thus, funding of this proposal will allow Dr. Seely to expand her own research career and simultaneously provide time to expand her mentorship role. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BLOOD PRESSURE REACTIVITY IN BLACKS--FUNCTION OF EXERCISE/FAMILIAL HYPERTENSION Principal Investigator & Institution: Bond, Vernon; Howard University 2400 6Th St Nw Washington, DC 20059 Timing: Fiscal Year 2001 Summary: African Americans have the highest incidence of essential hypertension (HT) than any racial group in the United States. The cause of this high prevalence of HIV in this population is not known. There is an undeniable genetic component to HT; however, this account for only a portion of the variance in blood pressure (BP) leading many researchers to emphasize the additional importance of environmental factors such as stress and physical inactivity. Studies have indicated that physically inactive individuals and offspring of hypertensive parents have an exaggerated BP response to stress. Demonstrations of abnormal increases in BP responsiveness to stress among normotensive individuals is of clinical importance in that such pressor reactivity is associated with the cause of or a marker for future development of HT. This abnormal increase in BP reactivity to stress in both sedentary individuals and offspring of hypertensive parents is attributed to an elevated sympathetic neural activity (SNA) which alters the cardiac output and or systemic vascular resistance. Aerobic physical activity intervention has been shown to decrease the SNA and thus may alter the pressor reactivity to stress. Whether a familial history of HT interact with physical activity to affect BP responses to stress in African Americans is not known. We hypothesize that aerobic physical activity intervention will attenuate the BP response to stress in sedentary normotensive young adult African Americans with a familial history of HIT. We further hypothesize that aerobic physical activity will attenuate the BP response to groups of sedentary normotensive young adult African Americans with a familial history of HT (n= 12 females and 12 males) and without a familial history of HT (n= 12 females and 12 males) will undergo a 12 week aerobic physical activity intervention program. Similar size sedentary groups with familial HT (12 females and 12
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males) and without familial HT (12 females and 12 males) will not undergo the physical activity intervention and will serve as the control. Systolic Bp, diastolic BP, and mean arterial BP responses at baseline and during conditions of provocative mental and physical stress will be determined and analyzed for between-group differences. Maximal oxygen uptake, cardiac output, stroke volume, systemic vascular resistance, heart rate, cardiac autonomic outflow, and skeletal muscle blood flow will be measured to determine the possible mechanism(s) of observed effects. The pattern of responses observed will increase our understanding of the interaction of genetics, physical activity interventions, and stress in the control of BP, and the cardiovascular factors involved in BP control. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BLOOD PRESSURE REDUCTION AND INSULIN SENSITIVITY IN HYPERTENSION Principal Investigator & Institution: Raskin, Phillip; University of Texas Sw Med Ctr/Dallas Dallas, TX 753909105 Timing: Fiscal Year 2001 Summary: Excess insulin production might be a factor leading to high blood pressure since it has been shown that insulin produces salt retention in the kidneys and increases the blood levels of adrenalin. It has also been suggested that decreased insulin sensitivity could be a consequence not a cause of hypertension. In order to evaluate if decreased insulin sensitivity is a consequence or a cause of high blood pressure investigators will study the effects of different hypotensive medications on insulin sensitivity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CARDIAC RECEPTOR ACTIVITY IN THE PREGNANT RAT Principal Investigator & Institution: Hines, Mary Christina. Thompson Professor of Research; None; University of Missouri Kansas City Kansas City, MO 64110 Timing: Fiscal Year 2001; Project Start 01-JUN-1996; Project End 30-APR-2006 Summary: Increased blood volume and decreased blood pressure are early and sustained alterations of pregnancy that are directly correlated with positive outcomes. The chronic maintenance of these cardiovascular adjustments implies a significant change in autonomic regulatory pathways, and it is known that reflex effects mediated by these pathways are attenuated during rat and human pregnancy, and further blunted during diseases, such as preeclampsia. One of our long-term objectives is to characterize alterations in these neural reflex pathways during pregnancy and to elucidate mechanisms involved. Understanding changes in these cardiovascular regulatory systems will improve clinical management of blood volume and pressure during pregnancy. Using the pregnant rat model, which undergoes hemodynamic changes similar to those in humans, we have demonstrated that afferent discharge in the autonomic receptors, which regulate blood volume and blood pressure, is attenuated during pregnancy. One explanation for a reduction in cardiac receptor sensitivity is the suggestion that pregnancy actually represents an "underfilled" state, and this concept will be explored in the present proposal. In addition, we are investigating the role of alterations in wall stretch and local paracrine factors in the reduction of afferent receptor firing during pregnancy. Based on our findings in the current funding cycle, three aims are proposed for this competing renewal: Aim #1: we will determine if exogenous blood volume expansion restores cardiac receptor activity in the late-pregnant rat to levels
20 Blood Pressure
observed in the nonpregnant animal, and if volume expansion has a differential effect in the early-pregnant animal; Aim #2: right atrial pressure/dimension relationships will be measured in late-pregnant and nonpregnant animals to gain a better understanding of the degree of stretch "sensed" by cardiac receptors; Aim #3: we will determine whether nitric oxide and/or endothelin, substances known to decrease baroreceptor firing in nonpregnant animals, mediate the reduction in cardiac and baroreceptor activity we have observed during pregnancy. The proposed research plan stems logically from the investigator's currently funded work on alterations in autonomic regulation of cardiovascular function during pregnancy. Data collected during the current grant period have provided intriguing new information about gestational modulation of autonomic receptor activity in the gravid rat. In this competitive renewal we will focus our efforts on mechanisms involved in these changes of pregnancy. The insights gained from these investigations will extend the understanding cardiovascular control in a heretofore-unstudied component of autonomic regulatory pathways in pregnancy, and will further elucidate physiologic as well and pathologic mechanisms of blood volume and blood pressure control during pregnancy that will broaden our knowledge base for clinical management of the pregnant woman. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CARDIOVASCULAR AUTONOMIC CONTROL IN STRESS AND ANXIETY Principal Investigator & Institution: Sloan, Richard P. Professor; Psychiatry; Columbia University Health Sciences New York, NY 10032 Timing: Fiscal Year 2001; Project Start 01-APR-1998; Project End 31-JAN-2003 Summary: (Adapted from the Applicant's Abstract): This is an application for an Independent Scientist Award (K02) to study cardiovascular autonomic control in stress and anxiety. It is based on a research program whose focus is to explore the relationships among psychological/behavioral characteristics such as anxiety, hostility, depression, and physical conditioning, the central and autonomic nervous system, and the cardiovascular and respiratory systems. The application proposes a series of experiments deriving from a model which identifies blood pressure variability (BPV) as a potential mechanism by which psychological/psychiatric factors and health behaviors confer increased risk of coronary artery disease (CAD) and catastrophic cardiac events. While evidence suggests that psychological factors such as anxiety, depression, and hostility are associated with increased risk of CAD, the mechanisms by which these factors exert their pathogenic effects are only poorly understood. Our model holds that autonomic control of the heart serves a buffering or inhibitory function over oscillations in blood pressure, which recent research in vascular biology and dynamics suggests may have pathogenic effects on the endothelium, in the case of atherogenesis, and on plaque stability, in the case of catastrophic cardiac events. We recently have shown that under conditions of psychological stress, the magnitude of these blood pressure oscillations is inversely related to the degree of autonomic control of the heart, as measured by heart period variability (HPV). Thus, in subjects with high levels of cardiac autonomic control, blood pressure oscillations are minimal whereas in subjects with low levels of control, they are increased considerably. Since psychological/behavioral characteristics such as anxiety, depression, and hostility have been shown to be associated with lower levels of HPV, these characteristics may be associated with disinhibition of blood pressure oscillations, either at rest, or more likely, in response to psychological stress. Together, these findings suggest that the mechanism by which psychological characteristics such as hostility have their pathogenic effect is through
Studies 21
reduced inhibition of BPV responses to challenge, which in turn promotes atherogenesis and plaque rupture. In this application, 5 experimental tests of this model are proposed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CARDIOVASCULAR EFFECTS OF THE ADRENOMEDULLIN GENE Principal Investigator & Institution: Caron, Kathleen M. Pathology and Lab Medicine; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, NC 27599 Timing: Fiscal Year 2001; Project Start 01-JUN-2001 Summary: The objective of this proposal is to identify the physiological functions of a newly identified vasoactive peptide, Adrenomedullin (Adm). Preliminary studies have suggested a variety of functions for Adm. Most acclaimed is Adm's potential role in blood pressure regulation since it has been found at markedly elevated plasma levels in patients with multiple forms of hypertension. Other studies have implicated Adm in such physiological processes as natriuresis, regulation of aldosterone, ACTH and renin secretion, thirst, embryonic implantation, and cellular proliferation. To examine the function of Adm within an intact physiological milieu, a series of mice will be generated that contain between 0-4 copies of the Adm gene by using the methods of homologous recombination in embryonic stem cells and the mechanisms of gene disruption and gene duplication. The specific aims of this proposal are to: 1) determine the essential biological functions of the Adm gene within an intact physiological milieu by characterizing a knockout mouse model and 2) determine the effects of varying Adm gene expression on blood pressure and related cardiovascular parameters by characterizing a "gene titration" of Adm. Elucidation of the physiological functions of Adm will enhance our general understanding of this new peptide. Moreover, determining the role of Adm in blood pressure regulation will lead to a better understanding of blood pressure homeostasis and may lead to new genetic and pharmacological strategies for the prevention or therapy of hypertension. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CARDIOVASCULAR REGULATION--AUTONOMIC/METABOLIC MECHANISMS Principal Investigator & Institution: Biaggioni, Italo; Professor of Medicine and Pharmacology; Vanderbilt University 3319 West End Ave. Nashville, TN 372036917 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2007 Summary: (provided by applicant): Local metabolic factors play an important role in modulating vascular smooth muscle tone, and interact with the autonomic nervous system to contribute to cardiovascular regulation. Nitric oxide (NO) is arguably one of the most important of these metabolic factors. Experimental evidence suggests that endothelial-derived NO exerts tonic vasodilatory effects even under resting conditions. Neuronal-derived NO acts centrally to inhibit sympathetic tone, and on presynaptic aderenergic neurons to inhibit norepinephrine release. There is substantial evidence that several disease states are characterized by ?NO deficiency?, including hypercholesterolemia, smoking and, potentially, hypertension. It is though that this NO deficiency contributes to the adverse cardiovascular events that characterizes these patient populations. Experimental systemic blockade of NO synthesis leads to an increase in blood pressure, indicating its importance on cardiovascular regulation. In normal subjects, however, the pressor effect of systemic NO inhibition is modest because of the restraining effect of the baroreflex. It is difficult, therefore, to gauge the
22 Blood Pressure
importance of NO on blood pressure regulation because of the 'close loop' characteristics of autonomic regulation. Similarly, the relative contribution of neuronal NO and endothelial NO to blood pressure control remains unclear. It would be advantageous, therefore, to develop a human model where the increase in blood pressure produced by systemic NOS inhibition reflects selective endothelial NO inhibition, unrestrained by baroreflex buffering. Patients with pure autonomic failure represent such a human model. Similarly, we can induce transient autonomic failure by blocking neurotransmission at the level of autonomic ganglia with trimethaphan. We propose to use these models to test the hypothesis that endothelial nitric oxide is an important modulator of blood pressure under normal conditions, and that its impairment contributes to hypertension. We will inhibit NO synthesis with L-arginine analogs to determine its effect on normal subjects, normotensive offspring of hypertensive parents, patients with essential hypertension, and patients with pure autonomic failure. About half of patients with pure autonomic failure paradoxically develop hypertension driven by increased vascular resistance. We also propose a proofof-concept study to determine if modulation of NO mechanisms with L-citrulline and Larginine provide a novel therapeutic option in this human model of hypertension. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CELLULAR L-ARGININE UPTAKE IN HYPERTENSION Principal Investigator & Institution: Mattson, David L. Professor; Medical College of Wisconsin Po Box26509 Milwaukee, WI 532264801 Timing: Fiscal Year 2003; Project Start 01-MAR-2003; Project End 28-FEB-2008 Summary: Nitric oxide (NO) in the kidney plays a critical role in the regulation of fluid and electrolyte balance and blood pressure. It has been widely accepted that both the production of NO and NO-dependent effects, are independent of extracellular Larginine and cellular L-arginine uptake; yet a series of recent studies from our laboratory and other laboratories has provided reason to question this view. These studies have demonstrated that supplementation of L-arginine, the substrate for NO synthase (NOS), directly into the renal medulla prevents sodium sensitive hypertension in the Dahl salt-sensitive (SS/Mcw) rat. Further experiments indicate that the cellular availability of L-arginine can regulate the production of NO and reactive oxygen species (ROS) in the kidney. We hypothesize that a deficiency in the L-arginine-nitric oxide pathway in the tubular and vascular segments of the kidney of the Dahl SS/Mcw rat contributes to the development of sodium-sensitive hypertension by reducing the availability of NO and/or increasing the levels of ROS. We will test this hypothesis in three Specific Aims. Aim 1 will utilize cellular and molecular techniques to quantify the differences in L-arginine uptake in whole tissue and isolated renal tubules and blood vessels of the SS/Mcw rat in comparison to control rats. Further studies in this aim will characterize the influence of altered L-arginine uptake mechanisms on NO release in renal tubules and blood vessels of the SS/Mcw rat. Aim 2 will employ novel in vivo microdialysis techniques to determine if the deficiency in L-arginine transport contributes to the decreased availability of NO and elevation in free radicals observed in the kidney of the SS/Mcw rat. Moreover, it will be determined if increased cellular Larginine uptake will normalize the levels of NO and ROS in the SS/Mcw rat. Experiments in Aim 3 will then determine the effects on renal function and arterial blood pressure when NO and ROS levels in the kidney are manipulated by altering cellular L-arginine uptake. Studies in this aim will describe the in vivo effects of manipulation of cellular L-arginine uptake on the acute pressure-natriuresis-diuresis relationship, intrarenal blood flow distribution, and the long-term regulation of fluid
Studies 23
and electrolyte balance and arterial blood pressure in SS/Mcw and control rats. Together, this integrated approach will determine the important role of cellular arginine uptake by cationic amino acid transporters (CAT) in the production of NO and ROS in the kidney, the regulation of renal sodium excretion, and the long-term control of arterial blood pressure in the Dahl SS/Mcw rat. Results of these studies should provide novel insights into the role of cationic amino acid transport in the control of renal function and arterial blood pressure. Moreover, these results may reveal that altering the dietary amino acid content and/or manipulating L-arginine uptake mechanisms may reduce the incidence of hypertension in the general population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CEREBROVASCULAR HEMODYNAMICS IN PRETERM BRAIN INJURY Principal Investigator & Institution: Watkins, Timothy W.; Children's Hospital (Boston) Boston, MA 021155737 Timing: Fiscal Year 2001; Project Start 01-JAN-1999; Project End 31-DEC-2002 Summary: Preterm brain injury remains an important complication of premature birth. Both hemodynamic abnormalities and alterations of cerebral blood flow have been associated with injury, but reliable methods for prospective identification of imminent injury are not available. To identify prospective physiologic risk factors, three aspects of the relationship among of oscillations of heart rate, oscillations of blood pressure, and oscillations of cerebral blood flow will be quantified: the arterial baroreflex, cerebral autoregulation, and the relation of the arterial baroreflex to cerebral autoregulation. These measurements will be obtained from a population of preterm neonates of birthweight less than 1000 grams. Measurements will be obtained at 8 hours, 24 hours, and one week of life. Oscillations of cerebral blood flow will be detected and quantified by near Infrared spectroscopy. Specific Aim number 1: Arterial baroreflex. Transfer functions analysis will quantify the response of heart rate to changes in arterial blood pressure. Hypothesis: Neonates who are subsequently found by head ultrasound to have severe brain injury will fail to exhibit normal baroreflex activity. This will be indicated by a lesser response of heart rate to changes in arterial blood pressure, and a response time that is lengthened. Specific Aim number 2: Cerebral autoregulation. Transfer function analysis will quantify cerebral autoregulation, defined as the normal buffering of changes in arterial blood pressure, so that passive relationships between arterial blood pressure and cerebral blood flow are enhanced. Hypothesis: Neonates who are subsequently found by head ultrasound to have severe brain injury will fail to exhibit normal cerebral autoregulation. This will be indicated by a greater response of cerebral blood flow to changes in arterial blood pressure, and a response time that is shortened. Specific Aim number 3. Arterial baroreflex vs. Cerebral autoregulation. Spectral coherence of the arterial baroreflex relation will be compared to the spectral coherence of cerebral autoregulation. Correlation between these two coherences will serve as a measure of association between them. Hypothesis: Enhanced baroreflex activity is a physiologic marker for better cerebral autoregulation. This will be indicated by a negative correlation between the coherence of the baroreflex and the coherence of cerebral autoregulation. This proposal will combine novel measurement of oscillations in cerebral blood flow with advanced signal processing techniques to quantify the relationship among oscillations of heart rate, oscillations of blood pressure, and oscillations of cerebral blood flow. By representing heart rate, blood pressure, and cerebrovascular blood flow as dynamic quantities, if may be possible to model their
24 Blood Pressure
relation to each other in a more useful way. This approach may provide the necessary and thus far unavailable foundation for an effective neuroprotective clinical strategy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CHRONIC NEURAL CONTROL OF BLOOD PRESSURE Principal Investigator & Institution: Sved, Alan F. Professor of Neuroscience & Psychiatry; Neuroscience; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260 Timing: Fiscal Year 2001; Project Start 01-JAN-1997; Project End 31-JAN-2004 Summary: The central nervous system (CNS) plays a key role in regulation of arterial blood pressure and an abnormality of the central neural control may result in hypertension or predispose an individual to develop hypertension in response to other factors. Studies conducted the current grant period have highlighted the role of the CNS in baroreceptor- independent long-term control of blood pressure. These studies have focused on the role of neurons in the rostral ventrolateral medulla (RVLM) in maintaining the tonic drive of sympathetic vasomotor tones are unknown. During the current grant period we have found that blockade receptors for excitatory amino acid neurotransmitters (EAA) in the RVLM will reduce blood pressure to the same extend as total autonomic blockade provide that neurons in the caudal ventrolateral medulla are inhibited. Based primarily on this observation, we have developed the hypothesis that tonically active EAA-mediated inputs to the RVLM excite RVLM-sympathoexcitatory neurons and simultaneously excite inhibitory inputs to these neurons via a circuit through the caudal ventrolateral medulla. Furthermore, we hypothesize that this balance between excitatory and inhibitory inputs to RVLM- sympathoexcitatory neurons controlled tonically by EAA-mediated inputs to the RVLM governs the longterm control of sympathetic vasomoter tone, and alteration of this balance may result in hypertension. Furthermore, based on preliminary data we proposed that the tonicallyactive EAA-mediated input to the RVLM comes from a specific region of the pontine reticular formation. To test these hypothesis, we propose a series of experiments to be conducted in anesthetized as well as conscious rats. Most experiments involved recording blood pressure and sympathetic nerve activity while altering the function of discrete regions of the brain stem by microinjection of neuroactive drugs. Five specific aims will be addressed: [1] to further examine the role of EAA-mediated inputs to the RVLM in the tonic regulation of sympathetic vasomotor tone; [2] to determine whether tonically-active EAA-mediated inputs to the RVLM originate from the pontine reticular formation; [3] to determine if the effects of tonically-active EAA-mediated inputs to the RVLM are altered in the chronic absence of baroreceptor feedback to the brain; [4] to determine whether the balance between excitatory and inhibitory inputs to RVLM sympathoexcitory neuron driven by tonically- active EAA-mediated inputs to the RVLM is altered in models of experimental hypertension; and [5] to begin to determine the role of the C1 population of neurons in the RVLM in mediating the responses driven by tonically-active inputs to the RVLM. These studies will contribute to our understanding of the neural control of blood pressure, and therefore may provide new insight to the pathogenesis and treatment of hypertension. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SYNDROME
CIRCULATORY
DYSFUNCTION
IN
CHRONIC
FATIGUE
Principal Investigator & Institution: Stewart, Julian M. Professor; Pediatrics; New York Medical College Valhalla, NY 10595
Studies 25
Timing: Fiscal Year 2001; Project Start 24-AUG-2001; Project End 31-JUL-2005 Summary: Chronic fatigue syndrome (CFS) is associated with orthostatic intolerance which often takes the form of postural orthostatic tachycardia syndrome (POTS) in adolescents. Preliminary data suggest the novel concept that defective vasoconstriction produces POTS in CFS with cardiac autonomic changes as a secondary response. CFS patients will be compared to healthy controls and to controls with simple faints to test 3 hypotheses: 1) Blood is redistributed peripherally and redistribution is enhanced during orthostasis producing increased microvascular filtration and dependent edema. Central hypovolemia causes decreased cardiac output, reflex tachycardia and reduced cerebral blood flow. This is enhanced during orthostasis producing increased microvascular filtration, dependent edema, and peripheral pooling. These changes alter the interstitium, and cause reflex tachycardia, reduced cerebral blood flow and often hypotension. Blood volume and cardiac output using the indocyanine green dye dilution technique will be measured supine, during conventional 700 head-up tilt, and during low angle head-up tilt. Cerebral blood flow velocity (CBFv) will be estimated by transcranial Doppler ultrasonography. Thoracic, splanchnic, and pelvic vascular volumes will be measured by impedance plethysmography, and limb blood flow, arterial flow, venous volume-pressure relation, and venous pressure will be measured by venous occlusion strain gauge plethysmography. These will show increased blood flow to lower extremities when upright. Central hypovolemia will occur and will reduce CBF and produce symptoms of CFS. Cardiac autonomic status including baroreflex will be assessed by heart rate and blood pressure variability and transfer function. Baroreflex and heart rate variability will be decreased and blood pressure variability will be increased related to circulatory deficit 2) The defect in vasoconstriction is heterogeneous comprising abnormal arterial baroreflex mediated sympathetic vasoconstriction in one subgroup of CFS patients and abnormal local vasoconstriction in a second subgroup with defective veno-arteriolar reflex (arterial baroreflex insensitive dysfunction). Low angle tilt will be used to activate baroreflex mediated and local reflexes. Local reflexes including myogenic, metabolic and veno-arteriolar will be sorted out through use of supine testing designed to specifically stimulate a specific reflex (limb hang, large pressure step and reactive hyperemia) and measuring peripheral resistance. 3) Cardiac autonomic findings are secondary to circulatory changes. Thus, tachycardia relates to vagal withdrawal because of circulatory insufficiency. CFS patients will be treated with midodrine or placebo in a cross-over study. Using supine and low angle tilt experiments, circulatory measurements and psychological instruments will be combined to demonstrate that circulatory abnormalities, autonomic abnormalities and symptoms correct in a subgroup of CFS patients with low resting peripheral resistance. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CLINICAL SIGNIFICANCE OF BLOOD PRESSURE IN THE VERY OLD Principal Investigator & Institution: Satish, Shiva; Internal Medicine; University of Texas Medical Br Galveston 301 University Blvd Galveston, TX 77555 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-JUL-2006 Summary: (provided by applicant): The clinical significance of elevated blood pressure in the very old, those aged 80 and older is unclear. It s been difficult to demonstrate increased morbidity and mortality associated with elevated blood pressure in the very old. Several population-based studies have shown either no relationship or even a positive association between blood pressure and survival in the very old. We and others
26 Blood Pressure
have shown that among the 80+ population the relationship between systolic blood pressure and mortality is more L-shaped, with highest mortality associated with systolic blood pressure of 120mm Hg or lower and lowest mortality at systolic blood pressures of 180 or higher. It has been argued that this observed L-shaped relationship is due to underlying comorbidity leading to both lower blood pressure and increased mortality. If this argument is correct, then it should be possible to identify a sub-population of healthy elderly without any comorbidity for whom the relationship of blood pressure to mortality is similar to what is found in younger populations. In this project our objective is to amine the effect of comorbidity on the relationship between blood pressure and morbidity and mortality in very old. To address these questions, we will examine the cohort of individuals at four EPESE sites (East Boston, New Haven, Iowa and Piedmont, NC) who were alive at the six year follow-up. Those 9134 subjects aged 71 years or more at 6-year follow-up point were followed for an additional 4 years. Detailed information also available regarding blood pressure, chronic medical conditions, health status, functional status, BMI, medication use and other variables. We will examine the relationship between blood pressure and adverse outcomes in the very old using Cox Proportional Hazard Analyses and Survival Analyses. Sample will be stratified based on comorbidity, functional status, blood pressure lowering medication use and blood pressure changes over time. A series of stratified analyses will be performed to examine the relationship between blood pressure and adverse outcomes, for different subsets of the older population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DETERMINATIONS OF MECHANISMS OF POTS USING ACUTE LABORATORY Principal Investigator & Institution: Low, Phillip A. Professor; Mayo Clinic Rochester 200 1St St Sw Rochester, MN 55905 Timing: Fiscal Year 2001 Summary: A variety of approaches have been used to alleviate symptoms in POTS (Postural Tachycardia Syndrome). Drugs reported to be of benefit include midodrine, propranolol, clonidine, and phenobarbital. Other measures used include volume expansion and physical countermaneuvers. These treatments may influence pathophysiologic mechanisms of POTS, such as alpha-receptor dysfunction, betareceptor supersensitivity, venous pooling or brainstem center dysfunction. Little is know about effects of these interventions on hemodynamic indices in POTS, or whether changes in indices correlated with improvements in symptoms. The aim is to study hemodynamic indices and symptom scores in POTS patients acutely treated with a variety of interventions. We studied 22 subjects meeting the criteria of POTS [20 females, 1 male, ages 28.7 + 6.8 yrs, range 14-39]. Subjects were studied with a routine 5 minute tilt protocol, monitoring ECG, noninvasive beat-to-beat blood pressure and impedance plethysmography, before and after the administration of an intervention (i.v. saline, midodrine, propranolol, clonidine, or phenobarbital). The hemodynamic indices used were: heart period (ECG), systolic, mean, and diastolic blood pressure (Finapres), cardiac output, stroke volume, end-diastolic volume, and peak flow (impedance plethysmography), and total peripheral resistance (calculated). Subjects used a visual analog scale to record any change in their symptoms between the tilts. Symptoms scores improved significantly after midodrine and saline. Midodrine and propranolol reduced the resting heart rate (p < 0.005) and the immediate and 5 minute heart rate responses to tild (p < 0.002). Clonidine accentuated the immediate drop in blood pressure tilt-up (p < 0.05). Effects on other hemodynamic indices were complex. We conclude that midodrine
Studies 27
and i.v. saline are effective in decreasing symptoms on tilt in patients with POTS when given acutely. Effects of treatments on heart rate and blood pressure responses generally reflected the known pharmacologic mechanisms of the agents. More complex effects on other hemodynamic indices will be discussed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DIETARY PATTERNS, SODIUM INTAKE, AND BLOOD PRESSURE Principal Investigator & Institution: Vollmer, William M. Senior Investigator; Kaiser Foundation Research Institute 1800 Harrison St, 16Th Fl Oakland, CA 94612 Timing: Fiscal Year 2001; Project Start 01-FEB-1997; Project End 31-JUL-2002 Summary: DASH2 is a multi-center, randomized clinical trial designed to compare the effects of three levels of sodium take and two dietary patterns on blood pressure. This coordinating center application is one of a coordinated set of applications from the five participating institutions. The two dietary patterns are a ~control diet~ that is typical of what Americans generally eat and a ~combination diet~ that is high in fruits, vegetables, fiber and low-fat dairy products and has a reduced total fat, saturated fat, and cholesterol content. The sodium levels range from high (reflecting current US consumption), to medium (reflecting current recommendations), to low (reflecting potentially optimal levels) and vary slightly according to calorie level. Participants are assigned to one of the two dietary patterns using a parallel group design, and are fed at each sodium level using a crossover design. Study participants (n=400) are adults, aged 22 and older, with high normal diastolic blood pressure. Stage 1 (mild) hypertension. Baseline range from 159/95. Half of the participants are African American and half are female. Participants attend a series of three eligibility screening visits followed by a towweek run-in feeding period and three one-month intervention feeding periods one at each of the three sodium levels. The study provides participants with all of their food during the run-in and intervention feeding periods, although participants resume their normal diets for up to five days between each of the three intervention feeding periods. During the controlled feeding periods participants are required to attend the clinic for at least one meal per day, five days per week, and take home food to eat for their other meals. Clinics deliver the interventions in four successive cohorts, with approximately 25 randomized participants per cohort, over a tow-year period. In support of the trial, the coordinating center: prepares and distributes all study documents, including the protocol, manual of procedures, and study forms; designs and implements a data management system; monitors and reports on trial progress; develops and implements trialwide quality control procedures; contacts with a central laboratory and a food analysis laboratory to provide analysis of blood, urine, and food speciments; develops a mechanism for randomizing study participants; caries out data analysis for the trial; conduct site visits; organizes central training and certification of staff; establishes a system of trialwide communications; and provides logistical support to the trial. The proposed DASH2 trial extends research on sodium intake and dietary patterns to address several issues of great relevance to clinical practice and public health. Sodium reduction, coupled with the dietary pattern, has great promise to lower blood pressure to an extent hitherto not demonstrated for any nonpharamacologic treatment and may be an alternative to drug therapy for persons with stage 1 hypertension or high normal blood pressure. For persons with moderate-to-severe hypertension, it may reduce medication requirements and simplify treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
28 Blood Pressure
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Project Title: DOSE-RESPONSE TO EXERCISE IN WOMEN AGED 45-75 YEARS Principal Investigator & Institution: Blair, Steven N. Professor; Cooper Institute Dallas, TX 75230 Timing: Fiscal Year 2001; Project Start 15-JAN-2001; Project End 31-DEC-2005 Summary: The primary goal of the Dose-Response to Exercise in Women Aged 45-75 Years (DREW) is to investigate the effects of different amounts of exercise on both cardiorespiratory fitness and risk factors for cardiovascular disease. Participants will be sedentary, overweight or obese, postmenopausal women who have high normal blood pressure or Stage I hypertension, and thus are at moderately high risk for cardiovascular disease. A total of 450 women (35 percent will be from minority groups) will be randomly assigned to a control group (N=100) or to 1 of 3 exercise groups (N=150 for the lowest exercise dose and 100 each in the two highest exercise groups). Women assigned to the exercise groups will exercise for 6 months at energy expenditures of 4, 8, or 12 kcal/kg per week. These exercises doses represent the consensus public health recommendation for physical activity from recently published guidelines from the U.S. Public Health Service, American Heart Association, and the American College of Sports Medicine (8 kcal/kg per week) and at doses 50 percent below (4 kcal/kg per week) 50 percent above (12 kcal/kg per week) the consensus dose. All women will exercise at 50 percent of VO2 max. The exercise sessions will take place in the laboratory, with individual supervision of each session and strict control of frequency, duration, and intensity. This will provide thorough documentation of the exact amount of exercise completed. Primary outcome measures are VO2 max and resting systolic blood pressure. Other cardiovascular disease risk factors, psychosocial variables, health-related quality of life, body composition, and fat distribution are secondary outcomes. Other secondary analyses will include a focus on the extent to which observed dose-response effects are modified by baseline levels of fitness, ethnicity, risk factors, or age. Assessments will take place at baseline and 6 months. The research will provide information about (1) patterns of change in outcomes produced by each of several exercise doses, (2) whether performing exercise at less than the current consensus dose has any benefit, (3) whether performing more exercise than the consensus dose has greater (or proportionally greater) health benefits, and (4) the characteristics of sedentary women who are most likely to benefit from various exercise doses. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: EFFECT OF A COMPUTER BASED REMINDER SYSTEM ON CARDIOVASC Principal Investigator & Institution: Phillips, Robert A. Director, Department of Medicine; Medicine; Mount Sinai School of Medicine of Nyu of New York University New York, NY 10029 Timing: Fiscal Year 2001; Project Start 05-FEB-2000; Project End 31-JAN-2003 Summary: Preventive strategies for cardiovascular disease are well-known, but physician implementation of these strategies has been less than optimal. Several studies have shown that computerized reminders and/or feedback increase utilization of preventive strategies. Patient-specific reminders suggest actions that a physician should consider at the time of visit. Patient-specific feedback is a report generated after the visit, which summarizes the collected data. Peer comparison feedback provides physicians with a periodic report analyzing their patient-care results in comparison with physicians in their own practice. We will conduct our project at the Mount Sinai Medical Center's
Studies 29
generated medical practice, where we currently have 3 teams (Groups A, B and C) or 40 primary care physicians (attendings and supervised housestaff; n=120 physicians) who serve our inner city population. We propose a two-year study, which involves all three groups. Group A physicians will receive two interventions: 1) Each physician will receive a personal digital assistant (PDA), which is a hand-held computer programmed with a reminder system that prompts entry of data essential to the management of blood pressure and lipids into standardized forms. 2) Each Group A physician will receive quarterly peer-comparison and patient-specific feedback. Group B physicians will collect data in the standard "paper chart" format and receive one intervention, i.e. quarterly peer-comparison feedback. Group C physicians will collect data in the standard fashion, however, these physicians receive no intervention (i.e. no personal digital assistant and no quarterly feedback and reminders). The aims of our study are: 1) To determine the combined of a physician- designed computer-based cardiovascular risk factor collection and reminder system and quarterly peer-comparison feedback to physicians on the degree of blood pressure and LDL-cholesterol control in an inner city population, and 2) To determine the effect of only quarterly peer- comparison feedback to physicians and groups on the degree of blood pressure and lipid control in an inner city population. Our hypothesis is that at the end of a two year intervention, use of personal digital assistants and a reminder/feedback system by Group A will improve blood pressure and lipid control by 10% compared to Group B. Group B, which receives only quarterly peer-comparison feedback, will have 10% improvement in blood pressure and lipid control compared to Group C, which documents visits in the usual fashion and receives no reminders nor feedback. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EMOTIONAL DISCLOSURE WRITING EFFECTS ON BLOOD PRESSURE Principal Investigator & Institution: Gerin, William; Medicine; Mount Sinai School of Medicine of Nyu of New York University New York, NY 10029 Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-AUG-2003 Summary: (adapted from investigator's abstract): Expressive writing (EW) is an intervention technique that has been shown to produce improvements in psychological and physical health in several controlled studies to date. The intervention calls for participants to write an essay, for 20 minutes at a time, on 3 successive days, expressing their thoughts and feelings about a traumatic experience. The positive health benefits of this intervention have been demonstrated in both healthy subjects, in terms of increases in subjective well-being and immune function and decreased health center visits, and clinic patients (i.e., asthmatics and rheumatoid arthritis patients), in terms of decreased physical symptoms. The mechanisms by which EW may exercise its beneficial effects are consistent with those that may underlie elevated blood pressure and hypertension. However, no study has yet examined the effects of EW on blood pressure. The proposed research will test the effects of an EW intervention on subsequent 24-hour ambulatory blood pressure (ABP) levels using a randomized controlled trial in which uncontrolled mild hypertensives are randomly assigned to the EW condition or a control condition. Post-intervention ambulatory BP monitoring will be performed at 1 and 4 months. On ABP assessment days, catecholamine levels will also be examined as an index of sympathetic activity through analysis of 24-hour urine samples. Chronic sympathetic activation is one proposed mechanism by which EW may operate, and measurement of pre- and post-intervention catecholamines will provide a test of that hypothesis. The EW participants will be further assigned randomly to a second EW
30 Blood Pressure
intervention or to a control condition, permitting comparison of the effects of zero, one, and two administrations of the intervention on ambulatory BP. The content of written material will also be analyzed for insight terms that may predict the effectiveness of the intervention on subsequent ambulatory BP. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CONTROL
ENDOGENOUS
OPIOIDS,
PAIN
AND
BLOOD
PRESSURE
Principal Investigator & Institution: Mccubbin, James A. Professor and Chair; Psychology; Clemson University 300 Brackett Hall Clemson, SC 296345702 Timing: Fiscal Year 2001; Project Start 01-AUG-1989; Project End 31-JUL-2003 Summary: This proposal is for continuation of our ongoing research on opioid abnormalities and blood pressure reactivity in persons at risk for hypertension. We are gradually becoming aware that regulation of both blood pressure and pain sensitivity is altered in pre-hypertensive populations. For example, persons at risk for hypertension have decreased opioid inhibition of blood pressure responses to stress. Paradoxically, they also show antinociceptive effects consistent with exaggerated opioid function. The scientific meaningfulness, both basic and clinical, of the links between pain sensitivity alterations and blood pressure dysregulation remains to be clarified. Recent studies by ourselves and others have emphasized the importance of opioids in regulation of 1) neuroendocrine and blood pressure responses to stress in hypertension development, 2) behavioral responses to pain, and 3) the relationship between pain sensitivity and blood pressure. The purpose of this continuation proposal is to further examine the role of endogenous opioids in blood pressure dysregulation by studies of circulatory and behavioral responses to aversive stimuli in persons at enhanced risk for hypertension. This will be accomplished by comparison of the effects of opioid blockade with naltrexone on pain sensitivity and blood pressure reactivity in young men and women with mildly elevated casual blood pressure. We hypothesize that abnormalities of both blood pressure control and pain sensitivity in the early stages of hypertension development are linked to altered opioid peptide function. Persons at risk for hypertension will show exaggerated opioid inhibition of pain sensitivity in the face of diminished opioid inhibition of blood pressure reactivity. Improved understanding of the opioidergic basis of altered pain sensitivity and blood pressure control will clarify the poorly characterized etiology of essential hypertension and possibly offer new preventive, diagnostic and therapeutic strategies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ENOS AND THE BLOOD LEAD-BLOOD PRESSURE RELATIONSHIP Principal Investigator & Institution: Lustberg, Mark; Epidemiology and Prev Medicine; University of Maryland Balt Prof School Baltimore, MD 21201 Timing: Fiscal Year 2001; Project Start 01-SEP-2001 Summary: Essential hypertension is a major cause of cardiovascular disease. Its etiologies are thought to involve both genetic and environmental factors. Elevated blood lead levels have been indicated as contributing factor in essential hypertension. It is unclear how lead exerts this effect. The purpose of this investigation is to consider endothelial nitric oxide synthase (eNOS) inhibition as a mechanism for this effect, using a population based approach and a recently reported Glu298Asp substitution polymorphism in eNOS. Specific Aims: 1) Describe the relation of the eNOS Glu298Asp polymorphism and blood pressure in this cohort. 2) Describe how the relation of lead
Studies 31
and blood pressure varies by the eNOS Glu298Asp polymorphism in this cohort. Methods: This will be a cross-sectional study of lead exposed workers and unexposed controls. Blood pressure and lead levels in these workers have been recorded, and blood samples have been taken. The blood samples will be genotyped for the Glu298Asp polymorphism. Linear regression models will be developed to examine the relation of lead and blood pressure in these workers. We will also consider stratified analyses, looking at odds ratios of hypertension. If eNOS is involved in lead induced increases in blood pressure, the lead-blood pressure relationship (the regression slopes or the odds ratios for hypertension) should different for individuals with and without Asp-variant eNOS. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ESTROGEN AND BRAIN CONTROL OF BLOOD PRESSURE Principal Investigator & Institution: Clark, John T. Assistant Professor; Meharry Medical College 1005-D B Todd Blvd Nashville, TN 37208 Timing: Fiscal Year 2001 Summary: The incidence of cardiovascular disease in women increases dramatically following menopause. This is, most likely, triggered by estrogen deprivation. The proposed collaborative project is designed to expand Dr. Clark's scientific armament so as to enable a successful transition to mainstream funding for his studies of neuroendocrine regulation of cardiovascular and sexual function during aging. Very few studies of neural control of the cardiovascular system have employed middle-aged rats that are most at risk for the hypertension and stroke, and none have carefully considered the potential collaborative contribution between the sympathetic nervous system and the cardiovascular system in the generation of stroke. This is especially important, because even a short term excess of vasoconstriction could greatly increase the mortality or morbidity associated with stroke. The proposed studies will test the hypothesis that the loss of normal and hypertensive female rats, thus allowing sympathetic nervous system response to increase. Further, the role of estrogen also increases the contractile responses of cerebral arteries to noradrenergic (sympathetic) stimulation. We hypothesize that these responses are potentiated in the stroke-prone rat. Our specific aims are to test the hypotheses that, in middle-aged female rats: [1] estrogen deprivation will result in decreased norepinephrine release in pre-optic- anterior hypothalamic area. This will be associated with increased blood pressure in normotensive and hypertensive female rats; [2] the interaction between estrogen and the nervous system occurs in specific areas relevant to blood pressure control, namely the organum vaculosum of the lamina terminalis, the subfornical organ, and the median pre-optic nucleus. Neuronal projections from these areas utilize angiotensin II and are responsive to estradiol; and [3] hypothalamic neurons, and in AT-1 gene expression in noradrenergic projections to the preoptic-anterior hypothalamic area. The antihypertensive effects of AT-1 receptor blockade will be attenuated in estrogen deprived middle-aged female rats. Taken together, these studies will provide important new information regarding the role of protective estrogens in neural regulation of blood pressure, and damage due to stroke, in stroke-prone hypertensive rats. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ETHNIC DIFFERENCES REGULATION AND BLOOD PRESSURE
IN
STRESS
INDUCED
SODIUM
Principal Investigator & Institution: Harshfield, Gregory A. Professor; Medical College of Georgia 1120 15Th St Augusta, GA 30912
32 Blood Pressure
Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2007 Summary: (provided by applicant) Essential hypertension has reached epidemic proportions in the African American (AA) community. Differences in the ability to regulate sodium adequately in a high salt environment and differences in stress have been hypothesized to contribute to the differences in essential hypertension between AAs and European Americans (Eas). The objective of Project 2 is to study the interactive relationship between salt and stress in the development of the ethnic differences in essential hypertension. The general hypothesis of this proposal is as follows: AAs compared to EAs are genetically predisposed to show slower natriuresis during and following stress due to differences in the regulation of vasoactive and volume regulatory agents. This results in extended periods of elevated blood pressure. The increased blood pressure load leads to the early development of preclinical disease states. Therefore, the first three aims of the study are to contrast AAs and EAs before, during, and two hours following a 60 minute behavioral challenge on changes in sodium handling (Aim 1), hemodynamic functioning (Aim 2), and vasoactive and volume regulatory agents of the sympathetic nervous system, the renin-angiotensinaldosterone system, and the endothelial system (Aim 3). The fourth aim of the study is to relate the response patterns to preclinical disease states of the heart (left ventricular mass), kidneys (micro albumin), and vasculature (pulse wave velocity, endothelial dependent vasodilation). The fifth aim of the study is to determine if the response pattern observed during laboratory testing is associated with blood pressure functioning during ambulatory testing. The final aims of the study are to determine the genetic polymorphism(s) associated with the hemodynamic change in blood pressure following stress. The proposed study will contribute significantly to the understanding of how salt and stress interact in the development of hypertension in AAs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FIELD CENTER - GENETICS OF HYPERTENSION Principal Investigator & Institution: Cooper, Richard S. Professor and Chair; Prev Medicine and Epidemiology; Loyola University Medical Center Lewis Towers, 13Th Fl Chicago, IL 60611 Timing: Fiscal Year 2001; Project Start 05-SEP-1995; Project End 30-JUN-2005 Summary: The NHLBI Family Blood Pressure Program is made up of four cooperating networks whose overall objective is to localize and characterize genes contributing to variation in blood pressure levels and hypertension status. The four networks were originally separately funded and competitive, but two critical realizations have led to full cooperation and collaboration. First, the oligogenic nature of blood pressure control dictates that large samples are necessary to achieve adequate statistical power for genomic linkage and association analyses. Second, linkage intervals are broad and contain large numbers of genes, so that success in identifying genes and mutations requires the effort of multiple laboratories freely sharing information. This coordination extends far beyond phenotyping and genotyping and is best exemplified by the Program's creation of a pooled data set and agreements about coordinated publications. During the initial funding period, the Program surpassed its original recruitment goals, carried out multiple genome-wide linkage and association analyses and created an interim pooled data set consisting of phenotype and genotype data from more than 10,000 individuals. In this renewal application, the Program proposes five specific aims to be carried out by all four networks. These aims can be grouped according to two complementary themes: First, these applicants will create and analyze a database of blood pressure- related phenotype and genotype data from all FBPP participants (Aim
Studies 33
1). Within linked regions, they will identify allelic variation within positional candidate genes and evaluate the relationship of these polymorphisms with blood pressure levels and hypertension status (Aims 2 and 3). Second, they will use quantitative measures of target organ damage to identify genes that influence susceptibility to develop hypertensive heart and kidney diseases (Aims 4 and 5). In addition to the Program specific aims, each network proposes specific aims to be carried out by that network alone, based on unique aspects of their population and interests and expertise of the investigators. The Family Blood Pressure Program represents the most determined multidisciplinary approach to the genetics of hypertension ever assembled. The resulting synthesis of ideas and amassed data permits rigorous hypothesis testing not otherwise possible and will hasten understanding of the previously elusive genetic variation responsible for disease risk. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENDER,NICOTINE AND STRESS-INDUCED ANALGESIA Principal Investigator & Institution: Girdler, Susan S. Associate Professor; Psychiatry; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, NC 27599 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 30-APR-2005 Summary: Epidemiologic as well as laboratory-based studies all document that women are more sensitive to pain than men. Involvement of the female sex hormones is indicated by animal studies that show estrogen increases sensitivity to pain, while progesterone and its metabolites (allopregnanolone and THDOC) decrease sensitivity to pain. Animal studies also indicate that the modulation of pain sensitivity by the female sex hormones involves the endogenous opioids, particularly beta-endorphins. However, whether sex hormones and other neuroendocrine factors can account for gender differences in the human pain experience has not been directly investigated. Another potential factor which may modulate pain sensitivity differently in men and women, and which may itself involve female sex hormones, involves smoking-related analgesia. Thus, the purpose of Study 1 to examine gender differences in sensitivity to a variety of experimental pain procedures as a function of female menstrual cycle phase. Also, since animal studies show that stress-induced analgesia (SIA) is modulated by the estrous cycle, Study 1 will also examine whether the female menstrual cycle influences gender differences in SIA. Using a within-subjects, randomized design, 96 healthy, non-smokers will be tested for sensitivity to tourniquet-induced ischemic pain, cold pressor pain, and thermal pain during three separate test sessions. For women, one session will occur during the early follicular phase (days 2-5; low hormones), one session during the late follicular phase (days 9- 12; high estrogen) and one session during their luteal phase (510 days after ovulation; high estrogen and progestins). Men will also be tested three times. In order to examine SIA, sensitivity to experimental pain will be compared after 20 minutes of mental stress (speech and math) versus after a 20-minute rest control period, counterbalancing order of stress and rest. Relationships between pain sensitivity (i.e., threshold and tolerance levels) and cardiovascular (blood pressure and vascular resistance) and neuroendocrine factors (estradiol, progesterone, allopregnanolone, THDOC, beta-endorphins, cortisol, ACTH and catecholamines) will be examined. It is predicted that gender differences in pain sensitivity will be greatest in the late follicular, followed by the luteal phase, while gender differences will be least in the early follicular phase. Study 2 will examine gender differences in smoking-related analgesia by testing 60 healthy subjects (30 men, 30 women), with half of each group comprised of habitual smokers. Identical test procedures and dependent measures described for Study 1 will
34 Blood Pressure
be employed. Each subject will be tested only once, however, during the high estrogen phase of the female cycle since it is hypothesized that one mechanism by which smoking reduces pain sensitivity in women is via reductions in estrogen. It is anticipated that men will show greater evidence for smoking-related analgesia since smoking will activate two pain inhibitory mechanisms in men (i.e., blood pressure-related hypoalgesia and beta-endorphin mechanisms) while, for women, smoking will activate primarily beta-endorphin mechanisms (directly and indirectly via estrogen). The results of these studies, combined, are expected to provide insight into endogenous (sex hormones, beta-endorphins, blood pressure) and exogenous (smoking) pain modulatory mechanisms that may contribute to gender differences in the experience of pain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENES AND HIGH BP: MEXICAN AMERICAN FIELD CENTER Principal Investigator & Institution: Hanis, Craig L. Professor; Human Genetics Center; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, TX 77225 Timing: Fiscal Year 2001; Project Start 05-SEP-1995; Project End 30-JUN-2005 Summary: The NHLBI Family Blood Pressure Program is made up of four cooperating networks whose overall objective is to localize and characterize genes contributing to variation in blood pressure levels and hypertension status. The four networks were originally separately funded and competitive, but two critical realizations have led to full cooperation and collaboration. First, the oligogenic nature of blood pressure control dictates that large samples are necessary to achieve adequate statistical power for genomic linkage and association analyses. Second, linkage intervals are broad and contain large numbers of genes, so that success in identifying genes and mutations requires the effort of multiple laboratories freely sharing information. This coordination extends far beyond phenotyping and genotyping and is best exemplified by the Program's creation of a pooled data set and agreements about coordinated publications. During the initial funding period, the Program surpassed its original recruitment goals, carried out multiple genome-wide linkage and association analyses and created an interim pooled data set consisting of phenotype and genotype data from more than 10,000 individuals. In this renewal application, the Program proposes five specific aims to be carried out by all four networks. These aims can be grouped according to two complementary themes: First, these applicants will create and analyze a database of blood pressure- related phenotype and genotype data from all FBPP participants (Aim 1). Within linked regions, they will identify allelic variation within positional candidate genes and evaluate the relationship of these polymorphisms with blood pressure levels and hypertension status (Aims 2 and 3). Second, they will use quantitative measures of target organ damage to identify genes that influence susceptibility to develop hypertensive heart and kidney diseases (Aims 4 and 5). In addition to the Program specific aims, each network proposes specific aims to be carried out by that network alone, based on unique aspects of their population and interests and expertise of the investigators. The Family Blood Pressure Program represents the most determined multidisciplinary approach to the genetics of hypertension ever assembled. The resulting synthesis of ideas and amassed data permits rigorous hypothesis testing not otherwise possible and will hasten understanding of the previously elusive genetic variation responsible for disease risk. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
Studies 35
•
Project Title: GENETIC DETERMINANTS OF HIGH BLOOD PRESSURE Principal Investigator & Institution: Weder, Alan B. Professor; Internal Medicine; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, MI 481091274 Timing: Fiscal Year 2001; Project Start 05-SEP-1995; Project End 30-JUN-2005 Summary: The NHLBI Family Blood Pressure Program is made up of four cooperating networks whose overall objective is to localize and characterize genes contributing to variation in blood pressure levels and hypertension status. The four networks were originally separately funded and competitive, but two critical realizations have led to full cooperation and collaboration. First, the oligogenic nature of blood pressure control dictates that large samples are necessary to achieve adequate statistical power for genomic linkage and association analyses. Second, linkage intervals are broad and contain large numbers of genes, so that success in identifying genes and mutations requires the effort of multiple laboratories freely sharing information. This coordination extends far beyond phenotyping and genotyping and is best exemplified by the Program's creation of a pooled data set and agreements about coordinated publications. During the initial funding period, the Program surpassed its original recruitment goals, carried out multiple genome-wide linkage and association analyses and created an interim pooled data set consisting of phenotype and genotype data from more than 10,000 individuals. In this renewal application, the Program proposes five specific aims to be carried out by all four networks. These aims can be grouped according to two complementary themes: First, these applicants will create and analyze a database of blood pressure- related phenotype and genotype data from all FBPP participants (Aim 1). Within linked regions, they will identify allelic variation within positional candidate genes and evaluate the relationship of these polymorphisms with blood pressure levels and hypertension status (Aims 2 and 3). Second, they will use quantitative measures of target organ damage to identify genes that influence susceptibility to develop hypertensive heart and kidney diseases (Aims 4 and 5). In addition to the Program specific aims, each network proposes specific aims to be carried out by that network alone, based on unique aspects of their population and interests and expertise of the investigators. The Family Blood Pressure Program represents the most determined multidisciplinary approach to the genetics of hypertension ever assembled. The resulting synthesis of ideas and amassed data permits rigorous hypothesis testing not otherwise possible and will hasten understanding of the previously elusive genetic variation responsible for disease risk. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: GENETIC DETERMINANTS OF HIGH BLOOD PRESSURE (GENOA) Principal Investigator & Institution: Brown, C A. Medicine; University of Mississippi Medical Center 2500 N State St Jackson, MS 39216 Timing: Fiscal Year 2001; Project Start 05-SEP-1995; Project End 30-JUN-2005 Summary: The NHLBI Family Blood Pressure Program is made up of four cooperating networks whose overall objective is to localize and characterize genes contributing to variation in blood pressure levels and hypertension status. The four networks were originally separately funded and competitive, but two critical realizations have led to full cooperation and collaboration. First, the oligogenic nature of blood pressure control dictates that large samples are necessary to achieve adequate statistical power for genomic linkage and association analyses. Second, linkage intervals are broad and contain large numbers of genes, so that success in identifying genes and mutations
36 Blood Pressure
requires the effort of multiple laboratories freely sharing information. This coordination extends far beyond phenotyping and genotyping and is best exemplified by the Program's creation of a pooled data set and agreements about coordinated publications. During the initial funding period, the Program surpassed its original recruitment goals, carried out multiple genome-wide linkage and association analyses and created an interim pooled data set consisting of phenotype and genotype data from more than 10,000 individuals. In this renewal application, the Program proposes five specific aims to be carried out by all four networks. These aims can be grouped according to two complementary themes: First, these applicants will create and analyze a database of blood pressure- related phenotype and genotype data from all FBPP participants (Aim 1). Within linked regions, they will identify allelic variation within positional candidate genes and evaluate the relationship of these polymorphisms with blood pressure levels and hypertension status (Aims 2 and 3). Second, they will use quantitative measures of target organ damage to identify genes that influence susceptibility to develop hypertensive heart and kidney diseases (Aims 4 and 5). In addition to the Program specific aims, each network proposes specific aims to be carried out by that network alone, based on unique aspects of their population and interests and expertise of the investigators. The Family Blood Pressure Program represents the most determined multidisciplinary approach to the genetics of hypertension ever assembled. The resulting synthesis of ideas and amassed data permits rigorous hypothesis testing not otherwise possible and will hasten understanding of the previously elusive genetic variation responsible for disease risk. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENETICS OF SALT SENSITIVITY IN AFRICAN AMERICANS Principal Investigator & Institution: Wright, Jackson T. Professor of Medicine; Medicine; Case Western Reserve University 10900 Euclid Ave Cleveland, OH 44106 Timing: Fiscal Year 2002; Project Start 15-MAY-2000; Project End 30-JUN-2005 Summary: The prevalence, morbidity, and mortality of arterial hypertension are disproportionately high in the African-American population. Essential hypertension is a polygenic and heterogeneous disorder. In particular, African-Americans display an amplified blood pressure response to salt. The cellular and molecular mechanisms of salt-sensitive hypertension in humans remain poorly defined and our knowledge of potential genetic mechanisms remains incomplete. We recently observed an augmented blood pressure response to a salt challenge in healthy non-obese African- Americans females as compared to Whites. African-Americans also had significantly higher intracellular Na and depressed activity of the Na pump (86 Rb uptake)as compared to Whites suggesting these may be important phenotypic markers of salt-sensitive hypertension. In fact, an increase in intracellular Na was positively correlated with the increases in systolic blood pressure following one week of low salt vs one week of high salt diet in African-Americans but not in Whites. The inverse relationship was noted for the Na pump in African-Americans. The proposed study will carry out genetic studies of sibships with at least two hypertensive embers ascertained from the AfricanAmerican population. Emphasizing model- free approaches to genetic linkage analysis based upon hypertensive sibling pairs, candidate genes that have been associated with salt-sensitive hypertension in either human or animal studies will be evaluated with respect to these intermediate phenotypes, and blood pressure responses to a salt challenge. The aims of this proposal are: l) To characterize the intermediate phenotypes of salt sensitivity, intracellular Na, sodium pump activity, and protein expression in a cohort of 500 hypertensive siblings in 160 sibships and to genotype these individuals;
Studies 37
wherever possible, parents of these subjects will also be genotyped in order to better establish identity by descent relationships. 2) To assess linkage of the various candidate loci with intermediate phenotypes relating to the magnitude of blood pressure change with a salt challenge using univariate and multivariate approaches. The overall aim of this project is to improve our understanding of the genetic basis and phenotypic characterization of salt-sensitive hypertension in African Americans. To this end, careful analytic attention will be paid to the development of improved phenotype definition, as well as to the consideration of gene-gene and gene-environment interaction. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENETICS OF VASCULAR REMODELING IN HYPERTENSION Principal Investigator & Institution: Berk, Bradford C. Professor & Chairman; Medicine; University of Rochester Orpa - Rc Box 270140 Rochester, NY 14627 Timing: Fiscal Year 2001; Project Start 01-JUN-1999; Project End 31-MAY-2003 Summary: An important long-term goal in the approach to treating atherosclerosis and hypertension is to understand the mechanisms that regulate the structure of blood vessels; a process we will term "vascular remodeling." Hypertension is a major risk factor for development of atherosclerosis (strong correlation between fatty streak formation and BP) and for clinical events (strong correlation between unstable angina, myocardial infarction, stroke and BP). Our major hypothesis is that hypertension is a major risk factor for atherosclerosis because the ability of the vessel to compensate for plaque burden (a process that requires outward vascular remodeling) is inhibited in hypertensive patients. We also suggest that impaired remodeling in hypertensives is due to 1) direct effects of elevated blood pressure, and 2) pressure-independent genes associated with essential hypertension that modulate the ability of the vessel to remodel. To gain insight into the mechanisms by which hypertension influences vascular remodeling we will selectively breed normotensive and hypertensive inbred rat strains that differ in their ability to remodel and perform a genetic analysis. Our preliminary data document significant differences in lumen diameter induced by blood flow among inbred rat strains. Our hypothesis is that among rats with genetic hypertension (e.g. SHR, SHR-SP, and Genetically Hypertensive rat of New Zealand (GH) there will be additional genetic determinants that modulate remodeling in response to physiologic stimuli such as flow. The use of genetic linkage analysis in the proposed project represents a novel approach to understanding the mechanisms that regulate vascular structure. Its advantage is that it is based on recombination probability, and requires no prior knowledge of the mechanisms to find the gene(s) that contribute to the process. We have developed and published a reproducible and quantitative model for flowdependent vascular remodeling. Using this model to study inbred rat strains we have made the exciting preliminary observation that the remodeling abilities of Brown Norway (BN, high) and GH (low) strains differ by more than 2 standard deviations. Based on these data our major goal is to perform a BN x GH cross and total genomic scan to identify major genes that alter the ability of vessels to remodel in hypertension. Aim 1: Characterize the time course of flow- induced remodeling in the carotid arteries of Brown Norway rats (BN, high remodelers) and Genetically hypertensive rats (GH, low remodelers). Aim 2: Intercross GH and BN to obtain 200 F2 progeny that express a range of remodeling and blood pressure phenotypes. Aim 3: Genotype P0 and F2 rats and use interval mapping to determine the chromosomal location of the quantitative trait loci (QTL) that are responsible for flow-induced remodeling and blood pressure. Aim 4. Create a congenic strain of GH rats containing genes associated with high remodeling ability.
38 Blood Pressure
Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENOME-WIDE SEARCH FOR CVD GENE-ENVIRONMENT INTERACTIONS Principal Investigator & Institution: Shuldiner, Alan R. Professor of Medicine; Medicine; University of Maryland Balt Prof School Baltimore, MD 21201 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2006 Summary: (provided by applicant): The overall objective of this proposal is to localize chromosomal loci (and ultimately genes) that interact with specific environmental exposures to modify risk factors for CVD using state-of-the-art molecular and statistical genetic approaches in the Old Order Amish, a unique closed founder population who are relatively genetically homogeneous, and have very large family sizes and well documented genealogies. Since February 1995, Dr. Shuldiner and his coworkers have recruited and studied over 2500 Amish individuals, 1,000 of whom are participants of Amish Family Calcification Study (AFCS), a study designed to examine independent and joint genetic influences on osteoporosis and coronary artery disease. Extensive phenotypic characterization of AFCS participants include blood pressure, body composition, bone mineral density, lipids, and coronary artery calcification by electron beam CT. DNA already has been collected on all AFCS subjects and a 5-cM genome scan (approximately 800 short tandem repeat (STR) markers) will be completed by Summer 2002. The Specific Aims of this proposal are: (1) To perform four focused short-term interventions and to measure CVD responses in subjects of AFCS including high fat meal and changes in endothelial function as assessed by flow-mediated vasodilation (FMD) studies; cold presser stress and changes in FMD and blood pressure; a high salt and low salt diets and changes in blood pressure; and aspirin therapy and measures of platelet function; (2) To characterize the genetic epidemiology of the CVD related response to each short-term intervention; (3) To identify specific chromosomal loci that influence CVD related responses to the four interventions by performing genome-wide linkage analysis (4) To identify and localize chromosomal regions and genes influencing CVD related responses by exploiting the extended linkage disequilibrium in this relatively young founder population to perform LD mapping with densely distributed single nucleotide polymorphisms (SNPs) within linked regions; and (5) To determine if chromosomal regions linked to, or associated with, variation in CVD trait responses are also linked to, or associated with, variation in coronary artery or aortic calcification. Discovery of context-dependent CVD genes will provide (i) critical insights into molecular mechanisms and new molecular targets for therapeutics; (ii) clinically useful information that will allow physicians to individualize pharmacological and nonpharmacological therapy, and (iii) blood tests for the early detection of susceptibility individuals so that targeted preventative interventions can be instituted. These advances will impact substantially on the quality of life of millions of older Americans with CVD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: G-PROTEIN-COUPLED RECEPTOR KINASE GENE VARIANTS AND HYPERTENSION Principal Investigator & Institution: Jose, Pedro A. Professor of Pediatrics; University of Virginia Charlottesville Box 400195 Charlottesville, VA 22904 Timing: Fiscal Year 2002; Project Start 01-SEP-1997; Project End 31-AUG-2007 Summary: The renal dopaminergic system participates in the pathogenesis of genetic hypertension. In human essential hypertension, single nucleotide polymorphisms
Studies 39
(SNPs) of a G protein-coupled receptor kinase, GRK4, increase GRK activity and cause the serine phosphorylation and uncoupling of the D1 receptor from its effector proteins in proximal tubule cells, effects of which are mimicked in Chinese hamster ovary (CHO) cells. Moreover, expressing GRK4-gamma- A142V but not the wild type gene in mice produces hypertension and impairs the diuretic and natriuretic but not the hypotensive effects of D1-like agonist stimulation. Our primary hypothesis is that GRK4-gamma variants are responsible for the D1 receptor coupling defect in the kidney and cause the inability of the kidney to properly excrete sodium in genetic hypertension. Essential hypertension is a heterogeneous disease in which both genetics and environment contribute to elevate blood pressure. Many diseases, including essential hypertension, have their genesis during development. Sodium intake, early in life in humans and animals, without impairing growth, affects adult blood pressure. Our secondary hypothesis is that alterations in sodium intake affect the development of hypertension in transgenic mice carrying the GRK4-gamma gene variants. Indeed, the overall hypothesis of this program project is that expression of disease in the young depends upon developmental steps made early in life in response to external and internal environmental challenges. Specific aim 1 will determine in transgenic mice the interactions of GRK4-gamma-A142V, with age and sodium intake on blood pressure elevation and whether the effect of GRK4-gamma-A142V is receptor, renal, and nephron segment specific. Specific aim 2 will determine whether transgenic mice carrying more than one GRK4-gamma gene variant develop a hypertension that is more severe than those carrying only one GRK4-gamma gene variant. The significant interaction GRK4 SNPs in hypertension was greater in the presence of more than one GRK4 SNP. In CHO cells, the expression of more than GRK4-gamma gene variant impairs D1 receptor function to a greater extent than that noted in CHO cells expressing only one GRK4gamma gene variant. Specific aim 3 will determine whether GRK4-gamma gene variants affect blood pressure in D1 and D5 knockout mice. This aim will test the hypothesis that GRK4-gamma regulates D1 but not D5 receptors. These studies should elucidate the mechanisms by which GRK4-gamma gene variants promote the development of genetic hypertension and determine whether GRK4-gamma is a salt-sensitivity gene. The identification of individuals with a salt-sensitivity gene could form thescientific basis of sodium restriction in a selected target population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HYPERGEN-BOSTON UNIVERSITY/FRAMINGHAM FIELD CENTER Principal Investigator & Institution: Ellison, R Curtis. Chief; Medicine; Boston University Medical Campus 715 Albany St, 560 Boston, MA 02118 Timing: Fiscal Year 2001; Project Start 05-SEP-1995; Project End 30-JUN-2005 Summary: The NHLBI Family Blood Pressure Program is made up of four cooperating networks whose overall objective is to localize and characterize genes contributing to variation in blood pressure levels and hypertension status. The four networks were originally separately funded and competitive, but two critical realizations have led to full cooperation and collaboration. First, the oligogenic nature of blood pressure control dictates that large samples are necessary to achieve adequate statistical power for genomic linkage and association analyses. Second, linkage intervals are broad and contain large numbers of genes, so that success in identifying genes and mutations requires the effort of multiple laboratories freely sharing information. This coordination extends far beyond phenotyping and genotyping and is best exemplified by the Program's creation of a pooled data set and agreements about coordinated publications. During the initial funding period, the Program surpassed its original recruitment goals,
40 Blood Pressure
carried out multiple genome-wide linkage and association analyses and created an interim pooled data set consisting of phenotype and genotype data from more than 10,000 individuals. In this renewal application, the Program proposes five specific aims to be carried out by all four networks. These aims can be grouped according to two complementary themes: First, these applicants will create and analyze a database of blood pressure- related phenotype and genotype data from all FBPP participants (Aim 1). Within linked regions, they will identify allelic variation within positional candidate genes and evaluate the relationship of these polymorphisms with blood pressure levels and hypertension status (Aims 2 and 3). Second, they will use quantitative measures of target organ damage to identify genes that influence susceptibility to develop hypertensive heart and kidney diseases (Aims 4 and 5). In addition to the Program specific aims, each network proposes specific aims to be carried out by that network alone, based on unique aspects of their population and interests and expertise of the investigators. The Family Blood Pressure Program represents the most determined multidisciplinary approach to the genetics of hypertension ever assembled. The resulting synthesis of ideas and amassed data permits rigorous hypothesis testing not otherwise possible and will hasten understanding of the previously elusive genetic variation responsible for disease risk. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HYPERGEN-NC Principal Investigator & Institution: Heiss, Gerardo; Professor; Epidemiology; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, NC 27599 Timing: Fiscal Year 2001; Project Start 05-SEP-1995; Project End 30-JUN-2005 Summary: The NHLBI Family Blood Pressure Program is made up of four cooperating networks whose overall objective is to localize and characterize genes contributing to variation in blood pressure levels and hypertension status. The four networks were originally separately funded and competitive, but two critical realizations have led to full cooperation and collaboration. First, the oligogenic nature of blood pressure control dictates that large samples are necessary to achieve adequate statistical power for genomic linkage and association analyses. Second, linkage intervals are broad and contain large numbers of genes, so that success in identifying genes and mutations requires the effort of multiple laboratories freely sharing information. This coordination extends far beyond phenotyping and genotyping and is best exemplified by the Program's creation of a pooled data set and agreements about coordinated publications. During the initial funding period, the Program surpassed its original recruitment goals, carried out multiple genome-wide linkage and association analyses and created an interim pooled data set consisting of phenotype and genotype data from more than 10,000 individuals. In this renewal application, the Program proposes five specific aims to be carried out by all four networks. These aims can be grouped according to two complementary themes: First, these applicants will create and analyze a database of blood pressure- related phenotype and genotype data from all FBPP participants (Aim 1). Within linked regions, they will identify allelic variation within positional candidate genes and evaluate the relationship of these polymorphisms with blood pressure levels and hypertension status (Aims 2 and 3). Second, they will use quantitative measures of target organ damage to identify genes that influence susceptibility to develop hypertensive heart and kidney diseases (Aims 4 and 5). In addition to the Program specific aims, each network proposes specific aims to be carried out by that network alone, based on unique aspects of their population and interests and expertise of the
Studies 41
investigators. The Family Blood Pressure Program represents the most determined multidisciplinary approach to the genetics of hypertension ever assembled. The resulting synthesis of ideas and amassed data permits rigorous hypothesis testing not otherwise possible and will hasten understanding of the previously elusive genetic variation responsible for disease risk. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HYPERGEN-NETWORK ADMINISTRATION & UTAH FIELD CENTER Principal Investigator & Institution: Hunt, Steven C. Professor; Internal Medicine; University of Utah 200 S University St Salt Lake City, UT 84112 Timing: Fiscal Year 2001; Project Start 05-SEP-1995; Project End 30-JUN-2005 Summary: The NHLBI Family Blood Pressure Program is made up of four cooperating networks whose overall objective is to localize and characterize genes contributing to variation in blood pressure levels and hypertension status. The four networks were originally separately funded and competitive, but two critical realizations have led to full cooperation and collaboration. First, the oligogenic nature of blood pressure control dictates that large samples are necessary to achieve adequate statistical power for genomic linkage and association analyses. Second, linkage intervals are broad and contain large numbers of genes, so that success in identifying genes and mutations requires the effort of multiple laboratories freely sharing information. This coordination extends far beyond phenotyping and genotyping and is best exemplified by the Program's creation of a pooled data set and agreements about coordinated publications. During the initial funding period, the Program surpassed its original recruitment goals, carried out multiple genome-wide linkage and association analyses and created an interim pooled data set consisting of phenotype and genotype data from more than 10,000 individuals. In this renewal application, the Program proposes five specific aims to be carried out by all four networks. These aims can be grouped according to two complementary themes: First, these applicants will create and analyze a database of blood pressure- related phenotype and genotype data from all FBPP participants (Aim 1). Within linked regions, they will identify allelic variation within positional candidate genes and evaluate the relationship of these polymorphisms with blood pressure levels and hypertension status (Aims 2 and 3). Second, they will use quantitative measures of target organ damage to identify genes that influence susceptibility to develop hypertensive heart and kidney diseases (Aims 4 and 5). In addition to the Program specific aims, each network proposes specific aims to be carried out by that network alone, based on unique aspects of their population and interests and expertise of the investigators. The Family Blood Pressure Program represents the most determined multidisciplinary approach to the genetics of hypertension ever assembled. The resulting synthesis of ideas and amassed data permits rigorous hypothesis testing not otherwise possible and will hasten understanding of the previously elusive genetic variation responsible for disease risk. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HYPERTENSION ANGIOTENSIN SYSTEMS
AND
THE
ROLE
OF
TISSUE
RENIN
Principal Investigator & Institution: Sigmund, Curt D. Professor; University of Iowa Iowa City, IA 52242 Timing: Fiscal Year 2001
42 Blood Pressure
Summary: An intrinsic tissue-renin angiotensin system (RAS) is defined as a tissuespecific system with the potential for the local generation and action for Ang-II. We and others hypothesize that this local generation of Ang-II may provide a level of local control independent of the circulating (or endocrine) system. It has been shown that the kidney and brain both express each RAS gene mRNA and contains each RAS product. Therefore, the kidney and brain may have the capability of generating ANG-II from AGT released locally from renal proximal convoluted tubules (PCT) or astrocytes, respectively. Before the inception of this project, the concept that intrinsic tissue renin systems existed was highly controversial because it was not experimentally feasible to physiologically separate the effects of tissue RAS from the endocrine RAS. We have since provided the first convincing evidence in support of the blood pressure regulatory function of a tissue RAS in the kidney. This was accomplished with the use of a transgenic model in which angiotensinogen (AGT) was specifically targeted to renal PCT cells and studies demonstrating that transgenic mice expressing RAS components specifically within the kidney exhibited chronic hypertension without changes in circulating Ang-II. Importantly, we recently demonstrated that the cre-loxP recombinase system could be used as an effective tool to generate a tissue-specific knockout of RAS genes to experimentally dissect tissue RAS. We will examine the overall hypothesis that intrinsic tissue renin-angiotensin systems play an integral role in the regulation of blood pressure and may participate in the development or maintenance of hypertension. We will focus on the specific aims: 1) we will test the hypothesis that the intra-renal RAS plays a critical role in the regulation of blood pressure and renal function, and when specifically ablated via the cre-loxP recombinase system will reduce blood pressure in a model of Ang II-dependent hypertension, lower basal blood pressure in normotensive mice, and alter renal function and 2) we will explore the hypothesis that an intrinsic RAS in the brain, derived from locally synthesized AGT (and therefore Ang-II), plays an important role in the regulation of basal blood pressure, and when specifically ablated will lower blood pressure in a model of Ang-II-dependent hypertension by altering central effector mechanisms. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HYPERTENSION, RISK FOR HYPERTENSION AND HYPOALGESIA Principal Investigator & Institution: France, Christopher R. Psychology; Ohio University Athens Athens, OH 45701 Timing: Fiscal Year 2001; Project Start 01-MAY-2000; Project End 30-APR-2004 Summary: The long-term objective of the proposed research is to evaluate hypoalgesia as a biobehavioral marker of risk for hypertension. The research will test the hypothesis that hypoalgesia and hypertension share a common pathophysiology (i.e., central opioid hyposensitivity) that is characterized by enhanced activation of endogenous opiates and supraspinal pain modulation systems. To the extent that this hypothesis is true, individual differences in nociceptive responses at rest, during opiate blockade, and during supraspinal activation may be used to predict longitudinal changes in blood pressure. The findings from this project may also help to explain the attenuation of clinical pain (e.g., angina) that can complicate early arid accurate detection of heart disease in individuals with hypertension. Three studies are proposed that will use the nociceptive flexion reflex (NFR), defined as the intensity of sural nerve stimulation required to elicit leg withdrawal, as an objective measure of nociception. Study l will determine NFR thresholds in controls and unmedicated patients with newly-diagnosed hypertension, and will assess endogenous opiates and descending pain modulation as mediators of hypertensive hypoalgesia. Study 2 will determine NFR thresholds in
Studies 43
young adults at high and low risk for hypertension (defined by parental history of hypertension and resting blood pressure), and will also assess endogenous opiates and descending pain modulation as mediators of hypoalgesia in those at high risk for hypertension. Study 3 will evaluate NFR thresholds at rest and changes in NFR threshold in response to Supraspinal modulation as predictors of longitudinal changes in blood pressure in young adults at high and low risk for hypertension. The proposed studies are important for several reasons. Studies l and 2 will assess promising mechanisms of hypoalgesia which may lead to important insights concerning the role of endogenous opiates in the pathophysiology of hypertension. Study 3 will evaluate nociceptive responses as a means of identifying those at greatest risk for hypertension among heterogeneous groups of high risk men and women. This information could be used to identify the best candidates for behavioral and other risk reduction efforts. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HYPERTENSION: PREDICTION OF BIOFEEDBACK SUCCESS Principal Investigator & Institution: Yucha, Carolyn B. Associate Dean for Research; Adult and Elderly Nursing; University of Florida Gainesville, FL 32611 Timing: Fiscal Year 2001; Project Start 01-FEB-2000; Project End 31-JAN-2003 Summary: In the next century, our health care system will attempt to manage chronic illness in the largest aging population ever known. Non-adherence to pharmacological therapy and to non- pharmacological therapy will prove very costly. Hypertension, present in more than 50 million Americans, increases the risk of cardiovascular disease and its assoicated morbidity and mortality. Thus it is critical that adherence to treatment of hypertension be increased. While medications are effective in certain patients, their adverse effects make compliance with treatment difficult to ensure. In addition, more and more persons are turning to alternative medicine to deal with their health problems. Biofeedback offers an alternative to medical treatment, having been shown to reduce both systolic and diastolic blood pressures and/or allow the reduction of antihypertensive medications in some patients, while having no adverse effects. Yet biofeedback therapy is time-intensive and technician-intensive. Therefore, it is critical to be able to predict which patients with essential hypertension are most likely to lower his/her blood pressure using these techniques. This research proposes to test three different means of predicting whether a hypertensive subject will or will not be successful in lowering his/her blood pressure using biofeedback. Specifically, the first set of predictive criteria to be tested is that proposed by Weaver and McGrady (1995). This model is derived from five variables: heart rate, finger temperature, forehead muscle tension, plasma renin response to furosemide, and mean arterial pressure response to furosemide. The second prediction model is based on the magnitude of circadian variations in blood pressure as measured by 24-hour ambulatory blood pressure monitoring. The third prediction model is based on locus of control of behavior. A total of 60 hypertensive subjects will be studied over a three-year period. The results of this study will enable those caring for hypertensive persons to recommend treatment (i.e., biofeedback) in an individualized way, thereby promoting adherence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HYPERTHERMIA EFFECTS ON HUMAN BAROFLEX FUNCTION Principal Investigator & Institution: Crandall, Craig G. Associate Professor; Internal Medicine; University of Texas Sw Med Ctr/Dallas Dallas, TX 753909105
44 Blood Pressure
Timing: Fiscal Year 2001; Project Start 01-JAN-1999; Project End 31-DEC-2002 Summary: (Adapted from applicant's abstract): The effects of hyperthermia on human baroreflex control of blood pressure are unknown. Hyperthermia increases sympathetic activity in humans evidenced by increases in cardiac output, heart rate, splanchnic and renal vascular resistances, and muscle sympathetic nerve activity. Since baroreceptor control of these variables is described by a sigmoidal relationship between changes in these efferent variables relative to changes in blood pressure, the PI suggests that the functional reserve to further increase these variables during a hypotensive challenge will be reduced in hyperthermia if the respective baroreflex curves are not adjusted. Thus, the following, hypothesis will be tested: hyperthermia alters baroreceptor control of blood pressure in humans. Studies have shown that hyperthermia attenuates alphaadrenoceptor responsiveness in both intact animals and isolated vessels. Similar studies have not been conducted in humans. If alpha-adrenoceptor responsiveness in humans is likewise attenuated in this environment, baroreceptor adjustments to a reduction in blood pressure in hyperthermia will be less effective in maintaining pressure since end organ vascular responses are attenuated. Therefore, studies will be conducted to test the hypothesis that hyperthermia decreases alpha- adrenoceptor responsiveness in humans. A primary function of baroreflexes is to maintain blood pressure to adequately perfuse the cerebral circulation. The cerebral circulation has a wide autoregulatory range in which large changes in perfusion pressure do not appreciably change cerebral blood flow. Sympathetic stimulation shifts both the lower and upper limits of this autoregulatory curve to higher pressures. Such a shift reduces the reserve to maintain cerebral blood flow during reductions in perfusion pressure, and may predispose the individual to syncope during a hypotensive challenge. As previously mentioned, hyperthermia increases sympathetic activity, and therefore may decrease the reserve to maintain cerebral blood flow during reductions in perfusion pressure in this environment. Thus, the following hypothesis will be tested: hyperthermia shifts the cerebrovascular autoregulatory curve to higher pressures resulting in impaired autoregulation of cerebral blood flow to decreases in perfusion pressure. To address these issues, integrated and individual baroreflex function will be assessed in normothermia and hyperthermia, as will alpha-adrenoceptor responsiveness in both skin and muscle. Finally steady state and dynamic cerebrovascular autoregulation will be assessed in normothermia and hyperthermia using transcranial Doppler. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LOW-RENIN HYPERTENSION IN AFRICAN AMERICANS Principal Investigator & Institution: Pratt, J. Howard. Professor of Medicine; Medicine; Indiana Univ-Purdue Univ at Indianapolis 620 Union Drive, Room 618 Indianapolis, IN 462025167 Timing: Fiscal Year 2001; Project Start 05-JUN-2001; Project End 31-MAY-2004 Summary: (Verbatim from the application): Low-renin hypertension is common in African Americans, with many failing to achieve a normal blood pressure despite the availability of a wide variety of antihypertensive agents. The low-renin state is consistent with increased retention of sodium. We have evidence that blacks have higher overall activity of the epithelial sodium channel (ENaC), a principal site for reabsorption of sodium within the kidney and where certain molecular mutations result in retention of sodium and severe low-renin hypertension (Liddle's syndrome). ENaC is upregulated by aldosterone. In the present proposal, we will study the usefulness of two drugs that inhibit ENaC activity, spironolactone, an antagonist of aldosterone, and amiloride, a direct inhibitor of ENaC, in blacks with low-renin hypertension who have
Studies 45
shown resistance to treatment. We will follow a simple protocol wherein we will study patients taking an optimal regimen of antihypertensive medication including a full dose of diuretic but in whom a normal blood pressure has not been achieved. The patients will be randomized to either spironolactone 25 mg per day, amiloride 10 mg per day, the combination of spironolactone 25 mg and amiloride 10 mg per day, or placebo for 9 weeks. In Specific Aim #1, we will test the hypothesis that drug-resistant, low-renin hypertensive blacks normalize their blood pressure in response to treatment with small doses of agents that reduce ENaC function. We will also test for a synergistic effect of spironolactone with amiloride to lower blood pressure. In Specific Aim #2, we will test the hypothesis that the mechanism whereby the anti-ENaC drugs lower blood pressure is by reducing an intrinsically higher level of ENaC function, as evidenced by lower levels of renin and aldosterone at baseline and greater increments during treatment in responders. In Specific Aim #3, we will test the hypothesis that blood pressure responses to spironolactone are related to the presence of molecular variants in ENaC subunits, variants that have been shown previously to associate with level of blood pressure. In summary, we explore unique but simple approaches to treatment of lowrenin hypertension in blacks, a treatment modality that could prove useful to many patients currently with uncontrolled blood pressure. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MACRONUTRIENTS AND CARDIOVASCULAR RISK Principal Investigator & Institution: Appel, Lawrence J. Associate Professor; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2002; Project Start 25-MAY-2002; Project End 31-MAR-2007 Summary: While there is widespread consensus that the optimal diet to reduce cardiovascular risk should be low in saturated fat, the type of macronutrient that should replace saturated fat (carbohydrate, protein or unsaturated fat) is a major, unresolved research question with substantial public health implications. The proposed study will evaluate these 3 dietary approaches by studying their effects on established coronary risk factors and a selected group of emerging risk factors. The study design is a randomized, three period cross-over feeding study that will compare the effects on blood pressure and plasma lipids of a carbohydrate-rich diet (the DASH diet) to two other diets, one rich in protein and another rich in unsaturated (UNSAT) fat, predominantly monounsaturated fat. The DASH diet has been shown to reduce blood pressure and LDL-cholesterol substantially, and is currently recommended by policy makers. During a 1 week run- in, all participants will be fed samples of the 3 study diets (DASH, PROTEIN and UNSAT). Using a three period cross-over design, participants will then be randomly assigned to the DASH, PROTEIN OR UNSAT diet. Each feeding period will last 6 weeks; a washout period of at least 2 weeks will separate each feeding period. Throughout feeding (run-in and the 3 intervention periods), participants will be fed sufficient calories to maintain their weight. Trial participants (n=200, approximately 50 percent female, approximately 50 percent African-American) will be 20 years of age or older, with systolic blood pressure of 120-159 mmHg and diastolic blood pressure of 80-95 mmHg. Primary outcomes variables will be blood pressure and the established plasma lipid risk factors (LDL-C, HDL-C and triglycerides). Secondary outcomes will include apolipoproteins VLDL-apoB and VLDL-apoCIII, which should be superior to triglycerides as predictors of cardiovascular events, as well as total apolipoprotein B, non-HDL cholesterol, and lipoprotein(a). In this fashion, the trial should advance our fundamental knowledge of the effects of diet on both traditional and emerging risk factors, and in the process, inform policy makers and health care providers on the
46 Blood Pressure
relative benefits of carbohydrate, protein and unsaturated fat, predominantly monounsaturated fat, as means to reduce cardiovascular risk. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MAGNESIUM'S ANTIHYPERTENSIVE EFFECTS IN PREECLAMPSIA Principal Investigator & Institution: Standley, Cynthia A. Physiology; Midwestern University 555 31St St Downers Grove, IL 60515 Timing: Fiscal Year 2003; Project Start 15-AUG-2003; Project End 31-AUG-2005 Summary: (provided by applicant): Preeclampsia consists of hypertension and proteinuria in pregnancy and is the most common cause of maternal mortality if left untreated. Hypertension in preeclampsia is implicated in the constellation of symptoms including seizures, glomerular damage and intrauterine growth retardation. Inhibition of nitric oxide synthase (NOS) in pregnant rats is an established model of preeclampsia, as it replicates these symptoms. Magnesium sulfate is the standard treatment for preeclampsia. However, magnesium's anti-hypertensive effects remain poorly understood. Magnesium acts as a vasodilator, an action customarily attributed to its ability to antagonize calcium entry into vascular smooth muscle cells (VSMC). Emerging evidence suggests that magnesium may also regulate vascular nitric oxide (NO). Therefore, magnesium may mediate vascular relaxation and reduction of blood pressure by activating the vascular NO/cGMP/protein kinase G (PKG) signaling pathway. We hypothesize that magnesium and NO act synergistically at the level of the vasculature to cause vasodilation and a reduction in blood pressure. Specifically, magnesium's ability to reduce blood pressure in the nitric oxide-inhibited animal model of preeclampsia is due to its ability to upregulate vascular NO/cGMP/PKG signaling, effectively reducing total vascular resistance and consequently blood pressure. To test this hypothesis, we will use the NOS inhibitor, NGnitro-L-arginine methyl ester (LNAME), to induce hypertension in pregnant rats. Then, graded doses of magnesium sulfate via chronic infusions in vivo, and acute treatment of vascular tissues ex vivo, will be used to address the following specific aims: 1) Determine if magnesium predictably reduces blood pressure and proteinuria and alters plasma/urinary NOS signaling metabolite levels, and whether these measures can be used therapeutically to predict and track hypertension; 2) Determine magnesium's effects on vascular inducible NOS (iNOS) and endothelial NOS (eNOS) expression; 3) Investigate magnesium's effects on vascular NOS signaling such as NOS activity, NO-mediated guanylate cyclase activity and PKG expression, and 4) Investigate magnesium's ability to regulate vascular reactivity in response to NO-generating stimuli. Data derived from these experiments will elucidate the anti-hypertensive effects of magnesium, its mode of action and the roles of NO and magnesium in preeclampsia and pregnancy-induced hypertension. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MARC PREDOCTORAL FELLOWSHIP Principal Investigator & Institution: Brisbon, Wendy; Anatomy and Physiology; Meharry Medical College 1005-D B Todd Blvd Nashville, TN 37208 Timing: Fiscal Year 2003; Project Start 29-AUG-2003; Project End 28-AUG-2006 Summary: (provided by applicant): My research focus is the role of estrogen in the neural control of blood pressure. Hypertension is a major health problem which greatly increases the risk of cardiovascular disease and stroke. In women, the incidence of cardiovascular disease and stroke increases dramatically following menopause. This is, most likely, due to estrogen depletion, which may trigger a slowly developing increase
Studies 47
in blood pressure. Also, hypertension and diabetes mellitus are often seen as coexisting conditions. My working hypothesis is that aging, estrogen loss, and diabetes mellitus cause decreases in anterior hypothalamic norepinephrine release and decreased activation of alpha-2-adrenoceptors. This leads to decreased sympathoinhibition, increased blood pressure, and increased stroke risk. The specific hypotheses to be tested are: [1] Estrogen maintains lower blood pressure through mechanisms that involve alpha-2-adrenoceptors in the anterior hypothalamic nucleus; and [2] Estrogen depletion and diabetes are associated with increased blood pressure and stroke risk. The increase in blood pressure associated with diabetes involves a decreased activation of alpha-2adrenoceptors in the anterior hypothalamic nucleus. My studies will use middle-aged hypertensive rats and transgenic mice. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MDRD LONG TERM FOLLOW UP STUDY Principal Investigator & Institution: Beck, Gerald J. Acting Chairman; Cleveland Clinic Foundation 9500 Euclid Ave Cleveland, OH 44195 Timing: Fiscal Year 1999; Project Start 30-SEP-1984; Project End 30-SEP-2004 Summary: The Modification of Diet in Renal Disease (MDRD) Study was a randomized clinical trial, funded by NIDDK, to determine the effect of dietary protein restriction and strict blood pressure control on the progression of chronic renal diseases of diverse causes in 840 patients. The planned duration of follow-up was 2-4 years, hence, the rate of decline in glomerular filtration rate (GFR), rather than the incidence of renal failure or death, was the primary outcome. The full-scale trial ended patient follow-up in January 1993. The purpose of this proposal is for the Data Coordinating Center (DCC) to obtain long-term followup data on the study Cohort and to continue data analysis. The fullscale trial showed a beneficial effect of the low blood pressure goal in patients with proteinuria and suggested a beneficial effect of reduced protein intake in patients with advanced renal disease (baseline GFR 13-24 mL/min/1.73 m2). However, the length of follow-up was insufficient to determine the efficacy of the low protein diet in patients with moderate renal disease (baseline GFR 25-55 ml/min/1.73m2, N = 585). During 10 months of additional follow-up after the end of the full-scale trial, the number of patients in the GFR 25-55 group to reach renal failure increased from 31 to 55, and a trend suggesting a benefit of the low protein diet on renal failure or death emerged (relative risk 0.63, 95% confidence interval: 0.30 - 1.02, p=.056). Based on observed rates of GFR decline, the projected number of patients in this group to reach renal failure increases to 163 by 9/96 and 263 by 9/2000, providing a unique opportunity for a much more accurate evaluation of this outcome. The primary goals of further follow-up are to assess the long-term effects of the diet and blood pressure interventions on 1) the incidence of renal failure or death and 2) nutritional status and cardiovascular outcomes prior to and following renal failure. Another fundamental goal is to document the longterm progression of renal disease by relating the extensive data from the full-scale study to long-term patient outcomes from the extended follow-up phase. Patient outcomes would be assessed from data provided by the patient and family, physicians' offices, hospital discharge summaries, and the USRDS. A pilot study demonstrating the feasibility of obtaining follow.up information has been completed. The MDRD Study Group has reported many results from the MDRD Study. This proposal will maintain this activity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
48 Blood Pressure
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Project Title: MEDULLARY RESPIRATORY NEURONS AND SLEEP APNEA Principal Investigator & Institution: Vidruk, Edward H. Preventive Medicine; University of Wisconsin Madison 750 University Ave Madison, WI 53706 Timing: Fiscal Year 2001; Project Start 01-MAY-1999; Project End 30-APR-2003 Summary: Our ultimate goal is to determine the roles of the different types of medullary respiratory neurons in initiating, sustaining and terminating apneas. By extracellular recording of their activity in intact unanesthetized cats we will identify the influence of changes in state of arousal, carbon dioxide, oxygenation and blood pressure on the activity of these neurons. We will focus on three different areas. AIM 1 entails the study of the responses of medullary respiratory neurons to carbon dioxide in wakefulness and in NREM and REM sleep employing a preparation we've developed utilizing ventilatorinduced apnea. We will describe the activation thresholds of the various neurons to carbon dioxide as well as the pattern of discharge near the thresholds. AIM 2 focuses on hypoxia-induced periodic breathing. This is a pattern of waxing and waning (hypopneas) ventilatory periods induced in cats by mild hypoxia. It is a destabilized breathing rhythm which is often a precursor to apnea. We will record medullary respiratory neurons to determine their roles in producing this pattern. These studies also will be done in wakefulness, NREM and REM sleep. AIM 3 centers on interactions between blood pressure and breathing. Changes in blood pressure could be a significant factor in causing destabilized breathing since they often accompany hypopneas and apnea. We will determine whether increases and decreases in blood pressure, some produced pharmacologically and some occurring spontaneously, alter the activity of medullary respiratory neurons. In so doing we will identify neurons which could mediate the ventilatory effects of blood pressure changes. These studies will be done in wakefulness and NREM and REM sleep to detect stat effects. Overall, our studies will produce new information about the basic properties of medullary respiratory neurons and their potential roles in initiating, sustaining and terminating hypopneas and apneas in wakefulness and sleep. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MENSTRUAL CYCLE AND BLOOD EFFECTS ON ACUTE PAIN Principal Investigator & Institution: Sherman, Jeffrey J. Oral Medicine; University of Washington Seattle, WA 98195 Timing: Fiscal Year 2001; Project Start 01-MAR-2000; Project End 28-FEB-2003 Summary: (Adapted from applicant's abstract) Temporomandibular disorders (TMD's) are a group of pain conditions characterized by pain in the muscles of mastication and/or the temporomandibular joint. Population prevalence of TMD is about twice as high in women as in men and it is more frequently reported during the reproductive years. About 80% of clinic cases presenting for TMD pain are female. The reasons for the gender discrepancy may involve biologic, psychologic and social factors such as hormonal differences, differences in pain perception, or differences in pain expression or health care utilization. Some data suggest that TMD patients demonstrate greater sensitivity to ischemic pain delivered using the submaximal effort tourniquet test. Sensitivity to the stimulus may vary across the menstrual cycle and be positively correlated with blood pressure during the luteal and follicular phase of the menstrual cycle. Experimental pain sensitivity has been shown to be inversely related to blood pressure in normal males, but this relationship is considerably less clear in females and pain patients. The investigators propose to further assess the discriminative ability of the submaximal effort tourniquet test and to study systematically the interrelationships
Studies 49
between blood pressure, menstrual cycle phase, and ischemic pain sensitivity in TMD patients and pain free controls. They intend to augment an ongoing project funded by the NIDCR and ORWH by adding the submaximal effort tourniquet test as well as resting and reactivity blood pressure measurement during experimental pain stimuli. The study will assess blood pressure variability and variability in responses to ischemic pain at critical points (menses, ovulatory, mid-luteal and late luteal/premenstrual phases) across three consecutive ovulatory cycles in female TMD cases and appropriate controls, to ascertain the extent to which variability in blood pressures and pain may be attributable to female gender, hormonal status, and/or presence of clinical TMD pain. Thus, the proposed study will determine the discriminative ability of the tourniquet test for distinguishing female and male TMD patients from same-sex, pain free controls and evaluate the interrelationships between menstrual cycle, blood pressure and pain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MENTORED DEVELOPMENT AW
PATIENT-ORIENTED
RESEARCH
CAREER
Principal Investigator & Institution: Mullaney, Scott; Medicine; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, CA 92093 Timing: Fiscal Year 2001; Project Start 01-JUL-2000; Project End 30-JUN-2005 Summary: (Adapted from the applicant's abstract): Currently, over 280,000 patients in the U.S. undergo chronic HD for the treatment of end-stage renal disease (ESRD). Technical advances have improved the procedure, yet dialysis- related blood pressure alterations remains a common complication and may contribute to increased morbidity and mortality in HD. Intradialytic hypotension (IH) occurs in up to 48% of HD treatments, contributes to inadequate dialysis and reduces patient comfort and compliance. IH results from a complex interaction between the patient's volume status and the cardiovascular and hemodynamic responses to fluid and solute removal. Several mediators have been incriminated for their likely contribution to IH including inflammatory cytokines [interleukin 1(IL-1) and tumor necrosis factor alpha (TNFa)], complement, and recently NO. NO, a potent vasodilator formed by nitric oxide synthase (NOS), is released from the vascular endothelium. NO levels are elevated in ESRD, and recent studies have reported a strong association between NO and IH with increased NO being associated with more IH. Although NO may have a significant effect on the hemodynamic response to HD, the mechanisms contributing to elevated NO levels, including the effect of HD have yet to be clearly defined. The applicant proposes to test the hypothesis that NO is an important mediator of the hemodynamic response to HD, and that reducing NO would allow for prevention and treatment of dialysis-related events. The project will provide an evaluation of the prevalence of elevated NO in hemodialysis patients, as well as explore the relationship of these levels to hemodynamic profiles including an assessment of blood volume changes and distribution of fluid in various compartments during dialysis. Additionally, mechanisms that may elevate NO levels will be explored through systematic study of the effect of HD and dialysis-related factors on NO levels. Finally, the effect of reducing NO levels, via NO scavengers or NOS inhibitors, on blood pressure changes will be studied. The proposed work will add to the knowledge and understanding of the pathophysiology of blood pressure changes in the HD patient population, and permit development of better strategies to prevent and treat the occurrence of IH in the HD population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MISOPROSTOL EFFECTS ON BLOOD PRESSURE CHANGES IN ESSENTIAL HYPERTENSION Principal Investigator & Institution: Munger, Mark A.; University of Utah 200 S University St Salt Lake City, UT 84112 Timing: Fiscal Year 2001 Summary: This proposal tested the hypothesis that misoprostol attenuates the rise in blood pressure induced by diclofenac sodium (a non-steroidal anti-inflammatory drug) in elderly patients with salt-sensitive, stage I-II essential hypertension. Misoprostol is a prostaglandin E2 analog that had been shown to attenuate the effects of single-dose oral ibuprofen on glomerular filtration rate, renal blood flow, and on blood pressure. This study, conceived by the Principal Investigator, was supported by an unrestricted grantin-aid from the Searle pharmaceutical company. The proposal was considered an investigator-initiated, hypothesis-oriented study generated by the Principal Investigator and his associates, and was not considered to be a drug company-sponsored clinical trial. This study has been completed, and the hypothesis confirmed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MODEL OF THE RENAL MEDULLARY MICROCIRCULATORY FUNCTION Principal Investigator & Institution: Edwards, Aurelie; Chemical Engineering; Tufts University Medford Boston Ave Medford, MA 02155 Timing: Fiscal Year 2001; Project Start 15-JUL-1999; Project End 30-JUN-2004 Summary: The production of maximally concentrated urine is made possible by the renal countercurrent multiplication system, which generates and maintains a hypertonic inner medulla, comprised of cortico- medullary gradients of NaCl and urea. Many features of the multiplication system remain to be elucidated, in particular the role of the medullary microcirculation. By modulating blood flow, vasa recta (i.e., the blood vessels in the renal medulla) can have a major effect on sodium and water homeostasis as well as on the long-term control of arterial blood pressure; their role in hypertension and congestive heart failure is thus highly relevant. Changes in renal medullary hemodynamics are also directly involved in pressure natriuresis. The overall goal of this research is to develop a comprehensive mathematical model of the renal medullary microcirculatory function in order to predict the efficiency of countercurrent exchange of water, small solutes, and macromolecules by the vasa recta. The specific aims of this project are the following. 1. To investigate the specific role of water channels (AQP-1) and urea transporters in descending vasa recta, incorporating data obtained on wildtype mice, AQP-1 deficient mice and AQP-1 deficient mice in which the AQP-1 gene has been replaced by means of an adenovirus. 2. To determine the mechanisms that control interstitial albumin concentration. The effects of albumin concentration polarization at the vessel walls will be determined as a first step. 3. To model the transport of oxygen in the renal medulla and to examine the effects of changes in blood flow rate and tubular consumption on oxygen tension. Medullary hypoxia is a consequence of the need for countercurrent exchange; however, too little oxygen can cause medullary hypoxic injury. 4. To examine how secretion of the vasoactive hormone nitric oxide into the vascular exchanger affects medullary blood flow and interstitial osmolality, and to investigate the relationship between the reduced medullary hematocrit, medullary hypoxia and the effectiveness of NO in the medulla. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MODELING MECHANORECEPTORS
OF
NON
LINEAR
DYNAMICS
OF
Principal Investigator & Institution: French, Andrew S.; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, CA 90033 Timing: Fiscal Year 2001 Summary: Renal autoregulation of arterial blood pressure requires maintenance of plasma and extracellular fluid volumes. Two mechanisms are thought to be involved in renal autoregulation: the tubuloglomerular feedback (TGF) and a vascular myogenic mechanism. The objective of this project has been to characterize the nonlinear dynamics and the interactions of these autoregulation mechanisms by using induced broadband perturbations of arterial blood pressure and analyzing the resulting blood flow data with nonlinear modeling methodologies. Using the novel methodologies developed in Core Project #1, we were able to quantify the nonlinear dynamics and the interactions between the two regulatory mechanisms (myogenic and TGF). Comparisons of nonlinear models of renal blood pressure and flow data obtained for normotensive rats and spontaneously hypertensive rats show unambiguously that the relative effect of the TGF mechanism is diminished in hypertensive rats and for high-level of forcing. This finding advances our understanding of hypertension and may lead to more effective clinical treatments. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MODELS FOR STUDYING THE GENETICS OF HYPERTENSION Principal Investigator & Institution: Smithies, Oliver; Excellence Professor of Pathology; Pathology and Lab Medicine; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, NC 27599 Timing: Fiscal Year 2001; Project Start 30-SEP-1992; Project End 31-AUG-2002 Summary: The objective of this renewal application is to continue work begun during the prior funding period focused on the analysis of the role of various candidate genes in hypertension through the manipulation of their dosage in genetically engineered mice. This prior work involved using gene targeting to create mice with zero, one, two, three, and four copies of candidate genes targeted at their normal chromosomal locations and then assessing the impact of these defined alterations on hypertension in the mouse. The studies demonstrated that gene dosage determines the levels of expression of these genes which either directly impacted on blood pressure, or had blunted effects on blood pressure due to homeostatic adjustments mediated by other genetic elements. The hypothesis that was developed from these prior studies and which is to be tested in the proposed studies are that variations in the level of expression of a variety of genes will lead to blood pressure changes that may be a reflection of increased expression of the manipulated genes or may be blunted or completely missed depending on the homeostatic adjustments mediated by other elements. Dr. Smithies interprets these blunted changes as virtual blood pressure changes since homeostatic adjustments (i.e.) altered chronic expression by other non-manipulated genes sensing blood pressure changes) which can be demonstrated result in an absence of detectable blood pressure changes. This hypothesis and its implications for the genetics of hypertension will be tested by the applicant in five specific aims. The first four aims will investigate the effects on blood pressure of altered expression of f our candidate genes: 1) the renin 1C gene 2) the Agtr1A gene 3) the type A natriuretic peptide receptor gene 4) the natriuretic peptide "clearance" type receptor gene. The final specific aim involves the development of a path diagram displaying the interaction of these genetic
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determinants from Aims 1-4. This includes predictions and the testing of these predictions using crosses between the mice generated for these studies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEURAL CONTROL OF CARDIORESPIRATORY FUNCTION Principal Investigator & Institution: Harper, Ronald M. Professor; Neurobiology; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, CA 90024 Timing: Fiscal Year 2001; Project Start 01-APR-1978; Project End 28-FEB-2005 Summary: (Applicant's abstract): Our hypotheses are that the substantial variation in breathing and blood pressure that occurs in rapid eye movement (REM) sleep results partially from state-induced activity changes on regions within the ventral medullary surface (VMS), and that recovery from extreme changes in blood pressure or sustained apnea within sleep depends on the cerebellar fastigial nucleus and one of its afferent structures, the inferior olive. In intact cats, we will 1) identify sites within cerebellar and other brain areas activated by chemoreceptor and blood pressure challenges, and the sequence of activation, using functional magnetic resonance imaging; 2) relate spontaneous respiratory and blood pressure changes during sleep-waking states to VMS regional activity, and activity in the cerebellar fastigial nuclei and inferior olive; 3) apply chemoreceptor and blood pressure challenges during sleep-waking states, and assess fastigial nucleus and inferior olive activity while charting respiratory and cardiovascular responses; 4) electrically stimulate the fastigial nucleus, and examine state-related influences on the VMS and on respiratory and cardiovascular activity; and 5) examine regional activity patterns over the entire VMS unilaterally with respect to ventilatory and blood pressure challenges during different states. Blood oxygen level dependent Echo-Planar functional magnetic resonance images will be obtained using a high-field animal scanner during blood pressure, chemoreceptor, and saline control challenges with anesthetized cats. Baseline and challenge images will be compared on a voxel-by-voxel basis, using t tests with multiple-comparisons correction. Microelectrode and optical probes will be placed in the fastigial nucleus and inferior olive, and a largearray optical probe will be placed over the entire VMS unilaterally. Single cell discharge, and images of scattered 660 and 560 nm light (to measure activity and perfusion, respectively) will be collected during baseline, ventilatory, and pressor challenges within each sleep-waking state. Correlations of regional VMS activity changes to respiratory and cardiovascular patterns will be assessed using cross-correlation, frequency-domain and event-related potential measures for optical signals, and pointprocess techniques for cell discharge. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NEURAL CONTROL OF FLUID HOMEOSTASIS IN HYPERTENSION Principal Investigator & Institution: Fink, Gregory D. Associate Professor; Pharmacology and Toxicology; Michigan State University 301 Administration Bldg East Lansing, MI 48824 Timing: Fiscal Year 2001; Project Start 01-JUL-1987; Project End 31-JUL-2003 Summary: High blood pressure (hypertension) continues to have a major impact on mortality and morbidity in most human populations. This is particularly the case where dietary sodium chloride (salt) intake is high. Thus, the long-term goal of this project is to provide an understanding of the mechanisms by which abnormal regulation of body sodium and water balance promote hypertension development. It is very likely that
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intrinsic kidney dysfunction plays a key role in this process. The central hypothesis motivating this work, however, is that humoral factors also involved in regulating body fluid volume and electrolyte concentration cause an increase in blood pressure by affecting neural cardiovascular control mechanisms (i.e. brain and autonomic nervous system). The proposed studies will focus on two such factors--angiotensin II and endothelin. Experiments utilizing chronic infusion of these peptides indicate that they influence blood pressure by at least two mechanisms: 1) "fast" pressor effects, primarily due to direct vasoconstriction; and 2) "slow" pressor effects, probably mediated via multiple indirect actions, including activation of neurogenic (sympathetic) pressor responses. High salt intake alone strongly enhances the slow pressor effects of angiotensin II and endothelin. Recent work, moreover, showed that both stenosis of a renal artery and experimental chronic renal failure (reduction in renal mass) also produced such enhancement (to the slow pressor effect of angiotensin II). The experiments proposed in this application will examine the mechanism and implications of these recent findings. All studies will be conducted in conscious Sprague-Dawley rats instrumented for direct, daily measurements of blood pressure and sodium/water balance; and for chronic administration of peptides. Several protocols will seek to establish if renal artery stenosis or reduced renal mass augment slow pressor mechanisms by: 1) affecting plasma peptide concentrations, 2) altering body fluid volume/electrolyte status, or 3) affecting neural input via renal sensory afferents. Others will address the question of how high salt intake is "sensed" by neurogenic pressor mechanisms responsive to angiotensin II and endothelin. The overall role of endothelin in the chronic maintenance of hypertension in rats with reduced renal mass will be assessed using newly developed pharmacological antagonists of endothelin receptors. Finally, a possible contribution of endothelin to angiotensin II induced hypertension will be explored. These investigations should provide new insights into the link between abnormalities in renal function and/or body fluid regulation and the pathogenesis of hypertension. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NITRIC OXIDE IN THE REGULATION OF RENIN RELEASE Principal Investigator & Institution: Beierwaltes, William H.; Case Western Reserve Univ-Henry Ford Hsc Research Administraion Cfp-046 Detroit, MI 48202 Timing: Fiscal Year 2001 Summary: The endothelium is a rich source of vasoactive factors which influence organ perfusion (blood flow), organ function, and blood pressure. We hypothesize that under normal conditions, endothelium-derived relaxing factor (EDRF) serves as a buffer against the effects of endogenous vasoconstrictors, especially angiotensin II (AII), or the endothelium- dependent constricting factor (EDCF), endoperoxide/thromboxane. We hypothesize further that under conditions resulting in increased AII, such as during sodium restriction or the development of hypertension, EDRF increases in response to elevated AII and/or increased blood pressure and counteracts vasoconstriction. Since the kidney is rich in AII, its perfusion is particularly influenced by EDRF. We will use a competitive substrate antagonist, NW-nitro-L-arginine (N-Arg), to inhibit EDRF. This will allow us to determine the influence of EDRF on the control of blood pressure and organ perfusion in normotensive rats as well as in various models of hypertension, particularly as it relates to endogenous AII. In specific aim #1 we hypothesize that the contribution of EDRF to vascular resistance is proportional to the basal blood pressure and/or the level of endogenous vasoconstrictors such as AII. We will examine the effect of blood pressure on the pressor response to N-Arg in normal rats. We will determine
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the influence of basal blood pressure on the pressor response to EDRF inhibition with N-Arg, whether EDRF increases with blood pressure, and whether inhibition of EDRF increases the pressor response to exogenous vasoconstrictors. We will determine whether chronic L-arginine administration, the substrate for EDRF, alters pressor responses, and whether inhibiting endogenous vasoconstrictors alters the systemic and renal response to N-Arg. In specific aim #2, we hypothesize that the renal circulation is particularly responsive to EDRF inhibition. To show this, we will compare the response of the renal and mesenteric vasculatures to EDRF inhibition and determine the relative changes in resistance, particularly those influenced by AII. In specific aim #3 we hypothesize that EDRF is increased in hypertension, particularly in AII-dependent models. We will determine whether EDRF is antihypertensive and buffers against increases in blood pressure, especially in renin-angiotensin dependent models of hypertension. We will determine whether systemic pressor and renal responses to EDRF inhibition are greater in hypertension, and whether this is a function of the dependence of different models of hypertension on AII. We will also examine whether chronic EDRF inhibition accelerates the onset of hypertension, and whether supplemental L-arginine administration retards its onset. In specific aim #4 we will study whether agents which transiently decrease renal function, such as diagnostic contrast materials, act by poisoning endothelial cells and consequently inhibiting EDRF production. We will examine whether contrast agents added directly to isolated vessels, or given to rats decreases endothelium- dependent vasodilation or renal function. The results of these studies will help us understand how the endothelium regulates blood pressure and modulates renal perfusion and function, particularly in opposition to constrictor influences such as AII and EDCF. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NOVEL APPROACHES IN LINKAGE ANALYSIS FOR COMPLEX TRAITS Principal Investigator & Institution: De Andrade, Mariza; Mayo Clinic Rochester 200 1St St Sw Rochester, MN 55905 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2004 Summary: (provided by applicant): Hypertension affects 50 million Americans and is the single greatest risk factor contributing to diseases of the brain, heart, and kidneys. There is a strong evidence that hypertension has a genetic basis. In this application, we propose to develop novel approaches to better understand the genetic mechanisms contributing to measures of blood pressure (BP) level, diagnostic category (hypertension versus normotension) and correlated traits. To achieve this goal, in the aim 1 we propose to localize genes influencing measures of blood pressure levels, diagnostic category and their correlates. To do so we will apply genome-wide multivariate linkage analyses based on the variance components approach and utilizing clusters of traits correlated with measures of blood pressure and/or diagnostics category. In the aim 2, we propose to develop exploratory diagnostic tools for linkage analysis of complex traits to further enhance our ability to localize genes influencing measures of blood pressure, diagnostic category and their correlates. To do so, we will extend the diagnostic tools used in regression analysis to the variance components approach used for linkage analysis of quantitative traits. In our case, for example, it can be used to identify outlier families since previous studies have shown that families with outlier values yield false-positive results. We will also extend tree-structure models to pedigree data. Tree-based modeling is an exploratory technique for uncovering structure in the data. The use of tree-structure models is advantageous because no
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assumptions are necessary to explore the data structure or to derive parsimonious model. These models are accurate classifiers (binary outcome) and predictors (quantitative outcomes). Thus, they will help us to better understand the underlying structure of the familial data. All these tools will be incorporated in the S-Plus software as a function. S-Plus was selected due to its capability and flexibility for analyzing large data sets. We will analyze family data from the Rochester Family Heart Study, collected in previously NIH funded grants (R01 HL30428 "Sodium Transport: Genetics and Hypertension", and R01 HL51021 "Molecular Epidemiology of Essential Hypertension"). No new data will be collected for this grant proposal. The application clearly fits the goal of this NHLBI grant program since it will explore new approaches using an existing data set collected through NHLBI support. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NOVEL PEG-HEMOGLOBIN MODIFICATION FOR BLOOD REPLACEMENT Principal Investigator & Institution: Vandegriff, Kim D. Vice President; Sangart, Inc. 11189 Sorrento Valley Rd, Ste 104 San Diego, CA 921211341 Timing: Fiscal Year 2001; Project Start 05-MAY-1999; Project End 31-AUG-2002 Summary: The goal of this Phase II proposal is to produce and test a new pegylated hemoglobin solution formulated under Phase I(HL 62818-01) with the long-term goal to commercialize this solution for blood replacement therapies based on oxygen transport and blood expansion properties. Critical physicochemical properties of hemoglobin solutions have been defined that work effectively at blood replacement. This is due to the absence of a vasoconstrictive response, a side-effect that is the rule rather than the exception for commercial hemoglobin-based oxygen carriers now in clinical trials. Key properties for an effective solution are: l) high viscosity, 2) high colloid osmotic pressure, and 3) high oxygen affinity. Phase I research formulated a specific hemoglobin solution using new, maleimide pegylation chemistry. This Phase II application proposes to produce pilot-scale batches of this protein (Specific Aim 1), and to test for in vitro diffusive oxygen transport using an artificial capillary system (Specific Aim 2), evaluation of blood pressure responses, cardiac output, and prevention of tissue hypoxia in a rat model (Specific Aim 3), and evaluation of effects on the microcirculation, including functional capillary density, vessel diameters, direct measurements of intravascular and tissue oxygenation, and NO levels in a hamster model (Specific Aim 4). PROPOSED COMMERCIAL APPLICATIONS: The method to modify hemoglobin with polyethylene glycol has significant potential to be developed into a commercial product for use as a blood replacement fluid. Such a product can be used in emergencies, wartime, or anytime blood is not available. Moreover, this product has the potential to be inexpensive and universally compatible with recipients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NOVEL THERAPY FOR FEMALE SEXUAL DYSFUNCTION Principal Investigator & Institution: Southan, Garry J.; Inotek Pharmaceuticals Corporation 100 Cummings Ctr, Ste 419E Beverly, MA 01915 Timing: Fiscal Year 2001; Project Start 14-SEP-2001; Project End 30-SEP-2002 Summary: (provided by applicant): Female sexual dysfunction is increasingly recognized as a significant and widespread abnormality, contributing to coital pain, decreased libido, and a loss of sexual pleasure. In contrast to the enormous scientific investment in discovering methods to correct male sexual dysfunction, there has been
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virtually no attention directed at elucidating the fundamental mechanisms accounting for clitoral engorgement, vaginal lubrication, and alterations in vaginal and vulval mucosal blood flows accompanying sexual arousal. Increasing anatomic evidence points to a role for nitric oxide as a mediator of female genital hyperemia, similar to the situation in the male. Topical application of traditional nitric oxide donors to the female genitalia, however, produces profound systemic side effects, including headache and hypotension. What is needed is a potent, but regionally restricted nitric oxide donor, that acts on the local vaginal circulation exclusively. Towards this end, we have developed a nitric oxide pro-drug (DS1) that is restricted from transepithelial flux by virtue of its large hydrodynamic radius. Nitric oxide is released from DS1 and is able to traverse mucosal surfaces and vasodilate underlying arteriolar beds, whereas the prodrug cannot traverse the epithelium and is confined to the apical mucosa. Nitric oxide that reaches the systemic circulation is immediately inactivated by hemoglobin and therefore does not circulate as a systemic vasodilator. Thus, DS1 represents a true "regional" vasodilator. We have obtained preliminary data in rats that topical DS1 applied to the vaginal mucosa produces profound and immediate increases in vaginal blood flow, with no effect on systemic blood pressure. Utilizing an anesthetized rat model, we now propose to obtain a pharmacodynamic profile of DS1. We will simultaneously compare the regional blood flow and the mean peripheral arterial pressure in order to verify regional selectivity. Justification of further development towards commercialization will require 1) no decrease in systemic blood pressure, 2) >100 percent increase in vaginal blood flow, and 3) duration of regional hyperemia >30 minutes. PROPOSED COMMERCIAL APPLICATION: NOT AVAILABLE Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: OHIO STATE UNIVERSITY APPLICATION TO AASK Principal Investigator & Institution: Hebert, Lee A. Director, Division of Nephrology; Internal Medicine; Ohio State University 1800 Cannon Dr, Rm 1210 Columbus, OH 43210 Timing: Fiscal Year 2001; Project Start 15-AUG-1994; Project End 30-JUN-2003 Summary: The African-American Study of Kidney Disease and Hypertension (AASK) is a multicenter, prospective, double-masked, randomized study which will determine the extent to which control of blood pressure, using 3 different antihypertensive regimens, can control the progression of hypertensive nephrosclerosis in African-Americans. The study is currently in Phase II. The Ohio State University seeks to be one of the 14 centers to be involved in the full-scale study (Phase III). We suggest that the Ohio State University program is well qualified to participate in Phase III of the AASK by virtue of: 1. Our experience in the conduct of controlled clinical trials involving blood pressure control and/or renal disease. These include: NIH Modification of Diet in Renal Disease (MDRD) Study; NIH/Bristol-Squibb Study of Captopril Therapy in Type I Diabetes and Nephropathy; NIH Trial of Plasmapheresis in Severe Lupus Nephritis; NIH Study of the Adult Nephrotic Syndrome; NIH/Hoechst Study of Ramipril therapy in Type I Diabetes and Nephropathy (active); NKF of Canada/Sandoz North American Nephrotic Syndrome Study (active); Sandoz MIST Study of Salt Sensitivity and Calcium Channel Blocker Therapy in Essential Hypertension (active); ADA Study of Insulin Sensitivity and Blood Pressure in Black Patents (active). 2. Our documented ability to recruit African-Americans and women into these clinical trials in proportion to their numbers in Central Ohio and the disease entity. 3. The favorable demographics of Columbus, Ohio, "urbanized area', including a population of approximately 1.4 million, 12% of whom are African-American (165,000). 4. The well-developed Nephrology clinical
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research space including an experienced GFR laboratory which performs approximately 500 GFRs/year for both clinical and research purposes. 5. Our ongoing studies specifically addressing the problem of hypertension and renal disease in AfricanAmericans. 6. The presence of ongoing programs that will directly aid in recruitment and retention of patients for the AASK. Those programs include: our affiliation with the State of Ohio "Ohio Risk Reduction Program (ORRP)", which is in the process of screening 1,200 adult urban African-Americans for health risk factors such as hypertension. Blood studies will identify those with increased serum creatinine levels for evaluation for the AASK; our Continuing Medical Education (CME) programs on hypertension and the kidney for Central Ohio physicians; support of the AASK by prominent members of the Central Ohio African-American community. 7. Our preparedness to begin recruitment to the AASK. We have already identified 17 patients from our programs who are candidates for the AASK. Thus, we are prepared to begin recruitment immediately. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: OXYGEN TRANSPORT CYS CELL FREE HEMOGLOBIN Principal Investigator & Institution: Winslow, Robert M. Adjunct Professor; Sangart, Inc. 11189 Sorrento Valley Rd, Ste 104 San Diego, CA 921211341 Timing: Fiscal Year 2001; Project Start 01-JUL-1999; Project End 30-JUN-2003 Summary: A hemoglobin-based oxygen carrier for clinical use remains elusive, primarily because cell-free hemoglobin induces vasoconstriction and reduced tissue oxygenation. We propose that vasoconstriction produced by cell-free hemoglobin is the result of normal autoregulatory mechanisms which are engaged in response to increased diffusive O2 transport when hemoglobin is free in the plasma space. We have discovered that the critical properties of cell-free hemoglobin responsible for this diffusive phenomenon, (ligand affinity, viscosity and colloid osmotic pressure) markedly influence the ability of cell-free hemoglobin to deliver O2 to tissue. Different types of chemical modification of hemoglobin elicit a range of physiological effects from vasoactivity and acid-base status to changes in blood volume in animals. These findings have led us to question the long-standing assumption that for cell-free hemoglobins to effectively transport O2, they must mimic the properties of RBCs. We will evaluate key physical and biochemical characteristics of modified hemoglobin solutions to identify pertinent properties that determine physiologic differences in O2 transport. Specific focus will be on ligand binding (O2 and NO), solution properties (viscosity and oncotic pressure), and molecular size. The proposal contains 4 Specific Aims. 1) To select and characterize model cell-free hemoglobins for study on the basis of ligand binding properties believed to be critical determinants of O2 transfer to tissue. These include O2 binding and NO reactivity at the hemes and as nitrosothiol. 2) To select and characterize model cell-free hemoglobins for study on the basis of solution properties believed to be critical determinants of O2 transfer to tissue. These include viscosity, colloid oncotic pressure, molecular weight and molar volume, and the influence of the type of modification (intramolecular versus surface). 3) To use these model cell-free oxygen carriers in an artificial capillary system to determine the alteration to 02 diffusion resulting from the physicochemical properties of the carriers. This system is independent of biological regulatory mechanisms. 4) To measure in vivo hemodynamic cardiac output, acid-base balance, lactate production, and blood volume responses to isovolemic exchange transfusion with the model carriers and subsequent hemorrhage in rats. The effect of the selected carriers on mean arterial blood pressure and cardiac output will provide indications of vasoactive response to hemodilution with these cell-
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free oxygen carriers in intact animals. Blood volume will be monitored to provide an indication of the fluid shifts that occur in response to isovolemic exchange transfusion. Arterial lactic acid and acid-base status provides additional indicators of the balance between O2 supply and demand. Taken together, these aims will not only lead to rationally-designed oxygen carriers for clinical use, but also important insight into mechanisms of vasoactivity and control of tissue oxygenation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: OXYGENASE METABOLITES AND RENAL MICROVASCULAR REACTIVITY Principal Investigator & Institution: Imig, John D. Associate Professor; Phys Med and Rehabilitation; Medical College of Georgia 1120 15Th St Augusta, GA 30912 Timing: Fiscal Year 2002; Project Start 01-JAN-1998; Project End 30-JUN-2006 Summary: (provided by the applicant): Hypertension that develops following the longterm administration of initially subpressor doses of angiotensin II in rats has many of the same renal and vascular changes that are associated with human essential hypertension. In the past five years, we have provided compelling evidence that CYP45O-derived epoxyeicosatrienoic acids (EETs) have anti-hypertensive properties and play a part in the maintenance of renal microvascular function. A novel approach to increase EET levels is to inhibit epoxide hydrolase enzymes that are responsible for the conversion of the biologically active EETs to dihydroxyeicosatrienoic acids (DHETs) that are void of effects on the preglomerular vasculature. Recently, a role for soluble epoxide hydrolase (sEH) in the long-term control of arterial blood pressure and the pathogenesis of experimental hypertension has been proposed. Preliminary studies in our laboratory demonstrate increased kidney sEH protein expression during angiotensin II hypertension. In addition, we have observed a decrease in arterial blood pressure in angiotensin II hypertension following administration of a highly selective sEH inhibitor. Based on these observations, we hypothesis that during the development of hypertension increased kidney sEH will decrease kidney EET levels which contributes to increased renal microvascular reactivity, blood pressure and renal vascular injury. We will directly determine the involvement of epoxide hydrolases to the excessive preglomerular vasoconstriction during the development of angiotensin II hypertension using the juxtamedullary nephron preparation. We will also determine renal microvascular EET and DHET levels and the regulation of kidney epoxide hydrolase enzymes during hypertension. The proposed studies will employ newly developed highly selective epoxide hydrolase inhibitors to determine their ability to lower arterial blood pressure and improve renal microvascular function in angiotensin II hypertension. Collectively, these studies will provide a comprehensive understanding of epoxide hydrolases in the long-term regulation of blood pressure and renal hemodynamic function during angiotensin II hypertension. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PAIN REGULATORY SYSTEM DYSFUNCTION IN CHRONIC PAIN Principal Investigator & Institution: Bruehl, Stephen; Anesthesiology; Vanderbilt University 3319 West End Ave. Nashville, TN 372036917 Timing: Fiscal Year 2001; Project Start 15-JAN-1999; Project End 31-DEC-2002 Summary: Elevated resting blood pressure (BP) is consistently related to diminished acute pain sensitivity. Ibis cardIovascular-related antinociception (mediated in part by endogenous opioids) is an important component of adaptation to pain in healthy
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individuals. it is unknown whether these antinociceptive mechanisms operate normally in chronic pain patients. Previous research indicates deficits in endogenous opioid levels in chronic pain patients, although little is known about the functional impact (e.g., diminished analgesia) of these deficits. Given the mediating role of endogenous opioids in cardiovascular-related antinociception and likely opioid deficits in chronic pain conditions, it is hypothesized that chronic pain patients will display alterations in these normally adaptive cardiovascular-pain regulatory relationships. The long-term objective of these studies is to explore the nature of dysfunction in the endogenous pain regulatory systems of chronic pain patients. improved understanding of the mechanisms contributing to chronic pain has the potential to lead to improved treatment for chronic pain patients. The specific aims of these studies are threefold: 1) examine the relationship between resting blood pressure and acute pain sensitivity in both neuropathic and nociceptive chronic pain patients as contrasted to normals, 2) examine possible differences in degree of endogenous opioid mediation of the relationship between resting blood pressure and acute pain sensitivity across the pain patient and normal control subgroups, and 3) examine whether endogenous opioid dysfunction in chronic pain is progressive and therefore related to pain duration. Sixty chronic pain patients (study l=neuropathic back pain, study 2=nociceptive back pain) and 60 healthy controls will undergo a laboratory ischemic pain stimulus once under placebo and once under opioid blockade with naloxone (randomized, counterbalanced order). in both sessions, resting BP will be determined at baseline. Pain patients will also rate their clinical pain before and after drug administration. it is expected that controls will display significant negative correlations between resting BP and acute pain sensitivity, which is at least partially eliminated by naloxone. Pain patients are expected to demonstrate no correlation or a positive correlation between resting BP and acute pain responsiveness, and will be unresponsive to opioid blockade. Greater pain duration is expected to be associated with smaller changes in the BP/pain relationship in response to opioid blockade. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PAIN, OPIOID ANALGESIA AND BLOOD PRESSURE CONTROL Principal Investigator & Institution: Taylor, Bradley K. Division of Pharmacology; University of Missouri Kansas City Kansas City, MO 64110 Timing: Fiscal Year 2001; Project Start 15-FEB-1998; Project End 31-JAN-2003 Summary: (Applicant's Abstract) Previous studies found that hypertensive SHR rats showed smaller pain responses in acute pain models and suggested that blood pressure control systems can attenuate the processing of brief nociceptive signals. By contrast, preliminary studies found that SHR rats show exaggerated nociceptive responses in a model of inflammatory pain (the formalin test). To test the hypothesis that hypertension decreases nociception in tests of acute pain, and increases nociception in tests of persistent pain, AIM 1A will evaluate nociceptive responses in awake, unrestrained rats in two acute models of nociception and in the formalin test (a short-duration model of persistent inflammatory pain) after: 1) Reduction of blood pressure in SHR rats; and 2) Increases of blood pressure in normotensive rats. Whereas inflammatory pain in the formalin test lasts one hour, inflammatory pain in an arthritic model and neuropathic pain in a spinal nerve ligation model is manifested by hyperalgesia that lasts days to weeks. AIM 1B will evaluate nociception in these models using SHR rats and other experimental models of hypertension. Naloxone eliminates the difference in acute pain sensitivity between normotensive and SHR rats, indicating that tonic endogenous opioid activity is greater in the SHR rat. To test the hypothesis that opioids regulate
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inflammatory hyperalgesia in the hypertensive rat, AIM 2 will evaluate the effects of selective opioid receptor agonists and antagonists on persistent pain in the SHR rat and other experimental models of hypertension. Sympathetic activity is a crucial determinant of blood pressure, and may also exacerbate the inflammatory hyperalgesia associated with tissue injury. Based on preliminary results obtained with a short-acting opioid agonist, it was concluded that peripheral mechanisms during acute nociception modulate the temporal profile of persistent nociception. To test the hypothesis that hypertension contributes to the magnitude and temporal profile of inflammation, AIM 3A will evaluate the effects of opioids on plasma extravasation and prostaglandin content in multiple models of hypertension. Nociception and cardiovascular systems are also controlled by supraspinal sites, notably the noradrenergic locus coeruleus (LC). Since activity of the LC is depressed in the SHR rat and since activation of the LC is antinociceptive, the exaggerated nociceptive responses in the SHR may reflect abnormal functioning of the LC. To test this hypothesis, AIM 3B will use a novel neurotoxin to selectively lesion the noradrenergic neurons of the LC, followed by evaluation of arterial pressure and nociception. The results of these studies will facilitate our understanding of the mechanisms that contribute to chronic pain in the hypertensive patient. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PATIENT-ORIENTED RESEARCH IN EARLY LIFE ORIGINS OF CVD Principal Investigator & Institution: Gillman, Matthew W. Associate Professor; Harvard Pilgrim Health Care, Inc. 93 Worcester St Wellesley, MA 02481 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-JUL-2006 Summary: The lifecourse approach to chronic disease proposes that factors operating not only in adult life, but also from conception, have impact on lifelong health. Among the more publicized findings in this area are associations between lower birth weight and adult cardiovascular disease mortality, incidence, and risk factors such as blood pressure. These newer investigations have led to a series of exciting research questions and opportunities concerning underlying mechanisms, relations of pre- and post-natal determinants, and implications for clinical medicine and public health. This proposed K24 award will allow Dr. Gillman and his mentees to focus intensively on this area of research for the next five years, a critical period not only for the field itself, but also for expanding his potential for significant contributions and for nurturing the next generation of patient-oriented researchers in this field. The specific aims of this proposal are 1. Research project to examine associations among maternal gestational protein intake, placental hormone activity, and blood pressure in the offspring. This project will take advantage of the infrastructure provided by an ongoing NIH-funded prospective cohort study of pregnant women and their offspring (Project Viva). 2. To provide a nourishing professional environment for the training and advancement of beginning clinical researchers, who will conduct and analyze data from Project Viva and other ongoing patient-oriented research studies in the area of the lifecourse approach to chronic disease. Major foci will be in the areas of pregnancy and infancy determinants of a. childhood cardiovascular risk factors, chiefly blood pressure, b. asthma in early childhood, and c. development of obesity in childhood and adolescence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PERINATAL ASSESSMENT OF AT RISK POPULATIONS Principal Investigator & Institution: Fifer, William P. Professor; New York State Psychiatric Institute 1051 Riverside Dr New York, NY 10032
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Timing: Fiscal Year 2001; Project Start 30-SEP-1994; Project End 30-APR-2004 Summary: (adapted from investigator's abstract) The long-term objectives of this proposal are to elucidate physiologic mechanisms that underlie the Sudden Infant Death Syndrome, and to develop age-appropriate, non-invasive tests that will identify infants who are at the greatest risk for SIDS. These tests focus on assessments of peripheral and central mechanisms involved in the integrated control of cardiac, blood pressure, and respiratory function. Subjects are the fetuses and infants of mothers from a lowsocioeconomic status population in New York City and from a rural Native American population on the Pine Ridge Reservation in South Dakota, which is at unusually high risk for SIDS. The proposed studies begin with measurements made during late gestation. Assessments then continue through infancy to document the physiologic changes that coincide with the period of maximal risk for SIDS. These postnatal studies incorporate measurements made during sleep under basal conditions as well as during head-up and head-down tilting. The principal dependent variables are heart rate and several indices of heart rate variability, respiratory rate and variability, body temperature, and electrocortical activity and beat-to-beat blood pressure. Five experiments will address the following aims; Patterns of developmental change in cardiorespiratory activity measured from the late fetal period through infancy will distinguish groups of infants at increased risk for SIDS How postnatal development of heart rate, blood pressure and respiratory responses to the challenge of head-up and head-down tilting will be altered in groups of infants at increased risk for SIDS Physiologic responses to tilt are dependent upon sleep state and this dependency may change with age Blood pressure decreases to head-up tilt are larger in the prone sleeping position Head-up tilting will induce cortical activation which will be diminished during the period of greatest vulnerability to SIDS Respiratory and heart rate responses to tilt will be diminished in the morning hours and Responses to tilt will vary with time after feeding. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PHYSICAL ACTIVITY ON BLOOD PRESSURE OF FEMALE AFRICAN-AMERICANS Principal Investigator & Institution: Muntner, Paul; Tulane University of Louisiana New Orleans, LA 70118 Timing: Fiscal Year 2002; Project Start 20-SEP-2002; Project End 31-AUG-2007 Summary: We propose to conduct an efficacy trial and an effectiveness trial of a physical activity intervention among African-American women with hypertension (systolic/diastolic blood pressure [BP] > 140/90 mmHg or currently taking antihypertensive medications). The first open, randomized, controlled trial with two parallel arms will include a supervised physical activity intervention program. Eligible participants (African-American women with established hypertension) will be randomly assigned to participate in a 12-week monitored aerobic exercise program (n65) or usual care (n=65). Study participants will be recruited from the general internal medicine (GIM) clinics at the Medical Center of Louisiana in New Orleans (MCLNO). The primary aim of the efficacy trial is to determine the BP lowering effect of 12 weeks of aerobic exercise. The second trial being proposed is a two center randomized controlled trial to determine the effectiveness of physician counseling on physical activity levels and blood pressure. African-American women with hypertension will be recruited from the general internal medicine (GIM) clinics at the Medical Center of Louisiana in New Orleans (MCLNO) and Tulane University. The proposed study is an open, randomized, controlled trial with two parallel arms. A total of 180 sedentary
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African-American women (90 in each arm) with hypertension will be recruited for this study. Eligible and enrolled participants will meet with one of 20 primary care providers who will be randomized to provide usual care (n=10) or a tailored 10-minute educational program (n=10) aimed at increasing the participant's physical activity levels in addition to usual care. Reinforcement and further tailored counseling will be provided by the physician at a 3-month follow-up visit and through bi-weekly telephone calls by a trained health educator. Change in fitness, assessed by VO2 max testing, between the group receiving physical activity counseling and the group receiving usual care at the 6-month follow-up visit will be the primary endpoint. Change in physical activity levels and blood pressure will also be examined as secondary endpoints. In sum, these studies should help to address the challenge of health disparities in African-Americans. Because of the current high prevalence of inactivity in the United States, increasing physical activity could have a tremendous impact on the disproportionate burden of CVD, stroke, diabetes mellitus and ESRD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PHYSIOLOGIC IMMIGRANTS
STRESS/BLOOD
PRESSURE
IN
FILIPINO
Principal Investigator & Institution: Brown, Daniel E. Professor; University of Hawaii at Hilo Box 1357 Hilo, HI 96720 Timing: Fiscal Year 2001 Summary: The effect of social and biological factors on physiological measures of stress will be examined in non-managerial hotel workers in a rural and a urban region of Hawaii. A large number of hotel-workers are immigrants from the Philippines and they will be the major focus of the study. Filipino-Americans have high prevalence rates of hypertension and high mortality rates from strokes compared with means for the state of Hawaii. Preliminary studies suggest that Filipino immigrants have elevated age- and body mass-adjusted blood pressure during sleep compared with Caucasians, and that Filipinos have differential stress perceptions of some daily activities than do Caucasians and that Filipinos have differential stress perceptions on some daily activities than do Caucasians. This study proposes to add to under understanding of how cultural, social and psychological orientation influence the biological stress response and cardiovascular health of Filipino immigrant hotel workers, and to compare these relationships with those of their Filipino-American (non- migrant) and non-Filipino coworkers The study will investigate the influence of sex, reported mood, job strain, lifestyle incongruity, differing degrees of orientation toward Western versus traditional Filipino (Ilocano) lifestyles, rural-urban contrasts, and other behavioral variability on ambulatory blood pressure and urinary catecholamines measured at work, home and while asleep. The relationship of these factors to cortisol excretion during work and to fasting blood lipid profiles will also be examined. An ecological design is used, with monitoring of physiological measures during a typical work day, and information about the subjects' body size and composition, attitudes toward work and home life, and health histories will be obtained. The research is designed to provide insights into how stress may contribute toward the high hypertension prevalence among Filipinos in Hawaii. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PLANT-BASED DIETRY INTERVENTION IN TYPE 2 DIABETES Principal Investigator & Institution: Barnard, Neal D.; Physicians Committee for Responsible Med Responsible Medicine Washington, DC 20016
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Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2005 Summary: (provided by applicant): Diabetes often leads to serious complications, including coronary heart disease, kidney disease, and blindness, among others. Previous studies have suggested that low-fat, plant-based diets can have a strongly favorable effect on the management of type 2 diabetes mellitus, as well as on the elevations of body weight and serum cholesterol that often accompany it, reducing the risk of complications, and raising the possibility of reducing or even eliminating medication use for many individuals. Evidence suggests that the dietary recommendations that are most effective in diabetes management may be similar to the low-fat, vegetarian diets that have demonstrated utility in reversing coronary artery blockages. However, no study to date has examined the effect of a low-fat, vegetarian diet as an intervention for diabetes in a substantial number of participants, and most studies using plant-based (near-vegetarian) diets have also included exercise as a major intervention component, making it impossible to separate the effects of physical activity from those of diet or to reach any definitive conclusion as to which type of dietary intervention is best. This study, which follows an encouraging preliminary trial reported in Preventive Medicine in 1999, will test the hypothesis that a low-fat, vegetarian diet yields significant improvements in key indices of diabetic control, including glycosylated hemoglobin, fasting serum glucose and insulin concentrations, microalbuminuria, and medication requirements, as well as in cardiovascular risk factors, such as body weight, serum lipids, and blood pressure, in a 22-week intervention controlled throughout for exercise, with a 1-year follow-up. Sixty-eight volunteers with type 2 diabetes will be randomly assigned to a low-fat, vegan (intervention) diet or a control diet deriving 15-20percent of energy from protein and < 7percent of energy from saturated fats, with carbohydrate and monounsaturated fats together providing 60-70percent of energy intake, based on current American Diabetes Association guidelines. Participants in both groups will be asked to attend weekly meetings for nutrition and cooking instruction and group support, and will be asked not to alter their exercise patterns. Physical activity will be monitored by use of the Bouchard 3-Day Physical Activity Record. (Bouchard 1983) Diets will be assessed at baseline and 11, 22, and 74 weeks, using a 3-day dietary record. Fasting serum glucose will be monitored for the study duration and will be used to adjust medications according to a set protocol. Glycosylated hemoglobin, insulin concentrations, 24-hour urinary albumin, body weight, blood pressure, serum lipids, and related cardiovascular risk factors will be measured at baseline, 22 weeks, and 74 weeks. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PORTAL VENOUS FATTY ACIDS AS A DETERMINANT OF BLOOD PRESSURE Principal Investigator & Institution: Grekin, Roger J.; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, MI 481091274 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 30-JUN-2002 Summary: Obesity markedly increases the risk of developing hypertension, but the mechanisms which lead to obesity-related hypertension are poorly understood. The long-term objectives of this proposal are to evaluate the role of non-esterified fatty acids (NEFA) in the genesis of obesity-related hypertension. In particular, the relationship between splanchnic production of NEFA and blood pressure regulation will be explored. Four specific aims are proposed. The relationship between splanchnic and systemic NEFA production, sympathetic nerve activity and blood pressure in lean individuals and subjects with visceral and lower body obesity will be determined. The
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suppressibility of NEFA production in these individuals will also be compared to measurements of sympathetic activity. The effects of dietary induced weight reduction and pharmacologic therapy on splanchnic and systemic NEFA production, sympathetic nerve activity and blood pressure will be assessed. Ninety women will be studied. Thirty lean control subjects, thirty individuals with lower body obesity and thirty individuals with upper obesity will be studied. Body fat distribution will be characterized using DEXA and CT scanning and blood pressure will be assessed using ambulatory monitoring. Splanchnic and systemic NEFA production will be determined using infusions of 3H-palmitate following hepatic venous catheterization. Renal norepinephrine (NE) spillover will be measured and NE production will be estimated using kinetic analysis of norepinephrine (NE) spillover will be measured and NE production will be estimated using kinetic analysis of the decay of infused 3H-NE. Suppressibility of NEFA production will be determined during a hyperinsulinemic, euglycemic clamp study. Measurements of both NEFA production and NE kinetics will be repeated during the clamp study. Thirty women will undergo a sixteen week supervised weight loss program entailing weekly meetings with a dietitian and dietary supervision. Body composition, blood pressure, NEFA production and suppressibility and NE spillover and kinetics will be measured after completion of the weight loss program to determine the relationship between the hypotensive effects of weight loss and changes in NEFA metabolism. A second intervention study will be performed in third women to test the effects of pharmacologic lowering of NEFA production on blood pressure and NE kinetics. Individuals will be treated with nicotine acid and troglitazone to reduce fasting NEFA levels by 50%. Studies will be repeated at the conclusion of the pharmacologic intervention. Taken together, these studies should provide information regarding the role of splanchnic NEFA in the genesis of obesityrelated hypertension. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PREDICTING SYSTOLIC BP CONTROL IN THE ELDERLY Principal Investigator & Institution: Bailey, Kent R. Professor; Mayo Clinic Rochester 200 1St St Sw Rochester, MN 55905 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-AUG-2004 Summary: NHANES III data show that fewer than 30% of patients who are hypertensive have been treated to the goal blood pressure of less than 140/90 mm Hg. Older patients are more likely to have uncontrolled blood pressure than are younger patients. The SHIELD Study revealed that 41% of people over the age of 65 years and 65% of African Americans over that age have poorly controlled hypertension. Poor blood pressure control also disproportionately causes cardiovascular disease in patient over 60. Systolic blood pressure is the primary predictor in this age group for the development of stroke, congestive heat failure (most common reason for hospitalization in the elderly), renal failure and coronary heart disease. There is even exciting new data showing that control of systolic blood pressure in the elderly reduces the risk for the development of Alzheimer?s dementia. Failure to achieve blood pressure control is determined by three factors: physician practice (behavior), antihypertensive medication efficacy, and adherence to the prescribed medications (patient factors). Our study proposes to develop models that describe each of these factors independently and then develop a model that encompasses all three factors. Specific Aim 1 will identify and quantify differences in physician response to elevated systolic blood pressure in hypertensive patients greater than 60 years of age compared to their younger counterparts. Specific Aim 2 will analyze the differences in responsiveness of systolic blood pressure to
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treatment regimens using one or more antihypertensive medications. Specific Aim 3 examines adherence and postulates that adherence is the same between younger and older hypertensives. This study is to be conducted using a unique clinical database. Over 7,000 patients with more than 25,000 observations are present in the Mayo Clinic Rochester Hypertension Continuity Clinic Database. This Sybase database is well constructed to answer the important questions posed in Aims 1-3 regarding the management of hypertension. This study will provide significant and generalizable answers to the question of why control rates for systolic hypertension remain low and will provide direction for altering clinical practice to reduce cardiovascular morbidity and mortality among older hypertensives. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PRENATAL SET POINT FOR ADULT BLOOD PRESSURE Principal Investigator & Institution: Faber, Job J. Professor; Oregon Health & Science University Portland, OR 972393098 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2007 Summary: Late gestation fetal sheep will be treated to create systemic and pulmonary arterial hypertensions. One group will have high circulating angiotensin-II levels. There will be two normotensive control groups, one with normal and one with low angiotensin-II. The animals will be studied as fetuses, as newborns and as young adults. Circulatory measurements will include arterial pressures, right and left atrial pressures and cardiac outputs. We will also make plasma renin activity/renal ar6terial pressure response curves and measurements of glomerular filtration rates. Analytical measurements will include plasma renin activities, circulating angiotensin-II levels, catecholamines, plasma protein and blood hemoglobin concentrations, blood gases, osmolalities and electrolytes. Coronary pressure-flow relations will be determined under anesthesia with and without chemical dilation by means of adenosine infusions to determine coronary reserve. The animals will be killed for structural studies of heart and kidney. It is anticipated that prenatal hypertensions will produce lasting circulatory abnormalities later in life. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PRESSURE AND FLOW INDUCED REMODELING OF CORONARY ARTERY Principal Investigator & Institution: Kassab, Ghassan S. Biomedical Engineering; University of California Irvine Campus Dr Irvine, CA 92697 Timing: Fiscal Year 2003; Project Start 15-DEC-1997; Project End 30-JUN-2007 Summary: (provided by applicant): The study of adaptation mechanisms in structure and function of blood vessels in response to physical stress is important in human health and disease. The objective of this proposal is to gain a better understanding of the adaptation mechanisms in the structure, mechanical properties and function of the coronary arteries to altered mechanical forces, including principal and shear stresses, in experimental models of hypertension and flow-overload, respectively. The effects of increased pressure and flow will be examined separately by studying the right coronary artery in aortic and pulmonary banding, respectively. The specific aims are: 1) To measure and state the physical loading acting on the blood vessels precisely and analytically with the nonstationary, nonlinear, and stochastic features taken into account; 2) To study the morphometric remodeling of coronary arterial blood vessels in vivo during the progression of hypertension and/or fiow-overload; 3) To determine the
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stress-strain relationship and the stress-tissue remodeling relationship in response to hypertension and/or flow-overload; 4) To study the remodeling of the threedimensional structure of elastin and collagen under the various mechanical loadings prescribed in Aim 3 in unfixed, unstained tissue; and 5) To study the dynamics, linearity, superposability and non-linearity of the changes of morphometry and mechanical properties of Aims 2 and 3 in response to the dynamic changes of the magnitude and direction of the loading in Aim 1. The recorded in vivo blood pressure and flow data will be characterized with the intrinsic mode function method. The time course of change of blood vessel diameter, length and volume will be measured using digital subtraction angiography and video densitometery. The remodeling of the mechanical properties of coronary arteries will be measured in circumferential distension, longitudinal extension and torsion using a tri-axial machine. The changes in collagen and elastin fibers will be visualized with multi-photon microscopy. This research will clarify the role played by increased flow and pressure on coronary blood vessel remodeling by expressing the results mathematically in terms of indicial response functions and by using these functions to clarify the structural and mechanical remodeling that signifies hypertension and hypertrophy as important risk factors for coronary artery disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PRIMATE MODEL OF HYPERTENSIVE CEREBROVASCULAR DISEASE Principal Investigator & Institution: Killiany, Ronald J. Anatomy and Neurobiology; Boston University Medical Campus 715 Albany St, 560 Boston, MA 02118 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2003 Summary: Within the next twenty years, 50% of all individuals in this country will be 50 years old or older, an aging time point that has been characterized in cross sectional data by the onset of cognitive decline. This shifting of the population to a proportionately greater number of older individuals has fueled concerns about the effects of aging and age-related diseases and their relationship to cognitive decline. One of the most common conditions affecting individuals as they age is hypertension, the incidence of which is 25% among all adults in the US., and greater than 50% among all adults over the age of 65. At present, this condition affects over 60 million people in the U S alone, of whom it is estimated 50% may be untreated. Moreover, evidence has accumulated to show convincingly that hypertension, in addition to aging, produces impairment in multiple domains of cognitive function, even at mildly elevated levels of blood pressure. In addition, hypertension is a major risk factor for cerebrovascular dementia which alone accounts for approximately 20% of all dementia and likely contributes to another 15% to 20% of the dementia cases. However, the mechanism by which hypertension induces neuropathological changes is poorly understood, in part because only limited animal models exist for studying these processes. The purpose of this project is to test a novel device for inducing hypertension in the non-human primate. The device is surgically implanted into the chest of the monkey surrounding the thoratic arota. The device can be adjusted externally to narrow the diameter of the arota (but not fully constricting it) resulting in increased blood flow and hypertension to the upper limbs and head. By adjusting the device gradually over a period of time, the blood pressure can be raised gradually until hypertension is induced. We will test this device in non-survival and short-term survival situations in five monkeys. They will be continuously monitored for blood pressure, body temperature, EKG and activity using radiotelemetry devices and values compare from pre-implant to post-implant levels.
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Finally, as part of a preliminary effort to understand the mechanism by which neuropatholoigical processes are induced in the brain, we will survey the brain and aorta for signs of pathology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PSYCHOLOGICAL PREDICTORS OF BLOOD PRESSURE IN AFRICAN AMERICANS Principal Investigator & Institution: Harrell, Jules P.; Howard University 2400 6Th St Nw Washington, DC 20059 Timing: Fiscal Year 2002; Project Start 01-JUN-1977; Project End 31-JUL-2006 Summary: The sequelae of hypertension rank among the chief causes of death in the African American community. Interrupting the chain of events that contribute to hypertension would improve substantially the health status of this group. Borderline hypertensives are more likely to develop established hypertension over time. However, predictive models are in need of improvement. Behavioral approaches seek to identify modifiable elements of the environment or of persons that predispose one to cardiovascular disease. The present study tests the utility of three psychological and two psychophysiological predictors of arterial monitored for a period of four years. Resting blood pressure, depressive affect, and psychological stress levels will be assessed twice each year. Participants will complete indices of hostility and cultural orientation during the first and third years of the study. Regression models will determine if hostility, stress, depression, and cultural orientation predict existing blood pressure levels or increases in pressure over time. Cardiovascular reactivity to handgrip and psychomotor tasks will be expressed in terms of systemic overperfusion (additional cardiac output) and the ratio of shared versus simple contributions of cardiac and vascular determinants of blood pressure. These indices will be employed as predictors of both causal blood pressure levels and changes in blood pressure across the four-year measurement period. The study is designed to identify a set of predictors of blood pressure status that are subject to modification prior to the onset of the target organ damage associated with hypertension. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PSYCHOSOCIAL FACTORS AND CARDIOVASCULAR DISEASE Principal Investigator & Institution: Pickering, Thomas G. Professor of Medicine; Medicine; Columbia University Health Sciences New York, NY 10032 Timing: Fiscal Year 2003; Project Start 01-SEP-1994; Project End 31-AUG-2008 Summary: (provided by applicant): This program Project proposal represents a continuation of our existing Program Project (PO1HL47540), which is now entering its 10th year. Supported by NHLBI since 1985, it comprises a body of work that focuses on the role of psychosocial factors in the development of hypertension and cardiovascular disease, led by a well-established, multidisciplinary group of investigators at Mount Sinai School of Medicine and focus on a set of inter-related themes concerning the causes and consequences of sustained blood pressure elevation. Project 1 (International Follow-Up of Ambulatory BP and CV Events) extends our focus on the utility of ambulatory blood pressure monitoring in a clinical and research applications. The goal is to complete the data collection for a comprehensive database of ambulatory blood pressures and follow-up cardiovascular events in patients seen in our clinic over the past 23 years. These data will be pooled with the dose-response relationship between ambulatory blood pressure and cardiovascular events and investigate
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similarities/differences across cultures. Project 2 (Masked Hypertension-Risk Factors and Consequences) focuses on the difference between ambulatory and clinic blood pressures and those persons who exhibit normal clinic blood pressure but hypertensive blood pressure during ambulatory monitoring in the natural environment. These persons (estimated at 10%-20% of the population) represent an important model for the study of human hypertension, as these persons may be at elevated risk for end organ damage due to their elevated ambulatory blood pressure and are unlikely to be treated. This study will investigate the reproducibility of the ABP/clinic BP difference, the psychosocial factors that are associated with this difference, and whether this difference is associated with left ventricular structure and function. Project 3 (Effects of Angry Perseverative Cognition on Ambulatory BP) is an extension of our research examining the cognitive and psychological underpinnings of prolonged blood pressure elevation. This study will utilize a field manipulation of angry cognition, and examine the effects on blood pressure recovery in the laboratory and in the field. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PULSATILE ARTERIAL LOAD IN PREECLAMPSIA Principal Investigator & Institution: Shroff, Sanjeev G. Mcginnis Professor of Bioengineering& Me; Magee-Women's Health Corporation 204 Craft Ave Pittsburgh, PA 15213 Timing: Fiscal Year 2002; Project Start 14-JUN-2002; Project End 31-JAN-2007 Summary: Changes in pulsatile arterial load (PAL) early in gestation (e.g., increased global arterial compliance, AC) play an important adaptive role in normal pregnancy (e.g., minimize arterial pressure and flow pulsatiles) and preliminary data suggest that aberrant PAL responses may be involved in the pathophysiology of preeclampsia. Working model: AC does not increase early in gestation in subjects destined to develop preeclampsia resulting in increased arterial pressure and flow pulsatiles, and consequently, increased pulsatile (oscillatory) shear stress at vascular endothelium, which is known to cause a sustained activation of endothelial pro-oxidant processes. Over time, this sustained endothelial dysfunction and/or inadequate compensation by anti-oxidant defenses can lead to the hemodynamic milieu commonly seen with the onset of the clinical syndrome of preeclampsia (high blood pressure; high systemic vascular resistance, SVR; and normal-to-low cardiac output). Thus, the focus of the present proposal is to comprehensively examine systemic arterial and left ventricular (LV) properties in primiparous control and prior preeclamptic women, both in the nonpregnant state and throughout the second gestation. Hypotheses: 1) In subjects with a history of preeclampsia, differences in vascular mechanical properties (PAL in particular) and/or endothelial function exist in the non-pregnant state and chronic antioxidant therapy(vitamin C supplementation) can help reduce these differences. 2) In subjects destined to develop preeclampsia, the increase in AC during early gestation, which is seen in normal pregnancy, is significantly attenuated. Two groups of primiparous women will be studied at 6-12 months post- partum (Aim 1a): i) prior preeclamptic subjects (n=70, Group 1) and ii) control subjects (n=70, Group 2). Group 1 subjects will be restudied following an 8-week supplementation with either vitamin C (N=35) or placebo (n=35) (Aim 1b). Finally, a longitudinal study will be conducted in two groups of primiparous women (pre-conception-during second gestation-postpartum) (Aim 2): i) prior preeclamptic subjects (n=70) and ii) control subjects (n=15). Non-invasive measurements will be performed to quantify arterial properties (global: aortic input impedance spectrum, SVR, AC, wave reflection indices; regional: pulse wave velocity, pressure-diameter relationships, indices of vessel wall stiffness), LV
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properties (size, shape, and mass, indices of myocardial contractility), and endothelial function (forearm blood flow response to mental stress). Blood and urine samples will be analyzed to derive indices of endothelial activation, oxidative stress, and dyslipidemia. Results of these studies are expected to provide insights into the role of pulsatile arterial load in the pathogenesis of preeclampsia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PULSATILE HEMODYNAMICS AND CAROTID STENTING Principal Investigator & Institution: Quick, Christopher M. Veterinary Physiology & Pharmacology; Texas A&M University System College Station, TX 778433578 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): Angioplasty and stenting of the large conductance vessels that supply the brain is a relatively new treatment that may be a viable alternative to carotid endarterectomy. Based on the extensive history of coronary artery stenting, it can be surmised that restenosis will be a key factor limiting the long-term success of carotid arterial stenting. The hemodynamic factors that influence restenosis, especially pulsatile pressure and flow, have received little scrutiny. We hypothesize that the degree of in-stent restenosis is related to pulsatility of pressure and flow. The following four specific aims will address this hypothesis: 1) To measure the degree of restenosis after carotid artery stenting and associated changes in pulsatile blood pressure and flow; 2) To predict with a patient-specific computational model the short and long-term changes in pulsatile pressure and flow after stenting; 3) To compare restenosis in rabbit iliac arteries that are subjected to high and low levels of pulsatile pressure and flow; 4) To compare remodeling factors in chronically stented vessels subjected to high and low levels of pulsatility. Dr. Quick is an engineer who has an extensive background in computational modeling of pulsatile hemodynamics in vascular beds. Funding is sought for a five-year training periodfor Dr. Quick to transition to a career in quantitative vascular biology. This project, addressing the interaction of hemodynamics and vascular biology, is a fundamentally new direction forDr. Quick, yet complements his expertise. Having studied the effect of vascular mechanical properties on oscillatory blood pressure and flow, he can now focus on the effect of oscillatory pressure and flow on vascular mechanical properties. This project represents a natural progression from theoretical tools to study the phenomena of vascular remodeling to the experimental tools to study the mechanisms of remodeling. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: RACISM, COPING AND AMBULATORY BLOOD PRESSURE Principal Investigator & Institution: Brondolo, Elizabeth N. Psychology; St. John's University Jamaica, NY 11439 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 31-MAY-2007 Summary: (provided by applicant): Racial disparities in health status, and in particular the excess rates of hypertension (HT) among Blacks, are widely recognized. Investigators have hypothesized that social stressors, including exposure to racism or ethnic discrimination, may contribute to increased risk for HT and cardiovascular disease (CVD). The specific aim of the proposed study is to test a model of the relationships among ethnic discrimination, coping, and ambulatory blood pressure (ABP). The model proposes that perceived exposure to ethnic discrimination will be positively associated with the average level of ABP and with the magnitude and duration of acute blood pressure and heart rate responses to current negative
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interpersonal interactions. Coping styles and strategies used to manage ethnic discrimination are expected to mediate the relationship of ethnic discrimination to ABP. Socioeconomic status (SES) is expected to moderate the relationship of racism to coping and the relationships of ethnic discrimination and coping to ABP. To test the generalizability of this model, the hypotheses will be tested in a multi-site sample of 720 American-born Black and Latino men and women drawn from urban primary care medical practices. These practices are located in culturally diverse communities, serving patients from a range of socioeconomic backgrounds. Participants will wear an ambulatory blood pressure monitor for 24 hours. Questionnaires will be used to assess past exposure to ethnic/racial discrimination. Diaries completed at the time of each ambulatory blood pressure reading will be used to identify day-of-testing negative and potentially discriminatory interactions. Both characteristic styles of coping and episodespecific strategies for coping with ethnic discrimination are examined. Demographic and personality variables likely to affect perceptions of ethnic discrimination will be examined and controlled. Structural equation modeling will be employed to evaluate the relationships among perceived ethnic discrimination to coping and ABP. Additional analyses will examine the association of gender, SES, and race/ethnicity to the use of different styles and strategies for coping with ethnic discrimination, and the effects of these characteristics on the relationship of coping to ABP. The study has implications for theories concerning the relationship of psychosocial stress to risk for HT and for the development of interventions to reduce racial disparities in health status. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RACISM, SOCIAL SUPPORT, AND ALCOHOL USE AND BLOOD PRESSURE IN AFRICAN AMERICANS Principal Investigator & Institution: Robinson, Elwood L. Professor; North Carolina Central University 160 Alexander-Dunn Bidg. Durham, NC 27707 Timing: Fiscal Year 2001 Summary: Two of the leading threats to american health are high blood pressure and alcohol-abuse. It is well documented that high blood pressure is linearly related to higher rates of certain forms of coronary heart disease (CHD) and stroke, and the relationship between hypertension and mortality is especially strong for African Americans. Moreover, African Americans alcoholics may run a greater risk than white alcoholics for blood pressure elevations as their drinking careers lengthen. Stressors, or the problems and pressures of life, have long been suspected as culprits linked to both hypertension and alcohol abuse. Racism has been reported to prevail as a primary stressor facing African Americans today. Several studies have described the potentially damaging social, economic, and political consequences of racism and its negative effects on individual well-being (Jaynes & Williams, 1989; Katz & Taylor, 1988; Schuman, Steeth, & Bobo, 1985). Recent studies from epidemiological literature have suggested that exposure to chronic stress of racism, prejudice, and discrimination may contribute to the disproportionately high rates of hypertension among African Americans. Social support has been purported to exert a buffering effect in ameliorating or attenuating the deleterious effects of stress on physical and mental health. Many epidemiological studies suggest that social support is related to reduced morbidity and mortality, particularly for cardiovascular disease. However, most of these studies have focused on white populations in the United States, Western Europe, and Scandinavia. This study proposes to investigate racism/discrimination, social support, alcohol use, and blood pressure in subjects that were drawn from a random sample survey of household residents in Erie county, New York. Overall, three waves of data are available for both
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cross-sectional and longitudinal data analysis. The specific aims are: (l) To examine the influence of racism on alcohol use and BP in African Americans; (2) To determine if social support buffers these relations and investigate the relation between social network measures and social support; and (3) To assess the effects of age, gender, and socioeconomic status on the above relations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RECIPES, MENUS, AND FOOD GUIDELINES FOR TREATMENT & PREVENTION OF HYPERTENSION Principal Investigator & Institution: Mcmurry, Martha; Oregon Health & Science University Portland, OR 972393098 Timing: Fiscal Year 2001 Summary: The purpose of this study is to develop recipes which are tasty and which sound like foods which American families might like to prepare and eat. These foods will be based on the DASH (Dietary Approaches to Stop Hypertension) national blood pressure study. The DASH diet has been found to lower blood pressure. We will examine the results of using this diet in persons with high blood pressure or are at risk for high blood pressure (also called "hypertension"). We will provide meals which include foods to sample that are based on the DASH eating plan. These foods and recipes will be evaluated according to taste preferences and eating habits, with feedback requested on how we can improve them. 15 mealtime sessions will occur at the CRC over a 6 month period. Participants will be members of the "DASH Foods Tasting Panel." Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: REDOX CONTROL OF MEDULLARY FUNCTION AND BLOOD PRESSURE Principal Investigator & Institution: Cowley, Allen W. Professor and Chair; Medical College of Wisconsin Po Box26509 Milwaukee, WI 532264801 Timing: Fiscal Year 2003; Project Start 01-MAR-2003; Project End 28-FEB-2008 Summary: The overall goal of this project is to advance our understanding of the role that reactive oxygen species (ROS) and reactive nitrogen species (RNS) play in determining renal function, especially that of the renal medulla, a region that is vulnerable to excess O2- production. We have previously established that changes in renal medullary blood flow play an important role in sodium homeostasis and the longterm regulation of arterial pressure and shown that nitric oxide (NO) production plays a key role in the regulation of blood flow to this region. We hypothesize that excess production of ROS in the renal medulla reduces NO bioavailability, lowers medullary blood flow, increases tubular sodium reabsorption and results in a salt-sensitive form of hypertension. This project, as all others in this PPG, utilizes Dahl salt-sensitive rats that are genetically defined (SS/Mcw) and a newly developed consomic control strain derived from the inbred SS/Mcw strain in which chromosome 13 from the saltinsensitive BN/Mcw strain has been introgressed into the genomic background of the SS/Mcw rat (SS.BN13 consomic strain). This consomic SS.BN13 strain is 98% identical to the SS/Mcw strain but is relatively salt-insensitive. Aim 1 will determine if the renal medulla of Dahl salt-sensitive rats (SS/Mcw) produces excess ROS (O2, H2O2, ONOO) that feeds back to uncouple nitric oxide syntheses enzymes (NOS) and reduce the redo ratio of tetrahydrobiopterin (BH4)/dihydrobiopterin (BH2) (i.e., a vicious cycle of O2. production). Newly developed fluorescent microdialysis and HPLC analytical
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techniques will enable comparison of ROS and NO pathways in salt-sensitive (SS/Mcw) and in salt-insensitive consomic SS.BN13 rats. Our preliminary data indicate that this control strain exhibits significantly lower levels of medullary ROS. Studies will also determine whether lowering of ROS in the medulla of SS/Mcw rats by chronic medullary infusion of antioxidants increases medullary blood flow and reduces saltinduced hypertension. Aim 2 will determine the effects of induced medullary elevations of ROS in salt-insensitive SS.BN13 consomic rats. Medullary blood flow, renal interstitial hydrostatic pressure (RIHP), arterial pressure (AP) and the pressure-natriuresis relationships will be determined in response to chronic elevations of O2-, H2O2, and ONOO-. The concept of NOS uncoupling will be examined by measurement of medullary tissue BH4/BH2 ratios determined by HPLC, and NO, O2 and H2O2 values obtained by microdialysis techniques. Aim 3 will determine the dynamic interrelationships of O2 and NO within and between vascular and tubular segments of the renal medulla using thin, superfused medullary tissue stripes. NO responses to agents that stimulate and inhibit ROS will be compared in control SS.BN13 and salt-sensitive SS/Mcw rats. Novel fluorescent dyes, coupled with high speed capture of microscopic images will enable the measurement of intracellular NO independent from NO in the interstitial space thereby determining whether NO released from tubules could act as a paracrine substance to control medullary blood flow. Taken together, these studies will provide novel and clinically relevant data defining the role that ROS play in the regulation of renal medullary function and the development of salt-sensitive hypertension, information that would be expected to lead to new therapeutic modalities in the treatment of human hypertension. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: REGULATION OF INTRAOCULAR PRESSURE AND OCULAR BLOOD FLOW Principal Investigator & Institution: Liu, John H. Professor; Ophthalmology; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, CA 92093 Timing: Fiscal Year 2003; Project Start 01-NOV-1991; Project End 30-NOV-2007 Summary: (provided by applicant): Glaucoma is a leading cause of blindness. An elevated intraocular pressure (IOP) is a major risk factor. We have been studying the 24hour pattern of IOP under strictly controlled laboratory conditions. Data have been collected from healthy young and elderly volunteers, from untreated glaucoma patients/suspects, and from glaucoma patients treated with timolol or latanoprost. In order to know whether or not surgical treatment sufficiently reduces IOP in glaucoma patients at night, we will study the 24-hour pattern of IOP in glaucoma patients receiving laser trabeculoplasty (Aim 1). An elevated IOP alters the ocular perfusion pressure and consequently may affect ocular blood flow. How the 24-hour variation of IOP affects ocular blood flow is unknown. Ocular blood flow may very well vary independently from IOP over the 24 hours. Therefore, we will study the 24-hour pattern of ocular blood flow in healthy individuals (Aim 2). Blood flow in the retrobulbar blood vessels will be characterized using the color Doppler imaging technique in the laboratory. Young and elderly volunteers will be selected based upon their home recordings of ambulatory blood pressure, sleep conditions, and IOP. Since an abnormal ocular blood flow may be another risk factor for glaucoma, we will study the 24-hour pattern of ocular blood flow in glaucoma patients (Aim 3). Similar home recordings will be performed to select representative glaucoma patients with excessive dipping of nocturnal blood pressure and with sleep apnea. Laboratory data will be collected from untreated glaucoma patients/suspects and from glaucoma patients receiving medical
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treatment with timolol or latanoprost and those surgically treated with laser trabeculoplasty. The long-term goal of the proposed studies is to define the endogenous mechanisms in the regulation of human IOP and ocular blood flow. Experimental results should provide fundamental information about how ocular blood flow is regulated during the day and at night in healthy individuals. New knowledge of ocular blood flow and IOP in patients would have implications for the better diagnosis and treatment of glaucoma. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: REGULATION OF RENAL OXYGENATION AND BLOOD PRESSURE Principal Investigator & Institution: Zou, Ai-Ping; Associate Professor; Physiology; Medical College of Wisconsin Po Box26509 Milwaukee, WI 532264801 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2007 Summary: (provided by applicant): It has been demonstrated that the activities of many paracrine or autocrine systems such as nitric oxide synthases, cyclooxyganses, heme oxygenases and others are much higher in the renal medulla than in the renal cortex. These local humoral systems have been indicated to importantly control the constancy of renal blood flow and oxygenation, sodium excretion and arterial blood pressure. However, the mechanism activating these renal medullary protective systems is still poorly understood. Our preliminary experiments have shown that a low PO2 milieu and corresponding activation of gene transcription in the renal medulla may contribute to the great activity of these paracrine and autocrine systems. An oxygen-sensitive transcription factor, hypoxia inducible factor-la (HIF-1alpha) was found highly expressed in the renal medulla and upregulated in response to decrease in tissue oxygenation or cell hypoxia. Inhibition of HIF-1alpha in this kidney region resulted in increase in arterial blood pressure and enhancement of the salt sensitivity of arterial blood pressure. Based on these data, we hypothesize that HIF-lalpha-activated transcription in the renal medulla may increase the expression of oxygen-sensitive genes, which contributes to the oxygen homeostasis and prevention of hypoxic injury in this kidney region and thereby participates in the control of renal function and arterial blood pressure. In this grant proposal, we will determine whether this HIF-1alphamediated gene transcription in the renal medulla is importantly involved in the renal adaptive response to high salt intake and whether blockade of HIF-1alpha increases the salt sensitivity of arterial blood pressure in rats. We will also determine whether alterations of HIF-1a levels influence the reactivity of renal medullary vessels to different vasoconstrictors and whether increased HIF-1alpha levels protect the renal medulla from vasoconstrictive or hypoxic injury. Furthermore, we will determine the functional significance of those HIF1alpha-activated genes in the control of renal function and arterial blood pressure by analyzing the expression of a prototype gene, heme oxygenase-1. Finally, we will determine whether an abnormality of HIF-1alphamediated gene transcription contributes to the increased salt sensitivity of arterial blood pressure in Dahl salt-sensitive hypertensive rats. These studies will clarify the underlying mechanism regulating renal medullary function and the salt sensitivity of arterial blood pressure and ultimately may suggest new therapies for the treatment of renal ischemia and hypertension at gene transcriptional level. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: REGULATION OF RENAL VASCULAR CELLS IN HYPERTENSION Principal Investigator & Institution: Gelband, Craig H. Associate Professor; Physiology and Functional Genomics; University of Florida Gainesville, FL 32611
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Timing: Fiscal Year 2001; Project Start 01-JUL-1996; Project End 19-APR-2002 Summary: (Verbatim from Applicant's abstract): The relationship between renal blood flow and glomerular filtration rate is well established. A decrease in renal blood flow lowers glomerular filtration rate, triggering water retention and increases in extracellular fluid volume, cardiac output and arterial pressure. If both renal blood flow and glomerular filtration rate remain suppressed, the initial steps in the development of hypertension have taken place. Since changes in renal blood flow have been implicated in certain vascular disorders, including hypertension and renal vasospasm, this research will help fill the existing gap of knowledge regarding the relationship between ion channel regulation and vascular reactivity in the renal vasculature. It has been clearly shown that Kv, KCa and L-type Ca2+ channel activity in small resistance arterioles of the kidney are altered in the spontaneously hypertensive rat (SHR) and deoxycorticosterone acetate (DOCA) hypertensive rat when compared to their proper control. Yet the mechanism(s) by which these alterations take place has yet to be elucidate. The general hypothesis of this application is that regulation of K+ and Ca2+ channel activity, either by signaling molecules or by a change in number, depolarize membrane potential in renal resistance arteriolar vascular smooth muscle cells from hypertensive rats thereby increasing vascular smooth muscle tone. Using a multifaceted approach of vascular reactivity, patch clamp electrophysiology, molecular techniques (Western blot and RNase protection) and confocal microscopy, this research project will advance our understanding of the involvement of membrane conductances in the regulation of renal vascular excitation-contraction coupling and blood pressure in health and disease. The aims of the proposed research are fourfold: (1) To biophysically and pharmacologically characterize the mechanism(s) by which there is a decrease in Kv channel current density in renal resistance arteriolar vascular smooth muscle cells of hypertensive rat models. (2) To biophysically and pharmacologically characterize the mechanism(s) by which there is an increase in L-type Ca2+ channel current density in renal resistance arteriolar vascular smooth muscle cells from hypertensive rat models. (3) To characterize the relationship between Ca2+ release from the sarcoplasmic reticulum, PKC and the depressed activity of KCa channels in renal resistance arterioles and renal vascular smooth muscle cells from hypertensive rat models. (4) To examine if lowering blood pressure with antisense gene therapy targeting the rennin-angiotensin system can prevent/reverse the mechanism(s) that lead to alterations in Kv, KCa, and Ltype Ca2+ channel activity. The results from these studies should significantly increase our knowledge of the mechanism(s) of hormonal modulation of vascular tone in a clinically relevant tissue, the renal vascular bed and its role in the development of hypertension. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RENAL BLOOD FLOW,SODIUM HANDLING AND THE DASH DIET Principal Investigator & Institution: Conlin, Paul R. Assistant Professor of Medicine; Brigham and Women's Hospital 75 Francis Street Boston, MA 02115 Timing: Fiscal Year 2003; Project Start 01-MAY-2003; Project End 31-JAN-2008 Summary: (provided by applicant):This application for a K24 award is to provide support for Paul R. Conlin, MD to allow him protected time to devote to patientoriented research and to act as a mentor for beginning clinical investigators. His longterm goal is to make significant contributions to the understanding of lifestyle modifications as they impact on renal and cardiovascular disease risk factors through clinical trials. Dr. Conlin has investigated the impact of dietary patterns and sodium on renal/adrenal function and cardiovascular disease risk factors. He was recently a
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collaborating investigator in the DASH (Dietary Approaches to Stop Hypertension) and DASH-Sodium studies, which showed that a low-fat diet enriched in fruits, vegetables and low-fat dairy products (DASH diet) either alone or with sodium restriction significantly lowered blood pressure. He is now studying the effect of three dietary patterns on renal and cardiovascular disease risk factors (blood pressure and lipid profile). This application proposes new specific aims in which he will study the effects of the DASH diet on the kidney- in particular, renal blood flow, renal vascular resistance and sodium excretion. These studies will test the hypotheses that the DASH diet vasodilates the renal vasculature and enhances sodium excretion in a manner that mimics ACE inhibition. These studies will be performed in individuals with high normal and Stage 1 hypertension, and subgroup analyses will be performed in African Americans. The results of these studies will reveal the added-value of the DASH diet on risk factors and protective effects on renal function in patients at risk for renal/cardiovascular disease. Dr. Conlin is fully committed to recruiting and mentoring junior clinical investigators destined for careers in patient-oriented research, particularly those interested in renal cardiovascular physiology, interventional nutrition or academic endocrinology, He has recently mentored 6 fellows and junior faculty, many of whom have achieved independent grant support. In addition, he will teach junior patientoriented research investigators in the K30 funded "Scholars in Clinical Science" Program at Harvard Medical School. Thus, with the support of this award he will have significant impact on future patient-oriented research at multiple levels. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RENAL SODIUM TRANSPORT IN THE OBESE ZUCKER RAT Principal Investigator & Institution: Ecelbarger, Carolyn A. Professor; Medicine; Georgetown University Washington, DC 20057 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2008 Summary: (provided by applicant): Obesity and insulin resistance are associated with hypertension. Inappropriate retention of sodium by the kidney is likely to play a major role. We previously showed that the obese Zucker rat (a model for these disorders) have increased renal protein abundance for three major sodium transport proteins: the alpha1 subunit of Na-K-ATPase, the thiazide-sensitive NaCI cotransporter (NCC or TSC) and the beta-subunit of the epithelial sodium channel (ENaC). In contrast, as, they aged, obese rats developed renal hypertrophy along with diabetes and had a relative decrease in many important salt and water transport proteins, as compared to age-matched controls. We suggest that dysregulation of several important hormone systems in sodium balance may play a role in both alterations in sodium transport protein expression, as well as, the rapid develop of nephropathy. Candidate systems include the renin-angiotensin-aldosterone system (RAAS) and insulin (and or insulin resistance). We hypothesize that dysregulation of major sodium transport proteins of the kidney in the obese Zucker rat with age, is due at least in part to increased RAAS activity, and hyperinsulinemia, which in combination, result in inappropriate sodium retention and elevated blood pressure. Our specific aims include: 1) to determine if angiotensin II At1a receptor expression, binding, and activity is upregulated in the obese Zucker rat and whether this upregulation plays a role in changes in renal sodium transporter regulation, blood pressure, and renal hypertrophy; 2) to determine if enhanced mineralocorticoid receptor (MR) activity plays a role in increased whole kidney protein abundance of the thiazide-sensitive NaCI cotransporter (NCC), blood pressure, and renal hypertrophy, in the obese Zucker rat; 3) to determine the cellular location and sensitivity of the renal insulin receptor in obese Zucker rats relative to lean age-mates; 4)
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to determine whether treatment of insulin resistance with a PPAR-gamma agonist will decrease relative renal protein abundance of NCC, beta-ENaC, and Na-K-ATPase, as well as reduce blood pressure and renal hypertrophy in the obese Zucker rat, and whether these effects are reversed with short-term insulin infusion. These studies will allow us to determine the importance of each of these potential regulatory hormone systems in dyregulation of sodium transporter expression, sodium balance, and blood pressure in these obese rats. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: REPERFUSION EFFECTS ON CEREBRAL ARTERY FUNCTION Principal Investigator & Institution: Cipolla, Marilyn J. Neurology; University of Vermont & St Agric College 340 Waterman Building Burlington, VT 05405 Timing: Fiscal Year 2001; Project Start 15-JUL-1999; Project End 31-MAR-2004 Summary: (from the Abstract) Ischemic brain injury is one of the most common pathophysiological processes affecting more than 400,000 people per year in the US in the form of stroke. Restoration of blood flow following short periods of ischemia has been shown to benefit the brain, however, experimental and clinical evidence indicates that reperfusion following longer periods of ischemia may worsen brain injury. While the effects of ischemia and reperfusion have been extensively studied in neuronal injury, little information regarding these effects on cerebral arteries, and how this dysfunction affects stroke outcome, is available. This study investigates the ischemic and reperfusion effects on cerebral artery function, focusing on myogenic tone and reactivity to pressure, both important components of vascular resistance and autoregulation of cerebral blood flow. The intraluminal suture model of focal cerebral ischemia in rats will be used to induce controlled ischemia and reperfusion in middle cerebral arteries. The arteries will then be dissected from the occluded side of the brain and studied in vitro in a system that allows control of intravascular pressure and continuous measurement of lumen diameter. Arteries will be studied under variable periods of ischemia and reperfusion to determine the threshold duration of ischemia and reperfusion that arteries can still maintain viable myogenic responses (Aim 1). Since preliminary experiments determined that 2 hours of ischemia followed by 24 hours of reperfusion results in significantly diminished reactivity to pressure and abnormal basal tone of middle cerebral arteries, we will investigate alterations in cerebral artery structure (e.g., actin cytoskeleton) and function (e.g., myogenic behavior) that may contribute to the loss of function. In addition, inhibitors of compounds known to be detrimental during ischemia and reperfusion (e.g., nitric oxide, superoxide radical) will be used to determine if cerebral artery function can be preserved during reperfusion (Aim 2). Lastly, one promising therapeutic approach involves thrombolysis to restore blood flow to ischemic regions of the brain; however, the use of thrombolytic agents carries the risk of edema formation and hemorrhage. One mechanism that may contribute to these processes during thrombolysis is an effect of the agents themselves on cerebral artery myogenic behavior. Normal cerebrovascular resistance is important during reperfusion and during treatment with thrombolytic agents if vascular integrity is to be maintained and tissue damage minimized. Therefore, Aim 3 will investigate the effects of two types of thrombolytic agents (tissue-type and urokinase) on cerebral artery function, including myogenic processes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PREGNANCY
ROLE
OF
ANG-(1-7)
IN
NORMAL
AND
HYPERTENSIVE
Principal Investigator & Institution: Brosnihan, K. Bridget. Professor; Surgery; Wake Forest University Health Sciences Winston-Salem, NC 27157 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2004 Summary: (provided by applicant): PIH is estimated to affect 7% to 10% of all pregnancies in the United States. Despite being one of the leading causes of maternal death and a major contributor of maternal and perinatal morbidity, the mechanisms responsible for the pathogenesis of PIH are unclear. It is well known that the RAAS is stimulated in normal pregnancy. The physiological consequences of the stimulated RAAS in normal pregnancy are incompletely understood. Initial findings from our group demonstrate that the novel heptapeptide of the RAAS, Ang-(1-7) is increased in pregnancy and reduced in PIH and preeclampsia. Since Ang-(1- 7) has been shown to act as a vasodilator and thus may counter regulate the actions of Ang II, our findings provide a basis for a possibly important physiological role of Aug-( 1- 7) in the course of pregnancy. It is our hypothesis that an appropriate balance of the vasoconstrictor and vasodilator components of the RAAS exerted by Ang II and Ang-(1- 7), respectively, constitute a crucial feature of cardiovascular regulation during an uncomplicated pregnancy. In particular, normal pregnancy may be characterized by vasodilatory actions of Aug-(1-7) that balance the vasoconstrictor effects of Ang II. In contrast, PIH and preeclampsia may result from an unbridled pressor action of Ang II as a consequence of marked reduction of vasodepressor effects of Ang-(1- 7). The hypothesis will be tested by the following Specific Aims. Specific Aim 1 will determine the time course of changes in the circulating and urinary levels of Ang II and Ang-(1- 7) as the principal vasoconstrictor and vasodilator components, respectively, of the RAAS throughout the course pregnancy of pregnancy in rats. Findings obtained in normal pregnant rats will be compared to a rat model of PIH produced by chronic reduction in utero placental perfusion pressure (RUPP). We will also monitor levels of active renin concentration, Ang I, angiotensin converting enzyme (ACE), Angiotensinogen (Aogen), and aldosterone in normal pregnant rats and in rats subjected to RUPP. Specific Aim 2 will demonstrate that long-term blockade of Ang-(1- 7) by chronic infusion of the Ang(1- 7) specific antagonist, ([D-Ala7]-Ang-(1-7) in otherwise normal pregnant rats tips the balance of blood pressure regulation toward hypertension. Also we will determine whether chronic administration of Ang-(1-7) reverses the hypertension of RUPP animals. We also propose to assess the response of mesenteric and uterine resistance arterioles to Ang peptides in normal pregnancy and hypertension caused by RUPP. The major goal of these studies is to understand the contribution of the vasodilator component of the RAAS to blood pressure regulation in normal pregnancy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ROLE OF CEREBROVASCULAR K+ CHANNELS IN HYPERTENSION Principal Investigator & Institution: Rusch, Nancy J. Professor; Physiology; Medical College of Wisconsin Po Box26509 Milwaukee, WI 532264801 Timing: Fiscal Year 2002; Project Start 01-MAR-1998; Project End 30-NOV-2005 Summary: The goal of this project is to provide a profile of the disease-specific expression of the Shaker (Kv1) gene family of voltage-gated K+ channels in the cerebral microcirculation of hypertensive rats. Our early results suggest that Shaker Kv1 channels upregulate in the cerebral circulation of normal Wistar Kyoto (WKY) rats during the maturation of the animal to emerge as predominant contributors to cerebral
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arterial membrane potential and diameter. However, this progression is highly suppressed in spontaneously hypertensive rats (SHR), in which maturation results in the exposure of the cerebral microcirculation to progressively higher blood pressure levels in vivo. Indeed, patch-clamped cerebrovascular smooth muscle cells from adult SHR show reduced Shaker Kv1 current compared to cells from normal Wistar Kyoto (WKY) rats, and this alteration is associated with smooth muscle cell depolarization and constriction. Notably, this vasoconstriction is regarded as a fundamental adaptive response of small cerebral arteries to the development of high blood pressure in vivo, which minimizes the damaging transmission of the high systemic pressure to the blood brain barrier. Based on these findings, and our evidence that the remodeling of K+ channels in the cerebral circulation critically protects this vascular bed from the lethal effects of high blood pressure, we will: (a) combine RT-PCR gene expression studies, Western blotting, and patch-clamp techniques to examine the expression and function of Shaker Kv1 channels in rat cerebrovascular smooth muscle cells during the development of genetic and renal forms of hypertension, and after correction of hypertension by vasodilator drugs (b) assess the physiological impact of these changes in Shaker Kv1 channel expression on the membrane potential and diameter of isolated cerebral arteries in vitro and arterioles in vivo, and (c) test the hypothesis that pressure-induced membrane depolarization is a triggering stimulus for the remodeling of Shaker Kv1 channels in the vascular smooth muscle membranes of the cerebral circulation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SAFETY, TOLERABILITY & ANTIHYPERTENSIVE EFFICACY OF MULTIPLE DOSE L-753 Principal Investigator & Institution: Elijovich, Fernando; University of Texas Medical Br Galveston 301 University Blvd Galveston, TX 77555 Timing: Fiscal Year 2001 Summary: The proposed research is a multicenter Phase II clinical trial of a new endothelin receptor antagonist (L-753,037), with a large ETz/ETb selectivity ratio). Its antihypertensive efficacy, as well as safety and tolerability, will be explored in Afreican American patients with essential hypertension. This project targets patients of African American background because the prevalence of salt-sensitivity of blood pressure is highest in this racial group (about 75%) and because there is evidence (in experimental animals and humans) that endothellin may be important in the regulation of vasoconstriction and blood pressure in salt-sensitive hypertension. The trial will be double blind, with two comparators, placebo, and the antigypertensive dihydropyridine amlodipine. Patients will be selected according to strict inclusion/exclusion criteria, including a narrow blood pressure window to be determined during an outpatient washout period (discontinuation of previous medications). The actual study will be carried out during an 8-day (9-night) admission to the GCRC. After two days on placebo, to establish a baseline and to exclude those patients that may fall below the blood pressure window as a response to hospitalization, the drugs will be administered as oral solutions for five days. The pharmacist will be the only member of the research team that will not be blind to the medication administered. Blood pressures will be recorded several times per day. Routine laboratory measurements will be carried out to assess safety of the compound. Measurements of vasoactive compounds and hormones will be also carried out, to unravel the mechanisms of blood pressure reduction, if any, by endothelin receptor blockade. Pulmonary function tests and blood gases will be measured because high doses of the compound have been found to have untoward effects on repiratory function of experimental animals. Once the period of
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administration of the drug is completed, the patients will be observed for an additional day at the GCRC, and later, on a follow-up outpatient visit. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SCOR: MOLECULAR GENETICS OF HYPERTENSION Principal Investigator & Institution: Lifton, Richard P. Chairman, Department of Genetics; Genetics; Yale University 47 College Street, Suite 203 New Haven, CT 065208047 Timing: Fiscal Year 2001; Project Start 01-FEB-1996; Project End 31-JAN-2006 Summary: The Yale Specialized Center of Research in Hypertension focuses on identification of the inherited abnormalities that contribute to high blood pressure and its consequences. To date, we have identified mutations in 4 genes that raise blood pressure, 8 genes that lower blood pressure, linkage for two more Mendelian hypertensive disease, and linkage for blood pressure in the general population. These findings have demonstrated the key role of renal salt homeostasis in determination of blood pressure variation in humans, and have begun to identify molecular mechanisms underlying relationships between blood pressure and bone density. In the current proposal, we propose a series of investigations that will extend these studies. Taking genes in which we have shown mutations alter blood pressure, we examine the impact of variants in these genes on blood pressure and related phenotypes in the Framingham Heart Study. We also search for a gene accounting for a substantial fraction of blood pressure variance in this population, and search for genes contributing to a common complication of hypertension, end stage renal disease. We continue our identification of Mendelian traits that affect blood pressure, and pursue the clinical consequences of these mutations. Finally, since virtually all known causes of hypertension act via a common pathway of increased activity of the amiloride-sensitive epithelial sodium channel, we investigate the signaling pathway that regulates the activity of this channel. These studies will continue to provide key information regarding the causes and consequences of hypertension in humans that have clinical and therapeutic implications. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SECONDARY PREVENTION IN SMALL SUBCORTICAL STROKES (SPS3) Principal Investigator & Institution: Benavente, Oscar R. Associate Professor; Medicine; University of Texas Hlth Sci Ctr San Ant 7703 Floyd Curl Dr San Antonio, TX 78229 Timing: Fiscal Year 2001; Project Start 05-SEP-1999; Project End 30-NOV-2002 Summary: Small subcortical strokes (S3), also known as lacunar infarcts, comprise nearly 25 percent of brain infarcts, are harbingers of vascular dementia, and are particularly frequent in Mexican- Americans. Combination antiplatelet therapy using clopidogrel plus aspirin and intensive lowering of blood pressure could substantially reduce major vascular events and cognitive decline in S3 patients. However, a large randomized clinical trial is required to define the efficacy and safety of these interventions specifically in patients with S3 due to presumed small vessel disease. This proposal is for a pilot study to: 1. Determine the lowest tolerable, achievable target blood pressures among survivors of S3. 2. To assess whether the difference between the lowest tolerable blood pressures are sufficiently different from that achieved by standard targets to substantially impact the occurrence of subsequent stroke and cognitive decline. 3. To quantitatively assess white matter abnormalities in S3 patient by serial MRI, correlating these with patient features, cognitive status, blood pressure
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control and antiplatelet treatment. 4. To assess the relationship of Mexican-American ethnicity to blood pressure interventions, tolerance of antiplatelet therapy, extent and progression of white matter abnormalities, and cognitive status, as well as to modify and assess existing screening tests of cognitive status for those who primarily speak Spanish. Participants with S3 attributed to small vessel disease will be randomized to treatment with aspirin (650mg/d) or aspirin plus clopidogrel (75mg/d) (double-blind), while those with a history of hypertension will additionally be randomized to three different target levels of blood pressure lowering (not blinded). The tolerance and achieved blood pressures in each target level will be the primary outcome, with tolerance and side-effects of antiplatelet therapy also assessed. Quantitative MRI will be done at entry and after a mean of one year, correlated with cognitive status, interventions and ethnicity. No clinical trials have assessed secondary prevention in S3, the most common type of stroke in Mexican Americans and accounting for about 150,000 strokes yearly in the US. While this pilot study is a necessary first-step for a larger, definitive clinical trial, valuable and unique information about blood pressure control after stroke and about issues relevant to stroke prevention in MexicanAmericans will emerge. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SECRETION AND RENAL EFFECTS OF CARDIAC PEPTIDES Principal Investigator & Institution: Dietz, John R. Physiology and Biophysics; University of South Florida 4202 E Fowler Ave Tampa, FL 33620 Timing: Fiscal Year 2001; Project Start 01-APR-1999; Project End 31-MAR-2003 Summary: (Adapted from the Investigator's Abstract) Hypertensive cardiovascular disease affects approximately 40-60 million Americans and is thought to be a primary contributor to coronary artery disease and stroke which collectively account for most of the cardiovascular deaths in this country. Over a period of many years it has become apparent that the regulation of arterial blood pressure is intimately linked to body salt and water balance. Recent evidence suggests that several peptides derived from the Nterminal portion of the atrial natriuretic factor (ANF) prohormone also play an important role in regulating kidney function and arterial blood pressure. The long term goals of the present application are to obtain a better understanding of the role of ANF and ANF prohormone peptides in the regulation of kidney function, blood volume and blood pressure. The applicant will carry out studies to investigate the role of nitric oxide, endothelin and adenosine on the paracrine regulation of ANF and proANF release. The applicant has shown previously that proANF 1-30 produces natriuresis and hypotension through, as yet, undefined mechanisms. He proposes to investigate four likely potential mechanisms that may contribute to the natriuretic properties of this peptide. These include prostaglandin synthesis, alterations in hemodynamics, cGMP synthesis and changes in activity of the renin-angiotensin-aldosterone system. Finally, the applicant proposes to develop specific antibodies to the rat forms of proANF 1-30 and 31-67 to provide accurate measurements of these peptides in rat tissues and plasma and to employ as antagonists in dissecting out the contribution of these peptides to natriuretic/anti-hypertensive mechanisms which are activated as part of the physiological response to volume expansion and chronic hypertension. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SIROMAL COX2 DERIVED PROSTANOIDS IN RENAL GROWTH AND INJ Principal Investigator & Institution: Breyer, Matthew D. Professor; Vanderbilt University 3319 West End Ave. Nashville, TN 372036917 Timing: Fiscal Year 2002; Project Start 01-SEP-1987; Project End 31-JUL-2007 Summary: (Taken directly from the application) Cyclooxygenases (COXs) play a critical role in regulating cell function through the enzymatic production of prostaglandins, a family of bioactive unsaturated fatty acids. The recent discovery of a second, mitogen inducible isoform, COX2, was quickly followed by the realization that as compared to COX1, COX2 derived prostanoids played a dramatic role in neoplastic proliferation and inflammation. Constitutive expression of COX2 in the kidney is greater than in almost any other tissue and the bulk of renal COX2 is in the interstitium. The goal of this proposal is to establish the role of renal interstitial COX2 expression in normal physiologic processes and disease. Renal dysgenesis is the dominant phenotype of the COX2 knockout. Specific Aim 1 will examine how COX2 derived prostaglandins promote renal development. The synthetic profile of COX1 and COX2 derived prostaglandins (i.e., PGE2 TxA2, PG12, PGF2a and PGD2) during nephrogenesis as well as the down-stream prostanoid receptors through which they promote development, will be determined. These studies will utilize several locally generated knockout mice including EP1, EP2 and EP4 receptor knockouts as well as COX1, and COX2 null mice. Specific Aim 2 will examine the role of tubulointerstitial prostanoids in the pathogenesis of in diabetic nephropathy in the db/db mouse. Potential protective effects of COX1 gene disruption as well as EP2 and EP4 receptor, disruption on the progression of diabetic nephropathy will be determined in the db/db mouse. Finally Specific Aim 3 will examine the role of interstitial cells in maintaining blood pressure and renal medullary blood flow. A critical relationship between blood pressure and medullary interstitial cells has long been suggested. These studies will utilize a novel COX2 conditional knockout (i.e., COX2 a floxed allele) and an interstitial cell specific Cre to establish a cell specific knockout of COX2. The role of interstitial cells cyclooxygenase products in regulating renal medullary blood flow and its potential link to blood pressure regulation will thereby be determined. Through the information gained, we hope to establish new therapeutic targets within the prostaglandin pathway for treating renal disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SOY ISOFLAVONES ON NO PRODUCTION IN POSTMENOPAUSAL WOMEN Principal Investigator & Institution: Wong, William W. Professor; Pediatrics; Baylor College of Medicine 1 Baylor Plaza Houston, TX 77030 Timing: Fiscal Year 2002; Project Start 15-SEP-2002; Project End 31-AUG-2004 Summary: (provided by applicant): Cardiovascular disease is the leading cause of death among women in the United States. Postmenopausal women are most susceptible to this deadly disease. The dramatic increase in cardiovascular mortality rate among postmenopausal women is largely due to deterioration in arterial compliance associated with the reduction in nitric oxide (NO) production during menopause. Estrogen replacement therapy reverses the deterioration process by stimulating NO production but introduces increased risk of breast cancer. Isoflavones, which have chemical structures similar to estradiol but possess anti-cancer properties, are found in abundance in soybeans. Our preliminary data showed that diastolic blood pressure was
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reduced by 12% and urinary nitrate excretion was increased by 33% in postmenopausal women receiving soy isoflavone therapy. We are not aware of any studies confirming the stimulatory effect of soy isoflavones on NO production. Therefore, we propose to study 56 healthy postmenopausal women with high-normal blood pressure, using a double-blind, randomized, placebo-controlled design, to confirm the stimulatory effect of soy isoflavone therapy on NO production and reduction in blood pressure and vascular resistance. We propose to use a primed, 6-h constant infusion of L-guanidino15N2]arginine to measure the NO production, both before and after 6 weeks of isoflavone or placebo therapy. Gas chromatography-mass spectrometry will be used to measure the isotopic abundance of L-guanidino-'5N2]arginine and the products of the arginine-NO synthase pathway in the blood and urine samples. To monitor the hemodynamic effects of isoflavone therapy, 24-h ambulatory blood pressure, arterial compliance, and basal and post-ischemic forearm blood flow will be measured, before and after 6 weeks of isoflavone or placebo therapy. Plasma isoflavone concentrations, an index of subject compliance, will be measured by HPLC-mass spectrometry. The sample size will allow us to detect differences of 0.3 % pool/h in NO production, 0.2 mmol/d in urinary nitrate excretion, 1 mmHg/mL/min in arterial compliance, 3 mL.min-1.100 mL forearm-1 in forearm bloodflow, and8 mmHg in diastolic blood pressure. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STATISTICAL GENETICS ANALYSIS OF BLOOD PRESSURE Principal Investigator & Institution: Churchill, Gary A. Staff Scientist; Boston University Medical Campus 715 Albany St, 560 Boston, MA 02118 Timing: Fiscal Year 2001; Project Start 01-FEB-1996; Project End 31-JAN-2006 Summary: Statistical Analysis of QTL Crosses and Gene Expression Arrays This project will apply newly developed statistical methods to experimental data obtained form rodent models of hypertension in order to identify genes and pathways that underlie blood pressure regulation in mammals. The first component, quantitative trait locus (QTL) mapping, will identify polymorphic loci that affect blood pressure in rodents. Epistasis analysis will be used to identify loci that participate in common biochemical pathways. The second component, gene expression microarray analysis, will identify changes in the expression of genes in tissue samples. The analysis of expression data will identify the downstream consequences of allelic variation at both QTL and candidate genes. The combination of a phenotype driven approach, QTL mapping, with a gene driven approach, expression analysis, will allow us to identify and characterize the effects of allelic variations that lead to hypertension. Our analyses of these two types of data will generate testable hypotheses about specific genes and pathways related to hypertension in rodents that can then be extended to human hypertension. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PRODUCTION
STEROIDS
/VASCULAR
REACTIVITY
/NITRIC
Principal Investigator & Institution: Keller-Wood, Maureen Pharmacodynamics; University of Florida Gainesville, FL 32611
E.
OXIDE Professor;
Timing: Fiscal Year 2001; Project Start 06-APR-2001; Project End 31-MAR-2003 Summary: (Adapted from applicant's description): The overall goal of these studies is to test the hypothesis that there is an interaction between increased secretion of adrenal corticosteroids and increased secretion of estrogen during pregnancy which is necessary for normal blood pressure control in the peripartal period. Studies in pregnant,
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hypocorticoid ewes and clinical experience in pregnant women with hypoadrenocorticism suggest that normal blood pressure control in late pregnancy requires increased adrenal secretion. Insufficient supply of cortisol results in rapid and profound hypotension, with increased morbidity and mortality in both mother and fetus. The experiments in this proposal will directly test the hypothesis that a decrease in cortisol at a time of increased estrogen results in a greater decrease in vascular reactivity to phenylephrine and that this correlates with increased production of nitric oxide production in one or more sites in the body. Four groups of ewes will be studied: adrenalectomized, ovariectomized ewes, adrenalectomized ovariectomized ewes treated with estradiol, adrenal- intact ovariectomized ewes, and adrenal-intact ovariectomized ewes treated with estradiol. All adrenalectomized ewes will be treated with aldosterone and cortisol for one week following surgery, and then the adrenal steroid infusions will be stopped to produce the hypoadrenal state. Animals will be studied at a time point (8 hours) in which the adrenalectomized estrogen treated animals are hypotensive, but the adrenalectomized ewes without estradiol treatment are not overtly hypotensive. Experiments will test vascular reactivity in response to phenylephrine in all 4 groups of ewes to test the hypothesis that estrogen administration decreases vascular reactivity in adrenalectomized ewes. Experiments will also determine plasma levels of nitrates and nitrites and the ability of infusion of L-NAME, an inhibitor of nitric oxide synthase (NOS), to increase vascular reactivity in adrenalectomized ewes with estradiol treatment. Experiments will also test the concentrations of cGMP, and levels of iNOS, eNOS, and nNOS protein measured by Western analysis and mRNA by RT-PCR in aorta, uterine artery, mesenteric artery, renal artery, renal interlobular artery, renal medulla and cortex, and skeletal muscle, taken from animals in the same 4 experimental groups. These experiments will determine if absence of cortisol results in increased NOS in one or more of these sites. Samples of tissue will also be examined by immunohistochemistry to more precisely identify the cell populations containing iNOS, eNOS or nNOS in these ewes. These experiments will therefore describe which isoform(s), and in which cells, NOS is altered by cortisol withdrawal, either alone or in combination with increased estrogen. This information will form the basis of future experiments to determine the mechanism of the interaction of estrogen and cortisol in control of NO and regulation of blood pressure during pregnancy. These studies will therefore add to our understanding of normal blood pressure control during pregnancy, and of the pathophysiology of hypoadrenocorticism at term. These studies will also to our understanding of the counterbalancing effects of increased cortisol and increased estrogens in control of normal blood pressure in normal pregnancy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STOP ATHEROSCLEROSIS IN NATIVE DIABETICS STUDY (SANDS) Principal Investigator & Institution: Howard, Barbara V. President; Medstar Research Institute Hyattsville, MD 20783 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): Although once protected from cardiovascular disease (CVD), American Indians now have incidence rates higher than the general US population. The majority of CVD cases occur in individuals with diabetes. It is therefore imperative that intervention strategies to reduce CVD in diabetic individuals be developed and validated in this population. This proposal is for a randomized 3-year trial to examine the effects on CVD of intensive LDL reduction (goal less than or equal to 75 mg/dL) and intensive blood pressure lowering (goal less than or equal to 115/75
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mmHg), compared to usual targets of less than or equal to 100 mg/dL and less than or equal to 130/85 mmHg. These cutpoints were chosen because mean LDL and blood pressure levels are lower in this population, but there is a strong relation between LDL, blood pressure, and CVD at levels below current targets. The primary endpoint will be carotid intimal-medial thickness. Secondary endpoints will include cardiac function measures by echocardiography, lipoproteins, albuminuria, and C-reactive protein (CRP). The study will enroll 488 diabetic American Indian men and women more than 40 years of age and will be conducted in four field centers involving Indian Health/Tribal primary care facilities in Phoenix/Sacaton, Arizona; Chinle, Arizona; Rapid City/Pine Ridge, South Dakota; and Lawton, Oklahoma, with input from American Indian physicians and community members. Study results will provide evidence needed to develop community-based programs to treat and prevent the epidemic of CVD among American Indians. The data will also be valuable in understanding the effects of intensive risk-factor reduction on atherosclerosis burden and cardiac function in diabetic individuals in all US populations and provide evidence for determining LDL and blood pressure treatment goals for diabetic patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STRESS, BLOOD PRESSURE AND ETHNICITY Principal Investigator & Institution: Dimsdale, Joel E. Professor; Psychiatry; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, CA 92093 Timing: Fiscal Year 2001; Project Start 16-JUN-1985; Project End 31-JUL-2004 Summary: (adapted from the investigator's abstract): This competing renewal examines how blood pressure regulation differs between blacks and whites. There is increasing evidence suggesting that blood pressure decreases (or "dips") less at nighttime in certain groups of individuals and that such relative non-dipping of blood pressure is related to adverse health outcomes. Data suggest that non-dipping is found more frequently in Blacks. We will study 80 blacks and 80 whites in an effort to understand the psychological and physiological correlates of nocturnal BP dipping. Patients' sleep and ambulatory blood pressure will be studied at home and in the Clinical Research Center environment. Physiological characterization will include 24-hour urinary norepinephrine, beta-adrenergic receptors on lymphocytes, hemodynamic responses to behavioral stressors, heart rate and blood pressure responses to infused isoproterenol. Psychological characterization will include assessment of life stressors and job stress, mood, anger/hostility, and social desirability. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: STUDY OF SANDOSTATIN LAR IN PATIENTS WITH CIRRHOSIS Principal Investigator & Institution: Benner, Kent G. Associate Professor of Medicine; Oregon Health & Science University Portland, OR 972393098 Timing: Fiscal Year 2001 Summary: Bleeding from large veins in the esophagus (esophageal varices) occurs in about 1/3 of patients with cirrhosis and can be life threatening. Medications called betablockers are currently given to patients with large veins in the esophagus to drop the pressure in the vein and decrease the chance of bleeding, but about half of patients do not take them because of contraindications, poor tolerance or difficulties with compliance. Octreotide is a short acting medication widely used in the short run to stop bleeding from varices, once it has occurred. It works by blunting the rise in pressure in these veins, which occurs after meals. A newly developed, long-acting release
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preparation of octreotide, Sandostatin LAR, may be effective for long-term use to prevent bleeding from varices. This study is intended to determine the safety of Sandostatin LAR and its effect on blood flow and pressure in the veins supplying the varices after a meal in 24 cirrhotic patients. Persons who participate in this study will receive a test dose of octreotide and have blood drawn over 24 hours to determine their tolerance and the levels of the drug in the blood. They will then be randomly assigned to receive 10mg, or 30 mg Sandostatin LAR or an inactive placebo (salt water) every 4 weeks for 3 injections. Blood samples drawn before the test medication is given (Sandostatin LAR or placebo), at 14 days, prior to the second (day 28) and third injections (day 56) and 28 days after the third injection (day 84) will be used to determine the blood levels of the LAR preparation. Blood flow in the veins supplying the varices will be determined by ultrasound (sonar) before and after a test meal before the test medication is given and on days 28, 56 and 84 after initiation of Sandostatin LAR. In addition, pressure in the veins supplying the varices will be measured both before and after meals using a small tube that enters a vein in the neck and is passed into the veins draining the liver. This will be done before the study medicine is given and on day 84, 28 days after the last dose of study medication. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SYMPATHETIC AND VASCULAR FUNCTION IN SLEEP APNEA Principal Investigator & Institution: Leuenberger, Urs A. Associate Professor of Medicine; Medicine; Pennsylvania State Univ Hershey Med Ctr 500 University Dr Hershey, PA 17033 Timing: Fiscal Year 2003; Project Start 01-FEB-2003; Project End 31-JAN-2007 Summary: (provided by applicant): The focus of this project is to examine mechanisms of sympathetic activation and abnormal vascular function in obstructive sleep apnea (OSA). OSA has emerged as an important risk factor for hypertension, cardiovascular disease and premature death. Recent epidemiological and experimental data support the concept that OSA may cause hypertension. The mechanisms that link OSA and hypertension are unknown. Based on preliminary data, we postulate that increased activity of the sympathetic nervous system and an inability of peripheral blood vessels to vasodilate normally may contribute to the cardiovascular complications of OSA. Our prior investigations demonstrated that OSA is accompanied by chronic sympathoexcitation that is in part reversible with continuous positive airway pressure (CPAP) therapy. Conversely, preliminary data suggest that repetitive hypoxia leads to a sustained increase of sympathetic activity and blood pressure in normal humans. Preliminary data also suggest that the responses to chemoreflex stimulation are enhanced in OSA. Furthermore, based on preliminary data we postulate that in OSA the ability to vasodilate is impaired and that this vasodilator defect improves with CPAP therapy. The cause of impaired vasodilation in OSA is not known. In specific aim 1) we will determine the neurocirculatory effects of repetitive hypoxia in normal humans and in patients with OSA. We hypothesize that repetitive hypoxia leads to a sustained increase of sympathetic nerve activity and that these responses are accentuated in OSA. In specific aim 2) we will determine mechanisms responsible for impaired vasodilator capacity in OSA. We hypothesize that vasodilator capacity is reduced in OSA because of heightened sympathetic discharge and/or a specific vascular defect. If vasodilator function is restored after CPAP therapy, this will suggest that the repetitive hypoxic stress of OSA plays an important role. The studies will be performed in conscious humans in a General Clinical Research Center environment using state-of-the-art experimental techniques. Findings will provide insight into the link between OSA and
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cardiovascular disease and will increase our understanding of the interaction of sympathetic and vascular mechanisms in the regulation of blood flow and blood pressure. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SYMPATHETIC NEUROEFFECTOR JUNCTIONS AND BLOOD PRESSURE Principal Investigator & Institution: O'connor, Daniel T. Professor; Medicine; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, CA 92093 Timing: Fiscal Year 2001; Project Start 01-JUN-1999; Project End 31-MAY-2004 Summary: (Adapted from Applicant's Abstract) The sympathetic branch of the autonomic system is a key regulator of blood pressure. Secretory vesicles of chromaffin cells and sympathetic axons release co-stored transmitters by exocytosis into the bloodstream or synaptic clefts, where they contact cardiovascular target cells. In addition to catecholamines, the secretory "quantum" includes neuropeptides (such as NPY), and -chromogranins, precursors of active peptides which influence vascular responses to sympatho- adrenal activation, and hence blood pressure. This Program links 4 projects with longstanding collaborations in synthesis, release, and actions (preand post-synaptic) of these transmitters, integrating their effects on blood pressure. Central hypotheses and themes focus interactive efforts. Projects 1 & 2 include human studies, and Project 2 probes sympathetic neuroeffector mechanisms in intact rodents, while Projects 2-4 clarify cellular mechanisms in transmitter biosynthesis and release, and also exploit ex vivo biological materials from Projects 1 & 2 for phenotyping. Human studies probe the genetic basis of heritable alterations in autonomic activity in pedigrees with hypertension (Project 1; Core D), and each Project (1-4) participates in phenotyping unique autonomic traits in pedigree members. Already, significant, novel genetic linkages have emerged, with intriguing allelic variations found in the alpha1beta-adrenergic receptor and the renal kallikrein promoter. Five core facilities provide defined cell populations, signal probes, genotyping, physical mapping, informatics, catecholamine and vasoactive peptide assays, and imaging. Using molecular biologic and informatic tools, the program aims to achieve a new level of understanding of the dynamic complexity of the sympathetic neuroeffector junction, and how its components contribute to heritable changes in blood pressure, and ultimately to human hypertension. This program therefore represents a unique opportunity to define the genetic basis of autonomic dysfunction in human essential hypertension. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THE CARDIOPULMONARY EFFECTS OF PARTICULATE EXPOSURE Principal Investigator & Institution: Christiani, David C. Professor; Environmental Health; Harvard University (Sch of Public Hlth) Public Health Campus Boston, MA 02460 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 31-MAR-2007 Summary: (provided by applicant): Population-based epidemiologic studies of communities in the United States have revealed a consistent association between ambient particulate air pollution and increases in morbidity and mortality. The observed increases result from both respiratory and cardiovascular diseases. Similar associations have been observed for rates of hospital admissions for respiratory and cardiovascular diseases for subjects over age 65. Results from the first phase of this
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study (ES R01 09860) showed significant cardiac and airway changes after both environmental and occupational particulate exposures. The objective of this application is to investigate the role of both occupational and non-occupational exposure to particulates in the development of respiratory and cardiac responses in boilermakers. We will employ a detailed, continuous exposure assessment to PM2.5 with and PM1.0 with repeated measures of biologic and physiologic markers of response. In addition, we will employ novel techniques for the assessment of particulate-induced physiologic responses, including gene expression using mRNA microarrays. Hypotheses to be addressed in this established cohort of boilermakers include: (1) Short-term exposure to particulates from occupational, ambient, and indoor exposures results in airway inflammation and obstruction measured by serial expired NO and FEV1; (2) Chronic exposures to particulates result in long-term decreases in expired NO and FEV1; (3) Exposure to particulates results in acute changes in cardiovascular function measured as heart-rate variability, heart-rate, and blood pressure; (4) Exposure to particulates results in increased acute phase reactant (c-reactive protein, fibrinogen) concentration in the serum; (5) Exposure to particulates induces systemic responses resulting in alterations in white blood cell gene expression assessed by mRNA microarray analysis pre- and postexposure; (6) Common chronic medical conditions such as hypertension, COPD, and asthma predispose particulate-exposed individuals to changes in cardiac function (heart rate, heart rate variability, and blood pressure). The results of this work will have important implications for preventive efforts aimed at reducing particle-associated morbidity and mortality. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THE CPA: SOMATIC AND AUTONOMIC SYSTEMS Principal Investigator & Institution: Panneton, W Michael. Anatomy and Neurobiology; St. Louis University St. Louis, MO 63110 Timing: Fiscal Year 2001; Project Start 01-JAN-2001; Project End 31-DEC-2004 Summary: (Verbatim from the application): The long-term goal of my research is to establish the brainstem circuits through which trigeminal neurons modulate cardiovascular and respiratory activity in mammals. The cardiorespiratory depression (the diving response) seen after stimulation of he upper respiratory tract (URT) has served as my model. The aims for this proposal are directed towards elucidating the control of blood pressure, specifically in regard to both nasal and muscle stimulation. We shall focus our attention on the interplay between the caudal pressor area (CPA) and its interaction with the premotor sympathetic bulbospinal neurons of the rostroventrolateral medulla RVLM). Since the CPA is basically undefined in the rat, two of our aims are directed to locating it and demonstrating its connections, especially with the RVLM. Two other aims will define its role in blood pressure regulation in general as well as to nasal nd muscle stimulation. A fifth aim will define the primary afferent termination of sensory fibers innervating the triceps sure muscle in the rat. We propose specifically to 1) localize the CPA in the caudal medulla; 2) define the input/output of the CPA; 3) define the central termination of sensory fibers to the triceps sure muscle; 4) determine the role of the CPA during the diving esponse and muscle stimulation; and, 5) characterize the responses of individual neurons in the CPA to hypertensive, hypotensive, oxious, and nasal and muscle stimuli. The CPA has been defined in variable positions within the caudal medulla depending on the species in question. Aim I specifically will identify its location in the rat. Blood pressure will be recorded after stimulating the caudal medulla; such a procedure should localize the pressor areas there. Two complimentary neuroanatomical methodologies will determine the
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output/input of the PA, especially to the RVLM, as outlined in Aim II The orthogradely transported tracer biotinylated dextrin amine and the retrogradely transported tracer fluorogold will elucidate projections from/to the CPA. There is some controversy regarding the input o the dorsal horn of primary afferent fibers from muscle. Aim III will use transganglionic transport of HRP to investigate this roblem and correlate this data to that seen in Aim II. In Aim IV, the CPA will be tested to determine its role in controlling blood pressure to both nasal and muscle stimulation. Chemical lesions using ibotenic acid will be made in the CPA and changes in cardiovascular behavior to such stimulation determined. Finally, neurons in the CPA will be monitored electrophysiologically in Aim V and their responses recorded to hypertensive, hypotensive, noxious, and nasal and muscle stimuli. This study will provide the most complete study of the CPA, about which little is known. Stimulation of the URT or large muscles in man causes an increase in sympathetic discharge and hypertension. Understanding the brainstem mechanisms governing he vascular constriction after either of these somatic stimuli may provide a neurological explanation for this. Such knowledge may lead to an understanding of essential hypertension. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THE RENAL-SPECIFIC EXPRESSION OF ACE Principal Investigator & Institution: Bernstein, Kenneth E. Associate Professor; Pathology; Emory University 1784 North Decatur Road Atlanta, GA 30322 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2005 Summary: The renin-angiotensin system is very important in the physiologic control of blood pressure and fluid balance. That said, it is also important to realize that the physiologic actions of the renin-angiotensin system are more complex than simple blood pressure control, as evidenced by the phenotype of knockout mice that lack a functional renin-angiotensin system. Our group has created mice that lack ACE. These animals have very low systolic blood pressures and are unable to effectively concentrate urine. However, what was most dramatic and unexpected was that the mice have a marked under-development of the renal medulla. We hypothesize that part of the pathophysiology of the renal phenotype is due to the lack of the local generation of angiotensin II within the kidney. This application proposes experiments to study the renal phenotype in ACE knockout mice. Our approach will be to create new strains of genetically-altered mice expressing ACE activity in selected portions of the renal nephron. These studies are designed to discriminate between angiotensin II as a local factor necessary for renal development and function, and other pathophysiologic mechanisms that may be responsible for the renal phenotype of these animals. We also describe a second line of ACE knockout mice that lacks the tissue bound form of this enzyme. The phenotype of these animals suggests that it is expression of ACE within tissues, as opposed to plasma ACE activity, that is responsible for regulating blood pressure. Using homologous recombination to create novel strains of genetically altered mice, we will examine precisely which tissues are most responsible for blood pressure control. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: TRIAGE BLOOD PRESSURE ALARM TECHNOLOGY Principal Investigator & Institution: Vosburgh, Frederick; Sr Staff Fellow, Lab of Biochemistry; Nekton Research, Llc 4625 Industry Ln Durham, NC 27713 Timing: Fiscal Year 2003; Project Start 04-APR-2003; Project End 31-DEC-2003
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Summary: (provided by applicant): We propose a novel sensor for continuous, real-time, non-invasive monitoring for acute changes in blood pressure and for issuing alarms automatically. Originally conceived for triage, e.g. in the wake of a large highway accident or a terrorist attack, this device would be a useful additional tool in triage of multiple trauma victims, particularly when sufficient medical personnel are not present. In Phase I, we will complete design of the sensor, and fabricate and demonstrate a prototype using a man-made mimic of an artery. We also shall gather information regarding end-user preferences and wireless communications. This information and experience gathered using the prototype will be used in Phase II to design and develop a wireless commercial device that incorporates the sensor and which functions untethesed and unattended to provide continuous and automatic monitoring for acute changes in blood pressure, while rejecting motion artifacts, to issue a reliable alarm in the event of an acute change in blood pressure. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: VARIABILITY OF HEART RATE, BLOOD PRESSURE & CEREBRAL OXYGENATION: LBW NEONATES Principal Investigator & Institution: Eichenwald, Eric; Children's Hospital (Boston) Boston, MA 021155737 Timing: Fiscal Year 2001 Summary: The broad objective of the study is to characterize the physiologic relationships between variability of heart rate, blood pressure, and cerebral oxygenation in a population of preterm newborns at high risk for severe brain injury. The study aims to identify and describe the physiologic antecedents of brain injury in a way that will facilitate subsequent interventional trials. From comparison of repeated measures during the first week of life, the investigators will characterize the developmental maturation of autonomic nervous system modulation of these factors. Previous experiments have found a close correlation between changes in cerebral oxygenation with changes in blood flow velocity as measured by Doppler ultrasound. Data suggests that correlation between fluctuations in mean arterial blood pressure with fluctations in cerebral oxygenation measured by near infrared spectroscopy can stratify likelihood of finding brain injury, including intraventricular hemorrhage and periventricular leukomalacia. An important aim of the study is to confirm and clarify this apparent relation between blood pressure and cerebral oxygenation. Measurement, characterization, and monitoring of unstable cerebral oxygen delivery, and more importantly, its relation to blood pressure and heart rate variability may provide a useful starting point from which to devise neuroprotective clinical strategies. Because blood pressure and heart rate variability are physiologic variables that can be manipulated, the investigators may be able to exploit the relation between these parameters and cerebral oxygenation in a prophylactic manner. Specific Aims: Fourier analysis will be used to quantify variability of cerebral oxygenation. Using coherence functions and transfer functions as previously described, the investigators will evaluate: 1) heart rate variability as a function of blood pressure variability; and 2) variability of cerebral oxygenation as a function of blood pressure variability. The former is a parameter of the baroreflex; the latter of cerebral autoregulation. With respect to transfer functions analysis of the baroreflex and of cerebral autoregulation, blood pressure will be considered the input signal. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: VASCULAR TONE AND BLOOD PRESSURE CONTROL DURING EXERCISE Principal Investigator & Institution: Buckwalker, John B. Anesthesiology; Medical College of Wisconsin Po Box26509 Milwaukee, WI 532264801 Timing: Fiscal Year 2002; Project Start 15-JUL-2002; Project End 30-JUN-2006 Summary: (provided by applicant): The regulation of blood pressure during exercise is of paramount importance to ensure adequate perfusion of vital organs and exercising skeletal muscle. It has been argued that because the vast majority of cardiac output during exercise is directed toward active skeletal muscle, vasoconstriction in exercising skeletal muscle is of primary importance in maintaining blood pressure. Indeed, previous publications by the applicant demonstrated substantial alpha adrenergic receptor mediated vasoconstriction in exercising skeletal muscle even at heavy workloads. Stimulation of non-adrenergic receptors in vascular smooth muscle, such as purinergic (P2X), neuropeptide Y (NPY Y1), and endothelin (ETA) receptors can also produce vasoconstriction in the vasculature of resting skeletal muscle, but the contribution of these receptors to tonic vasoconstriction in exercising skeletal muscle remains largely unknown. Preliminary data in this application clearly demonstrate the potential for P2X and NPY Y1 receptor mediated vasoconstriction in exercising skeletal muscle. Despite the existence of sympathetic vasoconstriction in active skeletal muscle, previous work by the applicant demonstrated that exercise produces an attenuation of alpha adrenergic receptor responsiveness in the vasculature of skeletal muscle. It remains to be determined whether non-adrenergic receptors in vascular smooth muscle exhibit a similarly reduced responsiveness from rest to exercise although pilot studies described in this application provide an intriguing suggestion that P2X and NPY Y1 receptor responsiveness in skeletal muscle is also attenuated during exercise. The overall hypothesis underlying this proposal is that non-adrenergic receptors contribute to vasoconstriction in exercising skeletal muscle. Two specific aims are proposed: 1. To determine the contribution of non-adrenergic receptors to vasoconstriction in exercising skeletal muscle. 2. To examine non-adrenergic receptor responsiveness in the vasculature of skeletal muscle at rest and exercise. A major strength of the proposed studies is the ability to study basic physiological mechanisms in conscious, exercising animals. A unique aspect of the experimental protocols is the ability to deliver agonists and antagonists to a discrete vascular bed without altering arterial pressure or blood flow in other vascular beds. The proposed studies will provide valuable new information regarding the physiological mechanisms by which blood flow to active skeletal muscle is regulated during dynamic exercise. This is an issue of fundamental importance that may have important implications for individuals with peripheral vascular disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: VASOACTIVE AUTACOIDS IN BLOOD PRESSURE REGULATION Principal Investigator & Institution: Carretero, Oscar A. Division Head; Medicine; Case Western Reserve Univ-Henry Ford Hsc Research Administraion Cfp-046 Detroit, MI 48202 Timing: Fiscal Year 2001; Project Start 01-SEP-1982; Project End 31-AUG-2002 Summary: This program project was started in September, 1982. It coordinates molecular biological, biochemical, physiological and pharmacological approaches to investigation of the role of vasoactive hormones and autacoids in circulatory homeostasis. The central theme of the program is the role of vasoactive systems
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(autocrine, paracrine, and endocrine) in the regulation of renal function and blood pressure (BP) and in the pathogenesis of hypertension. Major research emphasis is placed on the coordinated investigation of vasoactive hormones and autacoids. We postulate that a) vasodepressor autacoids such as kinins, endothelium- derived relaxing and contracting factors (EDRF and EDCF), and eicosanoids, in synergism with endocrine hormones such as atrial natriuretic factor (ANF) and brain natriuretic peptide (BNP), act by opposing hypertensive stimuli, and b) their blockade results in high BP or accelerated development of hypertension. specifically, we will investigate the role of kallikrein-kinin, SEV (which is a newly discovered member of the kallikrein family), renin-angiotensin, eicosanoids, EDRF, EDCF, ANF, and the effect of their inhibition and stimulation on: 1) BP, 2) renal blood flow and function, 3) vascular reactivity and tone, 4) microcirculation, 5) renal transport, 6) regulation of vascular smooth muscle function and growth, and 7) cardiac hypertrophy. These studies will be carried out both in normotensive animals and in different models of hypertension. this program project integrates the research activities and funding of the Hypertension and Vascular Research Division at Henry Ford Hospital. Four core units (Administrative, Radioimmunoassay, Biochemistry, and Biostatistics) will support and facilitate the scientific efforts of the investigators of the eight projects. Special expertise is centralized in the core units so that money, space, and equipment are used most efficiently. In addition, use of the core facilities removes the burden of day-to-day administrative and methodological concerns from project investigators, so that participants are free to spend their time and energy directly on their experiments. The scientists of the Hypertension and Vascular Research Division have created an exciting environment that is conducive to high-quality research. Since the inception of this program, significant advances have been made in determining the physiological and pathophysiological roles of vasoactive hormones and autacoids in the regulation of blood flow, renal function, BP and the pathogenesis of hypertension. The PPG provides a better integration of effort in which our continuing collaboration and sharing of ideas and expertise accelerates and acquisition of new knowledge about the role of humoral factors in circulatory homeostasis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: VASOACTIVE HORMONES: RECEPTORS AND SIGNALING MECHANISM Principal Investigator & Institution: Douglas, Janice G. Professor; Medicine; Case Western Reserve University 10900 Euclid Ave Cleveland, OH 44106 Timing: Fiscal Year 2001; Project Start 01-JUL-1989; Project End 30-APR-2005 Summary: The renin-angiotensin system regulates blood pressure and fluid homeostasis through effects mediated by specific receptors that are widely distributed. Molecular biological and pharmacological observations have confirmed the existence of two major subtypes of angiotensin II receptors: AT1 receptors that are highly sensitive to biphenylimidazoles (e.g. losartan), and AT2 receptors that are sensitive to tetrahydroimidopyridines (e.g. PD 123319). Abundant physiological and pharmacological data have been accumulated to substantiate the observation that the AT1 receptor mediates a majority of the known effects of Ang II. By contrast, much less is known about AT1 mediated effects, however, it is generally accepted that there is a "yin yang" relationship. Functional data indicate that the AT2 receptor opposes the blood pressure elevation of the AT1 receptor and other cellular actions as well. Data is now accumulating that a major mechanism whereby the AT2 receptor regulates blood pressures is through its ability to facilitate Na excretion. The overall goal of the PPG is to
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elucidate cellular/molecular mechanisms important for the regulation of blood pressure through effects on ion transport. The central hypothesis is that the AT2 receptor in the proximal tubule is responsible for diminished salt and fluid reabsorption that is observe in high physiological concentrations of angiotensin II. To test this hypothesis, we have assembled three projects that are directed at gaining a better understanding of structural/functional aspects of angiotensin receptors and cellular signaling pathways with influences on cytoskeleton and ion transporters in kidney epithelium. Attainment of this goal necessitates a multi- disciplinary group encompassing cell/organ physiology, molecular biology, biochemistry, pharmacology, biophysics and genetics. The program stresses a broad application to the problem of receptors, effectors, and coupling mechanisms to downstream targets employing cells and subcellular organelles and emphasizes and application of state- of-the-art techniques. Studies at a whole animal level will involve continuous infusions, assessments of blood pressure, and selective breeding of transgenic mice. Studies at a cellular level will utilize electrophysiology, fluorescent probes, pH measurement, and confocal microscopy. Studies at a molecular level involve cloning receptor subtypes, transfections of receptors (wild type and mutants), small G- protein (wild type and mutants), G-protein subunits and constitutively active and dominant negative mutants of phosphatases and kinases. Cores provide administrative support, tissue culture, animal models, biostatistics, and analytical instrumentation measures to enhance the scientific merit of all projects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: VESTIBULAR INFLUENCES ON THE SYMPATHETIC NERVOUS SYSTEM Principal Investigator & Institution: Yates, Bill J. Associate Professor; Otolaryngology; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, PA 15260 Timing: Fiscal Year 2001; Project Start 01-APR-1990; Project End 31-MAR-2004 Summary: (Adapted from the Investigator's Abstract) Research over the past decade has demonstrated that the vestibular system influences the control of blood pressure, both in humans and in animal models. The effects of the vestibular system on cardiovascular control are mainly mediated through the sympathetic division of the autonomic nervous system. Peripheral vestibular lesions have been shown to diminish the capability to rapidly and accurately make necessary cardiovascular adjustments during changes in posture. Thus, one role of vestibulo-cardiovascular influences appears to be eliciting changes in blood distribution in the body so that stable blood pressure is maintained during movement. However, deficits in correcting blood pressure following vestibular lesions diminish over time, and are less severe when non-labyrinthine sensory cues regarding body position in space are provided; these observations show that pathways that mediate vestibulo-sympathetic reflexes are subject to plasticity. The focus of the current grant is to explore the adaptive plasticity in cardiovascular responses elicited by the central vestibular system. In particular, the role that the cerebellum may play in adaptation of these responses will be examined, as well as the possibility that nonlabyrinthine inputs to the central vestibular system may be important in controlling blood pressure during movement. Three specific aims are proposed in the current application. In the first aim, the role of the posterior cerebellar vermis in modulating vestibulo-cardiovascular responses will be explored. This region of the vestibulocerebellum, which includes the uvula and parts of the nodulus, has been shown in numerous studies to participate in the regulation of blood pressure. Because this cerebellar region has extensive projections to areas of the vestibular nuclei that mediate
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vestibulo-sympathetic responses and is known to participate in plastic changes in vestibulo-ocular reflexes, it seems likely that the uvula and nodulus modulate vestibular influences on cardiovascular regulation. The second specific aim will determine the sources of non-labyrinthine inputs to the vestibular nuclei, and will explore the role of these signals in modulating activity of vestibular nucleus neurons following vestibular lesions. The third specific aim will determine whether nonlabyrinthine inputs to the vestibular nuclei have the capacity to elicit compensatory blood pressure changes during body rotations. By understanding the mechanisms through which cardiovascular adjustments are made during movement and changes in posture, therapeutic strategies may be developed to alleviate autonomic problems in patients with central or peripheral vestibular lesions and in astronauts, who are known to suffer from postural-related hypotension following spaceflight. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: VESTIBULAR-CEREBROVASCULAR INTERACTIONS IN HUMANS Principal Investigator & Institution: Serrador, Jorge M.; Hebrew Rehabilitation Center for Aged 1200 Centre St, Roslindale Boston, MA 02131 Timing: Fiscal Year 2003; Project Start 01-MAY-2003; Project End 30-APR-2006 Summary: (provided by applicant): Falls are a leading cause of morbidity in the elderly, resulting in 36 million hospital visits per year, at a cost in excess of $10 billion. While the cause of many falls remains unexplained, syncope and orthostatic hypotension are important factors. Since vestibular activation has been shown to have an active role in the regulation of blood pressure during orthostatic stress, and vestibular function decreases with age >60 years, we hypothesize that vestibular hypo-function in the elderly results in impaired regulation of blood pressure during orthostasis, which in turn results in cerebral hypo-perfusion and syncope. Previous evidence that vestibular activation has direct effects on cerebral blood flow suggests that vestibular inputs affect the cerebrovascular response to orthostasis. The goal of this research is to examine the role of vestibular inputs in cerebral blood flow regulation and the effect of these inputs on orthostatic tolerance. Our general hypothesis is that otolith-mediated vestibular inputs act as a feed forward mechanism causing cerebral vasodilatation, to compensate for the decrease in cerebral perfusion pressure caused by the upright posture. We propose two specific aims to address this hypothesis: 1) Determine the effect of tilts in the pitch (sagittal) and roll (lateral) planes on cerebral blood flow and cerebral autoregulation in young and older subjects (with and without vestibular deficits). This aim will be accomplished by passively tilting subjects with eyes closed from a horizontal to 80 degree upright posture in the pitch and roll planes; and 2) Determine the effect of otolith stimulation during centrifugation on cerebral blood flow in labyrinthine defective inpatients and healthy controls. This aim will be accomplished by varying the radius of rotation of labyrinthine-defective patients and healthy gender- and agematched controls on a short arm centrifuge. The results of these studies will provide direct evidence on the role of vestibular inputs in cerebrovascular regulation. This work may lead to new methods to diagnose those at risk for falls, as well as ways to train the vestibular system to minimize cerebral hypo-perfusion, syncope, and falls in the elderly. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: VISCERAL ADIPOSITY AND CVD RISK IN WOMEN Principal Investigator & Institution: Daniels, Stephen R. Professor of Pediatrics and Environment; Children's Hospital Med Ctr (Cincinnati) 3333 Burnet Ave Cincinnati, OH 45229
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Timing: Fiscal Year 2001; Project Start 05-MAR-2001; Project End 28-FEB-2006 Summary: Obesity is associated with increased morbidity and mortality. Concern about obesity has increased as the prevalence and severity have increased and the age of onset has decreased. It has also become clear that the location of fat may play an important role in determining the risk associated with obesity. Intra-abdominal fat has been shown to have particularly adverse consequences related to cardiovascular risk factors. Of interest is the fact that a number of studies have shown that the impact of overall adiposity differs by race. For each unit increase in adiposity, blacks appear to have less of an increase in blood pressure and triglycerides and less of a decrease in HDL cholesterol compared to whites. This racial difference in the relationship of adiposity to cardiovascular risk status may be related to differences in the distribution of fat. It is hypothesized that for a given level and increase in total body fat (measured by DEXA) black women will have less intra-abdominal fat (measured by magnetic resonance imaging). The proposed cohort study will be comprised of 650 black and white women who have been followed since age nine or 10 years as part of the NHLBI Growth and Health Study. Subjects will be studied at age 23 and again at age 25 years. At each examination, subjects will have measurement of total fat (DEXA), intra-abdominal fat (MRI), fasting lipids and lipoproteins, insulin and glucose, blood pressure, and left ventricular mass (by echocardiography). In addition, the timing of pubertal maturation and dietary intake of fat and sucrose will be evaluated as potential determinants of intra-abdominal fat using data previously collected from age nine years to age 22 years. Study of this cohort provides a unique opportunity to evaluate whether differences in deposition of intraabdominal fat are related to racial differences in the relationship between adiposity and cardiovascular risk factors. It will also allow evaluation of childhood and adolescent determinants of adult intra-abdominal adiposity. The results of this investigation may provide insight into the prevention of intra-abdominal fat accumulation and ultimate lowering of risk for cardiovascular disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: VISUAL ADAPTATION LIMITS AND AGE-RELATED DISEASE Principal Investigator & Institution: Eisner, Alvin; Senior Scientist; None; Oregon Health & Science University Portland, OR 972393098 Timing: Fiscal Year 2001; Project Start 01-FEB-1999; Project End 31-JAN-2003 Summary: The proposed research will determine the extent to which diseased visual systems can be pushed selectively beyond the limits of their effective adaptation capabilities so that their sensitivities become categorically different from normal. The emphasis will be on glaucoma-related visual dysfunction that cannot be attributed directly to the loss of optic nerve cells. This dysfunction involves adaptation processes that actively maintain visual response. It occurs for people who have a slight degree of glaucomatous optic neuropathy combined with high blood pressure, and could be due to either condition. The research will help clarify the relation between high blood pressure and glaucoma-related visual dysfunction. It will focus on how to exceed the limits of the visual system's adaptation capabilities so that subtle physiologic compromise can be amplified into large sensitivity changes. A major emphasis will concern the visual system's ability to maintain a stable effective operating range for resolving temporally modulated stimuli, i.e. for detecting flicker. Psychophysical tests of visual function after adaptation-field onset will be compared with clinical assessments of early glaucomatous damage. The prevalence of visual adaptation abnormalities will be examined for four clinically-defined groups of middle-age subjects: 1) glaucoma subjects with positive medical histories of high blood pressure, 2) glaucoma subjects
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with negative medical histories of high blood pressure, 3) non-glaucoma subjects with positive medical histories of high blood pressure and negative clinical histories of ocular hypertension, and 4) healthy normal subjects. Young healthy subjects will be tested also. The experiments will identify the types of processes that underlie flicker response abnormalities and will integrate a diverse set of existing results concerning suppression of flicker response under taxing adaptation conditions. The specific aims are 1) to determine whether people with high blood pressure have a higher-thannormal prevalence of visual dysfunction, 2) to determine how often foveal visual adaptation is abnormal for people who have high blood pressure but do not have glaucoma, and vice versa, 3) to determine whether certain subtypes or stages of glaucoma are associated with certain types of foveal adaptation abnormalities, 4) to identify the mechanisms by which glaucoma and/or high-blood-pressure alter foveal flicker response, and 5) to determine if the limits of the visual system's flicker-response operating-range can be specified as precisely at bright ambient light levels as they have been at dim ambient light levels. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: WELL-BEING AND BLOOD PRESSURE IN BLACK TWINS Principal Investigator & Institution: Brandon, Dwayne T. Gerontology Center; Pennsylvania State University-Univ Park 201 Old Main University Park, PA 16802 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 30-JUN-2003 Summary: The objective of the proposed study is to examine sources of individual differences in measures of well-being, blood pressure, and the relationship between well-being and blood pressure in adult African Americans. The specific aims of the proposed study are: 1. to examine the relationship between measures of well-being and blood pressure among a sample of African American twins; 2. to decompose the genetic and environmental sources of variance in the relationship between well- being and blood pressure; 3. to account for the impact of psychosocial variables (e.g. age, gender, education) on the relationship of well being and blood pressure. African Americans experience one of the highest rates of hypertension in the world. However, little is known about the sources of individual differences in blood pressure in this population. The proposed study will analyze measures of well-being (stress & active coping) and blood pressure (systolic and diastolic) collected from participants of the Carolina African American Twin Study of Aging (CAATSA). Participants in CAATSA range in age from 25 to 89 years. The sample currently includes 90 identical twin pairs and 97 same-sex fraternal twins pairs. Data analysis will be conducted using biometrical model fitting procedures. Multivariate genetic models will be used to examine genetic and environmental influences on measures of well-being blood pressure, and the relationship of well-being and blood pressure. Understanding the sources of individual differences (genetic and environmental) in blood pressure in this population is critical to comprehending the etiology of hypertension and ameliorating this health disparity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: WORK HOURS, MUSCULOSKELETAL DISORDERS AND CVD RISK Principal Investigator & Institution: Landsbergis, Paul A. Community and Preventive Med; Mount Sinai School of Medicine of Nyu of New York University New York, NY 10029 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 29-SEP-2005
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Summary: Stressful features of work organization, including long work hours, have recently been identified as risk factors for blood pressure elevation and cardiovascular disease (CVD) and have been suggested as risk factors for work-related musculoskeletal disorders (WMSDs). The proposed study has two primary specific aims, to determine: 1) associations between extended work hours, ergonomic risk factors, other psychosocial job stressors, and WMSDs; and 2) associations between extended work hours, other psychosocial job stressors (including job strain, effort-reward imbalance and shift work), blood pressure elevation and CVD risk. The study population includes white-collar and blue-collar men and women from the health care, transportation, and manufacturing industries, many of whom currently use overtime extensively. The study is also designed to examine the effect of characteristics of overtime, to assess how overtime may interact with other stressful features of work organization, ergonomic stressors or demographic measures, and to investigate the impact of recent changes in the organization of work on work hours, psychosocial job stressors, ergonomic risk factors, and work climate. Initial efforts will include analyses of available employer records on work hours and WMSDs in the transportation and manufacturing industries, and secondary analysis of existing medical data bases in the health care industry. A population-based case-control study of incident cases of WMSDs will be conducted among health care workers. 200 cases and 200 healthy incidence-density-matched controls will be interviewed in person. Ergonomic observation of an individual representing each job title held by study participants will be conducted. 40 job-matched controls will also be selected from workers in the same job titles as cases to assess information bias in the cases, and to allow substitution of job-matched controls' biomechanical job exposures for cases in whom such data cannot be collected. A crosssectional study of a random sample of 400 employees, stratified by overtime use, from participating employers in various industries, will be conducted to investigate risk factors for blood pressure elevation and CVD. Participants will have their blood pressure measured while working using an innovative method (work site point estimates) to obtain a valid estimate of mean workday blood pressure. A sub-sample of 100 employees will be followed over 2 years and have their blood pressure measured during periods of high vs. low overtime. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: WORKSITE BLOOD PRESSURE STUDY Principal Investigator & Institution: Schwartz, Joseph E.; Weill Medical College of Cornell Univ New York, NY 10021 Timing: Fiscal Year 2001 Summary: The goal of this project is to bring to a responsible conclusion the 13- year Work Site Blood Pressure Study. Begun in 1985, this study was designed to test the hypothesis that job strain is a risk factor for hypertension and cardiovascular target organ damage. With 475 initially- healthy participants, including sizable proportions of women and minorities, recruited from ten work sites this is the largest study of work stress and ambulatory blood pressure in the world. The repeat assessments of study participants every 3-4 years has resulted in a dataset that is unique in its combination of psychosocial and cardiovascular measures. At the conclusion of the present funding period, we will have completed the fourth and final round of assessments on all available participants from the first nine work sites. This proposal requests funds to support one more year of data collection so that participants from our tenth site, who were first evaluated in 1995, can be reassessed. This site from which 103 participants (all nurses) were recruited, was added to the cohort study in order to increase the number of
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women in the study from 81 to a more respectable 174. While the total period of followup will only be 3 years, rather than the 6-10 years for participants from the other sites, this second re-evaluation is critical to our being able to address the same questions with women that we have already addressed and are planning to address for men. During the first year, we will also obtain ambulatory blood pressure recordings on those former participants who have left the NYC metropolitan area during the course of the study, and therefore have not been available for follow-up. Years 2 and 3 of the grant will be used to conduct extensive analyses of this rich database and prepare manuscripts for publication. There are many etiological questions about the development of hypertension and target organ damage, both in relation to psychosocial factors and independent of them, that can only be addressed with a longitudinal database that containing high-quality repeat assessments of the cardiovascular outcome measures using state-of-the-art methodology. It will require at least two years to reap the benefits of the many years of effort and extraordinary cooperation of study. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “blood pressure” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for blood pressure in the PubMed Central database: •
A score for predicting risk of death from cardiovascular disease in adults with raised blood pressure, based on individual patient data from randomised controlled trials. by Pocock SJ, McCormack V, Gueyffier F, Boutitie F, Fagard RH, Boissel JP. 2001 Jul 14; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=34541
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Accuracy of the advanced trauma life support guidelines for predicting systolic blood pressure using carotid, femoral, and radial pulses: observational study. by Deakin CD, Low JL. 2000 Sep 16; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27481
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Association between birth weight and adult blood pressure in twins: historical cohort study. by Poulter NR, Chang CL, MacGregor AJ, Snieder H, Spector TD. 1999 Nov 20; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28278
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Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. by Adler AI, Stratton IM, Neil HA, Yudkin JS, Matthews DR, Cull CA, Wright AD, Turner RC, Holman RR. 2000 Aug 12; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27455
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Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.
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Benefits and side effects of blood pressure lowering treatment: what was wrong with doxazosin in the ALLHAT? by Gavras I, Gavras H. 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=64825
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Blood pressure and ageing: longitudinal cohort study. by Starr JM, Inch S, Cross S, MacLennan WJ, Deary IJ. 1998 Aug 22; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28645
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Blood pressure and mortality in elderly people aged 85 and older: community based study. by Boshuizen HC, Izaks GJ, van Buuren S, Ligthart GJ. 1998 Jun 13; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28576
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Blood Pressure Monitoring in Cardiovascular Medicine and Therapeutics. by LaMotte LC. 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=101141
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Blood pressure reduction and diabetes insipidus in transgenic rats deficient in brain angiotensinogen. by Schinke M, Baltatu O, Bohm M, Peters J, Rascher W, Bricca G, Lippoldt A, Ganten D, Bader M. 1999 Mar 30; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=22405
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Cardiovascular abnormalities with normal blood pressure in tissue kallikreindeficient mice. by Meneton P, Bloch-Faure M, Hagege AA, Ruetten H, Huang W, Bergaya S, Ceiler D, Gehring D, Martins I, Salmon G, Boulanger CM, Nussberger J, Crozatier B, Gasc JM, Heudes D, Bruneval P, Doetschman T, Menard J, Alhenc-Gelas F. 2001 Feb 27; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=30190
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Changes in blood pressure among students attending Glasgow University between 1948 and 1968: analyses of cross sectional surveys. by McCarron P, Okasha M, McEwen J, Smith GD. 2001 Apr 14; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=30581
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Choosing a first-line drug in the management of elevated blood pressure: What is the evidence? 2: [beta]-Blockers. by Wright JM. 2000 Jul 25; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=80212
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Choosing a first-line drug in the management of elevated blood pressure: What is the evidence? 3: Angiotensin-converting-enzyme inhibitors. by Wright JM. 2000 Aug 8; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=80294
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Chronic Control of High Blood Pressure in the Spontaneously Hypertensive Rat by Delivery of Angiotensin Type 1 Receptor Antisense. by Iyer SN, Lu D, Katovich MJ, Raizada MK. 1996 Sep 3; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=38537
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Comparison of acceptability of and preferences for different methods of measuring blood pressure in primary care. by Little P, Barnett J, Barnsley L, Marjoram J, Fitzgerald-Barron A, Mant D. 2002 Aug 3; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=117641
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Comparison of agreement between different measures of blood pressure in primary care and daytime ambulatory blood pressure. by Little P, Barnett J, Barnsley L, Marjoram J, Fitzgerald-Barron A, Mant D. 2002 Aug 3; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=117640
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Contribution of parental blood pressures to association between low birth weight and adult high blood pressure: cross sectional study. by Walker BR, McConnachie A, Noon JP, Webb DJ, Watt GC. 1998 Mar 14; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28489
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Cost effectiveness analysis of improved blood pressure control in hypertensive patients with type 2 diabetes: UKPDS 40. by [No authors listed]; 1998 Sep 12; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28661
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Debate: Does it matter how you lower blood pressure? by Alderman MH. 2000; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=59601
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Debate: does it matter how you lower blood pressure? by McInnes GT. 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=59626
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Decreased blood pressure response in mice deficient of the [alpha]1b-adrenergic receptor. by Cavalli A, Lattion AL, Hummler E, Nenniger M, Pedrazzini T, Aubert JF, Michel MC, Yang M, Lembo G, Vecchione C, Mostardini M, Schmidt A, Beermann F, Cotecchia S. 1997 Oct 14; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=23548
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Effect of Helicobacter pylori infection on blood pressure: a community based cross sectional study. by Harvey R, Lane A, Murray L, Harvey I, Nair P, Donovan J. 2001 Aug 4; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=35348
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Elevated blood pressures in mice lacking endothelial nitric oxide synthase. by Shesely EG, Maeda N, Kim HS, Desai KM, Krege JH, Laubach VE, Sherman PA, Sessa WC, Smithies O. 1996 Nov 12; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=24066
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Engineering analysis of biological variables: An example of blood pressure over 1 day. by Huang W, Shen Z, Huang NE, Fung YC. 1998 Apr 28; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=20170
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Evaluation of a community-based automated blood pressure measuring device. by Lewis JE, Boyle E, Magharious L, Myers MG. 2002 Apr 30; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=102353
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Generation of Transgenic Mice with Elevated Blood Pressure by Introduction of the Rat Renin and Angiotensinogen Genes. by Ohkubo H, Kawakami H, Kakehi H, Takumi T, Arai H, Yokota Y, Iwai M, Tanabe Y, Masu M, Hata J, Iwao H, Okamoto H, Yokoyama M, Nomura T, Katsuki M, Nakanishi S. 1990 Jul 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=54280
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Genetic Control of Blood Pressure and the Angiotensinogen Locus. by Kim H, Krege JH, Kluckman KD, Hagaman JR, Hodgin JB, Best CF, Jennette C, Coffman TM, Maeda N, Smithies O. 1995 Mar 28; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=42293
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Glucagon-like peptide-1 receptor stimulation increases blood pressure and heart rate and activates autonomic regulatory neurons. by Yamamoto H, Lee CE, Marcus JN, Williams TD, Overton JM, Lopez ME, Hollenberg AN, Baggio L, Saper CB, Drucker DJ, Elmquist JK. 2002 Jul 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=151031
100 Blood Pressure
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How well can blood pressure be controlled? Progress report on the Systolic Hypertension in Europe Follow-Up Study (Syst-Eur 2). by Thijs L, Staessen JA, Beleva S, Birkenhager WH, Bulpitt CJ, Celis H, Fletcher AE, Kermova R, Leonetti G, Laks T, Mantov S, Nachev C, Sarti C, Tuomilehto J, Fagard RH. 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=64833
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Implementing intensive control of blood glucose concentration and blood pressure in type 2 diabetes in England: cost analysis (UKPDS 63). by Gray A, Clarke P, Farmer A, Holman R. 2002 Oct 19; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=129631
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Knockout of the [alpha]1A /C-adrenergic receptor subtype: The [alpha]1A /C is expressed in resistance arteries and is required to maintain arterial blood pressure. by Rokosh DG, Simpson PC. 2002 Jul 9; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=123165
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Long chain polyunsaturated fatty acid supplementation in infant formula and blood pressure in later childhood: follow up of a randomised controlled trial. by Forsyth JS, Willatts P, Agostoni C, Bissenden J, Casaer P, Boehm G. 2003 May 3; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=153849
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Lower target blood pressure for patients with diabetes mellitus. by Chen BH. 2000 Nov 28; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=80449
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Natriuretic peptide receptor 1 expression influences blood pressures of mice in a dose-dependent manner. by Oliver PM, John SW, Purdy KE, Kim R, Maeda N, Goy MF, Smithies O. 1998 Mar 3; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=19408
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New insights into the effects on blood pressure of diets low in salt and high in fruits and vegetables and low-fat dairy products. by Vollmer WM, Sacks FM, Svetkey LP. 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=59628
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Predictors of normotension on withdrawal of antihypertensive drugs in elderly patients: prospective study in second Australian national blood pressure study cohort. by Nelson MR, Reid CM, Krum H, Muir T, Ryan P, McNeil JJ. 2002 Oct 12; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=128950
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Randomized trial evaluating the framing of cardiovascular risk and its impact on blood pressure control [ISRCTN87597585]. by Fahey T, Montgomery AA, Peters TJ. 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=58836
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Reduced growth, abnormal kidney structure, and type 2 (AT2) angiotensin receptormediated blood pressure regulation in mice lacking both AT1A and AT1B receptors for angiotensin II. by Oliverio MI, Kim HS, Ito M, Le T, Audoly L, Best CF, Hiller S, Kluckman K, Maeda N, Smithies O, Coffman TM. 1998 Dec 22; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28071
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Regulation of Blood Pressure by the Type 1A Angiotensin II Receptor Gene. by Ito M, Oliverio MI, Mannon PJ, Best CF, Maeda N, Smithies O, Coffman TM. 1995 Apr 11; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=42199
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Regulation of renin expression and blood pressure by vitamin D3. by Sigmund CD. 2002 Jul 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=151071
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Reliability of patients measuring blood pressure at home: prospective observational study. by Nordmann A, Frach B, Walker T, Martina B, Battegay E. 1999 Oct 30; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28268
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Smooth muscle-selective deletion of guanylyl cyclase-A prevents the acute but not chronic effects of ANP on blood pressure. by Holtwick R, Gotthardt M, Skryabin B, Steinmetz M, Potthast R, Zetsche B, Hammer RE, Herz J, Kuhn M. 2002 May 14; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=124542
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The [alpha]1D-adrenergic receptor directly regulates arterial blood pressure via vasoconstriction. by Tanoue A, Nasa Y, Koshimizu T, Shinoura H, Oshikawa S, Kawai T, Sunada S, Takeo S, Tsujimoto G. 2002 Mar 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=150908
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The Calorically Restricted Low-Fat Nutrient-Dense Diet in Biosphere 2 Significantly Lowers Blood Glucose, Total Leukocyte Count, Cholesterol, and Blood Pressure in Humans. by Walford RL, Harris SB, Gunion MW. 1992 Dec 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=50586
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The sodium-restricted DASH diet lowers blood pressure. by Hoey J. 2001 May 29; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=81136
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Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. by [No authors listed]; 1998 Sep 12; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28659
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Transgenic amplification of glucocorticoid action in adipose tissue causes high blood pressure in mice. by Masuzaki H, Yamamoto H, Kenyon CJ, Elmquist JK, Morton NM, Paterson JM, Shinyama H, Sharp MG, Fleming S, Mullins JJ, Seckl JR, Flier JS. 2003 Jul 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=162290
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Two Point Mutations within the Adducin Genes are Involved in Blood Pressure Variation. by Bianchi G, Tripodi G, Casari G, Salardi S, Barber BR, Garcia R, Leoni P, Torielli L, Cusi D, Ferrandi M, Pinna LA, Baralle FE, Ferrari P. 1994 Apr 26; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=43710
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Uroguanylin knockout mice have increased blood pressure and impaired natriuretic response to enteral NaCl load. by Lorenz JN, Nieman M, Sabo J, Sanford LP, Hawkins JA, Elitsur N, Gawenis LR, Clarke LL, Cohen MB. 2003 Oct 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=213491
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Use of intrinsic modes in biology: Examples of indicial response of pulmonary blood pressure to [plus minus] step hypoxia. by Huang W, Shen Z, Huang NE, Fung YC. 1998 Oct 27; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=23580
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Value of low dose combination treatment with blood pressure lowering drugs: analysis of 354 randomised trials. by Law MR, Wald NJ, Morris JK, Jordan RE. 2003 Jun 28; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=162261
102 Blood Pressure
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Within pair association between birth weight and blood pressure at age 8 in twins from a cohort study. by Dwyer T, Blizzard L, Morley R, Ponsonby AL. 1999 Nov 20; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=28277
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Xanthine oxidase activity associated with arterial blood pressure in spontaneously hypertensive rats. by Suzuki H, DeLano FA, Parks DA, Jamshidi N, Granger DN, Ishii H, Suematsu M, Zweifach BW, Schmid-Schonbein GW. 1998 Apr 14; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=22563
The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with blood pressure, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “blood pressure” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for blood pressure (hyperlinks lead to article summaries): •
A common beta1-adrenergic receptor polymorphism (Arg389Gly) affects blood pressure response to beta-blockade. Author(s): Sofowora GG, Dishy V, Muszkat M, Xie HG, Kim RB, Harris PA, Prasad HC, Byrne DW, Nair UB, Wood AJ, Stein CM. Source: Clinical Pharmacology and Therapeutics. 2003 April; 73(4): 366-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12709726&dopt=Abstract
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A model analysis of costs of blood pressure destabilization and edema associated with rofecoxib and celecoxib among older patients with osteoarthritis and hypertension in a Medicare Choice population. Author(s): Becker RV, Burke TA, McCoy MA, Trotter JP. Source: Clinical Therapeutics. 2003 February; 25(2): 647-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12749519&dopt=Abstract
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A new fixed-dose combination for added blood pressure control: telmisartan plus hydrochlorothiazide. Author(s): Lacourciere Y. Source: J Int Med Res. 2002 July-August; 30(4): 366-79. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12235918&dopt=Abstract
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PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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A new model of individual differences in hemodynamic profile and blood pressure reactivity. Author(s): Gregg ME, Matyas TA, James JE. Source: Psychophysiology. 2002 January; 39(1): 64-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12206296&dopt=Abstract
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A pilot randomized trial of induced blood pressure elevation: effects on function and focal perfusion in acute and subacute stroke. Author(s): Hillis AE, Ulatowski JA, Barker PB, Torbey M, Ziai W, Beauchamp NJ, Oh S, Wityk RJ. Source: Cerebrovascular Diseases (Basel, Switzerland). 2003; 16(3): 236-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12865611&dopt=Abstract
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A practical approach to achieving recommended blood pressure goals in diabetic patients. Author(s): Bakris GL. Source: Archives of Internal Medicine. 2001 December 10-24; 161(22): 2661-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11732930&dopt=Abstract
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A relation between blood pressure and stiffness of joints and skin. Author(s): Uiterwaal CS, Grobbee DE, Sakkers RJ, Helders PJ, Bank RA, Engelbert RH. Source: Epidemiology (Cambridge, Mass.). 2003 March; 14(2): 223-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12606890&dopt=Abstract
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A study of 24-hour ambulatory blood pressure monitoring in cases of intermittent acute porphyria with hypertension: special reference to safety and efficacy of angiotensin-converting enzyme inhibitor (enalapril) therapy. Author(s): Bandyopadhyay M, Gupta BK, Panwar RB, Kabra PK, Kaushik AN, Chadda VS. Source: Indian Heart J. 2002 November-December; 54(6): 734. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12674196&dopt=Abstract
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Abnormal nocturnal blood pressure fall in senile-onset depression with subcortical silent cerebral infarction. Author(s): Hamada T, Murata T, Omori M, Takahashi T, Kosaka H, Wada Y, Yoshida H. Source: Neuropsychobiology. 2003; 47(4): 187-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12824741&dopt=Abstract
104 Blood Pressure
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Abnormal nocturnal blood pressure falls in elderly hypertension: clinical significance and determinants. Author(s): Kario K, Shimada K, Pickering TG. Source: Journal of Cardiovascular Pharmacology. 2003 January; 41 Suppl 1: S61-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12688399&dopt=Abstract
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Abnormal temporal dynamics of blood pressure and RR interval regulation in patients with chronic heart failure: relationship to baroreflex sensitivity. Author(s): Davies LC, Francis DP, Willson K, Scott AC, Piepoli M, Coats AJ. Source: International Journal of Cardiology. 2002 November; 86(1): 107-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12243855&dopt=Abstract
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Abnormal vasoactive hormones and 24-hour blood pressure in obstructive sleep apnea. Author(s): Moller DS, Lind P, Strunge B, Pedersen EB. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2003 April; 16(4): 274-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12670743&dopt=Abstract
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Accurate measurement of blood pressure. Author(s): Fournier A, Safar M. Source: Jama : the Journal of the American Medical Association. 2003 June 4; 289(21): 2793; Author Reply 2793-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12783904&dopt=Abstract
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Accurate measurement of blood pressure. Author(s): Bendjelid K. Source: Jama : the Journal of the American Medical Association. 2003 June 4; 289(21): 2793; Author Reply 2793-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12783903&dopt=Abstract
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Accurate measurement of blood pressure. Author(s): Karnath BM. Source: Jama : the Journal of the American Medical Association. 2003 June 4; 289(21): 2792; Author Reply 2793-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12783902&dopt=Abstract
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Accurate measurement of blood pressure. Author(s): Schwartz AR, Haas DC, Gerin W, Pickering TG. Source: Jama : the Journal of the American Medical Association. 2003 June 4; 289(21): 2792; Author Reply 2793-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12783901&dopt=Abstract
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Achieving blood pressure control in patients with diabetes: a case study in primary care. Author(s): Wessell AM, Ornstein SM, Nietert PJ, Wilson JP, Brooks A. Source: Topics in Health Information Management. 2003 January-March; 24(1): 3-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12674389&dopt=Abstract
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Achieving goal blood pressure in patients with type 2 diabetes: conventional versus fixed-dose combination approaches. Author(s): Bakris GL, Weir MR; Study of Hypertension and the Efficacy of Lotrel in Diabetes (SHIELD) Investigators. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2003 May-June; 5(3): 202-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12826783&dopt=Abstract
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Acute blood pressure effects at the onset of supraventricular and ventricular tachycardia. Author(s): Taneja T, Kadish AH, Parker MA, Goldberger JJ. Source: The American Journal of Cardiology. 2002 December 15; 90(12): 1294-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12480037&dopt=Abstract
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Adiposity, central body fat distribution and blood pressure among young Bengalee adults of Kolkata, India: sexual dimorphism. Author(s): Bhadra M, Mukhopadhyay A, Bose K. Source: Journal of Physiological Anthropology and Applied Human Science. 2002 November; 21(6): 273-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12612398&dopt=Abstract
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Administration of raloxifene does not influence 24-hour ambulatory blood pressure of postmenopausal women with osteopenia: a double-blind placebo-controlled study. Author(s): Cagnacci A, Zanni AL, Volpe A. Source: American Journal of Obstetrics and Gynecology. 2003 May; 188(5): 1278-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12748498&dopt=Abstract
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Administration time-dependent effects of aspirin on blood pressure in untreated hypertensive patients. Author(s): Hermida RC, Ayala DE, Calvo C, Lopez JE, Fernandez JR, Mojon A, Dominguez MJ, Covelo M. Source: Hypertension. 2003 June; 41(6): 1259-67. Epub 2003 May 05. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12732586&dopt=Abstract
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Adolescent pain sensitivity is associated with cardiac autonomic function and blood pressure over 8 years. Author(s): Campbell TS, Ditto B, Seguin JR, Sinray S, Tremblay RE. Source: Hypertension. 2003 June; 41(6): 1228-33. Epub 2003 May 05. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12732589&dopt=Abstract
106 Blood Pressure
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Aerobic exercise for lowering blood pressure: a metaanalysis. Author(s): LaMonte MJ, Yanowitz FG. Source: Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine. 2002 November; 12(6): 407. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12650159&dopt=Abstract
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Age dependency and correlation of heart rate variability, blood pressure variability and baroreflex sensitivity. Author(s): Wang SY, Zhang LF, Wang XB, Cheng JH. Source: J Gravit Physiol. 2000 July; 7(2): P145-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12697491&dopt=Abstract
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Age variation in blood pressure: effect of sex and urbanization in a genetically homogeneous caste population of Andhra Pradesh. Author(s): Nirmala A. Source: American Journal of Human Biology : the Official Journal of the Human Biology Council. 2001 November-December; 13(6): 744-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11748813&dopt=Abstract
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Age-specific relevance of usual blood pressure to vascular mortality. Author(s): Adab P, Cheng KK, Jiang CQ, Zhang WS, Lam TH. Source: Lancet. 2003 April 19; 361(9366): 1391; Author Reply 1391-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12711500&dopt=Abstract
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Age-specific relevance of usual blood pressure to vascular mortality. Author(s): Jennrich R. Source: Lancet. 2003 April 19; 361(9366): 1390-1; Author Reply 1391-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12711498&dopt=Abstract
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Age-specific relevance of usual blood pressure to vascular mortality. Author(s): Port S. Source: Lancet. 2003 April 19; 361(9366): 1390; Author Reply 1391-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12711497&dopt=Abstract
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Age-specific relevance of usual blood pressure to vascular mortality. Author(s): Fournier A, Safar M. Source: Lancet. 2003 April 19; 361(9366): 1389-90; Author Reply 1391-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12711496&dopt=Abstract
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Age-specific relevance of usual blood pressure to vascular mortality. Author(s): Franklin SS, Wong ND, Kannel WB. Source: Lancet. 2003 April 19; 361(9366): 1389; Author Reply 1391-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12711495&dopt=Abstract
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Aggressive blood pressure management. Author(s): Miller NH. Source: The Journal of Cardiovascular Nursing. 2003 April-June; 18(2): 108-15. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12680569&dopt=Abstract
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Aging well and aging poorly: primary and secondary low blood pressure. Author(s): Harris TB. Source: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2003 July; 58(7): 662-4; Discussion 669-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12865487&dopt=Abstract
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Air pollution, blood pressure, and their long-term associations with mortality. Author(s): Lipfert FW, Perry HM Jr, Miller JP, Baty JD, Wyzga RE, Carmody SE. Source: Inhalation Toxicology. 2003 April 25; 15(5): 493-512. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12682860&dopt=Abstract
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Altered diurnal variation of blood pressure in elderly subjects with decreased activity of daily living and impaired cognitive function. Author(s): Ohya Y, Ohtsubo T, Tsuchihashi T, Eto K, Sadanaga T, Nagao T, Abe I, Fujishima M. Source: Hypertens Res. 2001 November; 24(6): 655-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11768724&dopt=Abstract
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Ambulatory blood pressure and brain atrophy in the healthy elderly. Author(s): Goldstein IB, Bartzokis G, Guthrie D, Shapiro D. Source: Neurology. 2002 September 10; 59(5): 713-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12221162&dopt=Abstract
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Ambulatory blood pressure and left ventricular structure and function in relation to the G-protein beta3-subunit polymorphism C825T in White Europeans. Author(s): Olszanecka A, Kawecka-Jaszcz K, Kuznetsova T, Stolarz K, Brand E, Ryabikov A, Herrmann SM, Nikitin Y, Staessen JA; European Project on Genes in Hypertension (EPOGH) Investigators. Source: Journal of Human Hypertension. 2003 May; 17(5): 325-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12756405&dopt=Abstract
108 Blood Pressure
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Ambulatory blood pressure monitoring for cardiovascular medicine. Author(s): Kario K, Yasui N, Yokoi H. Source: Ieee Engineering in Medicine and Biology Magazine : the Quarterly Magazine of the Engineering in Medicine & Biology Society. 2003 May-June; 22(3): 81-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12845823&dopt=Abstract
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Ambulatory blood pressure monitoring in patients with spinocerebellar degeneration. Author(s): Azuma T, Uemichi T, Funauchi M, Nagai Y, Matsubara T. Source: Acta Neurologica Scandinavica. 2002 October; 106(4): 213-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12225317&dopt=Abstract
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Ambulatory blood pressure monitoring in pediatric renal transplantation. Author(s): Mitsnefes MM, Portman RJ. Source: Pediatric Transplantation. 2003 April; 7(2): 86-92. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12654047&dopt=Abstract
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Ambulatory blood pressure monitoring in the management of hypertension. Author(s): O'Brien E. Source: Heart (British Cardiac Society). 2003 May; 89(5): 571-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12695477&dopt=Abstract
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Ambulatory blood pressure monitoring. Author(s): Ernst ME, Bergus GR. Source: Southern Medical Journal. 2003 June; 96(6): 563-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12938783&dopt=Abstract
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Ambulatory blood pressure monitoring. Author(s): Hansen KW, Poulsen PL, Mogensen CE. Source: Diabetic Medicine : a Journal of the British Diabetic Association. 2003 June; 20(6): 509; Author Reply 509. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12786692&dopt=Abstract
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Ambulatory blood pressure monitoring: technology with a purpose. Author(s): Ernst ME, Bergus GR. Source: American Family Physician. 2003 June 1; 67(11): 2262, 2268, 2270. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12800957&dopt=Abstract
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Ambulatory blood pressure, left ventricular mass, and conduit artery function late after successful repair of coarctation of the aorta. Author(s): de Divitiis M, Pilla C, Kattenhorn M, Donald A, Zadinello M, Wallace S, Redington A, Deanfield J. Source: Journal of the American College of Cardiology. 2003 June 18; 41(12): 2259-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12821257&dopt=Abstract
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An association between aortic pulse wave velocity, blood pressure and chronic inflammation in ESRD patients on peritoneal dialysis. Author(s): Stompor T, Rajzer M, Sulowicz W, Dembinska-Kiec A, Janda K, KaweckaJaszcz K, Wojcik K, Tabor B, Zdzienicka A, Janusz-Grzybowska E. Source: Int J Artif Organs. 2003 March; 26(3): 188-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12703883&dopt=Abstract
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An interaction between systolic blood pressure and angiotensin-converting enzyme gene polymorphism on carotid atherosclerosis. Author(s): Kawamoto R, Kohara K, Tabara Y, Miki T. Source: Hypertens Res. 2002 November; 25(6): 875-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12484511&dopt=Abstract
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Angiotensinogen gene promoter region variant modifies body size-ambulatory blood pressure relations in hypertension. Author(s): Tiago AD, Samani NJ, Candy GP, Brooksbank R, Libhaber EN, Sareli P, Woodiwiss AJ, Norton GR. Source: Circulation. 2002 September 17; 106(12): 1483-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12234952&dopt=Abstract
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Angiotensinogen single nucleotide polymorphisms, elevated blood pressure, and risk of cardiovascular disease. Author(s): Sethi AA, Nordestgaard BG, Gronholdt ML, Steffensen R, Jensen G, TybjaergHansen A. Source: Hypertension. 2003 June; 41(6): 1202-11. Epub 2003 May 12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12743009&dopt=Abstract
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Ankle-brachial blood pressure index predicts all-cause and cardiovascular mortality in hemodialysis patients. Author(s): Ono K, Tsuchida A, Kawai H, Matsuo H, Wakamatsu R, Maezawa A, Yano S, Kawada T, Nojima Y. Source: Journal of the American Society of Nephrology : Jasn. 2003 June; 14(6): 1591-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12761260&dopt=Abstract
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Antecedent blood pressure and risk of cardiovascular disease: the Framingham Heart Study. Author(s): Vasan RS, Massaro JM, Wilson PW, Seshadri S, Wolf PA, Levy D, D'Agostino RB; Framingham Heart Study. Source: Circulation. 2002 January 1; 105(1): 48-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11772875&dopt=Abstract
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Anthropometric measures, blood pressure and major laboratory examination results in the health check-up examination among the JPHC study participants at baseline survey. Japan Public Health Center-based Prospective Study on Cancer and Cardiovascular Diseases. Author(s): Baba S, Mannami T, Konishi M, Sasaki S. Source: J Epidemiol. 2001 October; 11(6 Suppl): S87-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11763144&dopt=Abstract
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Antihypertensive treatments obscure familial contributions to blood pressure variation. Author(s): Cui JS, Hopper JL, Harrap SB. Source: Hypertension. 2003 February; 41(2): 207-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12574083&dopt=Abstract
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Are heart rate and blood pressure responses to mental stress predictive of clinical cardiovascular events? The answer varies by coronary artery disease syndrome. Author(s): Sheps DS, Bragdon EE. Source: American Heart Journal. 2003 August; 146(2): 197-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12891181&dopt=Abstract
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Are low target blood pressure goals justified in persons with diabetes mellitus? Author(s): Crook ED, Velusamy L. Source: Current Hypertension Reports. 2003 June; 5(3): 231-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724056&dopt=Abstract
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Arm position and blood pressure: a risk factor for hypertension? Author(s): Mourad A, Carney S, Gillies A, Jones B, Nanra R, Trevillian P. Source: Journal of Human Hypertension. 2003 June; 17(6): 389-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12764401&dopt=Abstract
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Arterial blood pressure monitoring. Author(s): Bigatello LM, Schmidt U. Source: Minerva Anestesiol. 2003 April; 69(4): 201-9. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12766708&dopt=Abstract
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Arterial stiffness and blood pressure self-measurement with loaned equipment. Author(s): Calvo-Vargas C, Padilla-Rios V, Meza-Flores A, Vazquez-Linares G, TroyoSanroman R, Cerda AP, Asmar R. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2003 May; 16(5 Pt 1): 375-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745199&dopt=Abstract
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Arterial stiffness and central blood pressure, as determined by pulse wave analysis, in rheumatoid arthritis. Author(s): Klocke R, Cockcroft JR, Taylor GJ, Hall IR, Blake DR. Source: Annals of the Rheumatic Diseases. 2003 May; 62(5): 414-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12695151&dopt=Abstract
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Ask the Doctor. I take a beta blocker called atenolol and an ACE inhibitor every morning for my hypertension. When I get up in the morning, my blood pressure is high, but falls as the day goes on. It seems like it s always pretty good by the time I see my doctor, so she thinks everything is fine. Still, the high numbers worry me. Should I be on another drug? Author(s): Lee TH. Source: Harvard Heart Letter : from Harvard Medical School. 2001 December; 12(4): 8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11751081&dopt=Abstract
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Ask the Doctor. My older brother recently had a heart attack and bypass surgery at the age of 53! I am physically active and don t have any risk factors for heart disease. But neither did my brother, who also had normal cholesterol and blood pressure numbers. I ve been wondering if I should be taking a cholesterol-lowering medication, even though my cholesterol is normal. Author(s): Lee TH. Source: Harvard Heart Letter : from Harvard Medical School. 2001 December; 12(4): 8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11751084&dopt=Abstract
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Assessment of the novel selective aldosterone blocker eplerenone using ambulatory and clinical blood pressure in patients with systemic hypertension. Author(s): White WB, Carr AA, Krause S, Jordan R, Roniker B, Oigman W. Source: The American Journal of Cardiology. 2003 July 1; 92(1): 38-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12842242&dopt=Abstract
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Assessment of the techniques of blood pressure measurement by health professionals. Author(s): Veiga EV, Nogueira MS, Carnio EC, Marques S, Lavrador MA, de Moraes SA, Souza LA, Lima NK, Nobre F. Source: Arquivos Brasileiros De Cardiologia. 2003 January; 80(1): 89-93, 83-8. Epub 2003 February 19. English, Portuguese. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12612727&dopt=Abstract
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Association of a sodium channel alpha subunit promoter variant with blood pressure. Author(s): Iwai N, Baba S, Mannami T, Ogihara T, Ogata J. Source: Journal of the American Society of Nephrology : Jasn. 2002 January; 13(1): 80-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11752024&dopt=Abstract
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Association of blood pressure with intake of soy products and other food groups in Japanese men and women. Author(s): Nagata C, Shimizu H, Takami R, Hayashi M, Takeda N, Yasuda K. Source: Preventive Medicine. 2003 June; 36(6): 692-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12744912&dopt=Abstract
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Association of polymorphisms in GPR10, the gene encoding the prolactin-releasing peptide receptor with blood pressure, but not obesity, in a U.K. Caucasian population. Author(s): Bhattacharyya S, Luan J, Challis B, Schmitz C, Clarkson P, Franks PW, Middelberg R, Keogh J, Farooqi IS, Montague C, Brennand J, Wareham NJ, O'Rahilly S. Source: Diabetes. 2003 May; 52(5): 1296-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716769&dopt=Abstract
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Asymmetric dimethylarginine, blood pressure, and renal perfusion in elderly subjects. Author(s): Kielstein JT, Bode-Boger SM, Frolich JC, Ritz E, Haller H, Fliser D. Source: Circulation. 2003 April 15; 107(14): 1891-5. Epub 2003 Apr 07. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12681993&dopt=Abstract
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Attenuated adrenocortical and blood pressure responses to psychological stress in ad libitum and abstinent smokers. Author(s): al'Absi M, Wittmers LE, Erickson J, Hatsukami D, Crouse B. Source: Pharmacology, Biochemistry, and Behavior. 2003 January; 74(2): 401-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12479961&dopt=Abstract
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Automated ambulatory blood pressure monitoring: clinical utility in the family practice setting. Author(s): Marchiando RJ, Elston MP. Source: American Family Physician. 2003 June 1; 67(11): 2343-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12800963&dopt=Abstract
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Autonomic system activity and 24-hour blood pressure variations in subjects with normal- and high-tension glaucoma. Author(s): Riccadonna M, Covi G, Pancera P, Presciuttini B, Babighian S, Perfetti S, Bonomi L, Lechi A. Source: Journal of Glaucoma. 2003 April; 12(2): 156-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12671471&dopt=Abstract
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Barriers to blood pressure control in African Americans. Overcoming obstacles is challenging, but target goals can be attained. Author(s): Douglas JG, Ferdinand KC, Bakris GL, Sowers JR. Source: Postgraduate Medicine. 2002 October; 112(4): 51-2, 55, 59-62 Passim. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12400149&dopt=Abstract
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Better blood pressure control: how to combine drugs. Author(s): Brown MJ, Cruickshank JK, Dominiczak AF, MacGregor GA, Poulter NR, Russell GI, Thom S, Williams B; Executive Committee, British Hypertension Society. Source: Journal of Human Hypertension. 2003 February; 17(2): 81-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12574784&dopt=Abstract
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Blood lead, blood pressure, and hypertension in perimenopausal and postmenopausal women. Author(s): Nash D, Magder L, Lustberg M, Sherwin RW, Rubin RJ, Kaufmann RB, Silbergeld EK. Source: Jama : the Journal of the American Medical Association. 2003 March 26; 289(12): 1523-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12672769&dopt=Abstract
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Blood pressure among the Inuit (Eskimo) populations in the Arctic. Author(s): Bjerregaard P, Dewailly E, Young TK, Blanchet C, Hegele RA, Ebbesson SE, Risica PM, Mulvad G. Source: Scandinavian Journal of Public Health. 2003; 31(2): 92-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745758&dopt=Abstract
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Blood pressure and angiotensin converting enzyme inhibitor use in hypertensive patients with chronic renal insufficiency. Author(s): Ramirez LM. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2002 September; 15(9): 832-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12219882&dopt=Abstract
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Blood pressure and cardiac autonomic function in relation to risk factors and treatment perspectives in Type 1 diabetes. Author(s): Poulsen PL. Source: J Renin Angiotensin Aldosterone Syst. 2002 December; 3(4): 222-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12584666&dopt=Abstract
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Blood pressure and cardiovascular risks: implications of the presence or absence of a nocturnal dip in blood pressure. Author(s): Weir MR, Blantz RC. Source: Current Opinion in Nephrology and Hypertension. 2003 January; 12(1): 57-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12496667&dopt=Abstract
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Blood pressure and clinical outcome in acute ischemic stroke. Author(s): Lalouschek W, Lang W. Source: Stroke; a Journal of Cerebral Circulation. 2002 November; 33(11): 2548; Author Reply 2548. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12411640&dopt=Abstract
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Blood pressure and cognitive impairment in India and the United States: a crossnational epidemiological study. Author(s): Pandav R, Dodge HH, DeKosky ST, Ganguli M. Source: Archives of Neurology. 2003 August; 60(8): 1123-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12925370&dopt=Abstract
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Blood pressure and decline in kidney function: findings from the Systolic Hypertension in the Elderly Program (SHEP). Author(s): Young JH, Klag MJ, Muntner P, Whyte JL, Pahor M, Coresh J. Source: Journal of the American Society of Nephrology : Jasn. 2002 November; 13(11): 2776-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12397049&dopt=Abstract
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Blood pressure and heart rate during an episode of unstable angina as predictors of in-hospital outcome. Author(s): Ploj T, Bajuk K, Studen P, Noc M, Horvat M. Source: Wiener Klinische Wochenschrift. 2002 June 28; 114(12): 443-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12422578&dopt=Abstract
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Blood pressure and lipid lowering in the prevention of stroke: a note to neurologists. Author(s): Amarenco P. Source: Cerebrovascular Diseases (Basel, Switzerland). 2003; 16 Suppl 3: 33-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12740554&dopt=Abstract
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Blood pressure and other cardiovascular risk factors among treated hypertensives in Swedish primary health care. Author(s): Cederholm J, Nilsson PM, Anderberg CP, Froberg L, Petersson U; Q-Heart Study Group. Source: Scandinavian Journal of Primary Health Care. 2002 December; 20(4): 224-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12564574&dopt=Abstract
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Blood pressure and pulse pressure development in a population sample of women with special reference to basal body mass and distribution of body fat and their changes during 24 years. Author(s): Kristjansson K, Sigurdsson JA, Lissner L, Sundh V, Bengtsson C. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2003 January; 27(1): 128-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12532164&dopt=Abstract
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Blood pressure and vitamin C and fruit and vegetable intake. Author(s): Beitz R, Mensink GB, Fischer B. Source: Annals of Nutrition & Metabolism. 2003; 47(5): 214-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12748415&dopt=Abstract
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Blood pressure as a surrogate end point for hypertension. Author(s): Carter BL. Source: The Annals of Pharmacotherapy. 2002 January; 36(1): 87-92. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11816267&dopt=Abstract
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Blood pressure control and rates of edema following the administration of the cyclooxygenase-2 specific inhibitors celecoxib versus rofecoxib in patients with systemic hypertension and osteoarthritis. Author(s): Weaver A, Alderman M, Sperling R. Source: The American Journal of Cardiology. 2003 May 15; 91(10): 1291-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745131&dopt=Abstract
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Blood pressure control in stroke patients. What should the consulting neurologist advise? Author(s): Snider SR. Source: Neurology. 2003 February 11; 60(3): 525; Author Reply 525. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12578951&dopt=Abstract
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Blood pressure control--effects on diabetic nephropathy progression: how low does blood pressure have to be? Author(s): Newton CA, Raskin P. Source: Curr Diab Rep. 2002 December; 2(6): 530-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12643160&dopt=Abstract
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Blood pressure destabilization and related healthcare utilization among hypertensive patients using nonspecific NSAIDs and COX-2-specific inhibitors. Author(s): Zhao SZ, Burke TA, Whelton A, von Allmen H, Henderson SC. Source: Am J Manag Care. 2002 October; 8(15 Suppl): S401-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12416790&dopt=Abstract
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Blood pressure distribution in a Hungarian adolescent population: comparison with normal values in the USA. Author(s): Pall D, Katona E, Fulesdi B, Zrinyi M, Zatik J, Bereczki D, Polgar P, Kakuk G. Source: Journal of Hypertension. 2003 January; 21(1): 41-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12544434&dopt=Abstract
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Blood pressure effects of vitamin C: what's the key question? Author(s): Svetkey LP, Loria CM. Source: Hypertension. 2002 December; 40(6): 789-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12468557&dopt=Abstract
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Blood pressure elevation associated with sleep-related breathing disorder in a community sample of white and Hispanic children: the Tucson Children's Assessment of Sleep Apnea study. Author(s): Enright PL, Goodwin JL, Sherrill DL, Quan JR, Quan SF; Tucson Children's Assessment of Sleep Apnea study. Source: Archives of Pediatrics & Adolescent Medicine. 2003 September; 157(9): 901-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12963596&dopt=Abstract
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Blood pressure guidelines call for lifestyle modifications. Author(s): Traynor K. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 2002 December 1; 59(23): 2273-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12489362&dopt=Abstract
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Blood pressure high? A new definition of normal makes 45 million Americans “prehypertensive”. Author(s): Gorman C. Source: Time. 2003 May 26; 161(21): 79. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12800327&dopt=Abstract
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Blood pressure in children and adolescents with congenital adrenal hyperplasia (21hydroxylase deficiency): a preliminary report. Author(s): Roche EF, Charmandari E, Dattani MT, Hindmarsh PC. Source: Clinical Endocrinology. 2003 May; 58(5): 589-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12699440&dopt=Abstract
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Blood pressure in late adolescence and very low birth weight. Author(s): Doyle LW, Faber B, Callanan C, Morley R. Source: Pediatrics. 2003 February; 111(2): 252-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12563047&dopt=Abstract
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Blood pressure in relation to birth weight in twins and singleton controls matched for gestational age. Author(s): McNeill G, Tuya C, Campbell DM, Haggarty P, Smith WC, Masson LF, Cumming A, Broom I, Haites N. Source: American Journal of Epidemiology. 2003 July 15; 158(2): 150-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12851228&dopt=Abstract
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Blood pressure in relation to relative weight at birth through childhood and youth in obese and non-obese adult men. Author(s): Schack-Nielsen L, Holst C, Sorensen TI. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2002 December; 26(12): 1539-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12461670&dopt=Abstract
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Blood pressure in sleep disordered breathing. Author(s): Kohyama J, Ohinata JS, Hasegawa T. Source: Archives of Disease in Childhood. 2003 February; 88(2): 139-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12538317&dopt=Abstract
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Blood pressure increase and incidence of hypertension in relation to inflammationsensitive plasma proteins. Author(s): Engstrom G, Janzon L, Berglund G, Lind P, Stavenow L, Hedblad B, Lindgarde F. Source: Arteriosclerosis, Thrombosis, and Vascular Biology. 2002 December 1; 22(12): 2054-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12482834&dopt=Abstract
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Blood pressure independent association of microalbuminuria and left ventricular hypertrophy in hypertensive men. Author(s): Dell'omo G, Giorgi D, Di Bello V, Mariani M, Pedrinelli R. Source: Journal of Internal Medicine. 2003 July; 254(1): 76-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12823644&dopt=Abstract
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Blood pressure indices and cardiovascular disease in the Asia Pacific region: a pooled analysis. Author(s): Lawes CM, Bennett DA, Parag V, Woodward M, Whitlock G, Lam TH, Suh I, Rodgers A; Asia Pacific Cohort Studies Collaboration. Source: Hypertension. 2003 July; 42(1): 69-75. Epub 2003 May 19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12756223&dopt=Abstract
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Blood pressure levels among cross-cultural populations of Visakhapatnam district, Andhra Pradesh, India. Author(s): Kusuma YS, Babu BV, Naidu JM. Source: Annals of Human Biology. 2002 September-October; 29(5): 502-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12396370&dopt=Abstract
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Blood pressure lowering effect of sildenafil citrate in diabetes. Author(s): Gautam CS, Bhalla A, Singh R. Source: J Assoc Physicians India. 2003 January; 51: 89. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12693473&dopt=Abstract
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Blood pressure measurement in an ambulatory setting: concordance between physician and patient self-measurement. Author(s): Vinyoles E, Blancafort X, Lopez-Quinones C, Arque M, Brau A, Cerdan N, de la Figuera M, Diaz F, Pujol E. Source: Journal of Human Hypertension. 2003 January; 17(1): 45-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12571616&dopt=Abstract
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Blood pressure measurement: a century of achievements and improvements in the year 2002. Author(s): Himmelmann A, Hansson L, Hedner T. Source: Blood Pressure. 2002; 11(6): 325-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12523674&dopt=Abstract
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Blood pressure measurement--an observational study of 21 public health nurses. Author(s): Drevenhorn E, Hakansson A, Petersson K. Source: Journal of Clinical Nursing. 2001 March; 10(2): 189-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11820339&dopt=Abstract
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Blood pressure measurement--does anyone do it right?: An assessment of reliability of equipment in use and the measurement techniques of clinicians. Author(s): Waugh J, Halligan A, Shennan A. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2001 October; 27(4): 241. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12465614&dopt=Abstract
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Blood pressure measurement--does anyone do it right?: An assessment of the reliability of equipment in use and the measurement techniques of clinicians. Author(s): McVicker JT. Source: The Journal of Family Planning and Reproductive Health Care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists. 2001 July; 27(3): 163-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12457502&dopt=Abstract
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Blood pressure monitoring. Author(s): D'Cruz LT. Source: British Dental Journal. 2002 November 23; 193(10): 548. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12487108&dopt=Abstract
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Blood pressure patterns through consecutive pregnancies are influenced by body mass index. Author(s): Strevens H, Kristensen K, Langhoff-Roos J, Wide-Swensson D. Source: American Journal of Obstetrics and Gynecology. 2002 November; 187(5): 1343-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12439529&dopt=Abstract
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Blood pressure predicts risk of developing end-stage renal disease in men and women. Author(s): Tozawa M, Iseki K, Iseki C, Kinjo K, Ikemiya Y, Takishita S. Source: Hypertension. 2003 June; 41(6): 1341-5. Epub 2003 April 21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707291&dopt=Abstract
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Blood pressure profiles in adolescents with recently diagnosed type 2 diabetes. Author(s): Brosnan CA, Meininger JC, Swank PR, Reyes LR, Brosnan PG. Source: Diabetes Care. 2002 December; 25(12): 2354. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12453988&dopt=Abstract
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Blood pressure reduction and ACE inhibition in secondary stroke prevention: mechanism uncertain. Author(s): Davis SM, Donnan GA. Source: Stroke; a Journal of Cerebral Circulation. 2003 May; 34(5): 1335-6. Epub 2003 April 17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12702835&dopt=Abstract
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Blood pressure response to antihypertensive agents related to baseline blood pressure. Author(s): Sermswan A, Uboldejpracharak Y, Suthichaiyakul T, Sukontasarn A, Buranakitcharoen P. Source: J Med Assoc Thai. 2002 October; 85(10): 1113-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12501904&dopt=Abstract
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Blood pressure response to conventional and low-dose enalapril in chronic renal failure. Author(s): Elung-Jensen T, Heisterberg J, Kamper AL, Sonne J, Strandgaard S. Source: British Journal of Clinical Pharmacology. 2003 February; 55(2): 139-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12580985&dopt=Abstract
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Blood pressure response to hyperventilation test reflects daytime pressor profile. Author(s): Fontana F, Bernardi P, Lanfranchi G, Pisati MS, Merlo Pich E. Source: Hypertension. 2003 February; 41(2): 244-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12574089&dopt=Abstract
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Blood pressure responsiveness to obstructive events during sleep after chronic CPAP. Author(s): Marrone O, Salvaggio A, Bonsignore MR, Insalaco G, Bonsignore G. Source: The European Respiratory Journal : Official Journal of the European Society for Clinical Respiratory Physiology. 2003 March; 21(3): 509-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12662010&dopt=Abstract
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Blood pressure rise in spontaneous intracerebral haemorrhage: epiphenomenon or precipitating factor? Author(s): Passero S, Ciacci G, Rossi S. Source: Journal of Human Hypertension. 2003 January; 17(1): 77-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12571621&dopt=Abstract
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Blood pressure self-monitoring in pharmacies. Building on existing resources. Author(s): Chambers LW, Kaczorowski J, Levitt C, Karwalajtys T, McDonough B, Lewis J. Source: Can Fam Physician. 2002 October; 48: 1594-5, 1602-4. English, French. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12449541&dopt=Abstract
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Blood pressure stability in a normotensive population during intake of a monophasic oral contraceptive containing 20 microg ethinylestradiol and 75 g gestodene. Author(s): Endrikat J, Gerlinger C, Cronin M, Ruebig A, Schmidt W, Dusterberg B. Source: The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception. 2001 September; 6(3): 159-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11763980&dopt=Abstract
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Blood pressure variability in obstructive sleep apnea: role of sympathetic nervous activity and effect of continuous positive airway pressure. Author(s): Bao X, Nelesen RA, Loredo JS, Dimsdale JE, Ziegler MG. Source: Blood Pressure Monitoring. 2002 December; 7(6): 301-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12488649&dopt=Abstract
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Blood pressure variation in the institutionalized elderly. Author(s): Ice GH, James GD, Crews DE. Source: Coll Antropol. 2003 June; 27(1): 47-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12974132&dopt=Abstract
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Blood pressure, antihypertensive therapy and risk for renal injury in AfricanAmericans. Author(s): Kaperonis N, Bakris G. Source: Current Opinion in Nephrology and Hypertension. 2003 January; 12(1): 79-84. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12496670&dopt=Abstract
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Blood pressure, arterial function, structure, and aging: the role of hormonal replacement therapy in postmenopausal women. Author(s): Scuteri A, Ferrucci L. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2003 May-June; 5(3): 21925. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12826785&dopt=Abstract
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Blood pressure, atherosclerosis, and the incidence of age-related maculopathy: the Rotterdam Study. Author(s): van Leeuwen R, Ikram MK, Vingerling JR, Witteman JC, Hofman A, de Jong PT. Source: Investigative Ophthalmology & Visual Science. 2003 September; 44(9): 3771-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12939290&dopt=Abstract
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Blood pressure, body mass index and socio-economic status in the urban population of Antananarivo (Madagascar). Author(s): Mauny F, Viel JF, Roubaux F, Ratsimandresy R, Sellin B. Source: Annals of Tropical Medicine and Parasitology. 2003 September; 97(6): 645-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14515869&dopt=Abstract
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Blood pressure, risk of ischemic cerebrovascular and ischemic heart disease, and longevity in alpha(1)-antitrypsin deficiency: the Copenhagen City Heart Study. Author(s): Dahl M, Tybjaerg-Hansen A, Sillesen H, Jensen G, Steffensen R, Nordestgaard BG. Source: Circulation. 2003 February 11; 107(5): 747-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12578879&dopt=Abstract
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Blood pressure, smoking, and the incidence of lung cancer in hypertensive men in North Karelia, Finland. Author(s): Lindgren A, Pukkala E, Nissinen A, Tuomilehto J. Source: American Journal of Epidemiology. 2003 September 1; 158(5): 442-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12936899&dopt=Abstract
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Blood pressure-independent impact of antihypertensive agents on cardiovascular and renal disease. Author(s): Banerjee D, Materson BJ. Source: Current Hypertension Reports. 2002 December; 4(6): 445-52. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12419173&dopt=Abstract
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Blood pressure-lowering for secondary prevention of stroke: ACE inhibition is not the key. Author(s): Bath P. Source: Stroke; a Journal of Cerebral Circulation. 2003 May; 34(5): 1334-5. Epub 2003 April 17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12702833&dopt=Abstract
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Blood pressure-lowering for secondary prevention of stroke: ACE inhibition is the key. Author(s): Anderson C. Source: Stroke; a Journal of Cerebral Circulation. 2003 May; 34(5): 1333-4. Epub 2003 April 17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12702834&dopt=Abstract
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Body mass index growth in a sample of U.S. children: repeated measures data analysis of the Minneapolis Children's Blood Pressure Study. Author(s): Hlaing WM, Prineas RJ, Zhu Y, Leaverton PE. Source: American Journal of Human Biology : the Official Journal of the Human Biology Council. 2001 November-December; 13(6): 821-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11748820&dopt=Abstract
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Body size, fat distribution, menarcheal age and blood pressure in 14-year-old girls. Author(s): Koziel S, Kolodziej H, Ulijaszek S. Source: European Journal of Epidemiology. 2001; 17(12): 1111-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12530770&dopt=Abstract
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By the way, doctor. I recently read that Tylenol and anti-inflammatory drugs can cause high blood pressure. This doesn't leave me with many pain relief options. What do you suggest? Author(s): Robb-Nicholson C. Source: Harvard Women's Health Watch. 2003 February; 10(6): 8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12604441&dopt=Abstract
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Can I stop taking this blood pressure medicine? Author(s): Townsend RR. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2003 May-June; 5(3): 234. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12826792&dopt=Abstract
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Can relaxation lower metaboreflex-mediated blood pressure elevations? Author(s): Anthony B, Boudreaux L, Dobbs I, Jamal S, Guerra P, Williamson JW. Source: Medicine and Science in Sports and Exercise. 2003 March; 35(3): 394-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12618568&dopt=Abstract
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Cannabis, tobacco, and caffeine use modify the blood pressure reactivity protection of ascorbic acid. Author(s): Brody S, Preut R. Source: Pharmacology, Biochemistry, and Behavior. 2002 July; 72(4): 811-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12062570&dopt=Abstract
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Cardiac and renal effects of standard versus rigorous blood pressure control in autosomal-dominant polycystic kidney disease: results of a seven-year prospective randomized study. Author(s): Schrier R, McFann K, Johnson A, Chapman A, Edelstein C, Brosnahan G, Ecder T, Tison L. Source: Journal of the American Society of Nephrology : Jasn. 2002 July; 13(7): 1733-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12089368&dopt=Abstract
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Cardiovascular effects of successful renal transplantation: a 1-year sequential study of left ventricular morphology and function, and 24-hour blood pressure profile. Author(s): Ferreira SR, Moises VA, Tavares A, Pacheco-Silva A. Source: Transplantation. 2002 December 15; 74(11): 1580-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12490792&dopt=Abstract
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Carotid artery intimal-medial thickness and left ventricular hypertrophy in children with elevated blood pressure. Author(s): Sorof JM, Alexandrov AV, Cardwell G, Portman RJ. Source: Pediatrics. 2003 January; 111(1): 61-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12509555&dopt=Abstract
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Casual blood pressure and ambulatory blood pressure measurement in children. Author(s): Koch VH. Source: Sao Paulo Medical Journal = Revista Paulista De Medicina. 2003 March 5; 121(2): 85-9. Epub 2003 July 14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12870057&dopt=Abstract
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Catechol-o-methyltransferase and blood pressure in humans. Author(s): Jordan J, Lipp A, Tank J, Schroder C, Stoffels M, Franke G, Diedrich A, Arnold G, Goldstein DS, Sharma AM, Luft FC. Source: Circulation. 2002 July 23; 106(4): 460-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12135946&dopt=Abstract
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Cerebral autoregulation in carotid artery occlusive disease assessed from spontaneous blood pressure fluctuations by the correlation coefficient index. Author(s): Reinhard M, Roth M, Muller T, Czosnyka M, Timmer J, Hetzel A. Source: Stroke; a Journal of Cerebral Circulation. 2003 September; 34(9): 2138-44. Epub 2003 August 14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12920261&dopt=Abstract
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Cerebral oxygen and microdialysis monitoring during aneurysm surgery: effects of blood pressure, cerebrospinal fluid drainage, and temporary clipping on infarction. Author(s): Kett-White R, Hutchinson PJ, Al-Rawi PG, Czosnyka M, Gupta AK, Pickard JD, Kirkpatrick PJ. Source: Journal of Neurosurgery. 2002 June; 96(6): 1013-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12066900&dopt=Abstract
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Challenges for the prevention of primary and secondary stroke: the importance of lowering blood pressure and total cardiovascular risk. Author(s): Chalmers J, Chapman N. Source: Blood Pressure. 2001; 10(5-6): 344-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11822538&dopt=Abstract
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Change in blood pressure in the age interval 70-90. Late blood pressure peak related to longer survival. Author(s): Lernfelt B, Svanborg A. Source: Blood Pressure. 2002; 11(4): 206-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12361187&dopt=Abstract
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Changes in blood pressure and muscle sympathetic nerve activity during water drinking in humans. Author(s): Endo Y, Yamauchi K, Tsutsui Y, Ishihara Z, Yamazaki F, Sagawa S, Shiraki K. Source: Japanese Journal of Physiology. 2002 October; 52(5): 421-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12533246&dopt=Abstract
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Changes in tooth position in humans in relation to arterial blood pressure. Author(s): Ioi H, Nakata S, Nakasima A, Counts AL, Nanda RS. Source: Archives of Oral Biology. 2002 March; 47(3): 219-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11839358&dopt=Abstract
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Chart review and pilot study of blood pressure control in acute ischemic stroke. Author(s): Naidech A, Khasani S, Lafaye K, Martin J, Weisberg L. Source: J La State Med Soc. 2003 March-April; 155(2): 99-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12778994&dopt=Abstract
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Checking up on blood pressure monitors. Author(s): Lewis C. Source: Fda Consumer. 2002 September-October; 36(5): 10-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12412546&dopt=Abstract
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Childhood blood pressure predicts adult microalbuminuria in African Americans, but not in whites: the Bogalusa Heart Study. Author(s): Hoq S, Chen W, Srinivasan SR, Berenson GS. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2002 December; 15(12): 1036-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12460698&dopt=Abstract
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Chocolate and blood pressure in elderly individuals with isolated systolic hypertension. Author(s): Taubert D, Berkels R, Roesen R, Klaus W. Source: Jama : the Journal of the American Medical Association. 2003 August 27; 290(8): 1029-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12941673&dopt=Abstract
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Choroidal blood flow and arterial blood pressure. Author(s): Polak K, Polska E, Luksch A, Dorner G, Fuchsjager-Mayrl G, Findl O, Eichler HG, Wolzt M, Schmetterer L. Source: Eye (London, England). 2003 January; 17(1): 84-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12579176&dopt=Abstract
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Chronic effects of workplace noise on blood pressure and heart rate. Author(s): Lusk SL, Hagerty BM, Gillespie B, Caruso CC. Source: Archives of Environmental Health. 2002 July-August; 57(4): 273-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12530593&dopt=Abstract
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Circadian blood pressure overswinging in a physically fit, normotensive African American woman. Author(s): Borer KT, Cornelissen G, Halberg F, Brook R, Rajagopalan S, Fay W. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2002 September; 15(9): 827-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12219880&dopt=Abstract
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Circadian blood pressure patterns and life stress. Author(s): Fallo F, Barzon L, Rabbia F, Navarrini C, Conterno A, Veglio F, Cazzaro M, Fava GA, Sonino N. Source: Psychotherapy and Psychosomatics. 2002 November-December; 71(6): 350-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12411770&dopt=Abstract
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Circadian changes in blood pressure and their relationships to the development of microalbuminuria in type 1 diabetic patients. Author(s): Hogan D, Lurbe E, Salabat MR, Redon J, Batlle D. Source: Curr Diab Rep. 2002 December; 2(6): 539-44. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12643161&dopt=Abstract
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Circadian pattern of blood pressure, heart rate, and double product in liver glycogen storage disease. Author(s): Yetman RJ, Andrew-Casal M, Hermida RC, Dominguez BW, Portman RJ, Northrup H, Smolensky MH. Source: Chronobiology International. 2002 July; 19(4): 765-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12182502&dopt=Abstract
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Circadian variation of blood pressure and endothelial function in patients with essential hypertension:a comparison of dippers and non-dippers. Author(s): Higashi Y, Nakagawa K, Kimura M, Noma K, Hara K, Sasaki S, Goto C, Oshima T, Chayama K, Yoshizumi M. Source: Journal of the American College of Cardiology. 2002 December 4; 40(11): 203943. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12475467&dopt=Abstract
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Classification of blood pressure levels by ambulatory blood pressure in hypertension. Author(s): Bur A, Herkner H, Vlcek M, Woisetschlager C, Derhaschnig U, Hirschl MM. Source: Hypertension. 2002 December; 40(6): 817-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12468563&dopt=Abstract
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Clinical evaluation of a self blood pressure monitor according to the First International Consensus Conference on Self Blood Pressure Measurement. Author(s): Ploin D, Baguet JP, Pierre H, De Gaudemaris R, Mallion JM. Source: Blood Pressure Monitoring. 2002 December; 7(6): 335-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12488655&dopt=Abstract
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Clinical significance of blood pressure response triggered by a doctor's visit in patients with essential hypertension. Author(s): Munakata M, Saito Y, Nunokawa T, Ito N, Fukudo S, Yoshinaga K. Source: Hypertens Res. 2002 May; 25(3): 343-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12135311&dopt=Abstract
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Coarctation of the aorta with lower blood pressure at the right upper extremity. Author(s): Goudevenos JA, Papathanasiou A, Michalis LK. Source: Heart (British Cardiac Society). 2002 November; 88(5): 498. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12381643&dopt=Abstract
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Coffee acutely increases sympathetic nerve activity and blood pressure independently of caffeine content: role of habitual versus nonhabitual drinking. Author(s): Corti R, Binggeli C, Sudano I, Spieker L, Hanseler E, Ruschitzka F, Chaplin WF, Luscher TF, Noll G. Source: Circulation. 2002 December 3; 106(23): 2935-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12460875&dopt=Abstract
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Combination of lisinopril and nifedipine GITS increases blood pressure control compared with single drugs in essential hypertensive patients. Author(s): Taddei S, Omboni S, Ghiadoni L, Caiazza A, Fogari R, Innocenti P, Porcellati C, Giovannetti R, Corradi L, Mancia G, Salvetti A. Source: Journal of Cardiovascular Pharmacology. 2003 April; 41(4): 579-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12658059&dopt=Abstract
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Combined effects of systolic blood pressure, serum cholesterol and smoking on coronary heart disease and stroke. Author(s): Thulasimani M, Ramaswamy S. Source: European Heart Journal. 2002 December; 23(23): 1887-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12445541&dopt=Abstract
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Commentary: epidemiological transition and socioeconomic inequalities in blood pressure in Jamaica. Author(s): Gulliford M. Source: International Journal of Epidemiology. 2003 June; 32(3): 408-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12777428&dopt=Abstract
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Commentary: Modifying body weight not birthweight is the key to lowering blood pressure. Author(s): Huxley R. Source: International Journal of Epidemiology. 2002 October; 31(5): 1051-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12435783&dopt=Abstract
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Common questions and answers in the management of hypertension: Am I more likely to develop diabetes if I have high blood pressure? Author(s): Townsend RR. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2003 March-April; 5(2): 175-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12671335&dopt=Abstract
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Comparative effect of lercanidipine, felodipine, and nifedipine GITS on blood pressure and heart rate in patients with mild to moderate arterial hypertension: the Lercanidipine in Adults (LEAD) Study. Author(s): Romito R, Pansini MI, Perticone F, Antonelli G, Pitzalis M, Rizzon P. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2003 July-August; 5(4): 249-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12939564&dopt=Abstract
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Comparative effects of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers on blood pressure and the kidney. Author(s): Thurman JM, Schrier RW. Source: The American Journal of Medicine. 2003 May; 114(7): 588-98. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12753883&dopt=Abstract
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Comparative effects of Irbesartan on ambulatory and office blood pressure: a substudy of ambulatory blood pressure from the Irbesartan in Patients with Type 2 Diabetes and Microalbuminuria study. Author(s): Rossing K, Christensen PK, Andersen S, Hovind P, Hansen HP, Parving HH; Irbesartan in Patients with Type 2 Diabetes and Microalbuminuria Study. Source: Diabetes Care. 2003 March; 26(3): 569-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12610003&dopt=Abstract
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Comparison of acceptability of and preferences for different methods of measuring blood pressure in primary care. Author(s): Little P, Barnett J, Barnsley L, Marjoram J, Fitzgerald-Barron A, Mant D. Source: Bmj (Clinical Research Ed.). 2002 August 3; 325(7358): 258-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12153924&dopt=Abstract
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Comparison of agreement between different measures of blood pressure in primary care and daytime ambulatory blood pressure. Author(s): Little P, Barnett J, Barnsley L, Marjoram J, Fitzgerald-Barron A, Mant D. Source: Bmj (Clinical Research Ed.). 2002 August 3; 325(7358): 254. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12153923&dopt=Abstract
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Comparison of ambulatory blood pressure values in patients with glaucoma and ocular hypertension. Author(s): Yazici B, Usta E, Erturk H, Dilek K. Source: Eye (London, England). 2003 July; 17(5): 593-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12855965&dopt=Abstract
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Comparison of candesartan with lisinopril on ambulatory blood pressure and morning surge in patients with systemic hypertension. Author(s): Eguchi K, Kario K, Shimada K. Source: The American Journal of Cardiology. 2003 September 1; 92(5): 621-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12943892&dopt=Abstract
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Comparison of different measures of blood pressure. Agreement is not same as correlation. Author(s): Bissery A. Source: Bmj (Clinical Research Ed.). 2002 December 7; 325(7376): 1360. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12474819&dopt=Abstract
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Comparison of different measures of blood pressure. Ambulatory blood pressure may not be gold standard. Author(s): Palatini P. Source: Bmj (Clinical Research Ed.). 2002 December 7; 325(7376): 1360. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12474820&dopt=Abstract
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Comparison of different measures of blood pressure. Blood pressure measurement causes problems in clinical practice. Author(s): Marshall T. Source: Bmj (Clinical Research Ed.). 2002 December 7; 325(7376): 1360. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12474821&dopt=Abstract
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Comparison of different measures of blood pressure. Study was not first or only one. Author(s): Brueren M. Source: Bmj (Clinical Research Ed.). 2002 December 7; 325(7376): 1360. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12474818&dopt=Abstract
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Comparison of different measures of blood pressure. Use sphygmomanometers more, not less. Author(s): Hamilton WT, Sharp D. Source: Bmj (Clinical Research Ed.). 2002 December 7; 325(7376): 1360. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12468492&dopt=Abstract
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Comparison of home and office blood pressure in treated hypertensives in the Nordic Diltiazem (NORDIL) Study. Author(s): Kjeldsen SE, Hedner T, Syvertsen JO, Lund-Johansen P, Hansson L; NORDIL Group. Nordic Diltiazem. Source: Blood Pressure. 2002; 11(6): 371-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12523681&dopt=Abstract
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Comparison of non-invasive blood pressure measurements on the arm and calf during cesarean delivery. Author(s): Zahn J, Bernstein H, Hossain S, Bodian C, Beilin Y. Source: Journal of Clinical Monitoring and Computing. 2000; 16(8): 557-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12580231&dopt=Abstract
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Comparison of Portapres non-invasive blood pressure measurement in the finger with intra-aortic pressure measurement during incremental bicycle exercise. Author(s): Eckert S, Horstkotte D. Source: Blood Pressure Monitoring. 2002 June; 7(3): 179-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12131075&dopt=Abstract
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Comparison of talinolol and atenolol effects on blood pressure in relation to lipid and glucose metabolic parameters. Results from the TALIP study. Author(s): Sourgens H, Schmidt J, Derendorf H. Source: Int J Clin Pharmacol Ther. 2003 January; 41(1): 22-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12564742&dopt=Abstract
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Comparison of the blood pressure-lowering effects and tolerability of Losartan- and Amlodipine-based regimens in patients with isolated systolic hypertension. Author(s): Volpe M, Junren Z, Maxwell T, Rodriguez A, Gamboa R, Gomez-Fernandez P, Ortega-Gonzalez G, Matadamas N, Rodriguez F, Dass B, Kyle C, Clarysse L, Bryce A, Moreno-Heredia E, Germano G, Gilles L, Smith RD, Sanderson JE; CDSP-944 Study Group. Source: Clinical Therapeutics. 2003 May; 25(5): 1469-89. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12867222&dopt=Abstract
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Comparison of trough effect of telmisartan vs perindopril using self blood pressure measurement: EVERESTE study. Author(s): Ragot S, Ezzaher A, Meunier A, Poterre M, Bourkaib R, Herpin D. Source: Journal of Human Hypertension. 2002 December; 16(12): 865-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12522468&dopt=Abstract
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Comparison of usefulness of systolic, diastolic, and mean blood pressure and pulse pressure as predictors of cardiovascular death in patients >/=60 years of age (The Dubbo Study). Author(s): Palaniappan L, Simons LA, Simons J, Friedlander Y, McCallum J. Source: The American Journal of Cardiology. 2002 December 15; 90(12): 1398-401. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12480056&dopt=Abstract
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Compartment syndrome of the arm: a complication of noninvasive blood pressure monitoring during thrombolytic therapy for myocardial infarction. Author(s): Alford JW, Palumbo MA, Barnum MJ. Source: Journal of Clinical Monitoring and Computing. 2002 April-May; 17(3-4): 163-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12455731&dopt=Abstract
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Consequences of increased systolic blood pressure in patients with osteoarthritis and rheumatoid arthritis. Author(s): Singh G, Miller JD, Huse DM, Pettitt D, D'Agostino RB, Russell MW. Source: The Journal of Rheumatology. 2003 April; 30(4): 714-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12672188&dopt=Abstract
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Control of blood pressure in India: rule of halves still very much valid. Author(s): Joshi SR, Shah SN. Source: J Assoc Physicians India. 2003 February; 51: 151-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12725256&dopt=Abstract
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Controlling blood pressure with a healthy lifestyle. Author(s): O'Connell B. Source: Diabetes Self Manag. 2003 May-June; 20(3): 14-7, 21-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12778655&dopt=Abstract
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Controversy over the dicrotic notch and wave in the blood pressure record. Author(s): Geddes LA, Roeder R. Source: Ieee Engineering in Medicine and Biology Magazine : the Quarterly Magazine of the Engineering in Medicine & Biology Society. 2002 September-October; 21(5): 167-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12405075&dopt=Abstract
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Conundrum of the HOPE study: time of taking ramipril may account for lack of relation between blood pressure and outcome. Author(s): Taylor R. Source: Bmj (Clinical Research Ed.). 2003 September 20; 327(7416): 681-2; Author Reply 682. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14509993&dopt=Abstract
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Correlation of periprocedural systolic blood pressure changes with neurological events in high-risk carotid stent patients. Author(s): Howell M, Krajcer Z, Dougherty K, Strickman N, Skolkin M, Toombs B, Paniagua D. Source: Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists. 2002 December; 9(6): 810-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12546582&dopt=Abstract
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Cost analysis of ambulatory blood pressure monitoring in initiating antihypertensive drug treatment in Australian general practice. Author(s): Ewald B, Pekarsky B. Source: The Medical Journal of Australia. 2002 June 17; 176(12): 580-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12064956&dopt=Abstract
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C-reactive protein and blood pressure in the acute phase after an ischemic stroke. Author(s): Di Napoli M, Papa F. Source: Stroke; a Journal of Cerebral Circulation. 2003 April; 34(4): 839. Epub 2003 March 27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12663870&dopt=Abstract
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Cross-sectional study on blood pressure control in the department of nephrology of the Escola Paulista de Medicina - UNIFESP. Author(s): Freitas JB, Tavares A, Kohlmann O Jr, Zanella MT, Ribeiro AB. Source: Arquivos Brasileiros De Cardiologia. 2002 August; 79(2): 123-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12219185&dopt=Abstract
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Current successes and limitations of using genetic modification for blood pressure research. Author(s): Mullins LJ, Mullins J. Source: Pflugers Archiv : European Journal of Physiology. 2003 January; 445(4): 491-4. Epub 2002 November 12. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12548394&dopt=Abstract
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DASH diet lowers blood pressure and lipid-induced oxidative stress in obesity. Author(s): Lopes HF, Martin KL, Nashar K, Morrow JD, Goodfriend TL, Egan BM. Source: Hypertension. 2003 March; 41(3): 422-30. Epub 2003 February 03. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12623938&dopt=Abstract
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DASH diet, reduced salt lowers blood pressure. Author(s): Cockey CD. Source: Awhonn Lifelines / Association of Women's Health, Obstetric and Neonatal Nurses. 2000 August-September; 4(4): 16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11898274&dopt=Abstract
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Day- and night-time blood pressure elevation in children with higher grades of renal scarring. Author(s): Patzer L, Seeman T, Luck C, Wuhl E, Janda J, Misselwitz J. Source: The Journal of Pediatrics. 2003 February; 142(2): 117-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12584530&dopt=Abstract
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Daytime ambulatory blood pressure correlates strongly with the echocardiographic diameter of aortic coarctation. Author(s): Engvall J, Nystrom F. Source: Scandinavian Cardiovascular Journal : Scj. 2001 October; 35(5): 335-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11771825&dopt=Abstract
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Defensiveness and 3-year blood pressure levels among young adults: the mediating effect of stress-reactivity. Author(s): Rutledge T, Linden W. Source: Annals of Behavioral Medicine : a Publication of the Society of Behavioral Medicine. 2003 Winter; 25(1): 34-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12581934&dopt=Abstract
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Degree of arousal is most correlated with blood pressure reactivity during sleep in obstructive sleep apnea. Author(s): Yoon IY, Jeong DU. Source: Journal of Korean Medical Science. 2001 December; 16(6): 707-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11748349&dopt=Abstract
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Deteriorating ischaemic stroke. cytokines, soluble cytokine receptors, ferritin, systemic blood pressure, body temperature, blood glucose, diabetes, stroke severity, and CT infarction-volume as predictors of deteriorating ischaemic stroke. Author(s): Christensen H, Boysen G, Johannesen HH, Christensen E, Bendtzen K. Source: Journal of the Neurological Sciences. 2002 September 15; 201(1-2): 1-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12163186&dopt=Abstract
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Determinants of ambulatory blood pressure response to physical activity. Author(s): Cavelaars M, Tulen JH, van Bemmel JH, ter Borg MJ, Mulder PG, van den Meiracker AH. Source: Journal of Hypertension. 2002 October; 20(10): 2009-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12359979&dopt=Abstract
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Determinants of exercise blood pressure response in normotensive and hypertensive women: role of cardiorespiratory fitness. Author(s): Kokkinos PF, Andreas PE, Coutoulakis E, Colleran JA, Narayan P, Dotson CO, Choucair W, Farmer C, Fernhall B. Source: Journal of Cardiopulmonary Rehabilitation. 2002 May-June; 22(3): 178-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12042686&dopt=Abstract
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Determination of accuracy in neonates for non-invasive blood pressure device using an improved algorithm. Author(s): Nelson RM, Stebor AD, Groh CM, Timoney PM, Theobald KS, Friedman BA. Source: Blood Pressure Monitoring. 2002 April; 7(2): 123-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12048430&dopt=Abstract
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Detrusor and blood pressure responses to dorsal penile nerve stimulation during hyperreflexic contraction of the bladder in patients with cervical cord injury. Author(s): Lee YH, Creasey GH, Lim H, Song J, Song K, Kim J. Source: Archives of Physical Medicine and Rehabilitation. 2003 January; 84(1): 136-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12589635&dopt=Abstract
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Devices and techniques for blood pressure measurement and criteria for hypertension adopted by Brazilian physicians: exploratory study. Author(s): Mion D Jr, Pierin AM, Lessa I, Nobre F. Source: Arquivos Brasileiros De Cardiologia. 2002 December; 79(6): 597-600, 593-6. English, Portuguese. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12532243&dopt=Abstract
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DGAT1 promoter polymorphism associated with alterations in body mass index, high density lipoprotein levels and blood pressure in Turkish women. Author(s): Ludwig EH, Mahley RW, Palaoglu E, Ozbayrakci S, Balestra ME, Borecki IB, Innerarity TL, Farese RV Jr. Source: Clinical Genetics. 2002 July; 62(1): 68-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12123490&dopt=Abstract
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Diabetes technology news. Calcium antagonists aid high blood pressure control. Author(s): Walczak IM. Source: Diabetes Technology & Therapeutics. 2003; 5(3): 510-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12838935&dopt=Abstract
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Diabetics' high blood pressure is often undertreated, study says. Author(s): Levenson D. Source: Rep Med Guidel Outcomes Res. 2002 January 25; 13(2): 7-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12425320&dopt=Abstract
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Diagnostic value of simultaneous non-invasive continuous, ambulatory finger blood pressure and electrocardiogram monitoring in a patient with hypertrophic obstructive cardiomyopathy. Author(s): Boon D, van Goudoever J, Huijskes R, Piek JJ, van Montfrans GA. Source: Blood Pressure Monitoring. 2002 December; 7(6): 329-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12488654&dopt=Abstract
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Diastolic blood pressure is an important determinant of augmentation index and pulse wave velocity in young, healthy males. Author(s): Nurnberger J, Dammer S, Opazo Saez A, Philipp T, Schafers RF. Source: Journal of Human Hypertension. 2003 March; 17(3): 153-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12624604&dopt=Abstract
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Diastolic blood pressure is the first to rise in association with early subclinical obstructive sleep apnea: lessons from periodic examination screening. Author(s): Sharabi Y, Scope A, Chorney N, Grotto I, Dagan Y. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2003 March; 16(3): 236-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12620704&dopt=Abstract
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Diastolic blood pressure-estimated left ventricular dp/dt. Author(s): Yilmaz H, Minareci K, Kabukcu M, Sancaktar O. Source: Echocardiography (Mount Kisco, N.Y.). 2002 February; 19(2): 89-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11926969&dopt=Abstract
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Diet- and blood pressure-related knowledge, attitudes, and hypertension prevalence among African Americans: the KDBP Study. Knowledge of Diet and Blood Pressure. Author(s): Carter-Edwards L, Jackson SA, Runaldue MJ, Svetkey LP. Source: Ethn Dis. 2002 Winter; 12(1): S1-72-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11913625&dopt=Abstract
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Dietary calcium lowers the age-related rise in blood pressure in the United States: the NHANES III survey. Author(s): Hajjar IM, Grim CE, Kotchen TA. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2003 March-April; 5(2): 122-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12671324&dopt=Abstract
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Dietary effect on blood pressure. Author(s): Paolini M, Sapone A, Canistro D, Chieco P, Bauer C. Source: Lancet. 2002 November 30; 360(9347): 1786. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12480457&dopt=Abstract
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Dietary effect on blood pressure. Author(s): Dyer K, Richardson R, Fearon K, Buckner K. Source: Lancet. 2002 November 30; 360(9347): 1785-6; Author Reply 1786. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12480455&dopt=Abstract
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Dietary sodium restriction restores nocturnal reduction of blood pressure in patients with primary aldosteronism. Author(s): Takakuwa H, Shimizu K, Izumiya Y, Kato T, Nakaya I, Yokoyama H, Kobayashi K, Ise T. Source: Hypertens Res. 2002 September; 25(5): 737-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12452327&dopt=Abstract
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Diet-related factors, educational levels and blood pressure in a Chinese population sample: findings from the Japan-China Cooperative Research Project. Author(s): Yamori Y, Liu L, Mu L, Zhao H, Pen Y, Hu Z, Kuga S, Negishi H, Ikeda K; Japan-China Cooperative Study Group: Chongqing Project. Source: Hypertens Res. 2002 July; 25(4): 559-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12358141&dopt=Abstract
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Differences in blood pressure level and hypertension in three ethnic groups of northeastern India. Author(s): Hazarika NC, Biswas D, Narain K, Phukan RK, Kalita HC, Mahanta J. Source: Asia Pac J Public Health. 2000; 12(2): 71-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11836922&dopt=Abstract
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Differences in circadian blood pressure variability during gestation between healthy and complicated pregnancies. Author(s): Hermida RC, Ayala DE, Mojon A, Fernandez JR, Alonso I, Aguilar MF, Ucieda R, Iglesias M. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2003 March; 16(3): 200-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12620698&dopt=Abstract
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Different alcohol drinking and blood pressure relationships in France and Northern Ireland: The PRIME Study. Author(s): Marques-Vidal P, Arveiler D, Evans A, Amouyel P, Ferrieres J, Ducimetiere P. Source: Hypertension. 2001 December 1; 38(6): 1361-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11751718&dopt=Abstract
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Different drug classes have variable effects on blood pressure depending on the time of day. Author(s): Morgan TO, Anderson A. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2003 January; 16(1): 46-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12517682&dopt=Abstract
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Different effects of tacrolimus and cyclosporine on renal hemodynamics and blood pressure in healthy subjects. Author(s): Klein IH, Abrahams A, van Ede T, Hene RJ, Koomans HA, Ligtenberg G. Source: Transplantation. 2002 March 15; 73(5): 732-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11907418&dopt=Abstract
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Different effects of tacrolimus and cyclosporine on renal hemodynamics and blood pressure in healthy subjects. Author(s): Holt S, Moore K. Source: Transplantation. 2002 March 15; 73(5): 673-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11907407&dopt=Abstract
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Differential binding of transcription factor E2F-2 to the endothelin-converting enzyme-1b promoter affects blood pressure regulation. Author(s): Funke-Kaiser H, Reichenberger F, Kopke K, Herrmann SM, Pfeifer J, Orzechowski HD, Zidek W, Paul M, Brand E. Source: Human Molecular Genetics. 2003 February 15; 12(4): 423-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12566389&dopt=Abstract
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Differential blood pressure effects of oral glucose and intravenous L-arginine in healthy lean normotensive and obese hypertensive subjects. Author(s): Castejon AM, Hoffmann IS, Jimenez E, Cubeddu RJ, Baldonedo RM, Cubeddu LX. Source: Journal of Human Hypertension. 2002 March; 16 Suppl 1: S133-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11986911&dopt=Abstract
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Differential effects of antihypertensive agents on electrocardiographic voltage: results from the Appropriate Blood Pressure Control in Diabetes (ABCD) trial. Author(s): Havranek EP, Esler A, Estacio RO, Mehler PS, Schrier RW; Appropriate Blood Pressure Control in Diabetes Trial. Source: American Heart Journal. 2003 June; 145(6): 993-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12796754&dopt=Abstract
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Differential effects of once-daily antihypertensive drugs on blood pressure, left ventricular mass and sympathetic activity: Nifedipine-GITS versus felodipine-ER versus enalapril. Author(s): Leenen FH, Myers MG, Joyner CD, Toal CB. Source: The Canadian Journal of Cardiology. 2002 December; 18(12): 1285-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12518180&dopt=Abstract
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Differential influence of family history of hypertension and premature myocardial infarction on systolic blood pressure and left ventricular mass trajectories in youth. Author(s): Dekkers JC, Treiber FA, Kapuku G, Snieder H. Source: Pediatrics. 2003 June; 111(6 Pt 1): 1387-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12777557&dopt=Abstract
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Differentiation between primary and secondary hypertension in children using ambulatory blood pressure monitoring. Author(s): Flynn JT. Source: Pediatrics. 2002 July; 110(1 Pt 1): 89-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12093951&dopt=Abstract
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Digital envelope detector for blood pressure measurement using an oscillometric method. Author(s): Lee JY, Kim JK, Yoon G. Source: Journal of Medical Engineering & Technology. 2002 May-June; 26(3): 117-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12350278&dopt=Abstract
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Diminished circadian blood pressure rhythm in patients with asymptomatic normotensive pheochromocytoma. Author(s): Zelinka T, Widimsky J, Weisserova J. Source: Physiological Research / Academia Scientiarum Bohemoslovaca. 2001; 50(6): 631-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11829326&dopt=Abstract
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Discrepancies between direct and indirect blood pressure measurements using various recommendations for arm cuff selection. Author(s): Clark JA, Lieh-Lai MW, Sarnaik A, Mattoo TK. Source: Pediatrics. 2002 November; 110(5): 920-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12415030&dopt=Abstract
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Dissecting the contradictory findings of angiotensin converting enzyme genetic polymorphism with blood pressure and hypertension. Author(s): Zaman MM, Yoshiike N, Tanaka H. Source: Bangladesh Med Res Counc Bull. 2001 December; 27(3): 90-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12197628&dopt=Abstract
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Dissociation between blood pressure reduction and fall in proteinuria in primary renal disease: a randomized double-blind trial. Author(s): PROCOPA Study Group. Source: Journal of Hypertension. 2002 April; 20(4): 729-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11910310&dopt=Abstract
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Distribution of 24-h ambulatory blood pressure in children: normalized reference values and role of body dimensions. Author(s): Wuhl E, Witte K, Soergel M, Mehls O, Schaefer F, Kirschstein M, Busch C, Danne T, Gellermann J, Holl R, Krull F, Reichert H, Reusz GS, Rascher W; German Working Group on Pediatric Hypertension. Source: Journal of Hypertension. 2002 October; 20(10): 1995-2007. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12359978&dopt=Abstract
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Distribution of 24-h ambulatory blood pressure in children: normalized reference values and role of body dimensions. Author(s): Graves JW. Source: Journal of Hypertension. 2002 October; 20(10): 1939-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12359967&dopt=Abstract
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Distribution of blood pressure and prevalence of hypertension in Tehran adult population: Tehran Lipid and Glucose Study (TLGS), 1999-2000. Author(s): Azizi F, Ghanbarian A, Madjid M, Rahmani M. Source: Journal of Human Hypertension. 2002 May; 16(5): 305-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12082490&dopt=Abstract
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Distribution of blood pressure, body mass index and smoking habits in the urban population of Dar es Salaam, Tanzania, and associations with socioeconomic status. Author(s): Bovet P, Ross AG, Gervasoni JP, Mkamba M, Mtasiwa DM, Lengeler C, Whiting D, Paccaud F. Source: International Journal of Epidemiology. 2002 February; 31(1): 240-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11914327&dopt=Abstract
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Diuresis pattern, plasma vasopressin and blood pressure in healthy elderly persons with nocturia and nocturnal polyuria. Author(s): Asplund R. Source: The Netherlands Journal of Medicine. 2002 August; 60(7): 276-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12430573&dopt=Abstract
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Diurnal blood pressure curve in children and adolescents. Author(s): Lurbe E, Thijs L, Redon J, Alvarez V, Tacons J, Staessen J. Source: Journal of Hypertension. 1996 January; 14(1): 41-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12013493&dopt=Abstract
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Diurnal blood pressure patterns in long-term care settings. Author(s): Ice GH, James GD, Crews DE. Source: Blood Pressure Monitoring. 2002 April; 7(2): 105-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12048427&dopt=Abstract
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Do angiotensin receptor antagonists have benefits beyond blood pressure lowering? Author(s): Oparil S. Source: Current Hypertension Reports. 2002 June; 4(3): 219-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12003704&dopt=Abstract
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Do lipids, blood pressure, diabetes, and smoking confer equal risk of myocardial infarction in women as in men? The Reykjavik Study. Author(s): Jonsdottir LS, Sigfusson N, Gudnason V, Sigvaldason H, Thorgeirsson G. Source: Journal of Cardiovascular Risk. 2002 April; 9(2): 67-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12006913&dopt=Abstract
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Do trends in population levels of blood pressure and other cardiovascular risk factors explain trends in stroke event rates? Comparisons of 15 populations in 9 countries within the WHO MONICA Stroke Project. World Health Organization Monitoring of Trends and Determinants in Cardiovascular Disease. Author(s): Tolonen H, Mahonen M, Asplund K, Rastenyte D, Kuulasmaa K, Vanuzzo D, Tuomilehto J. Source: Stroke; a Journal of Cerebral Circulation. 2002 October; 33(10): 2367-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12364723&dopt=Abstract
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Do vestibular otolith organs participate in human orthostatic blood pressure control? Author(s): Watenpaugh DE, Cothron AV, Wasmund SL, Wasmund WL, Carter R 3rd, Muenter NK, Smith ML. Source: Autonomic Neuroscience : Basic & Clinical. 2002 September 30; 100(1-2): 77-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12422963&dopt=Abstract
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Do we need another protocol for assessing the validity of blood pressure measuring devices? Author(s): Campbell NR, McKay DW. Source: Blood Pressure Monitoring. 2002 February; 7(1): 1-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12040235&dopt=Abstract
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Do whole-grain oat cereals reduce the need for antihypertensive medications and improve blood pressure control? Author(s): Pins JJ, Geleva D, Keenan JM, Frazel C, O'Connor PJ, Cherney LM. Source: The Journal of Family Practice. 2002 April; 51(4): 353-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11978259&dopt=Abstract
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Does aldosterone modulate central control of blood pressure? Author(s): Tuck ML. Source: Journal of Hypertension. 2002 June; 20(6): 1079-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12023673&dopt=Abstract
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Does ambulatory blood pressure monitoring aid in the management of patients with hypertension? Author(s): Stephens MB, deGruy F. Source: The Journal of Family Practice. 2002 January; 51(1): 15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11927055&dopt=Abstract
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Does blood pressure differ between users and non-users of hormone replacement therapy? The Women's Health In the Lund Area (WHILA) Study. Author(s): Enstrom I, Lidfeldt J, Lindholm LH, Nerbrand C, Pennert K, Samsioe G. Source: Blood Pressure. 2002; 11(4): 240-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12361193&dopt=Abstract
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Does cyclooxygenase-2 affect blood pressure? Author(s): Cheng HF, Harris RC. Source: Current Hypertension Reports. 2003 February; 5(1): 87-92. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12530941&dopt=Abstract
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Does dexamethasone improve blood pressure in hypotensive ill neonates? Author(s): Nicholl R. Source: Archives of Disease in Childhood. 2001 September; 85(3): 253-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12035814&dopt=Abstract
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Does nitric oxide buffer arterial blood pressure variability in humans? Author(s): Cooke WH, Zhang R, Zuckerman JH, Cui J, Wilson TE, Crandall CG, Levine BD. Source: Journal of Applied Physiology (Bethesda, Md. : 1985). 2002 October; 93(4): 146670. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12235048&dopt=Abstract
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Does sodium sensitivity affect nocturnal blood pressure variation in outpatients with hypertension? Author(s): Watanabe Y, Nishimura H, Sanaka S, Otsuka K, Ohkawa S. Source: Clinical and Experimental Hypertension (New York, N.Y. : 1993). 2002 JanuaryFebruary; 24(1-2): 99-107. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11848174&dopt=Abstract
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Does taking an orthostatic blood pressure include taking the pulse? Author(s): Blazys D. Source: Journal of Emergency Nursing: Jen : Official Publication of the Emergency Department Nurses Association. 2000 October; 26(5): 479-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11876167&dopt=Abstract
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Drugs for treatment of very high blood pressure during pregnancy. Author(s): Duley L, Henderson-Smart DJ. Source: Cochrane Database Syst Rev. 2002; (4): Cd001449. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12519557&dopt=Abstract
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Duration of preoperative fast correlates with arterial blood pressure response to halothane in infants. Author(s): Friesen RH, Wurl JL, Friesen RM. Source: Anesthesia and Analgesia. 2002 December; 95(6): 1572-6, Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12456418&dopt=Abstract
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Dynamic cerebral autoregulation and beat to beat blood pressure control are impaired in acute ischaemic stroke. Author(s): Eames PJ, Blake MJ, Dawson SL, Panerai RB, Potter JF. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2002 April; 72(4): 467-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11909905&dopt=Abstract
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Dynamic cerebral autoregulatory response to blood pressure rise measured by nearinfrared spectroscopy and intracranial pressure. Author(s): Wagner BP, Pfenninger J. Source: Critical Care Medicine. 2002 September; 30(9): 2014-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12352034&dopt=Abstract
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Dyslexia and familial high blood pressure: an observational pilot study. Author(s): Taylor K, Stein J. Source: Archives of Disease in Childhood. 2002 January; 86(1): 30-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11806878&dopt=Abstract
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Early and late growth and blood pressure in adolescence. Author(s): Horta BL, Barros FC, Victora CG, Cole TJ. Source: Journal of Epidemiology and Community Health. 2003 March; 57(3): 226-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12594200&dopt=Abstract
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Early versus late morning measurement of blood pressure in healthy men. A potential source of measurement bias? Author(s): Bodegard J, Erikssen G, Sandvik L, Kjeldsen SE, Bjornholt J, Erikssen JE. Source: Blood Pressure. 2002; 11(6): 366-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12523680&dopt=Abstract
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Effect of amlodipine and hormone replacement therapy on blood pressure and bone markers in menopause. Author(s): Zacharieva S, Shigarminova R, Nachev E, Kamenov Z, Atanassova I, Orbetzova M, Stoynev A, Doncheva N, Borissova AM. Source: Methods Find Exp Clin Pharmacol. 2003 April; 25(3): 209-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12743626&dopt=Abstract
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Effect of angiotensin ii receptor blockade on arterial stiffness: beyond blood pressure reduction. Author(s): Mahmud A, Feely J. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2002 December; 15(12): 1092-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12460706&dopt=Abstract
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Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. Author(s): Wright JT Jr, Bakris G, Greene T, Agodoa LY, Appel LJ, Charleston J, Cheek D, Douglas-Baltimore JG, Gassman J, Glassock R, Hebert L, Jamerson K, Lewis J, Phillips RA, Toto RD, Middleton JP, Rostand SG; African American Study of Kidney Disease and Hypertension Study Group. Source: Jama : the Journal of the American Medical Association. 2002 November 20; 288(19): 2421-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12435255&dopt=Abstract
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Effect of doxazosin GITS on blood pressure in hypertensive and normotensive patients: a review of hypertension and BPH studies. Author(s): Lund-Johansen P, Kirby RS. Source: Blood Pressure. Supplement. 2003 May; Suppl 1: 5-13. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12800982&dopt=Abstract
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Effect of exercise training on blood pressure in postmenopausal Caucasian and African-American women. Author(s): Santa-Clara H, Szymanski L, Fernhall B. Source: The American Journal of Cardiology. 2003 April 15; 91(8): 1009-11, A8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12686352&dopt=Abstract
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Effect of four oral contraceptives on thyroid hormones, adrenal and blood pressure parameters. Author(s): Wiegratz I, Kutschera E, Lee JH, Moore C, Mellinger U, Winkler UH, Kuhl H. Source: Contraception. 2003 May; 67(5): 361-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12742558&dopt=Abstract
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Effect of losartan on nocturnal blood pressure in patients with stroke: comparison with angiotensin converting enzyme inhibitor. Author(s): Okuguchi T, Osanai T, Fujiwara N, Kato T, Metoki N, Konta Y, Okumura K. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2002 November; 15(11): 998-1002. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12441222&dopt=Abstract
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Effect of modest salt reduction on blood pressure: a meta-analysis of randomized trials. Implications for public health. Author(s): He FJ, MacGregor GA. Source: Journal of Human Hypertension. 2002 November; 16(11): 761-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12444537&dopt=Abstract
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Effect of nasal continuous positive airway pressure treatment on blood pressure in patients with obstructive sleep apnea. Author(s): Becker HF, Jerrentrup A, Ploch T, Grote L, Penzel T, Sullivan CE, Peter JH. Source: Circulation. 2003 January 7; 107(1): 68-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12515745&dopt=Abstract
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Effect of nocturnal blood pressure reduction on retrobulbar hemodynamics in glaucoma. Author(s): Feke GT. Source: Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie. 2002 October; 240(10): 870; Author Reply 871. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12530460&dopt=Abstract
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Effect of nocturnal blood pressure reduction on retrobulbar hemodynamics in glaucoma. Author(s): Hayreh SS. Source: Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie. 2002 October; 240(10): 867-8; Author Reply 869. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12530458&dopt=Abstract
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Effect of nortriptyline on the day-night systolic blood pressure difference in hypertensive and normotensive elderly depressed women. Author(s): Scalco MZ, Serro-Azul JB, Giorgi D, Almeida OP, Wajngarten M. Source: The American Journal of Cardiology. 2003 May 15; 91(10): 1279-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745123&dopt=Abstract
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Effect of systolic blood pressure and carotid stiffness on baroreflex gain in elderly subjects. Author(s): Mukai S, Gagnon M, Iloputaife I, Hamner JW, Lipsitz LA. Source: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2003 July; 58(7): 626-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12865478&dopt=Abstract
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Effect of the C825T polymorphism of the G protein beta 3 subunit on the systolic blood pressure-lowering effect of clonidine in young, healthy male subjects. Author(s): Nurnberger J, Dammer S, Mitchell A, Siffert W, Wenzel RR, Gossl M, Philipp T, Michel MC, Schafers RF. Source: Clinical Pharmacology and Therapeutics. 2003 July; 74(1): 53-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12844135&dopt=Abstract
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Effect of transdermal estrogen therapy on some vasoactive humoral factors and 24-h ambulatory blood pressure in normotensive postmenopausal women. Author(s): Zacharieva S, Atanassova I, Kirilov G, Kalinov K, Shigarminova R, Nachev E, Aslanova N. Source: Climacteric : the Journal of the International Menopause Society. 2002 September; 5(3): 293-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12419088&dopt=Abstract
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Effect of ultrafiltration on blood pressure variability in hemodialysis patients. Author(s): Kursat S, Ozgur B, Alici T. Source: Clinical Nephrology. 2003 April; 59(4): 289-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12708569&dopt=Abstract
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Effects of a hypocaloric, low-carbohydrate diet on weight loss, blood lipids, blood pressure, glucose tolerance, and body composition in free-living overweight women. Author(s): Meckling KA, Gauthier M, Grubb R, Sanford J. Source: Canadian Journal of Physiology and Pharmacology. 2002 November; 80(11): 1095-105. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12489929&dopt=Abstract
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Effects of ACE I/D and AT1R-A1166C polymorphisms on blood pressure in a healthy normotensive primary care population: first results of the Hippocates study. Author(s): Henskens LH, Spiering W, Stoffers HE, Soomers FL, Vlietinck RF, de Leeuw PW, Kroon AA. Source: Journal of Hypertension. 2003 January; 21(1): 81-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12544439&dopt=Abstract
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Effects of antihypertensive agents on blood pressure during exercise. Author(s): Arita M, Hashizume T, Wanaka Y, Handa S, Nakamura C, Fujiwara S, Nishio I. Source: Hypertens Res. 2001 November; 24(6): 671-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11768726&dopt=Abstract
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Effects of blood pressure level on progression of diabetic nephropathy: results from the RENAAL study. Author(s): Bakris GL, Weir MR, Shanifar S, Zhang Z, Douglas J, van Dijk DJ, Brenner BM; RENAAL Study Group. Source: Archives of Internal Medicine. 2003 July 14; 163(13): 1555-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12860578&dopt=Abstract
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Effects of blood pressure lowering in the acute phase of total anterior circulation infarcts and other stroke subtypes. Author(s): Ahmed N, Wahlgren NG. Source: Cerebrovascular Diseases (Basel, Switzerland). 2003; 15(4): 235-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12686786&dopt=Abstract
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Effects of blood pressure lowering with perindopril and indapamide therapy on dementia and cognitive decline in patients with cerebrovascular disease. Author(s): Tzourio C, Anderson C, Chapman N, Woodward M, Neal B, MacMahon S, Chalmers J; PROGRESS Collaborative Group. Source: Archives of Internal Medicine. 2003 May 12; 163(9): 1069-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12742805&dopt=Abstract
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Effects of celecoxib and rofecoxib on blood pressure and edema in patients > or =65 years of age with systemic hypertension and osteoarthritis. Author(s): Whelton A, White WB, Bello AE, Puma JA, Fort JG; SUCCESS-VII Investigators. Source: The American Journal of Cardiology. 2002 November 1; 90(9): 959-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12398962&dopt=Abstract
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Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. Author(s): Appel LJ, Champagne CM, Harsha DW, Cooper LS, Obarzanek E, Elmer PJ, Stevens VJ, Vollmer WM, Lin PH, Svetkey LP, Stedman SW, Young DR; Writing Group of the PREMIER Collaborative Research Group. Source: Jama : the Journal of the American Medical Association. 2003 April 23-30; 289(16): 2083-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12709466&dopt=Abstract
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Effects of furosemide versus captopril on postprandial and orthostatic blood pressure and on cerebral oxygenation in patients > or = 70 years of age with heart failure. Author(s): Mehagnoul-Schipper DJ, Colier WN, Hoefnagels WH, Verheugt FW, Jansen RW. Source: The American Journal of Cardiology. 2002 September 15; 90(6): 596-600. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12231083&dopt=Abstract
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Effects of hormone replacement therapy on the sympathetic nervous system and blood pressure. Author(s): Wyss JM, Carlson SH. Source: Current Hypertension Reports. 2003 June; 5(3): 241-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724057&dopt=Abstract
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Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride. Author(s): Jurgens G, Graudal NA. Source: Cochrane Database Syst Rev. 2003; (1): Cd004022. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12535503&dopt=Abstract
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Electrolyte intake and nonpharmacologic blood pressure control. Author(s): Espeland MA, Kumanyika S, Yunis C, Zheng B, Brown WM, Jackson S, Wilson AC, Bahnson J. Source: Annals of Epidemiology. 2002 November; 12(8): 587-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12495832&dopt=Abstract
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Elevated blood pressure is not related to saliva flow in patients with Sjogren's syndrome. Author(s): Sankar V, Brennan MT, Radfar L, Leakan RA, Pillemer SR. Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 2002 August; 94(2): 179-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12221385&dopt=Abstract
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Elevation of blood pressure induced by high-dose milnacipran. Author(s): Yoshida K, Higuchi H, Takahashi H, Shimizu T. Source: Human Psychopharmacology. 2002 December; 17(8): 431. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12457380&dopt=Abstract
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Emotional expressiveness, hostility and blood pressure in a longitudinal cohort of Alzheimer caregivers. Author(s): Shaw WS, Patterson TL, Semple SJ, Dimsdale JE, Ziegler MG, Grant I. Source: Journal of Psychosomatic Research. 2003 April; 54(4): 293-302. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12670605&dopt=Abstract
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Endothelin-1 gene variant associates with blood pressure in obese Japanese subjects: the Ohasama Study. Author(s): Asai T, Ohkubo T, Katsuya T, Higaki J, Fu Y, Fukuda M, Hozawa A, Matsubara M, Kitaoka H, Tsuji I, Araki T, Satoh H, Hisamichi S, Imai Y, Ogihara T. Source: Hypertension. 2001 December 1; 38(6): 1321-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11751711&dopt=Abstract
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Epidemiologic study of the association of low-Km mitochondrial acetaldehyde dehydrogenase genotypes with blood pressure level and the prevalence of hypertension in a general population. Author(s): Amamoto K, Okamura T, Tamaki S, Kita Y, Tsujita Y, Kadowaki T, Nakamura Y, Ueshima H. Source: Hypertens Res. 2002 November; 25(6): 857-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12484509&dopt=Abstract
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Epidemiological evidence of the association between dietary protein intake and blood pressure: a meta-analysis of published data. Author(s): Liu L, Ikeda K, Sullivan DH, Ling W, Yamori Y. Source: Hypertens Res. 2002 September; 25(5): 689-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12452320&dopt=Abstract
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Evaluation of patient counseling on blood pressure control of out-patients with hypertension at Chulalongkorn Hospital. Author(s): Aramwit P, Assawawitoontip S. Source: J Med Assoc Thai. 2003 June; 86 Suppl 2: S496-500. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12930031&dopt=Abstract
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Evaluation of skills and knowledge on orthostatic blood pressure measurement in elderly patients. Author(s): Jolobe OM. Source: Age and Ageing. 2003 January; 32(1): 117. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12540362&dopt=Abstract
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Evaluation of the overall system precision of the Welch-Allyn transtelephonic home blood pressure monitor in adults with Parkinson's disease. Author(s): Herbst T, Anis-Anwar Y, Giacco S, White WB. Source: Blood Pressure Monitoring. 2002 October; 7(5): 285-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12409889&dopt=Abstract
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Evaluation of the performance of a wrist blood pressure measuring device with a position sensor compared to ambulatory 24-hour blood pressure measurements. Author(s): Uen S, Weisser B, Wieneke P, Vetter H, Mengden T. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2002 September; 15(9): 787-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12219873&dopt=Abstract
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Exercise blood pressure in congenital heart disease and in patients after coarctation repair. Author(s): Hauser M. Source: Heart (British Cardiac Society). 2003 February; 89(2): 125-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12527653&dopt=Abstract
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Exercise blood pressure response is related to left ventricular mass. Author(s): Sung J, Ouyang P, Silber HA, Bacher AC, Turner KL, DeRegis JR, Hees PS, Shapiro EP, Stewart KJ. Source: Journal of Human Hypertension. 2003 May; 17(5): 333-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12756406&dopt=Abstract
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Exponential-exponential cosine fitting of blood pressure decay induced by a longacting calcium blocker, amlodipine, using home blood pressure measurement. Author(s): Mashima K, Nakatsu T, Murakami T, Kusachi S, Tominaga Y, Yamane S, Uesugi T, Mayumi E, Mitsuda T, Tsuji T. Source: Clinical and Experimental Hypertension (New York, N.Y. : 1993). 2003 April; 25(3): 145-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716077&dopt=Abstract
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Factors influencing the accuracy of oscillometric blood pressure measurement in critically ill patients. Author(s): Bur A, Herkner H, Vlcek M, Woisetschlager C, Derhaschnig U, Delle Karth G, Laggner AN, Hirschl MM. Source: Critical Care Medicine. 2003 March; 31(3): 793-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12626986&dopt=Abstract
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Factors influencing the systolic blood pressure response to drug therapy. Author(s): Campo C, Segura J, Ruilope LM. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2002 January-February; 4(1): 35-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11821635&dopt=Abstract
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Familial aggregation of blood pressure. Preliminary report. Author(s): Winkelstein W Jr, Kantor S, Ibrahim M, Sackett DL. Source: Jama : the Journal of the American Medical Association. 1966 March 7; 195(10): 848-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12608171&dopt=Abstract
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Familial aggregation of exercise heart rate and blood pressure in response to 20 weeks of endurance training: the HERITAGE family study. Author(s): An P, Perusse L, Rankinen T, Borecki IB, Gagnon J, Leon AS, Skinner JS, Wilmore JH, Bouchard C, Rao DC. Source: International Journal of Sports Medicine. 2003 January; 24(1): 57-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12582953&dopt=Abstract
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Finger systolic blood pressure indices for the diagnosis of vibration-induced white finger. Author(s): Bovenzi M. Source: International Archives of Occupational and Environmental Health. 2002 January; 75(1-2): 20-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11898873&dopt=Abstract
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Firefighters' blood pressure and employment status on hazardous materials teams in Massachusetts: a prospective study. Author(s): Kales SN, Soteriades ES, Christoudias SG, Tucker SA, Nicolaou M, Christiani DC. Source: Journal of Occupational and Environmental Medicine / American College of Occupational and Environmental Medicine. 2002 July; 44(7): 669-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12134531&dopt=Abstract
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First-trimester blood pressure and gestational diabetes in high-risk Chinese women. Author(s): Lao TT, Ho LF. Source: Journal of the Society for Gynecologic Investigation. 2003 February; 10(2): 94-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12593998&dopt=Abstract
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Fluid status, blood pressure, and cardiovascular abnormalities in patients on peritoneal dialysis. Author(s): Konings CJ, Kooman JP, Schonck M, Dammers R, Cheriex E, Palmans Meulemans AP, Hoeks AP, van Kreel B, Gladziwa U, van der Sande FM, Leunissen KM. Source: Perit Dial Int. 2002 July-August; 22(4): 477-87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12322819&dopt=Abstract
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Folic acid enhances endothelial function and reduces blood pressure in smokers: a randomized controlled trial. Author(s): Mangoni AA, Sherwood RA, Swift CG, Jackson SH. Source: Journal of Internal Medicine. 2002 December; 252(6): 497-503. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12472909&dopt=Abstract
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Frequency of spontaneous fist clenching during routine blood pressure measurements and its effect on measurement accuracy. Author(s): Smulders YM, Godfried MH, van Montfrans GA. Source: Blood Pressure Monitoring. 2002 June; 7(3): 145-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12131070&dopt=Abstract
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Future developments in ambulatory blood pressure monitoring and self-blood pressure monitoring in clinical practice. Author(s): Pickering T. Source: Blood Pressure Monitoring. 2002 February; 7(1): 21-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12040238&dopt=Abstract
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Gamma-glutamyltransferase, alcohol, and blood pressure. A four year follow-up study. Author(s): Lee DH, Ha MH, Kim JR, Gross M, Jacobs DR Jr. Source: Annals of Epidemiology. 2002 February; 12(2): 90-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11880216&dopt=Abstract
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Gender and age effects on the ambulatory blood pressure and heart rate responses to antihypertensive therapy. Author(s): White WB, Johnson MF, Black HR, Elliott WJ, Sica DA. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2001 December; 14(12): 1239-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11775133&dopt=Abstract
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Genetics and blood pressure response to exercise, and its interactions with adiposity. Author(s): Rankinen T, Bouchard C. Source: Preventive Cardiology. 2002 Summer; 5(3): 138-44. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12091756&dopt=Abstract
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Genome scan among Nigerians linking blood pressure to chromosomes 2, 3, and 19. Author(s): Cooper RS, Luke A, Zhu X, Kan D, Adeyemo A, Rotimi C, Bouzekri N, Ward R, Rorimi C. Source: Hypertension. 2002 November; 40(5): 629-33. Erratum In: Hypertension 2003 January; 41(1): 1E. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12411454&dopt=Abstract
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Genome scans for blood pressure and hypertension: the National Heart, Lung, and Blood Institute Family Heart Study. Author(s): Hunt SC, Ellison RC, Atwood LD, Pankow JS, Province MA, Leppert MF. Source: Hypertension. 2002 July; 40(1): 1-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12105129&dopt=Abstract
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Genome scans for hypertension and blood pressure regulation. Author(s): Samani NJ. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2003 February; 16(2): 167-71. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12559688&dopt=Abstract
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Genome-wide linkage analysis of lipids in the Hypertension Genetic Epidemiology Network (HyperGEN) Blood Pressure Study. Author(s): Coon H, Leppert MF, Eckfeldt JH, Oberman A, Myers RH, Peacock JM, Province MA, Hopkins PN, Heiss G. Source: Arteriosclerosis, Thrombosis, and Vascular Biology. 2001 December; 21(12): 1969-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11742872&dopt=Abstract
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Genomewide linkage scan of resting blood pressure: HERITAGE Family Study. Health, Risk Factors, Exercise Training, and Genetics. Author(s): Rice T, Rankinen T, Chagnon YC, Province MA, Perusse L, Leon AS, Skinner JS, Wilmore JH, Bouchard C, Rao DC. Source: Hypertension. 2002 June; 39(6): 1037-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12052838&dopt=Abstract
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Genotypes of the betaENaC gene have little influence on blood pressure level in the Japanese population. Author(s): Matsubara M, Metoki H, Suzuki M, Fujiwara T, Kikuya M, Michimata M, Ohkubo T, Hozawa A, Tsuji I, Hisamichi S, Araki T, Imai Y. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2002 February; 15(2 Pt 1): 189-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11863256&dopt=Abstract
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Glucose, blood pressure, and lipid control in older people with and without diabetes mellitus: the Cardiovascular Health Study. Author(s): Smith NL, Savage PJ, Heckbert SR, Barzilay JI, Bittner VA, Kuller LH, Psaty BM. Source: Journal of the American Geriatrics Society. 2002 March; 50(3): 416-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11943034&dopt=Abstract
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Goal blood pressure in treating hypertension. Author(s): Ames R. Source: Archives of Internal Medicine. 2002 January 14; 162(1): 105-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11784240&dopt=Abstract
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G-protein beta3-subunit gene variant, blood pressure and erythrocyte sodium/lithium countertransport in essential hypertension. Author(s): Poch E, Gonzalez-Nunez D, Compte M, De la Sierra A. Source: British Journal of Biomedical Science. 2002; 59(2): 101-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12113397&dopt=Abstract
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Group- and sex-specific effects of age, body composition and pulse rate on blood pressure variability in some cross-cultural populations of Visakhapatnam District; South India. Author(s): Kusuma YS, Babu BV, Naidu JM. Source: Journal of Cardiovascular Risk. 2001 December; 8(6): 337-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11873089&dopt=Abstract
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Guar attenuates fall in postprandial blood pressure and slows gastric emptying of oral glucose in type 2 diabetes. Author(s): Russo A, Stevens JE, Wilson T, Wells F, Tonkin A, Horowitz M, Jones KL. Source: Digestive Diseases and Sciences. 2003 July; 48(7): 1221-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12870776&dopt=Abstract
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Guidelines on high blood pressure in pregnancy give new classifications of disease. Author(s): Rollins G. Source: Rep Med Guidel Outcomes Res. 2000 December 18; 11(24): 5-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11902247&dopt=Abstract
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Guiding lights for antihypertensive treatment in patients with nondiabetic chronic renal disease: proteinuria and blood pressure levels? Author(s): Mulrow CD, Townsend RR. Source: Annals of Internal Medicine. 2003 August 19; 139(4): 296-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12965986&dopt=Abstract
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Health economics in the Hypertension Optimal Treatment (HOT) study: costs and cost-effectiveness of intensive blood pressure lowering and low-dose aspirin in patients with hypertension. Author(s): Jonsson B, Hansson L, Stalhammar NO. Source: Journal of Internal Medicine. 2003 April; 253(4): 472-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12653877&dopt=Abstract
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Heart rate and blood pressure responses to mental stress and clinical cardiovascular events in men and women after coronary artery bypass grafting: the Post Coronary Artery Bypass Graft (Post-CABG) biobehavioral study. Author(s): Herd JA, Hoogwerf BJ, Barton F, Terrin ML, Czajkowski SM, Lindquist R, Dupuis G. Source: American Heart Journal. 2003 August; 146(2): 273-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12891195&dopt=Abstract
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Heart rate and blood pressure turbulence--marker of the baroreflex sensitivity or consequence of postextrasystolic potentiation and pulsus alternans? Author(s): Voss A, Baier V, Hopfe J, Schirdewan A, Leder U. Source: The American Journal of Cardiology. 2002 January 1; 89(1): 110-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11779541&dopt=Abstract
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Hemodynamic changes and prognosis in patients with hypertrophic cardiomyopathy and abnormal blood pressure responses during exercise. Author(s): Nagata M, Shimizu M, Ino H, Yamaguchi M, Hayashi K, Taki J, Mabuchi H. Source: Clin Cardiol. 2003 February; 26(2): 71-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12625597&dopt=Abstract
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High blood pressure control: put the champagne away. Author(s): Lenfant C. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2002 NovemberDecember; 4(6): 391-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12461300&dopt=Abstract
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High blood pressure in African Americans. Author(s): Materson BJ. Source: Archives of Internal Medicine. 2003 March 10; 163(5): 521-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12622599&dopt=Abstract
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High blood pressure in the geriatric population: treatment considerations. Author(s): Sander GE. Source: The American Journal of Geriatric Cardiology. 2002 July-August; 11(4): 223-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12091771&dopt=Abstract
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High blood pressure research in Australian general practice. Author(s): Nelson M. Source: Aust Fam Physician. 2003 April; 32(4): 277. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12735270&dopt=Abstract
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High blood pressure: definitions, prognostic, and therapeutic implications. Author(s): Birbari AE. Source: J Med Liban. 2001 November-December; 49(6): 338-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12744637&dopt=Abstract
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High salt intake, its origins, its economic impact, and its effect on blood pressure. Author(s): Roberts WC. Source: The American Journal of Cardiology. 2001 December 1; 88(11): 1338-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11728372&dopt=Abstract
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Higher blood pressure among Inuit migrants in Denmark than among the Inuit in Greenland. Author(s): Bjerregaard P, Jorgensen ME, Lumholt P, Mosgaard L, Borch-Johnsen K; Greenland Population Study. Source: Journal of Epidemiology and Community Health. 2002 April; 56(4): 279-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11896135&dopt=Abstract
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Higher blood pressure in normoalbuminuric type 1 diabetic patients with a familial history of type 2 diabetes. Author(s): Damci T, Osar Z, Ilkova H. Source: Diabetes & Metabolism. 2002 November; 28(5): 417-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12461481&dopt=Abstract
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Higher blood pressure load (baric impact) in normotensives with endothelial dysfunction: a paraphysiological status of “pre-hypertension”. Author(s): Cugini P, Baldoni F, De Rosa R, Pandolfi C, Colotto M, Buccarella PA, Zamparelli C, Berti D, Passini B, Roncoroni V, Sabino D, Capria A. Source: Clin Ter. 2002 September-October; 153(5): 309-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12510414&dopt=Abstract
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High-meat, low-carbohydrate diet in pregnancy: relation to adult blood pressure in the offspring. Author(s): Shiell AW, Campbell-Brown M, Haselden S, Robinson S, Godfrey KM, Barker DJ. Source: Hypertension. 2001 December 1; 38(6): 1282-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11751704&dopt=Abstract
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High-normal blood pressure and microalbuminuria. Author(s): Knight EL, Kramer HM, Curhan GC. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2003 March; 41(3): 588-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12612982&dopt=Abstract
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High-normal blood pressure--more “high” than “normal”. Author(s): Panza JA. Source: The New England Journal of Medicine. 2001 November 1; 345(18): 1337-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11794154&dopt=Abstract
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Home blood pressure monitoring. Current knowledge and directions for future research. Author(s): Reims H, Fossum E, Kjeldsen SE, Julius S. Source: Blood Pressure. 2001; 10(5-6): 271-87. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11822532&dopt=Abstract
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Homeostasis model assessment of insulin resistance, quantitative insulin sensitivity check index, and oral glucose insulin sensitivity index in nonobese, nondiabetic subjects with high-normal blood pressure. Author(s): Kanauchi M, Yamano S, Kanauchi K, Saito Y. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 July; 88(7): 3444-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12843200&dopt=Abstract
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Homocysteine and blood pressure in the Third National Health and Nutrition Examination Survey, 1988-1994. Author(s): Lim U, Cassano PA. Source: American Journal of Epidemiology. 2002 December 15; 156(12): 1105-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12480655&dopt=Abstract
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Homocysteine and blood pressure. Author(s): van Guldener C, Nanayakkara PW, Stehouwer CD. Source: Current Hypertension Reports. 2003 February; 5(1): 26-31. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12530932&dopt=Abstract
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HOPE in PROGRESS--a tale of two trials: blood pressure reduction or drug mechanism? Author(s): Sander GE, Giles TD. Source: The American Journal of Geriatric Cardiology. 2002 September-October; 11(5): 332-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12214175&dopt=Abstract
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Hormone replacement in postmenopausal women: impact of progestogens on autonomic tone and blood pressure regulation. Author(s): Christ M, Seyffart K, Tillmann HC, Wehling M. Source: Menopause (New York, N.Y.). 2002 March-April; 9(2): 127-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11875332&dopt=Abstract
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Hostility, cultural orientation, and casual blood pressure readings in African Americans. Author(s): Daniels IN, Harrell JP, Floyd LJ, Bell SR. Source: Ethn Dis. 2001 Fall; 11(4): 779-87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11763302&dopt=Abstract
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How do minor changes in the definition of blood pressure control affect the reported success of hypertension treatment? Author(s): Green BB, Kaplan RC, Psaty BM. Source: Am J Manag Care. 2003 March; 9(3): 219-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12643339&dopt=Abstract
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How does the plethysmogram derived from the pulse oximeter relate to arterial blood pressure in coronary artery bypass graft patients? Author(s): Awad AA, Ghobashy MA, Stout RG, Silverman DG, Shelley KH. Source: Anesthesia and Analgesia. 2001 December; 93(6): 1466-71, Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11726424&dopt=Abstract
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How far should we lower blood pressure in the elderly. Author(s): Hansson L. Source: Cardiovascular Drugs and Therapy / Sponsored by the International Society of Cardiovascular Pharmacotherapy. 2001; 15(3): 275-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11713897&dopt=Abstract
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How pharmacists can assist physicians with controlling blood pressure. Author(s): Carter BL, Zillich AJ, Elliott WJ. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2003 January-February; 5(1): 31-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12556651&dopt=Abstract
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How should we measure blood pressure in the doctor's office? Author(s): Gerin W, Marion RM, Friedman R, James GD, Bovbjerg DH, Pickering TG. Source: Blood Pressure Monitoring. 2001 October; 6(5): 257-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12055421&dopt=Abstract
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How to use home blood pressure monitors in clinical practice. Author(s): Yarows SA, Staessen JA. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2002 January; 15(1 Pt 1): 93-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11824867&dopt=Abstract
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Human atrial natriuretic peptide gene delivery reduces blood pressure in hypertensive rats. Author(s): Lin KF. Source: Hypertension. 2001 December 1; 38(6): E37-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11751744&dopt=Abstract
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Hypertension and arrhythmia: blood pressure control and beyond. Author(s): Yildirir A, Batur MK, Oto A. Source: Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology. 2002 April; 4(2): 175-82. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12135251&dopt=Abstract
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Hypertension in the elderly: a review of the importance of systolic blood pressure elevation. Author(s): Basile J. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2002 March-April; 4(2): 108-12, 119. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11927790&dopt=Abstract
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Impact of abnormal nocturnal blood pressure fall on vascular function. Author(s): Marinakis AG, Vyssoulis GP, Michaelides AP, Karpanou EA, Cokkinos DV, Toutouzas PK. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2003 March; 16(3): 209-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12620699&dopt=Abstract
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Impact of ACE polymorphism on renal allograft function, blood pressure, and proteinuria under ACE inhibition. Author(s): Suwelack B, Kempkes-Koch M, Kobelt V, Hillebrand U, Matzkies F, Gerhardt U, Hohage H. Source: Transplantation Proceedings. 2002 August; 34(5): 1763-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12176567&dopt=Abstract
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Impact of blood pressure and insulin on the relationship between body fat and left ventricular structure. Author(s): Karason K, Sjostrom L, Wallentin I, Peltonen M. Source: European Heart Journal. 2003 August; 24(16): 1500-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12919774&dopt=Abstract
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Impact of hospitalization on blood pressure control in Italy: results from the Italian Group of Pharmacoepidemiology in the Elderly (GIFA). Author(s): Onder G, Gambassi G, Sgadari A, Williamson JD, Cesari M, Landi F, Bernabei R, Pahor M; Italian Group of Pharmacoepidemiology in the Elderly Study Investigators. Source: Pharmacotherapy. 2003 February; 23(2): 240-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12587813&dopt=Abstract
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Impact of multiple risk factor clustering on the elevation of blood pressure. Author(s): Tozawa M, Iseki K, Iseki C, Oshiro S, Higashiuesato Y, Ikemiya Y, Takishita S. Source: Hypertens Res. 2002 November; 25(6): 811-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12484502&dopt=Abstract
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Impact of visceral fat on blood pressure and insulin sensitivity in hypertensive obese women. Author(s): Faria AN, Ribeiro Filho FF, Gouveia Ferreira SR, Zanella MT. Source: Obesity Research. 2002 December; 10(12): 1203-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12490663&dopt=Abstract
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Impaired fasting glucose, blood pressure and cardiovascular disease mortality. Author(s): Henry P, Thomas F, Benetos A, Guize L. Source: Hypertension. 2002 October; 40(4): 458-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12364347&dopt=Abstract
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Implementing intensive control of blood glucose concentration and blood pressure in type 2 diabetes in England: cost analysis (UKPDS 63). Author(s): Gray A, Clarke P, Farmer A, Holman R; United Kingdom Prospective Diabetes Study (UKPDS) Group. Source: Bmj (Clinical Research Ed.). 2002 October 19; 325(7369): 860. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12386035&dopt=Abstract
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Importance of the renal medullary circulation in the control of sodium excretion and blood pressure. Author(s): Mattson DL. Source: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology. 2003 January; 284(1): R13-27. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12482743&dopt=Abstract
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Improved glycemic control by acarbose therapy in hypertensive diabetic patients: effects on blood pressure and hormonal parameters. Author(s): Rosenbaum P, Peres RB, Zanella MT, Ferreira SR. Source: Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Medicas E Biologicas / Sociedade Brasileira De Biofisica. [et Al.]. 2002 August; 35(8): 877-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12185379&dopt=Abstract
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Improvement of glycaemic control in type 2 diabetes: favourable changes in blood pressure, total cholesterol and triglycerides, but not in HDL cholesterol, fibrinogen, Von Willebrand factor and (pro)insulin. Author(s): Becker A, van der Does FE, van Hinsbergh VW, Heine RJ, Bouter LM, Stehouwer CD. Source: The Netherlands Journal of Medicine. 2003 April; 61(4): 129-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12852722&dopt=Abstract
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Improvement of left ventricular function and arterial blood pressure 1 year after simultaneous pancreas kidney transplantation. Author(s): Oppert M, Schneider U, Bocksch W, Izmir F, Muller AR, Settmacher U, Kampf D, Neuhaus P, Frei U, Kahl A. Source: Transplantation Proceedings. 2002 September; 34(6): 2251-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12270386&dopt=Abstract
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Improving blood pressure control in a pharmacist-managed hypertension clinic. Author(s): Vivian EM. Source: Pharmacotherapy. 2002 December; 22(12): 1533-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12495164&dopt=Abstract
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Income, education, and blood pressure in adults in Jamaica, a middle-income developing country. Author(s): Mendez MA, Cooper R, Wilks R, Luke A, Forrester T. Source: International Journal of Epidemiology. 2003 June; 32(3): 400-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12777427&dopt=Abstract
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Incomplete benefit of antihypertensive therapy on stroke reduction in older hypertensives with abnormal nocturnal blood pressure dipping (extreme-dippers and reverse-dippers). Author(s): Hoshide Y, Kario K, Schwartz JE, Hoshide S, Pickering TG, Shimada K. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2002 October; 15(10 Pt 1): 844-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12372670&dopt=Abstract
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Increase in nocturnal blood pressure and progression to microalbuminuria in diabetes. Author(s): Poulsen PL, Hansen KW, Mogensen CE. Source: The New England Journal of Medicine. 2003 January 16; 348(3): 260-4; Author Reply 260-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12530446&dopt=Abstract
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Increase in nocturnal blood pressure and progression to microalbuminuria in diabetes. Author(s): Caramori ML, Pecis M, Azevedo MJ. Source: The New England Journal of Medicine. 2003 January 16; 348(3): 260-4; Author Reply 260-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12530444&dopt=Abstract
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Increase in nocturnal blood pressure and progression to microalbuminuria in diabetes. Author(s): Marfella R, Esposito K, Giugliano D. Source: The New England Journal of Medicine. 2003 January 16; 348(3): 260-4; Author Reply 260-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12530443&dopt=Abstract
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Increase in nocturnal blood pressure and progression to microalbuminuria in diabetes. Author(s): Brotman DJ, Girod JP, Thomas S. Source: The New England Journal of Medicine. 2003 January 16; 348(3): 260-4; Author Reply 260-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12529473&dopt=Abstract
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Increase in nocturnal blood pressure and progression to microalbuminuria in type 1 diabetes. Author(s): Lurbe E, Redon J, Kesani A, Pascual JM, Tacons J, Alvarez V, Batlle D. Source: The New England Journal of Medicine. 2002 September 12; 347(11): 797-805. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12226150&dopt=Abstract
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Increased hypoxic blood pressure response in patients with amyotrophic lateral sclerosis. Author(s): Hecht MJ, Brown CM, Mittelhamm F, Werner D, Heuss D, Neundorfer B, Hilz MJ. Source: Journal of the Neurological Sciences. 2003 September 15; 213(1-2): 47-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12873754&dopt=Abstract
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Increased intima-media thickness of the carotid artery wall, normal blood pressure profile and normal left ventricular mass in subjects with primary hyperparathyroidism. Author(s): Nuzzo V, Tauchmanova L, Fonderico F, Trotta R, Fittipaldi MR, Fontana D, Rossi R, Lombardi G, Trimarco B, Lupoli G. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2002 October; 147(4): 453-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12370105&dopt=Abstract
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Increased postoperative arterial blood pressure stability with continuous epidural infusion of clonidine in children. Author(s): G Bergendahl HT, Lonnqvist PA, De Negri P, Ivani G, Eksborg S. Source: Anesthesia and Analgesia. 2002 October; 95(4): 1121-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12351311&dopt=Abstract
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Increased sodium concentrations in drinking water increase blood pressure in neonates. Author(s): Pomeranz A, Dolfin T, Korzets Z, Eliakim A, Wolach B. Source: Journal of Hypertension. 2002 February; 20(2): 203-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11821704&dopt=Abstract
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Increasing blood pressure causes a decrease in intracranial pressure in patients with brain injury. Author(s): Marion DW. Source: Critical Care Medicine. 2002 July; 30(7): 1671-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12131008&dopt=Abstract
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Increasing mean arterial blood pressure has no effect on jugular venous oxygen saturation in insulin-dependent patients during tepid cardiopulmonary bypass. Author(s): Kadoi Y, Saito S, Yoshikawa D, Goto F, Fujita N, Kunimoto F. Source: Anesthesia and Analgesia. 2002 August; 95(2): 266-72, Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12145032&dopt=Abstract
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Induction of heart rate and blood pressure turbulence in the electrophysiologic laboratory. Author(s): Roach D, Koshman ML, Duff H, Sheldon R. Source: The American Journal of Cardiology. 2002 November 15; 90(10): 1098-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12423710&dopt=Abstract
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Infant nutrition and blood pressure in early adulthood: the Barry Caerphilly Growth study. Author(s): Martin RM, McCarthy A, Smith GD, Davies DP, Ben-Shlomo Y. Source: The American Journal of Clinical Nutrition. 2003 June; 77(6): 1489-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12791629&dopt=Abstract
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Infant weight gain and later blood pressure. Author(s): Harder T, Plagemann A. Source: Circulation. 2002 September 24; 106(13): E58; Author Reply E58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12270877&dopt=Abstract
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Inflammation, blood pressure, and stroke: an opportunity to target primary prevention? Author(s): Muir KW. Source: Stroke; a Journal of Cerebral Circulation. 2002 December; 33(12): 2732-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12468759&dopt=Abstract
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Inflammation, endothelial dysfunction, and the risk of high blood pressure: epidemiologic and biological evidence. Author(s): Bautista LE. Source: Journal of Human Hypertension. 2003 April; 17(4): 223-30. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12692566&dopt=Abstract
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Inflationary oscillometric blood pressure monitoring: validation of the OMRONMIT. Author(s): Golara M, Jones C, Randhawa M, Shennan AH. Source: Blood Pressure Monitoring. 2002 December; 7(6): 325-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12488653&dopt=Abstract
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Inflationary oscillometry provides accurate measurement of blood pressure in preeclampsia. Author(s): Golara M, Benedict A, Jones C, Randhawa M, Poston L, Shennan AH. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2002 October; 109(10): 1143-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12387468&dopt=Abstract
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Influence of AT1 receptor blockade on blood pressure, renal haemodynamics and hormonal responses to intravenous angiotensin II infusion in hypertensive patients. Author(s): Fridman KU, Elmfeldt D, Wysocki M, Friberg PR, Andersson OK. Source: Blood Pressure. 2002; 11(4): 244-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12361194&dopt=Abstract
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Is “optimal” blood pressure an attainable goal. Author(s): Fandino-Sende F. Source: Clin Cardiol. 2002 November; 25(11): A20, 502. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12430777&dopt=Abstract
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Is “optimal” blood pressure an attainable goal? Author(s): Conti CR. Source: Clin Cardiol. 2002 September; 25(9): 403-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12269517&dopt=Abstract
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Is “optimal” blood pressure an attainable goal? Author(s): Dermksian G. Source: Clin Cardiol. 2002 November; 25(11): A20. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12430776&dopt=Abstract
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Is blood pressure at 68 an independent predictor of cognitive decline at 81? Results from follow-up study “Men born in 1914”, Malmo, Sweden. Author(s): Andre-Petersson L, Elmstahl S, Hagberg B, Janzon L, Reinprecht F, Steen G. Source: Aging & Mental Health. 2003 January; 7(1): 61-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12554316&dopt=Abstract
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Is cardiovascular remodeling in patients with essential hypertension related to more than high blood pressure? A LIFE substudy. Losartan Intervention For EndpointReduction in Hypertension. Author(s): Olsen MH, Wachtell K, Hermann KL, Frandsen E, Dige-Petersen H, Rokkedal J, Devereux RB, Ibsen H. Source: American Heart Journal. 2002 September; 144(3): 530-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12228792&dopt=Abstract
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Is it the agent or the blood pressure level that matters for renal protection in chronic nephropathies? Author(s): Locatelli F, Del Vecchio L, D'Amico M, Andrulli S. Source: Journal of the American Society of Nephrology : Jasn. 2002 November; 13 Suppl 3: S196-201. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12466314&dopt=Abstract
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Is systolic blood pressure sufficient for classification of blood pressure and determination of hypertension based on JNC-VI in an Iranian adult population? Tehran lipid and glucose study (TLGS). Author(s): Azizi F, Rashidi A, Ghanbarian A, Madjid M. Source: Journal of Human Hypertension. 2003 April; 17(4): 287-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12692573&dopt=Abstract
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Is the blood pressure of South Asian adults in the UK higher or lower than that in European white adults? A review of cross-sectional data. Author(s): Agyemang C, Bhopal RS. Source: Journal of Human Hypertension. 2002 November; 16(11): 739-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12444535&dopt=Abstract
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Is there a sex difference in the association between birth weight and systolic blood pressure in later life? Findings from a meta-regression analysis. Author(s): Lawlor DA, Ebrahim S, Davey Smith G. Source: American Journal of Epidemiology. 2002 December 15; 156(12): 1100-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12480654&dopt=Abstract
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Janus faces of the white coat effect: blood pressure not only rises, it may also fall. Author(s): Kumpusalo E, Teho A, Laitila R, Takala J. Source: Journal of Human Hypertension. 2002 October; 16(10): 725-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420197&dopt=Abstract
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JNC 7--it's more than high blood pressure. Author(s): Kottke TE, Stroebel RJ, Hoffman RS. Source: Jama : the Journal of the American Medical Association. 2003 May 21; 289(19): 2573-5. Epub 2003 May 14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12748200&dopt=Abstract
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Joint effect of the APOE gene and midlife systolic blood pressure on late-life cognitive impairment: the Honolulu-Asia aging study. Author(s): Peila R, White LR, Petrovich H, Masaki K, Ross GW, Havlik RJ, Launer LJ. Source: Stroke; a Journal of Cerebral Circulation. 2001 December 1; 32(12): 2882-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11739991&dopt=Abstract
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Joint symbolic dynamic analysis of beat-to-beat interactions of heart rate and systolic blood pressure in normal pregnancy. Author(s): Baumert M, Walther T, Hopfe J, Stepan H, Faber R, Voss A. Source: Medical & Biological Engineering & Computing. 2002 March; 40(2): 241-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12043807&dopt=Abstract
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J-shaped relationship between blood pressure and mortality in hypertensive patients: new insights from a meta-analysis of individual-patient data. Author(s): Boutitie F, Gueyffier F, Pocock S, Fagard R, Boissel JP; INDANA Project Steering Committee. INdividual Data ANalysis of Antihypertensive intervention. Source: Annals of Internal Medicine. 2002 March 19; 136(6): 438-48. Summary for Patients In: http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11900496&dopt=Abstract
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Lack of both sex differences and influence of resting blood pressure on muscle pain intensity. Author(s): Poudevigne MS, O'Connor PJ, Pasley JD. Source: The Clinical Journal of Pain. 2002 November-December; 18(6): 386-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12441833&dopt=Abstract
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Lack of control of high blood pressure and treatment recommendations in Canada. Author(s): Khan N, Chockalingam A, Campbell NR. Source: The Canadian Journal of Cardiology. 2002 June; 18(6): 657-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12107423&dopt=Abstract
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Less salt in bread: a cost-effective way to reduce New Zealand population blood pressure levels. Author(s): Ni Mhurchu C, Young L, Lawes C, Brooks J, Pound C, Duizer L, Rodgers A. Source: N Z Med J. 2003 June 20; 116(1176): U487. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12835812&dopt=Abstract
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Leucine7 to proline7 polymorphism in the preproneuropeptide Y is associated with the progression of carotid atherosclerosis, blood pressure and serum lipids in Finnish men. Author(s): Karvonen MK, Valkonen VP, Lakka TA, Salonen R, Koulu M, Pesonen U, Tuomainen TP, Kauhanen J, Nyyssonen K, Lakka HM, Uusitupa MI, Salonen JT. Source: Atherosclerosis. 2001 November; 159(1): 145-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11689216&dopt=Abstract
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Life-course exposure to job strain and ambulatory blood pressure in men. Author(s): Landsbergis PA, Schnall PL, Pickering TG, Warren K, Schwartz JE. Source: American Journal of Epidemiology. 2003 June 1; 157(11): 998-1006. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12777363&dopt=Abstract
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Lifestyle modification and blood pressure control: is the glass half full or half empty? Author(s): Pickering TG. Source: Jama : the Journal of the American Medical Association. 2003 April 23-30; 289(16): 2131-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12709472&dopt=Abstract
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Lifestyle modification to improve blood pressure control in individuals with diabetes: is physician advice effective? Author(s): Egede LE. Source: Diabetes Care. 2003 March; 26(3): 602-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12610008&dopt=Abstract
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Limitations of ambulatory blood pressure monitoring. Author(s): Palatini P. Source: Blood Pressure Monitoring. 2001 August; 6(4): 221-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11805474&dopt=Abstract
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Limitations of current validation protocols for home blood pressure monitors for individual patients. Author(s): Gerin W, Schwartz AR, Schwartz JE, Pickering TG, Davidson KW, Bress J, O'Brien E, Atkins N. Source: Blood Pressure Monitoring. 2002 December; 7(6): 313-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12488651&dopt=Abstract
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Linkage analysis of 2q14-q23 and 5q32 with blood pressure quantitative traits in Chinese sib pairs. Author(s): Ge D, Yang W, Huang J, Yao C, Xu X, Gan W, Zhao J, Liu D, Wang X, Duan X, Hui R, Shen Y, Yao Z, Qiang B, Gu D. Source: Journal of Hypertension. 2003 February; 21(2): 305-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12569260&dopt=Abstract
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Linkage disequilibrium and haplotype diversity in the genes of the renin-angiotensin system: findings from the family blood pressure program. Author(s): Zhu X, Yan D, Cooper RS, Luke A, Ikeda MA, Chang YP, Weder A, Chakravarti A. Source: Genome Research. 2003 February; 13(2): 173-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12566395&dopt=Abstract
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Lipid lowering: another method of reducing blood pressure? Author(s): Wierzbicki AS. Source: Journal of Human Hypertension. 2002 November; 16(11): 753-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12444536&dopt=Abstract
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Lipids, blood pressure and bone metabolism after growth hormone therapy in elderly hemodialysis patients. Author(s): Viidas U, Johannsson G, Mattson-Hulten L, Ahlmen J. Source: Journal of Nephrology. 2003 March-April; 16(2): 231-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12768070&dopt=Abstract
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Long-term effects of carotid sinus denervation on arterial blood pressure in humans. Author(s): Smit AA, Timmers HJ, Wieling W, Wagenaar M, Marres HA, Lenders JW, van Montfrans GA, Karemaker JM. Source: Circulation. 2002 March 19; 105(11): 1329-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11901044&dopt=Abstract
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Managing worry, stress and high blood pressure: African-American women holding it together through 'family'. Author(s): Boutain DM. Source: Ethn Dis. 2001 Fall; 11(4): 773-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11763301&dopt=Abstract
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Mean arterial pressure (MAP): an alternative and preferable measurement to systolic blood pressure (SBP) in patients for hypotension detection during hemapheresis. Author(s): Henry JB, Miller MC, Kelly KC, Champney D. Source: Journal of Clinical Apheresis. 2002; 17(2): 55-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12210707&dopt=Abstract
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Measurement of blood pressure at home: survey among pediatric nephrologists. Author(s): Bald M, Hoyer PF. Source: Pediatric Nephrology (Berlin, Germany). 2001 December; 16(12): 1058-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11793100&dopt=Abstract
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Measurement of the low-frequency component of blood pressure variability can assist the interpretation of heart rate variability data. Author(s): Introna R, Blair J, Martin DC. Source: Anesthesiology. 2003 July; 99(1): 237; Author Reply 237. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12826870&dopt=Abstract
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Measuring blood pressure accurately: new and persistent challenges. Author(s): Jones DW, Appel LJ, Sheps SG, Roccella EJ, Lenfant C. Source: Jama : the Journal of the American Medical Association. 2003 February 26; 289(8): 1027-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12597757&dopt=Abstract
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Measuring non-invasive blood pressure in obese patients. Author(s): Weeratunga GU. Source: Anaesthesia. 2003 June; 58(6): 616. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12852407&dopt=Abstract
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Mechanism of blood pressure and R-R variability: insights from ganglion blockade in humans. Author(s): Zhang R, Iwasaki K, Zuckerman JH, Behbehani K, Crandall CG, Levine BD. Source: The Journal of Physiology. 2002 August 15; 543(Pt 1): 337-48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12181304&dopt=Abstract
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Mechanism of the blood pressure--raising effect of cocaine in humans. Author(s): Tuncel M, Wang Z, Arbique D, Fadel PJ, Victor RG, Vongpatanasin W. Source: Circulation. 2002 March 5; 105(9): 1054-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11877354&dopt=Abstract
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Mechanisms of pressure natriuresis: how blood pressure regulates renal sodium transport. Author(s): McDonough AA, Leong PK, Yang LE. Source: Annals of the New York Academy of Sciences. 2003 April; 986: 669-77. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12763917&dopt=Abstract
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Metabolic acidosis, core-peripheral temperature difference and blood pressure response to albumin infusion in hypotensive, very premature infants. Author(s): Dimitriou G, Greenough A, Mantagos J, Skinner S. Source: Journal of Perinatal Medicine. 2001; 29(5): 442-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11723846&dopt=Abstract
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Microalbuminuria reduction with valsartan in patients with type 2 diabetes mellitus: a blood pressure-independent effect. Author(s): Viberti G, Wheeldon NM; MicroAlbuminuria Reduction With VALsartan (MARVAL) Study Investigators. Source: Circulation. 2002 August 6; 106(6): 672-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12163426&dopt=Abstract
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Microvascular correlates of blood pressure, plasma glucose, and insulin resistance in health. Author(s): Irving RJ, Walker BR, Noon JP, Watt GC, Webb DJ, Shore AC. Source: Cardiovascular Research. 2002 January; 53(1): 271-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11744037&dopt=Abstract
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Migraine is more frequent in individuals with optimal and normal blood pressure: a population-based study. Author(s): Wiehe M, Fuchs SC, Moreira LB, Moraes RS, Fuchs FD. Source: Journal of Hypertension. 2002 July; 20(7): 1303-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12131526&dopt=Abstract
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Minireview: computer simulations of blood pressure regulation by the reninangiotensin system. Author(s): Takahashi N, Hagaman JR, Kim HS, Smithies O. Source: Endocrinology. 2003 June; 144(6): 2184-90. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12746272&dopt=Abstract
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Model based analysis of the heart rate and blood pressure relationship. Author(s): Wessel N, Malberg H, Meyerfeldt U, Schirdewan A, Kurths J. Source: Biomed Tech (Berl). 2002; 47 Suppl 1 Pt 2: 543-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12465231&dopt=Abstract
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Modeling the circadian variability of ambulatorily monitored blood pressure by multiple-component analysis. Author(s): Hermida RC, Ayala DE, Fernandez JR, Mojon A, Alonso I, Calvo C. Source: Chronobiology International. 2002 March; 19(2): 461-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12025936&dopt=Abstract
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Moderators of blood pressure development from childhood to adulthood: a 10-year longitudinal study. Author(s): Dekkers JC, Snieder H, Van Den Oord EJ, Treiber FA. Source: The Journal of Pediatrics. 2002 December; 141(6): 770-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12461492&dopt=Abstract
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Multi-center genetic study of hypertension: The Family Blood Pressure Program (FBPP). Author(s): FBPP Investigators. Source: Hypertension. 2002 January; 39(1): 3-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11799070&dopt=Abstract
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Multicenter survey on hydration status and control of blood pressure in Japanese CAPD patients. Author(s): Nakayama M, Kawaguchi Y; Water and Electrolyte Balance (WEB) Study Group in CAPD. Source: Perit Dial Int. 2002 May-June; 22(3): 411-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12227402&dopt=Abstract
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Multiple lifestyle changes effectively lower blood pressure. Author(s): Rollins G. Source: Rep Med Guidel Outcomes Res. 2003 May 16; 14(10): 1, 6-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12870486&dopt=Abstract
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Multiscale analysis of blood pressure signals. Author(s): Marrone A, Polosa AD, Scioscia G, Stramaglia S, Zenzola A. Source: Physical Review. E, Statistical Physics, Plasmas, Fluids, and Related Interdisciplinary Topics. 1999 July; 60(1): 1088-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11969861&dopt=Abstract
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Muscle sympathetic nerve activity in blood pressure control against gravitational stress. Author(s): Mano T. Source: Journal of Cardiovascular Pharmacology. 2001 October; 38 Suppl 1: S7-11. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11811364&dopt=Abstract
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Narrowband auscultatory blood pressure measurement. Author(s): Sebald DJ, Bahr DE, Kahn AR. Source: Ieee Transactions on Bio-Medical Engineering. 2002 September; 49(9): 1038-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12214876&dopt=Abstract
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Neonatal blood pressure and salt taste responsiveness. Author(s): Zinner SH, McGarvey ST, Lipsitt LP, Rosner B. Source: Hypertension. 2002 September; 40(3): 280-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12215467&dopt=Abstract
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Neurobiology of birth weight influence on blood pressure values and variability in children and adolescents. Author(s): Friedman EH. Source: Hypertension. 2002 February; 39(2): E15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11847206&dopt=Abstract
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Neurohumoral characteristics of older hypertensive patients with abnormal nocturnal blood pressure dipping. Author(s): Kario K, Mitsuhashi T, Shimada K. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2002 June; 15(6): 531-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12074355&dopt=Abstract
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Neurovascular contact and blood pressure response in young, healthy, normotensive men. Author(s): Hohenbleicher H, Schmitz SA, Koennecke HC, Offermann J, Offermann R, Wolf KJ, Distler A, Sharma AM. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2002 February; 15(2 Pt 1): 119-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11863246&dopt=Abstract
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New expression profiles of voltage-gated ion channels in arteries exposed to high blood pressure. Author(s): Cox RH, Rusch NJ. Source: Microcirculation (New York, N.Y. : 1994). 2002; 9(4): 243-57. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12152102&dopt=Abstract
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New salt-sensitivity metrics: variability-adjusted blood pressure change and the urinary sodium-to-creatinine ratio. Author(s): Flack JM, Grimm RH Jr, Staffileno BA, Dnsc, Elmer P, Yunis C, Hedquist L, Dudley A. Source: Ethn Dis. 2002 Winter; 12(1): 10-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11913598&dopt=Abstract
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New strategies for blood pressure control. Author(s): Vidt DG. Source: Journal of Human Hypertension. 2002 March; 16 Suppl 1: S124-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11986909&dopt=Abstract
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New target molecules in the drug control of blood pressure and circulation. Author(s): Inoue R, Mori Y. Source: Current Drug Targets. Cardiovascular & Haematological Disorders. 2003 March; 3(1): 59-72. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12769645&dopt=Abstract
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Night-time blood pressure: dipping into the future? Author(s): Stolarz K, Staessen JA, O'Brien ET. Source: Journal of Hypertension. 2002 November; 20(11): 2131-3. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12409945&dopt=Abstract
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Nitric oxide production decreases after salt loading but is not related to blood pressure changes or nitric oxide-mediated vascular responses. Author(s): Dishy V, Sofowora GG, Imamura H, Nishimi Y, Xie HG, Wood AJ, Stein CM. Source: Journal of Hypertension. 2003 January; 21(1): 153-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12544447&dopt=Abstract
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No effect on central or peripheral blood pressure of systemic urotensin II infusion in humans. Author(s): Affolter JT, Newby DE, Wilkinson IB, Winter MJ, Balment RJ, Webb DJ. Source: British Journal of Clinical Pharmacology. 2002 December; 54(6): 617-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12492609&dopt=Abstract
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No surprises in blood pressure awareness study findings: we can do a better job. Author(s): Moser M. Source: Archives of Internal Medicine. 2003 March 24; 163(6): 654-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12639193&dopt=Abstract
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Nocturnal blood pressure dip in CADASIL. Author(s): Manabe Y, Murakami T, Iwatsuki K, Narai H, Warita H, Hayashi T, Shoji M, Imai Y, Abe K. Source: Journal of the Neurological Sciences. 2001 December 15; 193(1): 13-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11718744&dopt=Abstract
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Nocturnal blood pressure dipping and beta-adrenergic receptor sensitivity. Author(s): Profant J, Mills PJ, Dimsdale JE. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2002 April; 15(4 Pt 1): 364-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11991224&dopt=Abstract
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Nocturnal blood pressure predicts left ventricular mass index in normotensive elderly. Author(s): Morfis L, Butler SP, Shnier RC, Howes LG. Source: Blood Pressure. 2002; 11(1): 18-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11926346&dopt=Abstract
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Nocturnal blood pressure reduction: effect on retrobulbar hemodynamics in glaucoma. Author(s): Harris A, Evans D, Martin B, Zalish M, Kagemann L, McCranor L, Garzozi H. Source: Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie. 2002 May; 240(5): 372-8. Epub 2002 April 16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12073060&dopt=Abstract
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Noninvasive 24-hour ambulatory blood pressure monitoring: overview of technology and clinical applications. Author(s): Ernst ME, Bergus GR. Source: Pharmacotherapy. 2002 May; 22(5): 597-612. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12013359&dopt=Abstract
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Noninvasive blood pressure monitoring. Author(s): Dobbin KR. Source: Critical Care Nurse. 2002 April; 22(2): 123-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11961934&dopt=Abstract
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Noninvasive blood pressure performance: a reproducible method for quantifying motion artifact tolerance in oscillometry. Author(s): Van Horn RN, Kahlke RJ, Taylor LA, Dorsett TJ. Source: Biomed Instrum Technol. 2001 November-December; 35(6): 395-414. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11765699&dopt=Abstract
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Oat consumption does not affect resting casual and ambulatory 24-h arterial blood pressure in men with high-normal blood pressure to stage I hypertension. Author(s): Davy BM, Melby CL, Beske SD, Ho RC, Davrath LR, Davy KP. Source: The Journal of Nutrition. 2002 March; 132(3): 394-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11880561&dopt=Abstract
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Oat ingestion reduces systolic and diastolic blood pressure in patients with mild or borderline hypertension: a pilot trial. Author(s): Keenan JM, Pins JJ, Frazel C, Moran A, Turnquist L. Source: The Journal of Family Practice. 2002 April; 51(4): 369. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11978262&dopt=Abstract
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Obesity and hypertension in children; caffeine, stress, and elevated blood pressure; resistant hypertension; and is it lowering of blood pressure alone that accounts for reduction in cardiovascular events? Comments on the JCH Contents. Author(s): Moser M. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2001 NovemberDecember; 3(6): 343-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11723355&dopt=Abstract
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Obesity is the most important determinant of higher blood pressure among normotensive Chinese. Author(s): Tsao HM, Chen CH, Lin KC, Chou P. Source: Zhonghua Yi Xue Za Zhi (Taipei). 2002 June; 65(6): 268-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12201567&dopt=Abstract
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Obesity, body fat distribution, and ambulatory blood pressure in children and adolescents. Author(s): Lurbe E, Alvarez V, Redon J. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2001 NovemberDecember; 3(6): 362-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11723358&dopt=Abstract
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Office and ambulatory blood pressure elevation in children with chronic renal failure. Author(s): Mitsnefes MM, Kimball TR, Daniels SR. Source: Pediatric Nephrology (Berlin, Germany). 2003 February; 18(2): 145-9. Epub 2002 December 18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12579404&dopt=Abstract
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Office blood pressure variability as a predictor of acute myocardial infarction in elderly patients receiving antihypertensive therapy. Author(s): Hata Y, Muratani H, Kimura Y, Fukiyama K, Kawano Y, Ashida T, Yokouchi M, Imai Y, Ozawa T, Fujii J, Omae T. Source: Journal of Human Hypertension. 2002 February; 16(2): 141-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11850772&dopt=Abstract
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On a low calorie diet, are there separate and discrete effects of negative energy balance and weight loss on blood pressure? Author(s): Esler M. Source: Journal of Hypertension. 2003 February; 21(2): 261-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12569252&dopt=Abstract
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On Call. I am a subscriber to Harvard Men's Health Watch, but I am writing about my wife, not myself. She's only 58 and she's always been healthy, but over the past year she's been bothered by shaking and trembling in her hands, particularly when she's pouring tea or eating dinner. Her doctor gave her a blood pressure pill, but she's never had high blood pressure. Does she have Parkinson's? Should I take her to a specialist? Author(s): Simon HB. Source: Harvard Men's Health Watch. 2002 February; 6(7): 8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11869988&dopt=Abstract
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On call. My doctor prescribed Zestril for me because I have diabetes, even though my blood pressure has always been normal. I am 54, and my blood sugar came down to normal on pills. Do I really need another medicine? Author(s): Simon HB. Source: Harvard Men's Health Watch. 2003 August; 8(1): 8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12936865&dopt=Abstract
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Optimal blood pressure control and antihypertensive regimens in hypertensive renal disease: the potential of exploring the mechanisms of response variability. Author(s): Kocks MJ, de Zeeuw D, Navis GJ. Source: Current Opinion in Nephrology and Hypertension. 2002 March; 11(2): 135-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11856904&dopt=Abstract
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Optimal treatment of hypertension in African Americans. Reaching and maintaining target blood pressure goals. Author(s): Bakris GL, Ferdinand KC, Douglas JG, Sowers JR. Source: Postgraduate Medicine. 2002 October; 112(4): 73-4, 77-80, 83-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12400150&dopt=Abstract
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Optimizing blood pressure control in the obese patient. Author(s): Pischon T, Sharma AM. Source: Current Hypertension Reports. 2002 October; 4(5): 358-62. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12217253&dopt=Abstract
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Oral arginine reduces systemic blood pressure in type 2 diabetes: its potential role in nitric oxide generation. Author(s): Huynh NT, Tayek JA. Source: Journal of the American College of Nutrition. 2002 October; 21(5): 422-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12356784&dopt=Abstract
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Oral contraceptives: a risk factor for uncontrolled blood pressure among hypertensive women. Author(s): Lubianca JN, Faccin CS, Fuchs FD. Source: Contraception. 2003 January; 67(1): 19-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12521653&dopt=Abstract
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Orlistat improves blood pressure control in obese subjects with treated but inadequately controlled hypertension. Author(s): Bakris G, Calhoun D, Egan B, Hellmann C, Dolker M, Kingma I; orlistat and resistant hypertension investigators. Source: Journal of Hypertension. 2002 November; 20(11): 2257-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12409965&dopt=Abstract
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Parallel morning and evening surge in stroke onset, blood pressure, and physical activity. Author(s): Bursztyn M. Source: Stroke; a Journal of Cerebral Circulation. 2002 October; 33(10): 2346-7; Author Reply 2346-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12364717&dopt=Abstract
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Parallel morning and evening surge in stroke onset, blood pressure, and physical activity. Author(s): Stergiou GS, Vemmos KN, Pliarchopoulou KM, Synetos AG, Roussias LG, Mountokalakis TD. Source: Stroke; a Journal of Cerebral Circulation. 2002 June; 33(6): 1480-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12052978&dopt=Abstract
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Partnership caring: a theory of high blood pressure control in Iranian hypertensives. Author(s): Mohammadi E, Abedi HA, Gofranipour F, Jalali F. Source: International Journal of Nursing Practice. 2002 December; 8(6): 324-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12390585&dopt=Abstract
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Path analysis of familial resemblance in blood pressure in Middle Dalmatia, Croatia. Author(s): Skaric-Juric T. Source: Coll Antropol. 2003 June; 27(1): 229-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12974151&dopt=Abstract
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Patient initiated home blood pressure recordings are accurate in hypertensive pregnant women. Author(s): Waugh J, Habiba MA, Bosio P, Boyce T, Shennan A, Halligan AW. Source: Hypertension in Pregnancy : Official Journal of the International Society for the Study of Hypertension in Pregnancy. 2003; 22(1): 93-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12648446&dopt=Abstract
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Patient page. Blood pressure control and stroke: an ounce of prevention is worth a pound of cure. Author(s): Leonard AD, Brey RL. Source: Neurology. 2002 July 9; 59(1): E1-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12105335&dopt=Abstract
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Patient use of automatic blood pressure measures in retail stores: implications for diagnosis and treatment of hypertension. Author(s): Thiedke CC, Laird S, Detar DT, Mainous AG 3rd, Jenkins K, Ye X. Source: J S C Med Assoc. 2002 April; 98(2): 67-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11975140&dopt=Abstract
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Patient with a sudden drop in blood pressure. Author(s): Oliver JA, Landry DW. Source: Critical Care Medicine. 2003 January; 31(1): 326-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12545047&dopt=Abstract
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Patients' views of high blood pressure, its treatment and risks. Author(s): Taylor C, Ward A. Source: Aust Fam Physician. 2003 April; 32(4): 278-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12735271&dopt=Abstract
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Patient-specific differences between blood pressure estimated from 24 h ambulatory measurements and serial office self-recordings. Author(s): Pavek K, Nilsson G. Source: Blood Pressure Monitoring. 2002 June; 7(3): 163-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12131073&dopt=Abstract
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Pelvic pain, low blood pressure, and hemolysis after outpatient hysteroscopy in a patient with glucose-6-phosphate dehydrogenase deficiency. Author(s): De Angelis C, Re ME, Santoro G. Source: Fertility and Sterility. 2003 June; 79(6): 1442-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12798896&dopt=Abstract
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Perceived racism and blood pressure: a review of the literature and conceptual and methodological critique. Author(s): Brondolo E, Rieppi R, Kelly KP, Gerin W. Source: Annals of Behavioral Medicine : a Publication of the Society of Behavioral Medicine. 2003 Winter; 25(1): 55-65. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12581937&dopt=Abstract
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Perioperative blood pressure control, delayed graft function, and acute rejection after renal transplantation. Author(s): Thomas MC, Mathew TH, Russ GR, Rao MM, Moran J. Source: Transplantation. 2003 June 27; 75(12): 1989-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12829899&dopt=Abstract
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Piecewise latent growth curve modeling of systolic blood pressure reactivity and recovery from the cold pressor test. Author(s): Llabre MM, Spitzer SB, Saab PG, Schneiderman N. Source: Psychophysiology. 2001 November; 38(6): 951-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12240671&dopt=Abstract
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Plasma brain natriuretic peptide levels and blood pressure tracking in the Framingham Heart Study. Author(s): Freitag MH, Larson MG, Levy D, Benjamin EJ, Wang TJ, Leip EP, Wilson PW, Vasan RS; Framingham Heart Study. Source: Hypertension. 2003 April; 41(4): 978-83. Epub 2003 March 03. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12623868&dopt=Abstract
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Plasma leptin and blood pressure in men: graded association independent of body mass and fat pattern. Author(s): Barba G, Russo O, Siani A, Iacone R, Farinaro E, Gerardi MC, Russo P, Della Valle E, Strazzullo P. Source: Obesity Research. 2003 January; 11(1): 160-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12529499&dopt=Abstract
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Plasma membrane calcium ATPase overexpression in arterial smooth muscle increases vasomotor responsiveness and blood pressure. Author(s): Gros R, Afroze T, You XM, Kabir G, Van Wert R, Kalair W, Hoque AE, Mungrue IN, Husain M. Source: Circulation Research. 2003 October 3; 93(7): 614-21. Epub 2003 August 21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12933703&dopt=Abstract
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Polymorphic genes for kinin receptors, nephropathy and blood pressure in type 2 diabetic patients. Author(s): Zychma MJ, Gumprecht J, Trautsolt W, Szydlowska I, Grzeszczak W. Source: American Journal of Nephrology. 2003 March-April; 23(2): 112-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12481150&dopt=Abstract
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Polymorphism in exon 4 of the human 3 beta-hydroxysteroid dehydrogenase type I gene (HSD3B1) and blood pressure. Author(s): Rosmond R, Chagnon M, Bouchard C, Bjorntorp P. Source: Biochemical and Biophysical Research Communications. 2002 April 26; 293(1): 629-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12054649&dopt=Abstract
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Polymorphism of the angiotensin converting enzyme gene and blood pressure in a Japanese general population (the Shigaraki Study). Author(s): Tamaki S, Nakamura Y, Tsujita Y, Nozaki A, Amamoto K, Kadowaki T, Kita Y, Okamura T, Iwai N, Kinoshita M, Ueshima H. Source: Hypertens Res. 2002 November; 25(6): 843-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12484507&dopt=Abstract
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Portapres and differential oscillometric finger blood pressure changes during deep breathing test in the assessment of BRS index. Author(s): Jagomagi K, Raamat R, Talts J, Lansimies E, Jurvelin J. Source: Clinical Physiology and Functional Imaging. 2003 January; 23(1): 9-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12558608&dopt=Abstract
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Positional change in blood pressure and 8-year risk of hypertension: the CARDIA Study. Author(s): Thomas RJ, Liu K, Jacobs DR Jr, Bild DE, Kiefe CI, Hulley SB. Source: Mayo Clinic Proceedings. 2003 August; 78(8): 951-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12911043&dopt=Abstract
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Postextrasystolic regulation patterns of blood pressure and heart rate in patients with idiopathic dilated cardiomyopathy. Author(s): Voss A, Baier V, Schumann A, Hasart A, Reinsperger F, Schirdewan A, Osterziel KJ, Leder U. Source: The Journal of Physiology. 2002 January 1; 538(Pt 1): 271-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11773334&dopt=Abstract
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Postprandial systolic blood pressure responses of older people in residential care: association with risk of falling. Author(s): Le Couteur DG, Fisher AA, Davis MW, McLean AJ. Source: Gerontology. 2003 July-August; 49(4): 260-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12792163&dopt=Abstract
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Potential barriers to control of blood pressure. Author(s): Kalb JL, Marazon DJ, Snow RJ. Source: J Am Osteopath Assoc. 2002 April; 102(4): 209-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12003467&dopt=Abstract
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Practice audits: reliability of sphygmomanometers and blood pressure recording bias. Author(s): Ali S, Rouse A. Source: Journal of Human Hypertension. 2002 May; 16(5): 359-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12082498&dopt=Abstract
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Predicting blood pressure reactivity and heart rate variability from mood state following coronary artery bypass surgery. Author(s): Hallas CN, Thornton EW, Fabri BM, Fox MA, Jackson M. Source: International Journal of Psychophysiology : Official Journal of the International Organization of Psychophysiology. 2003 January; 47(1): 43-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12543445&dopt=Abstract
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Prevalence of obesity and its association with blood pressure, serum lipids and selected lifestyles in a Puerto Rican population of adolescents 12-16 years of age. Author(s): Venegas HL, Perez CM, Suarez EL, Guzman M. Source: P R Health Sci J. 2003 June; 22(2): 137-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12866137&dopt=Abstract
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Preventing cardiovascular disease in hypertension: effects of lowering blood pressure and cholesterol. Author(s): Green R, Kwok S, Durrington PN. Source: Qjm : Monthly Journal of the Association of Physicians. 2002 December; 95(12): 821-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12454325&dopt=Abstract
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Preventing coronary events by optimal control of blood pressure and lipids in patients with the metabolic syndrome. Author(s): Wong ND, Pio JR, Franklin SS, L'Italien GJ, Kamath TV, Williams GR. Source: The American Journal of Cardiology. 2003 June 15; 91(12): 1421-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12804727&dopt=Abstract
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Preventing increases in early-morning blood pressure, heart rate, and the ratepressure product with controlled onset extended release verapamil at bedtime versus enalapril, losartan, and placebo on arising. Author(s): White WB, Sica DA, Calhoun D, Mansoor GA, Anders RJ. Source: American Heart Journal. 2002 October; 144(4): 657-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12360162&dopt=Abstract
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Primary prevention of hypertension: clinical and public health advisory from The National High Blood Pressure Education Program. Author(s): Whelton PK, He J, Appel LJ, Cutler JA, Havas S, Kotchen TA, Roccella EJ, Stout R, Vallbona C, Winston MC, Karimbakas J; National High Blood Pressure Education Program Coordinating Committee. Source: Jama : the Journal of the American Medical Association. 2002 October 16; 288(15): 1882-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12377087&dopt=Abstract
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Principles and techniques of blood pressure measurement. Author(s): Pickering TG. Source: Cardiology Clinics. 2002 May; 20(2): 207-23. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12119797&dopt=Abstract
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Profile of interdialytic blood pressure in hemodialysis patients. Author(s): Santos SF, Mendes RB, Santos CA, Dorigo D, Peixoto AJ. Source: American Journal of Nephrology. 2003 March-April; 23(2): 96-105. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12481148&dopt=Abstract
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Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study. Author(s): Ohkubo T, Hozawa A, Yamaguchi J, Kikuya M, Ohmori K, Michimata M, Matsubara M, Hashimoto J, Hoshi H, Araki T, Tsuji I, Satoh H, Hisamichi S, Imai Y. Source: Journal of Hypertension. 2002 November; 20(11): 2183-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12409956&dopt=Abstract
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Prognostic value of absolute versus relative rise of blood pressure in pregnancy. Author(s): Onah H. Source: Afr J Reprod Health. 2002 April; 6(1): 32-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12476727&dopt=Abstract
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Prognostic value of office and ambulatory blood pressure measurements in pregnancy. Author(s): Hermida RC, Ayala DE. Source: Hypertension. 2002 September; 40(3): 298-303. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12215470&dopt=Abstract
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Prognostic value of systolic and diastolic blood pressure in treated hypertensive men: clarification. Author(s): Benetos A, Thomas F, Bean K, Gautier S, Smulyan H, Guize L. Source: Archives of Internal Medicine. 2003 January 13; 163(1): 121. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12523931&dopt=Abstract
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Progression of chronic kidney disease: the role of blood pressure control, proteinuria, and angiotensin-converting enzyme inhibition: a patient-level meta-analysis. Author(s): Jafar TH, Stark PC, Schmid CH, Landa M, Maschio G, de Jong PE, de Zeeuw D, Shahinfar S, Toto R, Levey AS; AIPRD Study Group. Source: Annals of Internal Medicine. 2003 August 19; 139(4): 244-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12965979&dopt=Abstract
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Progressive stroke, lacunae, and systemic blood pressure. Author(s): Bergui M, Bradac GB. Source: Stroke; a Journal of Cerebral Circulation. 2002 December; 33(12): 2735-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12468761&dopt=Abstract
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Psychiatric features and disturbance of circadian rhythm of temperature, pulse, and blood pressure in Wilson's disease. Author(s): Matarazzo EB. Source: The Journal of Neuropsychiatry and Clinical Neurosciences. 2002 Summer; 14(3): 335-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12154159&dopt=Abstract
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Psychological and physical stress-induced cardiovascular reactivity and diurnal blood pressure variation in women with different work shifts. Author(s): Kario K, Schwartz JE, Gerin W, Robayo N, Maceo E, Pickering TG. Source: Hypertens Res. 2002 July; 25(4): 543-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12358139&dopt=Abstract
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Psychosocial demands and ambulatory blood pressure: a field assessment approach. Author(s): Kamarck TW, Janicki DL, Shiffman S, Polk DE, Muldoon MF, Liebenauer LL, Schwartz JE. Source: Physiology & Behavior. 2002 December; 77(4-5): 699-704. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12527022&dopt=Abstract
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Publication bias and heterogeneity in the relationship between systolic blood pressure, birth weight, and catch-up growth--a meta analysis. Author(s): Schluchter MD. Source: Journal of Hypertension. 2003 February; 21(2): 273-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12569256&dopt=Abstract
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Pulsatile and steady 24-h blood pressure components as determinants of left ventricular mass in young and middle-aged essential hypertensives. Author(s): Mule G, Nardi E, Andronico G, Cottone S, Federico MR, Piazza G, Volpe V, Ferrara D, Cerasola G. Source: Journal of Human Hypertension. 2003 April; 17(4): 231-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12692567&dopt=Abstract
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Pulse pressure and diurnal blood pressure variation: association with micro- and macrovascular complications in type 2 diabetes. Author(s): Knudsen ST, Poulsen PL, Hansen KW, Ebbehoj E, Bek T, Mogensen CE. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2002 March; 15(3): 244-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11939615&dopt=Abstract
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Quality control of the blood pressure phenotype in the European Project on Genes in Hypertension. Author(s): Kuznetsova T, Staessen JA, Kawecka-Jaszcz K, Babeanu S, Casiglia E, Filipovsky J, Nachev C, Nikitin Y, Peleska J, O'Brien E. Source: Blood Pressure Monitoring. 2002 August; 7(4): 215-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12198337&dopt=Abstract
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Quality of blood pressure control and risk of cerebral bleeding in patients with oral anticoagulation. Author(s): Huber J, Stollberger C, Finsterer J, Schneider B, Langer T. Source: Acta Medica Austriaca. 2003; 30(1): 6-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12558558&dopt=Abstract
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Quantitation of the concordance between cerebral intravascular oxygenation and mean arterial blood pressure for the detection of impaired autoregulation. Author(s): Morren G, Naulaers G, Lemmerling P, Van Huffel S, Casaer P, Devlieger H. Source: Advances in Experimental Medicine and Biology. 2003; 510: 403-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12580462&dopt=Abstract
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Radical-trapping activity, blood pressure, and carotid enlargement in women. Author(s): Iannuzzi A, De Michele M, Panico S, Celentano E, Tang R, Bond MG, Sacchetti L, Zarrilli F, Galasso R, Mercuri M, Rubba P. Source: Hypertension. 2003 February; 41(2): 289-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12574097&dopt=Abstract
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Randomized, double-blind, placebo-controlled comparison of the action of orlistat, fluvastatin, or both an anthropometric measurements, blood pressure, and lipid profile in obese patients with hypercholesterolemia prescribed a standardized diet. Author(s): Derosa G, Mugellini A, Ciccarelli L, Fogari R. Source: Clinical Therapeutics. 2003 April; 25(4): 1107-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12809960&dopt=Abstract
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Rapid child growth raises blood pressure in adolescent boys who were thin at birth. Author(s): Adair LS, Cole TJ. Source: Hypertension. 2003 March; 41(3): 451-6. Epub 2003 February 10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12623942&dopt=Abstract
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Relation between sodium intake and blood pressure during sleep in young men. Author(s): Nishijima K, Tochikubo O. Source: Hypertens Res. 2003 February; 26(2): 135-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12627872&dopt=Abstract
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Relationship between autonomic neuropathy, 24-hr blood pressure and retinopathy in normoalbuminuric and normotensive type 1 diabetic patients. Author(s): Duvnjak L, Vuckovic S, Pepeonik Z, Metelko Z. Source: Diabetes Nutr Metab. 2003 April; 16(2): 102-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12846449&dopt=Abstract
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Relationship between blood pressure and Alzheimer's disease in Linxian County, China. Author(s): Wu C, Zhou D, Wen C, Zhang L, Como P, Qiao Y. Source: Life Sciences. 2003 January 24; 72(10): 1125-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12505543&dopt=Abstract
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Relationship between blood pressure and finger photoplethysmographic waveform during oxygen desaturation test: a model fitting approach. Author(s): Weng J, Matz H, Gehring H, Konecny E. Source: Biomed Tech (Berl). 2002; 47 Suppl 1 Pt 1: 233-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12451825&dopt=Abstract
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Relationship between blood pressure level in early pregnancy and subsequent changes in blood pressure during pregnancy. Author(s): Iwasaki R, Ohkuchi A, Furuta I, Ojima T, Matsubara S, Sato I, Minakami H. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2002 October; 81(10): 918-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12366481&dopt=Abstract
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Relationship between blood pressure, sleep K-complexes, and muscle sympathetic nerve activity in humans. Author(s): Tank J, Diedrich A, Hale N, Niaz FE, Furlan R, Robertson RM, MosquedaGarcia R. Source: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology. 2003 July; 285(1): R208-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12793998&dopt=Abstract
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Relationship between body composition and blood pressure in Bahraini adolescents. Author(s): Al-Sendi AM, Shetty P, Musaiger AO, Myatt M. Source: The British Journal of Nutrition. 2003 October; 90(4): 837-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14552329&dopt=Abstract
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Relationship between changes in serum leptin levels and blood pressure after weight loss. Author(s): Itoh K, Imai K, Masuda T, Abe S, Tanaka M, Koga R, Itoh H, Matsuyama T, Nakamura M. Source: Hypertens Res. 2002 November; 25(6): 881-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12484512&dopt=Abstract
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Relationship between diet and blood pressure in a representative Mediterranean population. Author(s): Schroder H, Schmelz E, Marrugat J. Source: European Journal of Nutrition. 2002 August; 41(4): 161-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12242584&dopt=Abstract
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Relationship between diurnal blood pressure, renal hemodynamic function, and the renin-angiotensin system in type 1 diabetes. Author(s): Miller JA, Curtis JR, Sochett EB. Source: Diabetes. 2003 July; 52(7): 1806-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12829650&dopt=Abstract
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Relationship between left ventricular mass and blood pressure in treated hypertension. Author(s): Missault LH, De Buyzere ML, De Bacquer DD, Duprez DD, Clement DL. Source: Journal of Human Hypertension. 2002 January; 16(1): 61-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11840231&dopt=Abstract
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Relationship between lipoprotein(a) levels, oxidative stress, and blood pressure levels in patients with essential hypertension. Author(s): Antonicelli R, Testa R, Bonfigli AR, Sirolla C, Pieri C, Marra M, Marcovina SM. Source: Clinical and Experimental Medicine. 2001 September; 1(3): 145-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11833851&dopt=Abstract
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Relationship of antihypertensive treatment regimens and change in blood pressure to risk for heart failure in hypertensive patients randomly assigned to doxazosin or chlorthalidone: further analyses from the Antihypertensive and Lipid-Lowering treatment to prevent Heart Attack Trial. Author(s): Davis BR, Cutler JA, Furberg CD, Wright JT, Farber MA, Felicetta JV, Stokes JD; ALLHAT Collaborative Research Group. Source: Annals of Internal Medicine. 2002 September 3; 137(5 Part 1): 313-20. Summary for Patients In: http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12204014&dopt=Abstract
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Relationship of blood pressure measures with coronary artery calcification. Author(s): Jamjoum LS, Bielak LF, Turner ST, Sheedy II PF, Boerwinkle E, Raghunathan TE, Peyser PA. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2002 December; 8(12): Cr775-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12503034&dopt=Abstract
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Relationship of internalized racism to abdominal obesity and blood pressure in AfroCaribbean women. Author(s): Tull SE, Wickramasuriya T, Taylor J, Smith-Burns V, Brown M, Champagnie G, Daye K, Donaldson K, Solomon N, Walker S, Fraser H, Jordan OW. Source: Journal of the National Medical Association. 1999 August; 91(8): 447-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12656433&dopt=Abstract
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Relationships among socioeconomic status, stress induced changes in cortisol, and blood pressure in African American males. Author(s): Kapuku GL, Treiber FA, Davis HC. Source: Annals of Behavioral Medicine : a Publication of the Society of Behavioral Medicine. 2002 Fall; 24(4): 320-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12434943&dopt=Abstract
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Relationships between age, blood pressure, and retinal vessel diameters in an older population. Author(s): Leung H, Wang JJ, Rochtchina E, Tan AG, Wong TY, Klein R, Hubbard LD, Mitchell P. Source: Investigative Ophthalmology & Visual Science. 2003 July; 44(7): 2900-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12824229&dopt=Abstract
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Relationships of the systolic blood pressure response during exercise with insulin resistance, obesity, and endurance fitness in men with type 2 diabetes mellitus. Author(s): Kumagai S, Kai Y, Hanada H, Uezono K, Sasaki H. Source: Metabolism: Clinical and Experimental. 2002 October; 51(10): 1247-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12370842&dopt=Abstract
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Relaxing music prevents stress-induced increases in subjective anxiety, systolic blood pressure, and heart rate in healthy males and females. Author(s): Knight WE, Rickard PhD NS. Source: J Music Ther. 2001 Winter; 38(4): 254-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11796077&dopt=Abstract
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Relevance of the plasma renin hormonal control system that regulates blood pressure and sodium balance for correctly treating hypertension and for evaluating ALLHAT. Author(s): Laragh JH, Sealey JE. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2003 May; 16(5 Pt 1): 407-15. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745204&dopt=Abstract
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Removing confounders from the relationship between mortality risk and systolic blood pressure at low and moderately increased systolic blood pressure. Author(s): Greenberg JA. Source: Journal of Hypertension. 2003 January; 21(1): 49-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12544435&dopt=Abstract
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Renal blood flow autoregulation in blood pressure control. Author(s): Persson PB. Source: Current Opinion in Nephrology and Hypertension. 2002 January; 11(1): 67-72. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11753089&dopt=Abstract
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Renoprotection: a matter of blood pressure reduction or agent-characteristics? Author(s): Vogt L, Navis G, de Zeeuw D. Source: Journal of the American Society of Nephrology : Jasn. 2002 November; 13 Suppl 3: S202-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12466315&dopt=Abstract
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Repeated blood pressure measurements in a sample of Swedish twins: heritabilities and associations with polymorphisms in the renin-angiotensin-aldosterone system. Author(s): Iliadou A, Lichtenstein P, Morgenstern R, Forsberg L, Svensson R, de Faire U, Martin NG, Pedersen NL. Source: Journal of Hypertension. 2002 August; 20(8): 1543-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12172316&dopt=Abstract
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Repeated measures of blood pressure and correlations between systolic pressure, pulse pressure and LV mass: a circular debate? Author(s): MacFadyen RJ, Lee KW. Source: Journal of Human Hypertension. 2003 April; 17(4): 219-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12692565&dopt=Abstract
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Reproducibility of ambulatory blood pressure measures in African-American adolescents. Author(s): Barnes VA, Johnson MH, Dekkers JC, Treiber FA. Source: Ethn Dis. 2002 Fall; 12(4): S3-101-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12477164&dopt=Abstract
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Rosiglitazone improves insulin sensitivity and lowers blood pressure in hypertensive patients. Author(s): Raji A, Seely EW, Bekins SA, Williams GH, Simonson DC. Source: Diabetes Care. 2003 January; 26(1): 172-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12502676&dopt=Abstract
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Rosiglitazone reduces blood pressure and urinary albumin excretion in type 2 diabetes: G Bakris et al. Author(s): Grossman E. Source: Journal of Human Hypertension. 2003 January; 17(1): 5-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12571610&dopt=Abstract
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Salt and blood pressure: new insight from human genetic studies. Author(s): Lifton RP, Wilson FH, Choate KA, Geller DS. Source: Cold Spring Harb Symp Quant Biol. 2002; 67: 445-50. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12858570&dopt=Abstract
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Salt restriction and not length of dialysis is the key to drug free blood pressure control in ESRD patients. Author(s): Shaldon S. Source: Journal of Nephrology. 2003 January-February; 16(1): 159. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12649549&dopt=Abstract
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Salt shakedown. DASH diet beats salt restriction at lowering blood pressure. Author(s): Blackburn GL. Source: Health News. 2002 December; 8(12): 5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12523268&dopt=Abstract
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Salt, blood pressure and the renin-angiotensin system. Author(s): He FJ, MacGregor GA. Source: J Renin Angiotensin Aldosterone Syst. 2003 March; 4(1): 11-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12692748&dopt=Abstract
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Secular changes in blood pressure in childhood, adolescence and young adulthood: systematic review of trends from 1948 to 1998. Author(s): McCarron P, Smith GD, Okasha M. Source: Journal of Human Hypertension. 2002 October; 16(10): 677-89. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420191&dopt=Abstract
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Selective recording in blood pressure readings may increase subsequent mortality. Author(s): Wingfield D, Freeman GK, Bulpitt CJ; General Practice Hypertension Study Group (GPHSG). Source: Qjm : Monthly Journal of the Association of Physicians. 2002 September; 95(9): 571-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12205334&dopt=Abstract
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Self-measured systolic blood pressure in the morning is a strong indicator of decline of renal function in hypertensive patients with non-diabetic chronic renal insufficiency. Author(s): Suzuki H, Nakamoto H, Okada H, Sugahara S, Kanno Y. Source: Clinical and Experimental Hypertension (New York, N.Y. : 1993). 2002 May; 24(4): 249-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12069356&dopt=Abstract
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Self-measurement and ambulatory monitoring of blood pressure: a subject's chronobiological perspective. Author(s): Stinson SM, Cornelissen G, Scarpelli PT, Halberg F. Source: Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie. 2002; 56 Suppl 2: 333S-338S. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12653189&dopt=Abstract
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Self-perpetuating effects of birth size on blood pressure levels in elderly people. Author(s): Yliharsila H, Eriksson JG, Forsen T, Kajantie E, Osmond C, Barker DJ. Source: Hypertension. 2003 March; 41(3): 446-50. Epub 2003 February 17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12623941&dopt=Abstract
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Self-reported measurement of heart rate and blood pressure in patients by physical therapy clinical instructors. Author(s): Frese EM, Richter RR, Burlis TV. Source: Physical Therapy. 2002 December; 82(12): 1192-200. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12444878&dopt=Abstract
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Serial hemodynamic measurements allow better blood pressure control than clinical judgment in those with refractory hypertension. Author(s): Basile J. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2002 NovemberDecember; 4(6): 434-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12461310&dopt=Abstract
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Serum- and glucocorticoid-regulated kinase (SGK1) gene and blood pressure. Author(s): Busjahn A, Aydin A, Uhlmann R, Krasko C, Bahring S, Szelestei T, Feng Y, Dahm S, Sharma AM, Luft FC, Lang F. Source: Hypertension. 2002 September; 40(3): 256-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12215463&dopt=Abstract
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Should we treat high-normal blood pressure? Author(s): Yeo KR, Yeo WW. Source: Journal of Hypertension. 2002 October; 20(10): 2057-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12359985&dopt=Abstract
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Sibutramine and blood pressure: a therapeutic dilemma. Author(s): Bray GA. Source: Journal of Human Hypertension. 2002 January; 16(1): 1-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11840223&dopt=Abstract
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Simultaneous heart rate and blood pressure variability analysis. Insight into mechanisms underlying neurally mediated cardiac syncope in children. Author(s): Moak JP, Bailey JJ, Makhlouf FT. Source: Journal of the American College of Cardiology. 2002 October 16; 40(8): 1466-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12392838&dopt=Abstract
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Sleep disorders and the failure to lower nocturnal blood pressure. Author(s): Ziegler MG. Source: Current Opinion in Nephrology and Hypertension. 2003 January; 12(1): 97-102. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12496673&dopt=Abstract
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Smoking as a modifier of the systolic blood pressure-induced risk of cardiovascular events and mortality: a population-based prospective study of middle-aged men. Author(s): Khalili P, Nilsson PM, Nilsson JA, Berglund G. Source: Journal of Hypertension. 2002 September; 20(9): 1759-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12195116&dopt=Abstract
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Smoking, blood pressure and cardiovascular risk. Author(s): Hausberg M, Kosch M, Barenbrock M. Source: Journal of Hypertension. 2002 September; 20(9): 1699-701. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12195103&dopt=Abstract
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Smoking, blood pressure and serum cholesterol-effects on 20-year mortality. Author(s): Houterman S, Verschuren WM, Kromhout D. Source: Epidemiology (Cambridge, Mass.). 2003 January; 14(1): 24-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12500042&dopt=Abstract
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Smooth blood pressure control obtained with extended-release felodipine in elderly patients with hypertension: evaluation by 24-hour ambulatory blood pressure monitoring. Author(s): Antonicelli R, Omboni S, Giovanni DC, Ansuini R, Mori A, Gesuita R, Parati G, Paciaroni E. Source: Drugs & Aging. 2002; 19(7): 541-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12182690&dopt=Abstract
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Socioeconomic disadvantage and change in blood pressure associated with aging. Author(s): Diez Roux AV, Chambless L, Merkin SS, Arnett D, Eigenbrodt M, Nieto FJ, Szklo M, Sorlie P. Source: Circulation. 2002 August 6; 106(6): 703-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12163431&dopt=Abstract
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Sodium and blood pressure. Author(s): De Wardener HE, MacGregor GA. Source: Current Opinion in Cardiology. 2002 July; 17(4): 360-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12151870&dopt=Abstract
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Sodium intake and blood pressure in healthy individuals. Author(s): Ducher M, Fauvel JP, Maurin M, Laville M, Maire P, Paultre CZ, Cerutti C. Source: Journal of Hypertension. 2003 February; 21(2): 289-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12569258&dopt=Abstract
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Strength training reduces arterial blood pressure but not sympathetic neural activity in young normotensive subjects. Author(s): Carter JR, Ray CA, Downs EM, Cooke WH. Source: Journal of Applied Physiology (Bethesda, Md. : 1985). 2003 June; 94(6): 2212-6. Epub 2003 January 31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12562680&dopt=Abstract
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Stress and health-related behaviour, personality characteristics and blood pressure in older school children. Author(s): Sevcikova L, Stefanikova Z, Jurkovicova J, Ruzanska S, Sabolova M, Aghova L. Source: Bratisl Lek Listy. 2001; 102(9): 420-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11763679&dopt=Abstract
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Stress-related influences on blood pressure in African American women. Author(s): Webb MS, Beckstead JW. Source: Research in Nursing & Health. 2002 October; 25(5): 383-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12221692&dopt=Abstract
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Study design of HOMED-BP: hypertension objective treatment based on measurement by electrical devices of blood pressure. Author(s): Fujiwara T, Matsubara M, Ohkubo T, Imai Y. Source: Clinical and Experimental Hypertension (New York, N.Y. : 1993). 2003 April; 25(3): 143-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716076&dopt=Abstract
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Success and predictors of blood pressure control in diverse North American settings: the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). Author(s): Cushman WC, Ford CE, Cutler JA, Margolis KL, Davis BR, Grimm RH, Black HR, Hamilton BP, Holland J, Nwachuku C, Papademetriou V, Probstfield J, Wright JT Jr, Alderman MH, Weiss RJ, Piller L, Bettencourt J, Walsh SM; ALLHAT Collaborative Research Group. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2002 NovemberDecember; 4(6): 393-405. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12461301&dopt=Abstract
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Successful blood pressure control in the African American Study of Kidney Disease and Hypertension. Author(s): Wright JT Jr, Agodoa L, Contreras G, Greene T, Douglas JG, Lash J, Randall O, Rogers N, Smith MC, Massry S; African American Study of Kidney Disease and Hypertension Study Group. Source: Archives of Internal Medicine. 2002 July 22; 162(14): 1636-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12123409&dopt=Abstract
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Summaries for patients. Blood pressure control in people with type 2 diabetes mellitus: recommendations from the American College of Physicians. Author(s): American College of Physicians. Source: Annals of Internal Medicine. 2003 April 1; 138(7): I70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12667047&dopt=Abstract
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Supine body position is an important factor influencing postprandial ambulatory blood pressure. Author(s): Kruszewski P, Bieniszewski L, Neubauer-Geryk J, Swierblewska E, KrupaWojciechowska B. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2003 January; 9(1): Cr34-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12552248&dopt=Abstract
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Systematic error in the determination of nocturnal blood pressure dipping status by ambulatory blood pressure monitoring. Author(s): Kammila S, Campbell NR, Brant R, deJong R, Culleton B; University of Calgary Clinical Hypertension Research Group. Source: Blood Pressure Monitoring. 2002 April; 7(2): 131-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12048431&dopt=Abstract
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Systemic sclerosis is not associated with clinical or ambulatory blood pressure. Author(s): Zakopoulos NA, Kotsis VT, Gialafos EJ, Papamichael CM, Pitiriga VCh, Mitsibounas DN, Mavrikakis ME. Source: Clin Exp Rheumatol. 2003 March-April; 21(2): 199-204. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12747274&dopt=Abstract
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Systolic and diastolic blood pressure control in antihypertensive drug trials. Author(s): Mancia G, Grassi G. Source: Journal of Hypertension. 2002 August; 20(8): 1461-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12172300&dopt=Abstract
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Systolic blood pressure at end-expiration measured by the automated systolic pressure variation monitor is equivalent to systolic blood pressure during apnea. Author(s): Schwid HA, Rooke GA. Source: Journal of Clinical Monitoring and Computing. 2000; 16(2): 115-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12578068&dopt=Abstract
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Systolic blood pressure elevation: it's where the action is. Author(s): Basile JN. Source: Drugs & Aging. 2003; 20(4): 287-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12641484&dopt=Abstract
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Systolic blood pressure is the main etiology for poorly controlled hypertension. Author(s): Alam MG, Barri YM. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2003 February; 16(2): 140-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12559681&dopt=Abstract
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Systolic blood pressure, diastolic blood pressure, and pulse pressure as predictors of risk for congestive heart failure in the Framingham Heart Study. Author(s): Haider AW, Larson MG, Franklin SS, Levy D; Framingham Heart Study. Source: Annals of Internal Medicine. 2003 January 7; 138(1): 10-6. Summary for Patients In: http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12513039&dopt=Abstract
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Systolic blood pressure, not BIS, is associated with movement during laryngoscopy and intubation. Author(s): Slavov V, Motamed C, Massou N, Rebufat Y, Duvaldestin P. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2002 November; 49(9): 918-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12419716&dopt=Abstract
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Systolic blood pressure. Author(s): Basile JN. Source: Bmj (Clinical Research Ed.). 2002 October 26; 325(7370): 917-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12399325&dopt=Abstract
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Systolic blood pressure: an underestimated cardiovascular risk factor. Author(s): Mancia G, Seravalle G, Grassi G. Source: Journal of Hypertension. 2002 June; 20 Suppl 5: S21-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12187912&dopt=Abstract
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Systolic versus diastolic blood pressure versus pulse pressure. Author(s): White WB. Source: Current Cardiology Reports. 2002 November; 4(6): 463-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12379164&dopt=Abstract
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T+31C polymorphism (M235T) of the angiotensinogen gene and home blood pressure in the Japanese general population: the Ohasama Study. Author(s): Matsubara M, Metoki H, Katsuya T, Kikuya M, Suzuki M, Michimata M, Araki T, Hozawa A, Tsuji I, Ogihara T, Imai Y. Source: Hypertens Res. 2003 January; 26(1): 47-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12661912&dopt=Abstract
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The 2000 Canadian recommendations for the management of hypertension: part two-diagnosis and assessment of people with high blood pressure. Author(s): Zarnke KB, Levine M, McAlister FA, Campbell NR, Myers MG, McKay DW, Bolli P, Honos G, Lebel M, Mann K, Wilson TW, Abbott C, Tobe S, Burgess E, Rabkin S; Canadian Hypertension Recommendations Working Group. Source: The Canadian Journal of Cardiology. 2001 December; 17(12): 1249-63. Review. English, French. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11773936&dopt=Abstract
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The 24-hour blood pressure pattern: does it have implications for morbidity and mortality? Author(s): Weber MA. Source: The American Journal of Cardiology. 2002 January 24; 89(2A): 27A-33A. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11835909&dopt=Abstract
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The ALLHAT Trial. Diuretics are still the preferred initial drugs for high blood pressure. Author(s): Vidt DG. Source: Cleve Clin J Med. 2003 March; 70(3): 263-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12678218&dopt=Abstract
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The CYP2C9 genotype predicts the blood pressure response to irbesartan: results from the Swedish Irbesartan Left Ventricular Hypertrophy Investigation vs Atenolol (SILVHIA) trial. Author(s): Hallberg P, Karlsson J, Kurland L, Lind L, Kahan T, Malmqvist K, Ohman KP, Nystrom F, Melhus H. Source: Journal of Hypertension. 2002 October; 20(10): 2089-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12359989&dopt=Abstract
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The DASH diet enhances the blood pressure response to losartan in hypertensive patients. Author(s): Conlin PR, Erlinger TP, Bohannon A, Miller ER 3rd, Appel LJ, Svetkey LP, Moore TJ. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2003 May; 16(5 Pt 1): 337-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745193&dopt=Abstract
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The differential blood pressure sign in general practice: prevalence and prognostic value. Author(s): Clark CE, Powell RJ. Source: Family Practice. 2002 October; 19(5): 439-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12356690&dopt=Abstract
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The dose-related effects of bolus esmolol on heart rate and blood pressure following laryngoscopy and intubation. Author(s): Bensky KP, Donahue-Spencer L, Hertz GE, Anderson MT, James R. Source: Aana Journal. 2000 October; 68(5): 437-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11759128&dopt=Abstract
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The effect of ambient temperature and barometric pressure on ambulatory blood pressure variability. Author(s): Jehn M, Appel LJ, Sacks FM, Miller ER 3rd; DASH Collaborative Research Group. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2002 November; 15(11): 941-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12441212&dopt=Abstract
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The effect of hospitalisation on ambulatory blood pressure in pregnancy. Author(s): Walker S, Permezel M, Brennecke S, Tuttle L, Ugoni A, Higgins J. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 2002 November; 42(5): 490-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12495092&dopt=Abstract
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The effect of nonsteroidal anti-inflammatory drugs on blood pressure in patients treated with different antihypertensive drugs. Author(s): Morgan T, Anderson A. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2003 January-February; 5(1): 53-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12556654&dopt=Abstract
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The effect of the interval between blood pressure determinations on the delay in the detection of changes: a computer simulation. Author(s): Kennedy RR, French R. Source: Anesthesia and Analgesia. 2003 April; 96(4): 944-8, Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12651638&dopt=Abstract
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The effect on ambulatory blood pressure of working under favourably and unfavourably perceived supervisors. Author(s): Wager N, Fieldman G, Hussey T. Source: Occupational and Environmental Medicine. 2003 July; 60(7): 468-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12819279&dopt=Abstract
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The effectiveness of Watson's Caring Model on the quality of life and blood pressure of patients with hypertension. Author(s): Erci B, Sayan A, Tortumluoglu G, Kilic D, Sahin O, Gungormus Z. Source: Journal of Advanced Nursing. 2003 January; 41(2): 130-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12519271&dopt=Abstract
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The effects of aging and radiation exposure on blood pressure levels of atomic bomb survivors. Author(s): Sasaki H, Wong FL, Yamada M, Kodama K. Source: Journal of Clinical Epidemiology. 2002 October; 55(10): 974-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12464373&dopt=Abstract
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The effects of clonidine premedication on the blood pressure and tachycardiac responses to ephedrine in elderly and young patients during propofol anesthesia. Author(s): Ishiyama T, Kashimoto S, Oguchi T, Matsukawa T, Kumazawa T. Source: Anesthesia and Analgesia. 2003 January; 96(1): 136-41, Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12505939&dopt=Abstract
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The effects of exercise on resting blood pressure in children and adolescents: a metaanalysis of randomized controlled trials. Author(s): Kelley GA, Kelley KS, Tran ZV. Source: Preventive Cardiology. 2003 Winter; 6(1): 8-16. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12624556&dopt=Abstract
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The effects of isometric exercise training on resting blood pressure and orthostatic tolerance in humans. Author(s): Howden R, Lightfoot JT, Brown SJ, Swaine IL. Source: Experimental Physiology. 2002 July; 87(4): 507-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12392115&dopt=Abstract
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The evidence base for tight blood pressure control in the management of type 2 diabetes mellitus. Author(s): Snow V, Weiss KB, Mottur-Pilson C; Clinical Efficacy Assessment Subcommittee of the American College of Physicians. Source: Annals of Internal Medicine. 2003 April 1; 138(7): 587-92. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12667031&dopt=Abstract
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The HEDIS performance NAVIGATOR for controlling high blood pressure: a resource to assist health plans improve patient adherence. Author(s): Turpin R, Jungkind K, Salvucci L. Source: Disease Management : Dm. 2003 Spring; 6(1): 43-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12899567&dopt=Abstract
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The relation between two polymorphisms in the glucocorticoid receptor gene and body mass index, blood pressure and cholesterol in obese patients. Author(s): Di Blasio AM, van Rossum EF, Maestrini S, Berselli ME, Tagliaferri M, Podesta F, Koper JW, Liuzzi A, Lamberts SW. Source: Clinical Endocrinology. 2003 July; 59(1): 68-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12807506&dopt=Abstract
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The relationship between changes in normal-range systolic blood pressure and cognitive function in middle-aged healthy women. Author(s): Hakamada-Taguchi R, Uehara Y, Haebara T, Negoro H, Toyo-oka T. Source: Hypertens Res. 2002 July; 25(4): 565-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12358142&dopt=Abstract
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The relationship between resting blood pressure and acute pain sensitivity in healthy normotensives and chronic back pain sufferers: the effects of opioid blockade. Author(s): Bruehl S, Chung OY, Ward P, Johnson B, McCubbin JA. Source: Pain. 2002 November; 100(1-2): 191-201. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12435472&dopt=Abstract
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The relationship between systolic blood pressure and cardiovascular risk--results of the Brisighella Heart Study. Author(s): Borghi C, Dormi A, L'Italien G, Lapuerta P, Franklin SS, Collatina S, Gaddi A. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2003 January-February; 5(1): 47-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12556653&dopt=Abstract
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The relationship between temporal changes in blood pressure and changes in cognitive function: atherosclerosis risk in communities (ARIC) study. Author(s): Ann Intern Med. 2002 Sep 3;137(5 Part 1):I38 Source: Preventive Medicine. 2002 September; 35(3): 258-63. /entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12204046
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The relationship of family income, family size, age and circumferences with blood pressure in the female students of the Bahauddin Zakariya University, Multan, Pakistan. Author(s): Khan TH, Manzoor U. Source: Anthropol Anz. 2002 September; 60(3): 293-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12378795&dopt=Abstract
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The relationship of waist circumference to blood pressure: the Olivetti Heart Study. Author(s): Siani A, Cappuccio FP, Barba G, Trevisan M, Farinaro E, Lacone R, Russo O, Russo P, Mancini M, Strazzullo P. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2002 September; 15(9): 780-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12219872&dopt=Abstract
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The role of blood pressure in lacunar strokes preceded by TIAs. Author(s): Lalive PH, Mayor I, Sztajzel R. Source: Cerebrovascular Diseases (Basel, Switzerland). 2003; 16(1): 88-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12766368&dopt=Abstract
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The role of blood pressure lowering before and after stroke. Author(s): Donnan GA, Davis SM, Thrift A. Source: Current Opinion in Neurology. 2003 February; 16(1): 81-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12544861&dopt=Abstract
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The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. Author(s): Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ; National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. Source: Jama : the Journal of the American Medical Association. 2003 May 21; 289(19): 2560-72. Epub 2003 May 14. Erratum In: Jama. 2003 July 9; 290(2): 197. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12748199&dopt=Abstract
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The sympathoadrenal system mediates the blood pressure and cardiac effects of human coagulation factor XII-related “new pressor protein”. Author(s): Mavrogiannis L, Trambakoulos DM, Boomsma F, Osmond DH. Source: The Canadian Journal of Cardiology. 2002 October; 18(10): 1077-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420043&dopt=Abstract
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Time trends in high blood pressure control and the use of antihypertensive medications in older adults: the Cardiovascular Health Study. Author(s): Psaty BM, Manolio TA, Smith NL, Heckbert SR, Gottdiener JS, Burke GL, Weissfeld J, Enright P, Lumley T, Powe N, Furberg CD; Cardiovascular Health Study. Source: Archives of Internal Medicine. 2002 November 11; 162(20): 2325-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12418946&dopt=Abstract
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Time-effect profile of antihypertensive agents assessed with trough/peak ratio, smoothness index and dose omission: an ambulatory blood pressure monitoring study with trandolapril vs. quinapril. Author(s): Radauceanu A, Virion JM, Boivin JM, Zannad F. Source: Fundamental & Clinical Pharmacology. 2002 December; 16(6): 545-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12685514&dopt=Abstract
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To what extent can we trust home blood pressure measurement? A randomized, controlled trial. Author(s): Bachmann LM, Steurer J, Holm D, Vetter W. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2002 NovemberDecember; 4(6): 405-7, 412. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12461302&dopt=Abstract
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Too much of a good thing? A critique of overemphasis on the use of ambulatory blood pressure monitoring in clinical practice. Author(s): Palatini P. Source: Journal of Hypertension. 2002 October; 20(10): 1917-23. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12359962&dopt=Abstract
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Total plasma homocysteine, age, systolic blood pressure, and cognitive performance in older people. Author(s): Budge MM, de Jager C, Hogervorst E, Smith AD; Oxford Project To Investigate Memory and Ageing (OPTIMA). Source: Journal of the American Geriatrics Society. 2002 December; 50(12): 2014-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12473014&dopt=Abstract
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Tracking of systolic blood pressure during childhood: a 15-year follow-up population-based family study in eastern Finland. Author(s): Fuentes RM, Notkola IL, Shemeikka S, Tuomilehto J, Nissinen A. Source: Journal of Hypertension. 2002 February; 20(2): 195-202. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11821703&dopt=Abstract
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Treatment of difficult-to-control blood pressure in a multidisciplinary clinic at a public hospital. Author(s): Tao LS, Hart P, Edwards E, Evans AT, Whitaker E, Smith P. Source: Journal of the National Medical Association. 2003 April; 95(4): 263-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12749616&dopt=Abstract
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Treatment of hypertension in type 2 diabetes mellitus: blood pressure goals, choice of agents, and setting priorities in diabetes care. Author(s): Vijan S, Hayward RA. Source: Annals of Internal Medicine. 2003 April 1; 138(7): 593-602. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12667032&dopt=Abstract
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Trials on blood pressure-lowering and secondary stroke prevention. Author(s): Chalmers J. Source: The American Journal of Cardiology. 2003 May 22; 91(10A): 3G-8G. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12781902&dopt=Abstract
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Tripling of blood pressure by sexual stimulation in a man with spinal cord injury. Author(s): McBride F, Quah SP, Scott ME, Dinsmore WW. Source: Journal of the Royal Society of Medicine. 2003 July; 96(7): 349-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12835450&dopt=Abstract
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Twenty-four-Hour blood pressure variability after acute ischemic stroke. Author(s): Hickey JV, Salmeron ET, Lai JM. Source: Critical Care Nursing Quarterly. 2002 August; 25(2): 1-12; Quiz 74-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12211332&dopt=Abstract
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U-curve relationship between orthostatic blood pressure change and silent cerebrovascular disease in elderly hypertensives: orthostatic hypertension as a new cardiovascular risk factor. Author(s): Kario K, Eguchi K, Hoshide S, Hoshide Y, Umeda Y, Mitsuhashi T, Shimada K. Source: Journal of the American College of Cardiology. 2002 July 3; 40(1): 133-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12103267&dopt=Abstract
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Uncontrolled early morning blood pressure in medicated patients: the ACAMPA study. Analysis of the Control of Blood Pressure using Abulatory Blood Pressure Monitoring. Author(s): Redon J, Roca-Cusachs A, Mora-Macia J. Source: Blood Pressure Monitoring. 2002 April; 7(2): 111-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12048428&dopt=Abstract
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Underestimation of the importance of blood pressure and cholesterol for coronary heart disease mortality in old age. Author(s): Clarke R, Lewington S, Youngman L, Sherliker P, Peto R, Collins R. Source: European Heart Journal. 2002 February; 23(4): 286-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11812064&dopt=Abstract
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Unravelling the fetal origins hypothesis: is there really an inverse association between birthweight and subsequent blood pressure? Author(s): Huxley R, Neil A, Collins R. Source: Lancet. 2002 August 31; 360(9334): 659-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12241871&dopt=Abstract
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US guidelines say blood pressure of 120/80 mm Hg is not “normal”. Author(s): Hopkins Tanne J. Source: Bmj (Clinical Research Ed.). 2003 May 24; 326(7399): 1104. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12763961&dopt=Abstract
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Use of automated home blood pressure monitoring in pregnancy. Author(s): Loewenstein L, Naschitz JE. Source: American Journal of Obstetrics and Gynecology. 2003 June; 188(6): 1662; Author Reply 1662-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12825012&dopt=Abstract
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Use of automated home blood pressure monitoring in pregnancy: is it safe? Author(s): Lo C, Taylor RS, Gamble G, McCowan L, North RA. Source: American Journal of Obstetrics and Gynecology. 2002 November; 187(5): 1321-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12439526&dopt=Abstract
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Use of lipid-lowering drugs and blood pressure control in patients with arterial hypertension. Author(s): Borghi C, Dormi A, Veronesi M, Immordino V, Ambrosioni E. Source: Journal of Clinical Hypertension (Greenwich, Conn.). 2002 July-August; 4(4): 277-85. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12147931&dopt=Abstract
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Use of oral antihypertensive medication preceding blood pressure elevation in hospitalized patients. Author(s): de Macedo CR, Noblat AC, Noblat L, de Macedo JM, Lopes AA. Source: Arquivos Brasileiros De Cardiologia. 2001 October; 77(4): 324-31. English, Portuguese. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11733801&dopt=Abstract
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Use of radial arterial tonometric continuous blood pressure measurement in cardiovascular reactivity studies. Author(s): Nelesen RA, Dimsdale JE. Source: Blood Pressure Monitoring. 2002 October; 7(5): 259-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12409884&dopt=Abstract
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Usefulness of home blood pressure measurement in the morning in type 2 diabetic patients. Author(s): Kamoi K, Miyakoshi M, Soda S, Kaneko S, Nakagawa O. Source: Diabetes Care. 2002 December; 25(12): 2218-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12453964&dopt=Abstract
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Utility of ambulatory blood pressure monitoring for diagnosis of hypertension in liver allograft recipients. Author(s): Otero-Anton E, Padin E, Tome S, Gonzalez-Quintela A, Calvo C, Hermida RC, Ayala DE, Castroagudin JF, Delgado M, Varo E. Source: Transplantation Proceedings. 2003 March; 35(2): 718. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12644109&dopt=Abstract
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Validation of a tonometric noninvasive arterial blood pressure monitor in the intensive care setting. Author(s): Steiner LA, Johnston AJ, Salvador R, Czosnyka M, Menon DK. Source: Anaesthesia. 2003 May; 58(5): 448-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12694001&dopt=Abstract
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Validation of the A&D UA-631 (UA-779 Life Source) device for selfmeasurement of blood pressure and relationship between its performance and large artery compliance. Author(s): Longo D, Bertolo O, Toffanin G, Frezza P, Palatini P. Source: Blood Pressure Monitoring. 2002 August; 7(4): 243-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12198341&dopt=Abstract
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Validation of the Microlife BP 3BTO-A oscillometric blood pressure monitoring device according to a modified British Hypertension Society protocol. Author(s): Cuckson AC, Reinders A, Shabeeh H, Shennan AH; British Hypertension Society. Source: Blood Pressure Monitoring. 2002 December; 7(6): 319-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12488652&dopt=Abstract
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Validation of the Omron HEM-907 device for blood pressure measurement. Author(s): El Assaad MA, Topouchian JA, Darne BM, Asmar RG. Source: Blood Pressure Monitoring. 2002 August; 7(4): 237-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12198340&dopt=Abstract
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Validation of the Welch Allyn 'Vital Signs' blood pressure measurement device in pregnancy and pre-eclampsia. Author(s): Reinders A, Cuckson AC, Jones CR, Poet R, O'Sullivan G, Shennan AH. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2003 February; 110(2): 134-8.
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http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12618156&dopt=Abstract •
Validation study of an automated wrist monitor, omron model HEM-608, compared with the standard methods for blood pressure measurement. Author(s): Plavnik FL, Zanella MT. Source: Arquivos Brasileiros De Cardiologia. 2001 December; 77(6): 532-40. English, Portuguese. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11799428&dopt=Abstract
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Value of low dose combination treatment with blood pressure lowering drugs: analysis of 354 randomised trials. Author(s): Law MR, Wald NJ, Morris JK, Jordan RE. Source: Bmj (Clinical Research Ed.). 2003 June 28; 326(7404): 1427. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12829555&dopt=Abstract
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Value of rilmenidine therapy and its combination with perindopril on blood pressure and left ventricular hypertrophy in patients with essential hypertension (VERITAS). Author(s): Farsang C, Lengyel M, Borbas S, Zorandi A, Dienes BS; VERITAS Investigators. Source: Current Medical Research and Opinion. 2003; 19(3): 205-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12803735&dopt=Abstract
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Variability in midlife systolic blood pressure is related to late-life brain white matter lesions: the Honolulu-Asia Aging study. Author(s): Havlik RJ, Foley DJ, Sayer B, Masaki K, White L, Launer LJ. Source: Stroke; a Journal of Cerebral Circulation. 2002 January; 33(1): 26-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11779884&dopt=Abstract
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Variability of phase shift between blood pressure and heart rate fluctuations: a marker of short-term circulation control. Author(s): Halamek J, Kara T, Jurak P, Soucek M, Francis DP, Davies LC, Shen WK, Coats AJ, Novak M, Novakova Z, Panovsky R, Toman J, Sumbera J, Somers VK. Source: Circulation. 2003 July 22; 108(3): 292-7. Epub 2003 Jul 14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12860920&dopt=Abstract
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Vascular capsule for telemetric monitoring of blood pressure. Author(s): Schmitz-Rode T, Schnakenberg U, Pfeffer JG, Piroth W, Vom Bogel G, Mokwa W, Gunther RW. Source: Rofo. Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Neuen Bildgebenden Verfahren. 2003 February; 175(2): 282-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12584632&dopt=Abstract
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Vascular mechanisms of sudden death in hypertrophic cardiomyopathy, including blood pressure responses to exercise. Author(s): Lim PO, Morris-Thurgood JA, Frenneaux MP. Source: Cardiology in Review. 2002 January-February; 10(1): 15-23. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11790265&dopt=Abstract
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Vasopeptidase inhibition: effective blood pressure control for vascular protection. Author(s): Quaschning T, Ruschitzka F, Luscher TF. Source: Current Hypertension Reports. 2002 February; 4(1): 78-84. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11790296&dopt=Abstract
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Very high frequency oscillations in the heart rate and blood pressure of heart transplant patients. Author(s): Toledo E, Pinhas I, Aravot D, Akselrod S. Source: Medical & Biological Engineering & Computing. 2003 July; 41(4): 432-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12892366&dopt=Abstract
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Violence exposure, catecholamine excretion, and blood pressure nondipping status in African American male versus female adolescents. Author(s): Wilson DK, Kliewer W, Teasley N, Plybon L, Sica DA. Source: Psychosomatic Medicine. 2002 November-December; 64(6): 906-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12461196&dopt=Abstract
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Vitamin E can reduce blood pressure in mild hypertensives. Author(s): Boshtam M, Rafiei M, Sadeghi K, Sarraf-Zadegan N. Source: Int J Vitam Nutr Res. 2002 October; 72(5): 309-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12463106&dopt=Abstract
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Volume control, blood pressure and cardiovascular function. Lessons from hemodialysis treatment. Author(s): Charra B, Chazot C. Source: Nephron. Physiology [electronic Resource]. 2003; 93(4): P94-101. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12759570&dopt=Abstract
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Water intake and 24-hour blood pressure monitoring in a patient with nephrogenic diabetes insipidus caused by a novel mutation of the vasopressin V2R gene. Author(s): Owada M, Kawamura M, Kimura Y, Fujiwara T, Uchida S, Sasaki S, Hiramori K. Source: Intern Med. 2002 February; 41(2): 119-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11868598&dopt=Abstract
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Weight and blood pressure change during clozapine treatment. Author(s): Baymiller SP, Ball P, McMahon RP, Buchanan RW. Source: Clinical Neuropharmacology. 2002 July-August; 25(4): 202-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12151907&dopt=Abstract
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Weight loss and weight maintenance, ambulatory blood pressure and cardiac autonomic tone in obese persons with the metabolic syndrome. Author(s): Laaksonen DE, Laitinen T, Schonberg J, Rissanen A, Niskanen LK. Source: Journal of Hypertension. 2003 February; 21(2): 371-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12569268&dopt=Abstract
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What is the mechanism of abnormal blood pressure response on exercise in hypertrophic cardiomyopathy? Author(s): Campbell R, Manyari DE, McKenna WJ, Frenneaux M. Source: Journal of the American College of Cardiology. 2003 June 4; 41(11): 2102; Author Reply 2102-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12798589&dopt=Abstract
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What is the optimal blood pressure target in renal patients? Author(s): Ruilope LM, Campo C, Segura J, Rodicio JL. Source: Adv Nephrol Necker Hosp. 2001; 31: 43-53. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11692470&dopt=Abstract
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What should be the goal blood pressure? Author(s): Bulpitt CJ. Source: Journal of Human Hypertension. 2001 December; 15(12): 831-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11773983&dopt=Abstract
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When can the practicing physician suspect white coat hypertension? Statement from the Working Group on Blood Pressure Monitoring of the European Society of Hypertension. Author(s): Verdecchia P, O'Brien E, Pickering T, Staessen JA, Parati G, Myers M, Palatini P; European Society of Hypertension Working Group on Blood Pressure Monitoring. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2003 January; 16(1): 87-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12517690&dopt=Abstract
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White coat effect in treated and untreated patients with high office blood pressure. Relationship with pulse wave velocity and left ventricular mass index. Author(s): Silveira A, Mesquita A, Maldonado J, Silva JA, Polonia J. Source: Rev Port Cardiol. 2002 May; 21(5): 517-30. English, Portuguese. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12174516&dopt=Abstract
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Why is blood pressure control unsatisfactory--or is it? Author(s): Hense HW, Maziak W, Heidrich J. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2002 September; 17(9): 1547-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12198202&dopt=Abstract
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Why lowering blood pressure is not enough: the hypertension syndrome and the clinical context of cardiovascular risk reduction. Author(s): Neutel JM. Source: Heart Disease. 2000 September-October; 2(5): 370-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11728284&dopt=Abstract
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Working Group on Blood Pressure Monitoring of the European Society of Hypertension International Protocol for validation of blood pressure measuring devices in adults. Author(s): O'Brien E, Pickering T, Asmar R, Myers M, Parati G, Staessen J, Mengden T, Imai Y, Waeber B, Palatini P, Gerin W; Working Group on Blood Pressure Monitoring of the European Society of Hypertension. Source: Blood Pressure Monitoring. 2002 February; 7(1): 3-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12040236&dopt=Abstract
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World Trade Center disaster effect on blood pressure. Author(s): Lipsky SI, Pickering TG, Gerin W. Source: Blood Pressure Monitoring. 2002 August; 7(4): 249. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12198342&dopt=Abstract
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Wrist blood pressure-measuring devices: a comparative study of accuracy with a standard auscultatory method using a mercury manometer. Author(s): Altunkan S, Yildiz S, Azer S. Source: Blood Pressure Monitoring. 2002 October; 7(5): 281-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12409888&dopt=Abstract
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Young men with high-normal blood pressure have lower serum adiponectin, smaller LDL size, and higher elevated heart rate than those with optimal blood pressure. Author(s): Kazumi T, Kawaguchi A, Sakai K, Hirano T, Yoshino G. Source: Diabetes Care. 2002 June; 25(6): 971-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12032101&dopt=Abstract
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CHAPTER 2. NUTRITION AND BLOOD PRESSURE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and blood pressure.
Finding Nutrition Studies on Blood Pressure The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail:
[email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “blood pressure” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
7
Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
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The following is a typical result when searching for recently indexed consumer information on blood pressure: •
Blood pressure and nutrient intake in the United States. Source: McCarron, David A. Morris, Cynthia D. Henry, Holly H. Stanton, John L. Nutrition-today (USA). (Jul-August 1984). volume 19(4) page 14-17, 20-23. circulatory disorders blood pressure diet risk sodium potassium retinol ascorbic acid feeding habits disease control statistical analysis 0029-666X Summary: trouble circulatoire pression sanguine regime alimentaire risque sodium potassium retinol acide ascorbique comportement alimentaire controle de maladies analyse statistique
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Diet for keeping blood pressure down. Source: Tufts-University-diet-and-nutrition-letter (USA). (July 1996). volume 14(5) page 6. diet blood pressure hypertension weight reduction alcoholic beverages physical activity potassium sodium chloride common salt 0747-4105 Summary: regime alimentaire pression sanguine hypertension baisse de poids boisson alcoolisee activite physique potassium chlorure de sodium sel de cuisine
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Good news about what to eat to take control of your blood pressure. Source: Walsh, J. Environmental-nutrition (USA). (December 1998). volume 21(12) page 1, 6. diet food intake common salt hypertension clinical trials human nutrition 0893-4452 Summary: regime alimentaire prise alimentaire homme sel de cuisine hypertension essai clinique nutrition humaine
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Scouting for sodium: and other nutrients important to blood pressure. Source: Kurtzweil, P. FDA-consumer (USA). (September 1994). volume 28(7) page 18-22. usa sodium blood pressure hypertension therapeutic diets nutrition labelling 0362-1332 Summary: etats unis sodium pression sanguine hypertension regime alimentaire therapeutique etiquetage informatif
Additional consumer oriented references include: •
Ask the doctor. For years, I have been taking reserpine for my high blood pressure. A younger doctor I recently saw had never met anyone taking it. Should I be switched to something new? Source: Lee, T H Harv-Heart-Lett. 1999 September; 10(1): 8 1051-5313
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Ask the doctor. I am a 70-year-old man with high blood pressure that I control with medication, diet, and exercise. My mother, aunt, and maternal grandfather all died in their 50s after a single stroke. Is there an inherited tendency to hemorrhagic stroke? Are there any precautions I can take? Source: Lee, Thomas H Harv-Heart-Lett. 2002 June; 12(10): 8 1051-5313
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Ask the doctor. I have used a medication called Aldomet for many years for my high blood pressure. Recently, I had to go to the hospital, and the young intern said that he had never heard of anyone using this drug and that it was something out of the history books. Should I be on another drug? Source: Lee, T H Harv-Heart-Lett. 1999 July; 9(11): 8 1051-5313
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Ask the doctor. I'm a 51-year-old man with no risk factors for heart disease other than being male. My blood pressure and cholesterol levels are fine. I exercise, and my diet is pretty good. I've never smoked. Yet I recently underwent a triple bypass for sudden chest pain. What could have caused this blockage and can I prevent future problems? Source: Lee, T H Harv-Heart-Lett. 2002 December; 13(4): 8 1051-5313
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Ask the doctor. My blood pressure is 180/80 mm Hg. My doctor tells me this a common problem for people in their 70s, like me. The problem is that whenever I try medicines at doses high enough to get my top number under 140 mm Hg (which I understand to be the goal), I get exhausted or have other side effects. Do I really need to worry about my blood pressure when the bottom number is so good? Source: Lee, T H Harv-Heart-Lett. 2000 November; 11(3): 7-8 1051-5313
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Blood pressure regulation and micronutrients. Source: Dakshinamurti, K. Dakshinamurti, S. Nutr-res-rev. Wallingford, Oxon, U.K. : CAB International. June 2001. volume 14 (1) page 3-43. 0954-4224
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By the way, doctor. At my last checkup, my doctor told me my blood pressure was elevated; it was 160/90. Over six weeks, I was able to get the diastolic pressure down to the low 80s through diet and exercise. But I have trouble keeping my systolic pressure down. It seems to fluctuate frequently and is especially dependent on my emotions. Any suggestions? Source: Robb Nicholson, C Harv-Womens-Health-Watch. 2000 August; 7(12): 8 1070910X
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By the way, doctor. I am 87 and have been taking blood pressure medications for years. In the past, side effects were a problem, but for about the last year I've done very well taking valsartan (Diovan) and hydrochlorothiazide (Esidrex). Now My blood pressure is about 165/72 mm hg. The top number seems high. One doctor told me that as long as the bottom number is low, I shouldn't be concerned. But I am. My father died from a stroke many years ago, and I'm pretty sure he had high blood pressure. Source: Lee, T H Harv-Health-Lett. 2000 February; 25(4): 8 1052-1577
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Can calcium lower blood pressure? Source: McGrath, M. Prevention (USA). (April 1988). volume 40(4) page 68, 70-73. diet calcium blood pressure circulatory disorders food additives 0032-8006
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Circadian blood pressure during the early course of type 1 diabetes. Analysis of 1,011 ambulatory blood pressure recordings in 354 adolescents and young adults. Author(s): Department of Pediatrics, University of Ulm, Germany.
[email protected] Source: Holl, R W Pavlovic, M Heinze, E Thon, A Diabetes-Care. 1999 July; 22(7): 1151-7 0149-5992
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Controlling blood pressure without drugs. Source: Anonymous Health-News. 1998 April 20; 4(5): 6 1081-5880
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Cutting salt better than exercise at controlling blood pressure. Source: Anonymous Harv-Heart-Lett. 2002 February; 12(6): 6 1051-5313
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DASH without the dash (of salt) can lower blood pressure. Author(s): Department of Foods and Nutrition, Purdue University, West Lafayette, IN 47906, USA. Source: Fleet, J C Nutr-Revolume 2001 September; 59(9): 291-3 0029-6643
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Health tips. Nondrug help for high blood pressure. Source: Anonymous Mayo-Clin-Health-Lett. 2001 March; 19(3): 3 0741-6245
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High blood pressure. Lifestyle changes replace drugs for some. Source: Anonymous Harv-Health-Lett. 1998 May; 23(7): 5 1052-1577
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High blood pressure: the end of an epidemic. Source: Liebman, B. Nutr-action-health-lett. [Washington, D.C. : Center for Science in the Public Interest,. December 2000. volume 27 (10) page 1, 3-9. 0885-7792
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I recently read that potassium supplements can reduce blood pressure. What is your opinion? I have borderline hypertension, which I'm trying to control with diet and exercise. Source: Robb Nicholson, C Harv-Womens-Health-Watch. 1999 January; 6(5): 8 1070910X
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I take Adalat (or nifedipine, also sold as Procardia) and captopril tablets daily for my high blood pressure. My physician told me not to take aspirin because of the possibility of drug interactions. From what I have read about aspirin, I hate to miss out on the benefits. Source: Lee, T H Harv-Heart-Lett. 1998 October; 9(2): 8 1051-5313
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In one HealthNews article, you wrote that vitamin C can lower your blood pressure, and in another you said that it increases the intima-media thickness (IMT), thereby increasing the risk of heart disease. Should I or shouldn't I take extra vitamin C? Author(s): Massachusetts Veterans Epidemiology Research and Information Center, USA. Source: Gaziano, J M Health-News. 2001 March; 7(3): 10 1081-5880
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International cooperative study on the relationship between dietary factors and blood pressure: a preliminary report from the Cardiovascular Diseases and Alimentary Comparison (CARDIAC) Study. The CARDIAC Cooperative Study Research Group. Author(s): WHO Collaborating Center for Research on Primary Prevention of Cardiovascular Diseases, Department of Pathology, Shimane Medical University, Izumo, Japan. Source: Yamori, Y Nara, Y Mizushima, S Mano, M Sawamura, M Kihara, M Horie, R Nutr-Health. 1992; 8(2-3): 77-90 0260-1060
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Less salt for lower blood pressure? Source: Anonymous Health-News. 2000 July; 6(7): 6 1081-5880
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Lowering the risk for high blood pressure. Source: Aftergood, L. Alfin Slater, R.B. Tufts-Univ-Diet-Nutr-Lett. New York, N.Y. : Tufts University Diet and Nutrition Letter. May 1987. volume 5 (3) page 3-6. 0747-4105
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Not only salt, but calcium and fish oils affect high blood pressure. Source: Mendoza, T.G. Environ-Nutr. New York, N.Y. : Environmental Nutrition, Inc. November 1988. volume 11 (11) page 1, 6. 0893-4452
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Olive oil lowers blood pressure. Source: Anonymous Health-News. 2000 May; 6(5): 8 1081-5880
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Relationship between ethnicity and glycemic control, lipid profiles, and blood pressure during the first 9 years of type 2 diabetes: U.K. Prospective Diabetes Study (UKPDS 55). Author(s): Fremantle Hospital, University of Western Australia. Source: Davis, T M Cull, C A Holman, R R Diabetes-Care. 2001 July; 24(7): 1167-74 01495992
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Salt and blood pressure. Source: Ashwell, M. B-N-F-Nutr-Bull-Br-Nutr-Found. London : The Foundation. May 1991. volume 16 (2) page 61-64. 0141-9684
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Salt shakedown. DASH diet beats salt restriction at lowering blood pressure. Source: Blackburn, G L Health-News. 2002 December; 8(12): 5 1081-5880
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Tackling high blood pressure. Source: Nutr-Action-Health-Lett. Washington, D.C. : Center for Science in the Public Interest. May 1989. volume 16 (4) page 1, 5-7. charts. 0199-5510
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The DASH diet. It may benefit your blood pressure, and more. Source: Anonymous Mayo-Clin-Health-Lett. 1998 April; 16(4): 7 0741-6245
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The newest blood pressure strategy. Source: Anonymous Johns-Hopkins-Med-Lett-Health-After-50. 1998 November; 10(9): 12 1042-1882
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Will olive oil lower your blood pressure? Source: Tufts-University-diet-and-nutrition-letter (USA). (September 1987). volume 5(7) page 1. plant oils blood pressure diet olea europaea fatty acids circulatory disorders 0747-4105
The following information is typical of that found when using the “Full IBIDS Database” to search for “blood pressure” (or a synonym): •
A nested case-control study on the high-normal blood pressure as a risk factor of hypertension in Korean middle-aged men. Author(s): Department of Preventive Medicine, Cheju National University College of Medicine, Cheju, Korea.
[email protected] Source: Bae, J M Ahn, Y O J-Korean-Med-Sci. 2002 June; 17(3): 328-36 1011-8934
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Anti-inflammatory effect of cerivastatin in vascular injury independent of serum cholesterol and blood pressure lowering effects in mouse model. Author(s): Department of Surgery, Affiliated Hospital of Guangdong Medical College, Zhanjiang 524001, China.
[email protected] Source: Chen, X Li, Z Li, J Chin-J-Traumatol. 2002 October; 5(5): 294-8 1008-1275
•
Blood pressure and urinary excretion of electrolytes in Spanish schoolchildren. Author(s): Hypertension Unit, University Hospital of Granada, Spain. Source: Maldonado Martin, A Garcia Matarin, L Gil Extremera, B Avivar Oyonarte, C Garcia Granados, M E Gil Garcia, F Latorre Hernandez, J Miro Gutierrez, J Soria Bonilla, A Vergara Martin, J Javier Martinez, M R J-Hum-Hypertens. 2002 July; 16(7): 473-8 09509240
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Blood pressure response to antihypertensive agents related to baseline blood pressure. Author(s): Cardiovascular Unit, Department of Medicine, Bangkok Metropolitan Administration Medical College and Vajira Hospital, Bangkok 10300, Thailand. Source: Sermswan, A Uboldejpracharak, Y Suthichaiyakul, T Sukontasarn, A Buranakitcharoen, P J-Med-Assoc-Thai. 2002 October; 85(10): 1113-20 0125-2208
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Camphor-Crataegus berry extract combination dose-dependently reduces tilt induced fall in blood pressure in orthostatic hypotension. Author(s): Center for Cardiovascular Pharmacology, ZeKaPha GmbH, Mainz, Germany.
[email protected] Source: Belz, G G Butzer, R Gaus, W Loew, D Phytomedicine. 2002 October; 9(7): 581-8 0944-7113
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•
Diet-related factors, educational levels and blood pressure in a Chinese population sample: findings from the Japan-China Cooperative Research Project. Author(s): World Health Organization Collaborating Center for Research on Primary Prevention of Cardiovascular Diseases, Kyoto, Japan. Source: Yamori, Y Liu, L Mu, L Zhao, H Pen, Y Hu, Z Kuga, S Negishi, H Ikeda, K Hypertens-Res. 2002 July; 25(4): 559-64 0916-9636
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Effect of exercise on blood pressure in rats with chronic NOS inhibition. Author(s): Akdeniz University, Medical Faculty, Department of Physiology, Kampus, 07070, Antalya, Turkey. Source: Kuru, O Senturk, K Demir, N Yesilkaya, A Erguler, G Erkilic, M Eur-J-ApplPhysiol. 2002 June; 87(2): 134-40 1439-6319
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Effect of long-term intake of milk products on blood pressure in hypertensive rats. Author(s): Institute of Biomedicine, Pharmacology, Biomedicum Helsinki, University of Helsinki, Finland.
[email protected] Source: Sipola, M Finckenberg, P Korpela, R Vapaatalo, H Nurminen, M L J-Dairy-Res. 2002 February; 69(1): 103-11 0022-0299
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Effect of modest salt reduction on blood pressure: a meta-analysis of randomized trials. Implications for public health. Author(s): Blood Pressure Unit, St George's Hospital Medical School, London, UK. Source: He, F J MacGregor, G A J-Hum-Hypertens. 2002 November; 16(11): 761-70 09509240
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Effects of Ginkgo biloba extract (EGb 761) on cerebral thrombosis and blood pressure in stroke-prone spontaneously hypertensive rats. Author(s): Laboratory of Physiology, Faculty of Nutrition, Kobe Gakuin University, Kobe, Japan.
[email protected] Source: Sasaki, Y Noguchi, T Yamamoto, E Giddings, J C Ikeda, K Yamori, Y Yamamoto, J Clin-Exp-Pharmacol-Physiol. 2002 November; 29(11): 963-7 0305-1870
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Effects of microinjection of adenosine into area postrema on heart rate, blood pressure and renal sympathetic nerve activity in rats. Author(s): Department of Physiology, Hebei Medical University, Shijiazhuang 050017;
[email protected] Source: Chen, S Li, D P He, R R Sheng-Li-Xue-Bao. 2000 August; 52(4): 313-7 0371-0874
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Endothelins induce gallbladder contraction independent of elevated blood pressure in vivo in the Australian possum. Author(s): Department of General and Digestive Surgery, Centre for Digestive Health, Flinders University of South Australia, Adelaide, Australia.
[email protected] Source: Al Jiffry, B O Chen, J W Toouli, J Saccone, G T J-Gastrointest-Surg. 2002 SepOctober; 6(5): 699-705 1091-255X
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Fluvastatin remodels resistance arteries in genetically hypertensive rats, even in the absence of any effect on blood pressure. Author(s): Department of Pharmacology and Toxicology, School of Medical Sciences, University of Otago, Dunedin, New Zealand.
[email protected] Source: Ledingham, J M Laverty, R Clin-Exp-Pharmacol-Physiol. 2002 October; 29(10): 931-4 0305-1870
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Mechanisms of blood pressure change after bolus injections of X-ray contrast media. Author(s): University of California, San Diego, La Jolla 92093-0632, USA. Source: Lasser, E C Lamkin, G E Acad-Radiol. 2002 May; 9 Suppl 1: S72-5 1076-6332
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Obesity correlates with increased blood pressures in urban Native American youth. Author(s): Department of Food Science and Nutrition, University of Minnesota, St Paul, Minnesota 55108, USA.
[email protected] Source: Smith, C Rinderknecht, K Am-J-Human-Biol. 2003 Jan-February; 15(1): 78-90 1042-0533
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Pharmacological studies on Myristica fragrans--antidiarrheal, hypnotic, analgesic and hemodynamic (blood pressure) parameters. Author(s): Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India.
[email protected] Source: Grover, J K Khandkar, S Vats, V Dhunnoo, Y Das, D Methods-Find-Exp-ClinPharmacol. 2002 December; 24(10): 675-80 0379-0355
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Role of automated measurements in understanding lifestyle effects on blood pressure. Author(s): Department of Medicine, University of Western Australia, West Australian Institute for Medical Research and HeartSearch, Perth, Australia.
[email protected] Source: Beilin, L J Blood-Press-Monit. 2002 February; 7(1): 45-50 1359-5237
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Role of blood pressure monitoring in non-pharmacological management of hypertension. Author(s): Division of Hypertension and Nephrology, National Cardiovascular Centre, Suita, Osaka, Japan. Source: Kawano, Y Blood-Press-Monit. 2002 February; 7(1): 51-4 1359-5237
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Salt shakedown. DASH diet beats salt restriction at lowering blood pressure. Source: Blackburn, G L Health-News. 2002 December; 8(12): 5 1081-5880
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Secular changes in blood pressure in childhood, adolescence and young adulthood: systematic review of trends from 1948 to 1998. Author(s): N Ireland Cancer Registry, The Queen's University Belfast, UK.
[email protected] Source: McCarron, P Smith, G D Okasha, M J-Hum-Hypertens. 2002 October; 16(10): 677-89 0950-9240
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The insulin-mediated vascular and blood pressure responses are suppressed in CGRP-deficient normal and diabetic rats. Author(s): Department of Physiology, Wayne State University School of Medicine, 540 E Canfield, Detroit, MI 48201-1928, USA. Source: Salem, N Dunbar, J C Diabetes-Metab-Res-Revolume 2002 May-June; 18(3): 23844 1520-7552
Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
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Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMD®Health: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
The following is a specific Web list relating to blood pressure; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
Vitamins Ascorbic Acid Source: Integrative Medicine Communications; www.drkoop.com Niacin Alternative names: Vitamin B3 (Niacin) Source: Integrative Medicine Communications; www.drkoop.com Niacin Source: WholeHealthMD.com, LLC. www.wholehealthmd.com
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Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,892,00.html Pyridoxine Alternative names: Vitamin B6 (Pyridoxine) Source: Integrative Medicine Communications; www.drkoop.com Vitamin B3 (Niacin) Alternative names: Niacin Source: Integrative Medicine Communications; www.drkoop.com Vitamin B6 Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin B6 (Pyridoxine) Alternative names: Pyridoxine Source: Integrative Medicine Communications; www.drkoop.com Vitamin C Source: Healthnotes, Inc. www.healthnotes.com Vitamin C Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin C (Ascorbic Acid) Source: Integrative Medicine Communications; www.drkoop.com Vitamin D Alternative names: Calciferol, Calcitrol, Cholecalciferol, Erocalciferol Source: Integrative Medicine Communications; www.drkoop.com Vitamin D Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,905,00.html Vitamin E Alternative names: Alpha-Tocopherol, Beta-Tocopherol, D-Alpha-Tocopherol, Delta-Tocopherol, Gamma-Tocopherol Source: Integrative Medicine Communications; www.drkoop.com Vitamin E Source: Prima Communications, Inc.www.personalhealthzone.com •
Minerals ACE Inhibitors (Angiotensin-Converting Enzyme Inhibitors) Source: Prima Communications, Inc.www.personalhealthzone.com Alpha-Tocopherol Source: Integrative Medicine Communications; www.drkoop.com
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Aluminum, Calcium, and Magnesium-Containing Preparations Source: Integrative Medicine Communications; www.drkoop.com Angiotensin-Converting Enzyme (ACE) Inhibitors Source: Healthnotes, Inc. www.healthnotes.com Beta-Tocopherol Source: Integrative Medicine Communications; www.drkoop.com Calcium Source: Healthnotes, Inc. www.healthnotes.com Calcium Source: Integrative Medicine Communications; www.drkoop.com Calcium Source: Prima Communications, Inc.www.personalhealthzone.com Calcium Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,884,00.html Calcium Channel–Blockers Source: Prima Communications, Inc.www.personalhealthzone.com Calcium/magnesium Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,937,00.html Calcium-Channel Blockers Source: Healthnotes, Inc. www.healthnotes.com Carnitine Source: Prima Communications, Inc.www.personalhealthzone.com Carnitine (L-Carnitine) Source: Integrative Medicine Communications; www.drkoop.com Chromium Source: Prima Communications, Inc.www.personalhealthzone.com Copper Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,886,00.html D-Alpha-Tocopherol Source: Integrative Medicine Communications; www.drkoop.com
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Delta-Tocopherol Source: Integrative Medicine Communications; www.drkoop.com Gamma-Tocopherol Source: Integrative Medicine Communications; www.drkoop.com HMG-CoA Reductase Inhibitors (Statins) Source: Integrative Medicine Communications; www.drkoop.com Iron Alternative names: Ferrous Sulfate Source: Integrative Medicine Communications; www.drkoop.com L-Carnitine Source: Healthnotes, Inc. www.healthnotes.com L-Carnitine Source: Integrative Medicine Communications; www.drkoop.com Magnesium Source: Healthnotes, Inc. www.healthnotes.com Magnesium Source: Integrative Medicine Communications; www.drkoop.com Magnesium Source: Integrative Medicine Communications; www.drkoop.com Magnesium Source: Prima Communications, Inc.www.personalhealthzone.com Magnesium Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,890,00.html Manganese Source: Integrative Medicine Communications; www.drkoop.com Potassium Source: Healthnotes, Inc. www.healthnotes.com Potassium Source: Integrative Medicine Communications; www.drkoop.com Potassium Source: Prima Communications, Inc.www.personalhealthzone.com Potassium Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10086,00.html
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Potassium Chloride Source: Healthnotes, Inc. www.healthnotes.com Spironolactone Source: Healthnotes, Inc. www.healthnotes.com Sulfur Source: Integrative Medicine Communications; www.drkoop.com Vinpocetine Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10065,00.html Zinc Source: Integrative Medicine Communications; www.drkoop.com •
Food and Diet Artichoke Source: Healthnotes, Inc. www.healthnotes.com Atkins Diet Source: Healthnotes, Inc. www.healthnotes.com Avocado Source: Healthnotes, Inc. www.healthnotes.com Beets Source: Healthnotes, Inc. www.healthnotes.com Chocolate Source: Healthnotes, Inc. www.healthnotes.com Coffee Source: Healthnotes, Inc. www.healthnotes.com Ferrous Sulfate Alternative names: Iron Source: Integrative Medicine Communications; www.drkoop.com Garlic Alternative names: Allium sativum Source: Healthnotes, Inc. www.healthnotes.com Garlic Source: Prima Communications, Inc.www.personalhealthzone.com Garlic Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca
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Garlic Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,21,00.html Garlic Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,786,00.html Grapefruit, pink Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,155,00.html Grapefruit, white Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,52,00.html High-Fiber Diet Source: Healthnotes, Inc. www.healthnotes.com Jerusalem Artichoke Source: Healthnotes, Inc. www.healthnotes.com Kohlrabi Source: Healthnotes, Inc. www.healthnotes.com Low-Fat Diet Source: Healthnotes, Inc. www.healthnotes.com Low-Salt Diet Source: Healthnotes, Inc. www.healthnotes.com Natural Sweeteners Source: Healthnotes, Inc. www.healthnotes.com Nutritional Yeast Alternative names: Brewer's Yeast Source: Integrative Medicine Communications; www.drkoop.com Omega-3 Fatty Acids Source: Integrative Medicine Communications; www.drkoop.com Omega-3 fatty acids Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,992,00.html
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Omega-6 Fatty Acids Source: Integrative Medicine Communications; www.drkoop.com Omega-6 fatty acids Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,1037,00.html Onions Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,27,00.html Parsnips Source: Healthnotes, Inc. www.healthnotes.com Porcini Mushrooms Source: Healthnotes, Inc. www.healthnotes.com Radishes Source: Healthnotes, Inc. www.healthnotes.com Rutabagas Source: Healthnotes, Inc. www.healthnotes.com Salmon Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,102,00.html Shiitake Mushrooms Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,308,00.html Tea Source: Healthnotes, Inc. www.healthnotes.com The Dean Ornish Diet Source: Healthnotes, Inc. www.healthnotes.com Tyramine-Free Diet Source: Healthnotes, Inc. www.healthnotes.com Vegetarian Diet Source: Healthnotes, Inc. www.healthnotes.com Winter Squash Source: Healthnotes, Inc. www.healthnotes.com Yams Source: Healthnotes, Inc. www.healthnotes.com
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CHAPTER 3. ALTERNATIVE MEDICINE AND BLOOD PRESSURE Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to blood pressure. At the conclusion of this chapter, we will provide additional sources.
The Combined Health Information Database The Combined Health Information Database (CHID) is a bibliographic database produced by health-related agencies of the U.S. federal government (mostly from the National Institutes of Health) that can offer concise information for a targeted search. The CHID database is updated four times a year at the end of January, April, July, and October. Check the titles, summaries, and availability of CAM-related information by using the “Simple Search” option at the following Web site: http://chid.nih.gov/simple/simple.html. In the drop box at the top, select “Complementary and Alternative Medicine.” Then type “blood pressure” (or synonyms) in the second search box. We recommend that you select 100 “documents per page” and to check the “whole records” options. The following was extracted using this technique: •
Garlic: Effects on Cardiovascular Risks and Disease, Protective Effects Against Cancer, and Clinical Adverse Effects Source: Gaithersburg, MD: National Center for Complementary and Alternative Medicine Clearinghouse. 2000. 7 p. Contact: Available from National Center for Complementary and Alternative Medicine Clearinghouse. P.O. Box 7923, Gaithersburg, MD 20898. (888) 644-6226; INTERNATIONAL PHONE: (301) 519-3153; TTY: (866) 464-3615; FAX: (866) 464-3616; EMAIL:
[email protected]. PRICE: Free. Publication Number: D153. Summary: This fact sheet summarizes the evidence report on garlic developed by the Agency for Healthcare Research and Quality. It contains a systematic review of clinical studies of garlic in humans. Three major areas are addressed: (1) Effects on cardiovascular-related disease and factors such as lipids, blood pressure, glucose,
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atherosclerosis, and thrombosis; (2) Any protective associations with cancer; and (3) Clinical adverse effects. The fact sheet includes sections on the search strategy, selection criteria, data collection and analysis, cardiovascular-related outcomes, associations with cancer, adverse effects, conclusions, limitations, and future research.
National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to blood pressure and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “blood pressure” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to blood pressure: •
A mysterious blood pressure increase in a drilling Naval reservist. Author(s): Wettach GE, Falvey SG. Source: Military Medicine. 2002 June; 167(6): 521-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12099092&dopt=Abstract
•
A review of nursing research on blood pressure. Author(s): Thomas SA, Liehr P, DeKeyser F, Frazier L, Friedmann E. Source: Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing / Sigma Theta Tau. 2002; 34(4): 313-21. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12501734&dopt=Abstract
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Ascorbic acid reduces blood pressure and arterial stiffness in type 2 diabetes. Author(s): Mullan BA, Young IS, Fee H, McCance DR. Source: Hypertension. 2002 December; 40(6): 804-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12468561&dopt=Abstract
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Autoregulation of blood pressure and thought: preliminary results of an application of brain imaging to psychosomatic medicine. Author(s): Jennings JR. Source: Psychosomatic Medicine. 2003 May-June; 65(3): 384-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12764211&dopt=Abstract
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Awareness, knowledge, and attitudes of older americans about high blood pressure: implications for health care policy, education, and research. Author(s): Egan BM, Lackland DT, Cutler NE. Source: Archives of Internal Medicine. 2003 March 24; 163(6): 681-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12639200&dopt=Abstract
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Biofeedback of R-wave-to-pulse interval normalizes blood pressure. Author(s): Rau H, Buhrer M, Weitkunat R. Source: Applied Psychophysiology and Biofeedback. 2003 March; 28(1): 37-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12737095&dopt=Abstract
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Blood pressure lowering effect of an olive leaf extract (Olea europaea) in L-NAME induced hypertension in rats. Author(s): Khayyal MT, el-Ghazaly MA, Abdallah DM, Nassar NN, Okpanyi SN, Kreuter MH. Source: Arzneimittel-Forschung. 2002; 52(11): 797-802. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12489249&dopt=Abstract
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Blood pressure profile in Nigerian children. Author(s): Hamidu LJ, Okoro EO, Ali MA. Source: East Afr Med J. 2000 April; 77(4): 180-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12858899&dopt=Abstract
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Blood pressure, hematologic and erythrocyte fragility changes in children suffering from sickle cell anemia following ascorbic acid supplementation. Author(s): Jaja SI, Ikotun AR, Gbenebitse S, Temiye EO. Source: Journal of Tropical Pediatrics. 2002 December; 48(6): 366-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12521281&dopt=Abstract
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Blood pressure-lowering effects of biofeedback treatment in hypertension: a metaanalysis of randomized controlled trials. Author(s): Nakao M, Yano E, Nomura S, Kuboki T. Source: Hypertens Res. 2003 January; 26(1): 37-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12661911&dopt=Abstract
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Camphor-Crataegus berry extract combination dose-dependently reduces tilt induced fall in blood pressure in orthostatic hypotension. Author(s): Belz GG, Butzer R, Gaus W, Loew D. Source: Phytomedicine : International Journal of Phytotherapy and Phytopharmacology. 2002 October; 9(7): 581-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12487321&dopt=Abstract
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Changes in blood pressure and heart rate by repetitive transcranial magnetic stimulation in rats. Author(s): Hong B, Kuwaki T, Ju K, Kumada M, Akai M, Ueno S. Source: Neuroscience Letters. 2002 August 23; 329(1): 57-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12161262&dopt=Abstract
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Circadian and orthostatic blood pressure is abnormal in the carotid sinus syndrome. Author(s): Mulcahy R, Jackson SH, Richardson DA, Lee DR, Kenny RA. Source: The American Journal of Geriatric Cardiology. 2003 September-October; 12(5): 288-92, 301. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12963853&dopt=Abstract
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Circadian heart rate and blood pressure variability considered for research and patient care. Author(s): Singh RB, Cornelissen G, Weydahl A, Schwartzkopff O, Katinas G, Otsuka K, Watanabe Y, Yano S, Mori H, Ichimaru Y, Mitsutake G, Pella D, Fanghong L, Zhao Z, Rao RS, Gvozdjakova A, Halberg F. Source: International Journal of Cardiology. 2003 January; 87(1): 9-28; Discussion 29-30. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12468050&dopt=Abstract
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Coenzyme Q10 improves blood pressure and glycaemic control: a controlled trial in subjects with type 2 diabetes. Author(s): Hodgson JM, Watts GF, Playford DA, Burke V, Croft KD. Source: European Journal of Clinical Nutrition. 2002 November; 56(11): 1137-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12428181&dopt=Abstract
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Comparative effect of positive and negative static magnetic fields on heart rate and blood pressure in healthy adults. Author(s): Hinman MR. Source: Clinical Rehabilitation. 2002 September; 16(6): 669-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12392343&dopt=Abstract
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Comparison of green tea extract and epigallocatechin gallate on blood pressure and contractile responses of vascular smooth muscle of rats. Author(s): Lim DY, Lee ES, Park HG, Kim BC, Hong SP, Lee EB. Source: Arch Pharm Res. 2003 March; 26(3): 214-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12723935&dopt=Abstract
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Compliance and blood pressure control in women with hypertension. Author(s): Bobb-Liverpool B, Duff EM, Bailey EY. Source: The West Indian Medical Journal. 2002 December; 51(4): 236-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12632640&dopt=Abstract
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Depressor effect on blood pressure and flow elicited by electroacupuncture in normal subjects. Author(s): Lin CF, Liao JM, Tsai SJ, Chiang PY, Ting H, Tang CY, Lou KL, Hsieh LC, Wang DW, Lin TB.
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Source: Autonomic Neuroscience : Basic & Clinical. 2003 August 29; 107(1): 60-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12927228&dopt=Abstract •
Dietary n-3 PUFAs affect the blood pressure rise and cardiac impairments in a hyperinsulinemia rat model in vivo. Author(s): Rousseau D, Helies-Toussaint C, Moreau D, Raederstorff D, Grynberg A. Source: American Journal of Physiology. Heart and Circulatory Physiology. 2003 September; 285(3): H1294-302. Epub 2003 January 09. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12521943&dopt=Abstract
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Dietary vitamin C supplementation decreases blood pressure in DOCA-salt hypertensive male Sprague-Dawley rats and this is associated with increased liver oxidative stress. Author(s): Elhaimeur F, Courderot-Masuyer C, Nicod L, Guyon C, Richert L, Berthelot A. Source: Molecular and Cellular Biochemistry. 2002 August; 237(1-2): 77-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12236589&dopt=Abstract
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Dietary vitamin E supplementation lowers blood pressure in spontaneously hypertensive rats. Author(s): Vasdev S, Gill V, Parai S, Longerich L, Gadag V. Source: Molecular and Cellular Biochemistry. 2002 September; 238(1-2): 111-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12349898&dopt=Abstract
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Different modes of manual acupuncture stimulation differentially modulate cerebral blood flow velocity, arterial blood pressure and heart rate in human subjects. Author(s): Backer M, Hammes MG, Valet M, Deppe M, Conrad B, Tolle TR, Dobos G. Source: Neuroscience Letters. 2002 November 29; 333(3): 203-6. Erratum In: Neurosci Lett. 2003 February 6; 337(2): 117. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12429383&dopt=Abstract
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Early morning surge in blood pressure. Author(s): Shimada K, Kario K, Umeda Y, Hoshide S, Hoshide Y, Eguchi K. Source: Blood Pressure Monitoring. 2001 December; 6(6): 349-53. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12055414&dopt=Abstract
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Effect of a methionine-supplemented diet on the blood pressure of Wistar-Kyoto and spontaneously hypertensive rats. Author(s): Robin S, Maupoil V, Groubatch F, Laurant P, Jacqueson A, Berthelot A. Source: The British Journal of Nutrition. 2003 April; 89(4): 539-48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12654173&dopt=Abstract
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Effect of calcium supplementation on blood pressure in patients with secondary hyperparathyroidism. Author(s): Saleh F, Jorde R, Sundsfjord J. Source: J Endocrinol Invest. 2003 January; 26(1): 35-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12602532&dopt=Abstract
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Effect of diet and exercise intervention on blood pressure, insulin, oxidative stress, and nitric oxide availability. Author(s): Roberts CK, Vaziri ND, Barnard RJ. Source: Circulation. 2002 November 12; 106(20): 2530-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12427646&dopt=Abstract
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Effect of the crude extract of Vernonia polyanthes Less. on blood pressure and renal sodium excretion in unanesthetized rats. Author(s): Romanezi da Silveira R, Foglio MA, Gontijo JA. Source: Phytomedicine : International Journal of Phytotherapy and Phytopharmacology. 2003 March; 10(2-3): 127-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12725565&dopt=Abstract
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Effects of Crocus sativus petals' extract on rat blood pressure and on responses induced by electrical field stimulation in the rat isolated vas deferens and guinea-pig ileum. Author(s): Fatehi M, Rashidabady T, Fatehi-Hassanabad Z. Source: Journal of Ethnopharmacology. 2003 February; 84(2-3): 199-203. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12648816&dopt=Abstract
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Effects of Cudrania tricuspidata water extract on blood pressure and renal functions in NO-dependent hypertension. Author(s): Kang DG, Hur TY, Lee GM, Oh H, Kwon TO, Sohn EJ, Lee HS. Source: Life Sciences. 2002 April 19; 70(22): 2599-609. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12269387&dopt=Abstract
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Effects of daily activities on ambulatory blood pressure during menstrual cycle in normotensive women. Author(s): Tsai PS, Yucha CB, Sheffield D, Yang M. Source: Applied Psychophysiology and Biofeedback. 2003 March; 28(1): 25-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12737094&dopt=Abstract
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Effects of dietary supplementation with isoflavones from red clover on ambulatory blood pressure and endothelial function in postmenopausal type 2 diabetes. Author(s): Howes JB, Tran D, Brillante D, Howes LG.
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Source: Diabetes, Obesity & Metabolism. 2003 September; 5(5): 325-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12940870&dopt=Abstract •
Effects of Ginkgo biloba extract (EGb 761) on cerebral thrombosis and blood pressure in stroke-prone spontaneously hypertensive rats. Author(s): Sasaki Y, Noguchi T, Yamamoto E, Giddings JC, Ikeda K, Yamori Y, Yamamoto J. Source: Clinical and Experimental Pharmacology & Physiology. 2002 November; 29(11): 963-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12366386&dopt=Abstract
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Effects of Helichrysum ceres extracts on renal function and blood pressure in the rat. Author(s): Musabayane CT, Munjeri O, Mdege ND. Source: Renal Failure. 2003 January; 25(1): 5-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12617328&dopt=Abstract
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Effects of high- and low-isoflavone soyfoods on blood lipids, oxidized LDL, homocysteine, and blood pressure in hyperlipidemic men and women. Author(s): Jenkins DJ, Kendall CW, Jackson CJ, Connelly PW, Parker T, Faulkner D, Vidgen E, Cunnane SC, Leiter LA, Josse RG. Source: The American Journal of Clinical Nutrition. 2002 August; 76(2): 365-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12145008&dopt=Abstract
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Effects of progressive muscle relaxation on blood pressure and psychosocial status for clients with essential hypertension in Taiwan. Author(s): Sheu S, Irvin BL, Lin HS, Mar CL. Source: Holistic Nursing Practice. 2003 January-February; 17(1): 41-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12597674&dopt=Abstract
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Effects of purified eicosapentaenoic and docosahexaenoic acids on glycemic control, blood pressure, and serum lipids in type 2 diabetic patients with treated hypertension. Author(s): Woodman RJ, Mori TA, Burke V, Puddey IB, Watts GF, Beilin LJ. Source: The American Journal of Clinical Nutrition. 2002 November; 76(5): 1007-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12399272&dopt=Abstract
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Effects of Qigong on blood pressure, blood pressure determinants and ventilatory function in middle-aged patients with essential hypertension. Author(s): Lee MS, Lee MS, Choi ES, Chung HT. Source: The American Journal of Chinese Medicine. 2003; 31(3): 489-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12943180&dopt=Abstract
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Effects of supine floating on heart rate, blood pressure and cardiac autonomic nervous system activity. Author(s): Nishimura M, Onodera S. Source: J Gravit Physiol. 2000 July; 7(2): P171-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12697518&dopt=Abstract
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Effects of unilateral nostril breathing on blood pressure and heart rate in righthanded healthy subjects. Author(s): Dane S, Caliskan E, Karasen M, Oztasan N. Source: The International Journal of Neuroscience. 2002 January; 112(1): 97-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12152408&dopt=Abstract
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Estrogen depletion increases blood pressure and hypothalamic norepinephrine in middle-aged spontaneously hypertensive rats. Author(s): Peng N, Clark JT, Wei CC, Wyss JM. Source: Hypertension. 2003 May; 41(5): 1164-7. Epub 2003 March 24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12654704&dopt=Abstract
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Exaggeration of blood pressure-related hypoalgesia and reduction of blood pressure with low frequency transcutaneous electrical nerve stimulation. Author(s): Campbell TS, Ditto B. Source: Psychophysiology. 2002 July; 39(4): 473-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12212639&dopt=Abstract
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Gestational calcium supplementation and blood pressure in the offspring. Author(s): Hatton DC, Harrison-Hohner J, Coste S, Reller M, McCarron D. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2003 October; 16(10): 801-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14553957&dopt=Abstract
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Hypertension and blood pressure among meat eaters, fish eaters, vegetarians and vegans in EPIC-Oxford. Author(s): Appleby PN, Davey GK, Key TJ. Source: Public Health Nutrition. 2002 October; 5(5): 645-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12372158&dopt=Abstract
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Impact of a workplace stress reduction program on blood pressure and emotional health in hypertensive employees. Author(s): McCraty R, Atkinson M, Tomasino D. Source: Journal of Alternative and Complementary Medicine (New York, N.Y.). 2003 June; 9(3): 355-69. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12816624&dopt=Abstract
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Increased systolic blood pressure in rats induced by a maternal low-protein diet is reversed by dietary supplementation with glycine. Author(s): Jackson AA, Dunn RL, Marchand MC, Langley-Evans SC. Source: Clinical Science (London, England : 1979). 2002 December; 103(6): 633-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12444916&dopt=Abstract
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Increases in hypertension and blood pressure during pregnancy with increased bone lead levels. Author(s): Rothenberg SJ, Kondrashov V, Manalo M, Jiang J, Cuellar R, Garcia M, Reynoso B, Reyes S, Diaz M, Todd AC. Source: American Journal of Epidemiology. 2002 December 15; 156(12): 1079-87. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12480651&dopt=Abstract
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Initial cost of care results in medically supervised water-only fasting for treating high blood pressure and diabetes. Author(s): Goldhamer AC. Source: Journal of Alternative and Complementary Medicine (New York, N.Y.). 2002 December; 8(6): 696-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12614522&dopt=Abstract
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Lack of long-term effect of vitamin C supplementation on blood pressure. Author(s): Kim MK, Sasaki S, Sasazuki S, Okubo S, Hayashi M, Tsugane S. Source: Hypertension. 2002 December; 40(6): 797-803. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12468560&dopt=Abstract
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Lifestyle modification as a means to prevent and treat high blood pressure. Author(s): Appel LJ. Source: Journal of the American Society of Nephrology : Jasn. 2003 July; 14(7 Suppl 2): S99-S102. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12819311&dopt=Abstract
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Long chain polyunsaturated fatty acid supplementation in infant formula and blood pressure in later childhood: follow up of a randomised controlled trial. Author(s): Forsyth JS, Willatts P, Agostoni C, Bissenden J, Casaer P, Boehm G. Source: Bmj (Clinical Research Ed.). 2003 May 3; 326(7396): 953. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12727766&dopt=Abstract
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Pharmacological studies on Myristica fragrans--antidiarrheal, hypnotic, analgesic and hemodynamic (blood pressure) parameters. Author(s): Grover JK, Khandkar S, Vats V, Dhunnoo Y, Das D. Source: Methods Find Exp Clin Pharmacol. 2002 December; 24(10): 675-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12616960&dopt=Abstract
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Pressor effect on blood pressure and renal nerve activity elicited by electroacupuncture in intact and acute hemorrhage rats. Author(s): Ting H, Liao JM, Lin CF, Chiang PY, Chang CC, Kuo DY, Lin TB. Source: Neuroscience Letters. 2002 July 12; 327(1): 5-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12098487&dopt=Abstract
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Reduction of rise in blood pressure and cortisol release during stress by Ginkgo biloba extract (EGb 761) in healthy volunteers. Author(s): Jezova D, Duncko R, Lassanova M, Kriska M, Moncek F. Source: Journal of Physiology and Pharmacology : an Official Journal of the Polish Physiological Society. 2002 September; 53(3): 337-48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12369732&dopt=Abstract
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Relationship of blood pressure with degree of Hawaiian ancestry. Author(s): Grandinetti A, Chen R, Kaholokula JK, Yano K, Rodriguez BL, Chang HK, Curb JD. Source: Ethn Dis. 2002 Spring; 12(2): 221-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12019931&dopt=Abstract
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Relationship of urinary sodium/potassium excretion and calcium intake to blood pressure and prevalence of hypertension among older Chinese vegetarians. Author(s): Kwok TC, Chan TY, Woo J. Source: European Journal of Clinical Nutrition. 2003 February; 57(2): 299-304. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12571663&dopt=Abstract
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Religiosity and its relation to blood pressure among selected Kuwaitis. Author(s): Al-Kandari YY. Source: Journal of Biosocial Science. 2003 July; 35(3): 463-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12887224&dopt=Abstract
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Role of blood pressure monitoring in non-pharmacological management of hypertension. Author(s): Kawano Y. Source: Blood Pressure Monitoring. 2002 February; 7(1): 51-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12040244&dopt=Abstract
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Soy milk lowers blood pressure in men and women with mild to moderate essential hypertension. Author(s): Rivas M, Garay RP, Escanero JF, Cia P Jr, Cia P, Alda JO. Source: The Journal of Nutrition. 2002 July; 132(7): 1900-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12097666&dopt=Abstract
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The antiproteinuric effect of losartan is systemic blood pressure dependent. Author(s): Crowe AV, Howse M, Vinjamuri S, Kemp GJ, Williams PS. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2003 October; 18(10): 2160-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13679496&dopt=Abstract
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The effect of low-dose potassium supplementation on blood pressure in apparently healthy volunteers. Author(s): Naismith DJ, Braschi A. Source: The British Journal of Nutrition. 2003 July; 90(1): 53-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12844375&dopt=Abstract
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The effect of magnesium supplementation on blood pressure: a meta-analysis of randomized clinical trials. Author(s): Jee SH, Miller ER 3rd, Guallar E, Singh VK, Appel LJ, Klag MJ. Source: American Journal of Hypertension : Journal of the American Society of Hypertension. 2002 August; 15(8): 691-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12160191&dopt=Abstract
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The effect of self-selected music during colonoscopy on anxiety, heart rate, and blood pressure. Author(s): Smolen D, Topp R, Singer L. Source: Applied Nursing Research : Anr. 2002 August; 15(3): 126-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12173164&dopt=Abstract
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The effects of acupuncture on blood pressure in different patients. Author(s): Guo W, Ni G. Source: J Tradit Chin Med. 2003 March; 23(1): 49-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12747201&dopt=Abstract
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The effects of protein intake on blood pressure and cardiovascular disease. Author(s): Appel LJ. Source: Current Opinion in Lipidology. 2003 February; 14(1): 55-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12544662&dopt=Abstract
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Wild garlic has a greater effect than regular garlic on blood pressure and blood chemistries of rats. Author(s): Preuss HG, Clouatre D, Mohamadi A, Jarrell ST. Source: International Urology and Nephrology. 2001; 32(4): 525-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11989540&dopt=Abstract
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Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
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Chinese Medicine: http://www.newcenturynutrition.com/
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drkoop.com®: http://www.drkoop.com/InteractiveMedicine/IndexC.html
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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
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Google: http://directory.google.com/Top/Health/Alternative/
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Healthnotes: http://www.healthnotes.com/
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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
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Open Directory Project: http://dmoz.org/Health/Alternative/
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HealthGate: http://www.tnp.com/
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WebMD®Health: http://my.webmd.com/drugs_and_herbs
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
The following is a specific Web list relating to blood pressure; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
General Overview Abdominal Wall Inflammation Source: Integrative Medicine Communications; www.drkoop.com Age-Related Cognitive Decline Source: Healthnotes, Inc. www.healthnotes.com Allergies Alternative names: Hay Fever Source: Prima Communications, Inc.www.personalhealthzone.com Allergy, Food Source: Integrative Medicine Communications; www.drkoop.com Alzheimer's Disease Source: Integrative Medicine Communications; www.drkoop.com
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Alzheimer's Disease, Non-Alzheimer's Dementia, and Normal Age-Related Memory Loss Source: Prima Communications, Inc.www.personalhealthzone.com Amenorrhea Source: Integrative Medicine Communications; www.drkoop.com Amyloidosis Source: Integrative Medicine Communications; www.drkoop.com Anaphylaxis Source: Integrative Medicine Communications; www.drkoop.com Angina Source: Healthnotes, Inc. www.healthnotes.com Angina Source: Integrative Medicine Communications; www.drkoop.com Angioedema Source: Integrative Medicine Communications; www.drkoop.com Anorexia Nervosa Source: Integrative Medicine Communications; www.drkoop.com Arteriosclerosis Source: Integrative Medicine Communications; www.drkoop.com Asthma Source: Integrative Medicine Communications; www.drkoop.com Asthma Source: Prima Communications, Inc.www.personalhealthzone.com Atherosclerosis Source: Healthnotes, Inc. www.healthnotes.com Atherosclerosis Source: Integrative Medicine Communications; www.drkoop.com Atherosclerosis and Heart Disease Prevention Source: Prima Communications, Inc.www.personalhealthzone.com Athletic Performance Source: Healthnotes, Inc. www.healthnotes.com Benign Prostatic Hyperplasia Alternative names: Prostate Enlargement Source: Prima Communications, Inc.www.personalhealthzone.com Bone Marrow Disorders Source: Integrative Medicine Communications; www.drkoop.com
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Bronchitis Source: Integrative Medicine Communications; www.drkoop.com Candidiasis Source: Integrative Medicine Communications; www.drkoop.com Canker Sores Source: Healthnotes, Inc. www.healthnotes.com Cardiac Arrhythmia Source: Healthnotes, Inc. www.healthnotes.com Cardiomyopathy Source: Healthnotes, Inc. www.healthnotes.com Cardiovascular Disease Overview Source: Healthnotes, Inc. www.healthnotes.com Chickenpox and Shingles Source: Integrative Medicine Communications; www.drkoop.com Chronic Fatigue Syndrome Source: Healthnotes, Inc. www.healthnotes.com Chronic Fatigue Syndrome Source: Integrative Medicine Communications; www.drkoop.com Chronic Myelogenous Leukemia Source: Integrative Medicine Communications; www.drkoop.com Cold Sores Source: Integrative Medicine Communications; www.drkoop.com Colds and Flus Source: Prima Communications, Inc.www.personalhealthzone.com Common Cold Source: Integrative Medicine Communications; www.drkoop.com Congestive Heart Failure Source: Healthnotes, Inc. www.healthnotes.com Congestive Heart Failure Source: Integrative Medicine Communications; www.drkoop.com Constipation Source: Integrative Medicine Communications; www.drkoop.com Coronary Artery Disease Source: Integrative Medicine Communications; www.drkoop.com
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Cough Source: Integrative Medicine Communications; www.drkoop.com Dementia Source: Integrative Medicine Communications; www.drkoop.com Depression Source: Integrative Medicine Communications; www.drkoop.com Depression (Mild to Moderate) Source: Prima Communications, Inc.www.personalhealthzone.com Diabetes Source: Healthnotes, Inc. www.healthnotes.com Diabetes Source: Prima Communications, Inc.www.personalhealthzone.com Diabetes Mellitus Source: Integrative Medicine Communications; www.drkoop.com Diarrhea Source: Integrative Medicine Communications; www.drkoop.com Dysphagia Source: Integrative Medicine Communications; www.drkoop.com Edema Source: Integrative Medicine Communications; www.drkoop.com Epilepsy Source: Integrative Medicine Communications; www.drkoop.com Erythema Source: Integrative Medicine Communications; www.drkoop.com Fainting Source: Integrative Medicine Communications; www.drkoop.com Food Allergy Source: Integrative Medicine Communications; www.drkoop.com Food Poisoning Source: Integrative Medicine Communications; www.drkoop.com Gastritis Source: Healthnotes, Inc. www.healthnotes.com Gastritis Source: Integrative Medicine Communications; www.drkoop.com
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Gastroesophageal Reflux Disease Source: Integrative Medicine Communications; www.drkoop.com Gestational Hypertension Source: Healthnotes, Inc. www.healthnotes.com Glaucoma Source: Integrative Medicine Communications; www.drkoop.com Gout Source: Healthnotes, Inc. www.healthnotes.com Gout Source: Integrative Medicine Communications; www.drkoop.com Heart Attack Source: Healthnotes, Inc. www.healthnotes.com Heart Attack Source: Integrative Medicine Communications; www.drkoop.com Heartburn Source: Integrative Medicine Communications; www.drkoop.com Heat Exhaustion Source: Integrative Medicine Communications; www.drkoop.com Hepatitis Source: Healthnotes, Inc. www.healthnotes.com Hepatitis, Viral Source: Integrative Medicine Communications; www.drkoop.com Herpes Simplex Virus Source: Integrative Medicine Communications; www.drkoop.com Herpes Zoster and Varicella Viruses Source: Integrative Medicine Communications; www.drkoop.com High Blood Pressure Source: Integrative Medicine Communications; www.drkoop.com High Cholesterol Source: Healthnotes, Inc. www.healthnotes.com High Cholesterol Source: Integrative Medicine Communications; www.drkoop.com High Cholesterol Source: Prima Communications, Inc.www.personalhealthzone.com
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Hirsuitism Source: Integrative Medicine Communications; www.drkoop.com HIV and AIDS Support Source: Healthnotes, Inc. www.healthnotes.com Hypercholesterolemia Source: Integrative Medicine Communications; www.drkoop.com Hyperkalemia Source: Integrative Medicine Communications; www.drkoop.com Hyperparathyroidism Source: Integrative Medicine Communications; www.drkoop.com Hypertension Source: Healthnotes, Inc. www.healthnotes.com Hypertension Source: Integrative Medicine Communications; www.drkoop.com Hypertension Alternative names: High Blood Pressure Source: Prima Communications, Inc.www.personalhealthzone.com Hyperthyroidism Source: Integrative Medicine Communications; www.drkoop.com Hypoglycemia Source: Integrative Medicine Communications; www.drkoop.com Hypothermia Source: Integrative Medicine Communications; www.drkoop.com Hypothyroidism Source: Integrative Medicine Communications; www.drkoop.com Impotence Source: Prima Communications, Inc.www.personalhealthzone.com Indigestion, Heartburn, and Low Stomach Acidity Source: Healthnotes, Inc. www.healthnotes.com Insect Bites and Stings Source: Integrative Medicine Communications; www.drkoop.com Insulin Resistance Syndrome Source: Healthnotes, Inc. www.healthnotes.com Liver Cirrhosis Source: Healthnotes, Inc. www.healthnotes.com
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Low Back Pain Source: Healthnotes, Inc. www.healthnotes.com Low Blood Sugar Source: Integrative Medicine Communications; www.drkoop.com Macular Degeneration Source: Healthnotes, Inc. www.healthnotes.com Macular Degeneration Source: Integrative Medicine Communications; www.drkoop.com Macular Degeneration Source: Prima Communications, Inc.www.personalhealthzone.com Menkes' Disease Source: Healthnotes, Inc. www.healthnotes.com Menopausal Symptoms (Other Than Osteoporosis) Source: Prima Communications, Inc.www.personalhealthzone.com Menopause Source: Healthnotes, Inc. www.healthnotes.com Menopause Source: Integrative Medicine Communications; www.drkoop.com Menstruation, Absence of Source: Integrative Medicine Communications; www.drkoop.com Migraine Headache Source: Integrative Medicine Communications; www.drkoop.com Mitral Valve Prolapse Source: Healthnotes, Inc. www.healthnotes.com Myelofibrosis Source: Integrative Medicine Communications; www.drkoop.com Myeloproliferative Disorders Source: Integrative Medicine Communications; www.drkoop.com Myocardial Infarction Source: Integrative Medicine Communications; www.drkoop.com Obesity Source: Integrative Medicine Communications; www.drkoop.com Pancreas, Inflammation of Source: Integrative Medicine Communications; www.drkoop.com
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Pancreatitis Source: Integrative Medicine Communications; www.drkoop.com Parathyroid, Overactive Source: Integrative Medicine Communications; www.drkoop.com Parkinson's Disease Source: Integrative Medicine Communications; www.drkoop.com Peptic Ulcer Source: Healthnotes, Inc. www.healthnotes.com Peptic Ulcer Source: Integrative Medicine Communications; www.drkoop.com Pericarditis Source: Integrative Medicine Communications; www.drkoop.com Peritonitis Source: Integrative Medicine Communications; www.drkoop.com Pharyngitis Source: Integrative Medicine Communications; www.drkoop.com Polycythemia Vera Source: Integrative Medicine Communications; www.drkoop.com Preeclampsia Source: Healthnotes, Inc. www.healthnotes.com Preeclampsia Source: Integrative Medicine Communications; www.drkoop.com Pregnancy and Postpartum Support Source: Healthnotes, Inc. www.healthnotes.com Pulmonary Edema Source: Integrative Medicine Communications; www.drkoop.com Pulmonary Hypertension Source: Integrative Medicine Communications; www.drkoop.com Reiter's Syndrome Source: Integrative Medicine Communications; www.drkoop.com Respiratory Infection, Bronchitis Source: Integrative Medicine Communications; www.drkoop.com Respiratory Infection, Cold Source: Integrative Medicine Communications; www.drkoop.com
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Retinopathy Source: Healthnotes, Inc. www.healthnotes.com Sarcoidosis Source: Integrative Medicine Communications; www.drkoop.com Scleroderma Source: Integrative Medicine Communications; www.drkoop.com Seizure Disorders Source: Integrative Medicine Communications; www.drkoop.com Senile Dementia Source: Integrative Medicine Communications; www.drkoop.com Serum Sickness Source: Integrative Medicine Communications; www.drkoop.com Shingles and Chickenpox Source: Integrative Medicine Communications; www.drkoop.com Shock Source: Integrative Medicine Communications; www.drkoop.com Sinus Infection Source: Integrative Medicine Communications; www.drkoop.com Sinusitis Source: Integrative Medicine Communications; www.drkoop.com Sleep Apnea Source: Integrative Medicine Communications; www.drkoop.com Sore Throat Source: Integrative Medicine Communications; www.drkoop.com Stomach Inflammation Source: Integrative Medicine Communications; www.drkoop.com Stroke Source: Healthnotes, Inc. www.healthnotes.com Syncope Source: Integrative Medicine Communications; www.drkoop.com Tendinitis Source: Integrative Medicine Communications; www.drkoop.com Thrombocytosis Source: Integrative Medicine Communications; www.drkoop.com
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Transient Ischemic Attacks Source: Integrative Medicine Communications; www.drkoop.com Varicella and Herpes Zoster Viruses Source: Integrative Medicine Communications; www.drkoop.com Viral Hepatitis Source: Prima Communications, Inc.www.personalhealthzone.com Warts Source: Integrative Medicine Communications; www.drkoop.com Water Retention Source: Integrative Medicine Communications; www.drkoop.com Yeast Infection Source: Integrative Medicine Communications; www.drkoop.com •
Alternative Therapy Acupuncture Source: Healthnotes, Inc. www.healthnotes.com Aromatherapy Source: Integrative Medicine Communications; www.drkoop.com Art therapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,671,00.html Ayurveda Source: Integrative Medicine Communications; www.drkoop.com Ayurveda Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,672,00.html Biofeedback Source: Healthnotes, Inc. www.healthnotes.com Biofeedback Source: Integrative Medicine Communications; www.drkoop.com Biofeedback Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,675,00.html Chelation therapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com
244 Blood Pressure
Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,679,00.html Chiropractic Source: Healthnotes, Inc. www.healthnotes.com Chiropractic Source: Integrative Medicine Communications; www.drkoop.com Colon therapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,682,00.html Color therapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,683,00.html Detoxification therapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10119,00.html Feldenkrais Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,695,00.html Guided Imagery Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,699,00.html Hemi-Sync Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/h.html Homeopathy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,703,00.html Hydrotherapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,705,00.html Hypnotherapy Source: Integrative Medicine Communications; www.drkoop.com
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Hypnotherapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,706,00.html Iridology Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,709,00.html Light Therapy Source: Healthnotes, Inc. www.healthnotes.com Macrobiotics Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,714,00.html Meditation Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,717,00.html Music therapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,719,00.html Naturopathy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,722,00.html Osteopathy Source: Integrative Medicine Communications; www.drkoop.com Prayer Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,728,00.html Qigong Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,729,00.html Relaxation Techniques Source: Integrative Medicine Communications; www.drkoop.com Spirituality Source: Integrative Medicine Communications; www.drkoop.com
246 Blood Pressure
Tai Chi Source: Integrative Medicine Communications; www.drkoop.com Tai Chi Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,737,00.html Traditional Chinese Medicine Source: Integrative Medicine Communications; www.drkoop.com Writing therapy Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,745,00.html Yoga Source: Integrative Medicine Communications; www.drkoop.com Yoga Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,746,00.html •
Chinese Medicine Gengnian'an Pian Alternative names: Gengnian'an Tablets Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Gengnian%27an%20Pian&mh =10&sb=---&view_records=View+Records Qingnao Jiangya Pian Alternative names: Qingnao Jiangya Tablets Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Hyperlink: http://www.newcenturynutrition.com/cgilocal/patent_herbs_db/db.cgi?db=default&Chinese=Qingnao%20Jiangya%20Pian& mh=10&sb=---&view_records=View+Records
•
Homeopathy Argentum nitricum Source: Healthnotes, Inc. www.healthnotes.com Aurum metallicum Source: Healthnotes, Inc. www.healthnotes.com
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Belladonna Source: Healthnotes, Inc. www.healthnotes.com Calcarea carbonica Source: Healthnotes, Inc. www.healthnotes.com Glonoinum Source: Healthnotes, Inc. www.healthnotes.com Lachesis Source: Healthnotes, Inc. www.healthnotes.com Natrum muriaticum Source: Healthnotes, Inc. www.healthnotes.com Nux vomica Source: Healthnotes, Inc. www.healthnotes.com Phosphorus Source: Healthnotes, Inc. www.healthnotes.com Plumbum Source: Healthnotes, Inc. www.healthnotes.com Sanguinaria Source: Healthnotes, Inc. www.healthnotes.com •
Herbs and Supplements 5-HTP Source: Integrative Medicine Communications; www.drkoop.com 5-Hydroxytryptophan (5-HTP) Source: Integrative Medicine Communications; www.drkoop.com Acanthopanax senticosus Source: Integrative Medicine Communications; www.drkoop.com Acebutolol Source: Healthnotes, Inc. www.healthnotes.com Achillea millefolium Source: Integrative Medicine Communications; www.drkoop.com ALA Source: Integrative Medicine Communications; www.drkoop.com Alpha2-Adrenergic Agonists Source: Integrative Medicine Communications; www.drkoop.com Alpha-Linolenic Acid (ALA) Source: Integrative Medicine Communications; www.drkoop.com
248 Blood Pressure
American Ginseng Alternative names: Panax quinquefolium Source: Integrative Medicine Communications; www.drkoop.com Amiloride Source: Healthnotes, Inc. www.healthnotes.com Amino acids Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10003,00.html Amino Acids Overview Source: Healthnotes, Inc. www.healthnotes.com Aminoglycosides Source: Integrative Medicine Communications; www.drkoop.com Amlodipine Source: Healthnotes, Inc. www.healthnotes.com Angelica sinensis Source: Integrative Medicine Communications; www.drkoop.com Angiotensin II Receptor Blockers Source: Healthnotes, Inc. www.healthnotes.com Antioxidants Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10004,00.html Apium graveolens Source: Integrative Medicine Communications; www.drkoop.com Arctostaphylos uva ursi Source: Integrative Medicine Communications; www.drkoop.com Arginine Source: Healthnotes, Inc. www.healthnotes.com Arginine Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10005,00.html Arnica Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,753,00.html
Alternative Medicine 249
Asian Ginseng Source: Healthnotes, Inc. www.healthnotes.com Asian Ginseng Alternative names: Panax ginseng Source: Integrative Medicine Communications; www.drkoop.com Astragalus Alternative names: Astragalus membranaceus, Astragalus membranaceus var. mongholicus, Huang-qi, Milk-Vetch Root Source: Integrative Medicine Communications; www.drkoop.com Astragalus Source: Prima Communications, Inc.www.personalhealthzone.com Astragalus membranaceus Source: Integrative Medicine Communications; www.drkoop.com Astragalus mongholicus Alternative names: Astragalus membranaceus, Astragalus membranaceus var. mongholicus, Huang-qi, Milk-Vetch Root Source: Integrative Medicine Communications; www.drkoop.com Astragalus sp Alternative names: Vetch, Rattlepod, Locoweed; Astragalus sp. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Atenolol Source: Healthnotes, Inc. www.healthnotes.com Baking soda Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,835,00.html Barberry Alternative names: Berberis vulgaris, Berberry Source: Integrative Medicine Communications; www.drkoop.com Bearberry Source: Integrative Medicine Communications; www.drkoop.com Beargrape Source: Integrative Medicine Communications; www.drkoop.com Benazepril Source: Healthnotes, Inc. www.healthnotes.com Berberis vulgaris Source: Integrative Medicine Communications; www.drkoop.com
250 Blood Pressure
Berberry Source: Integrative Medicine Communications; www.drkoop.com Beta-Adrenergic Blockers Source: Healthnotes, Inc. www.healthnotes.com Beta-Blockers Source: Integrative Medicine Communications; www.drkoop.com Beta-Blockers Source: Prima Communications, Inc.www.personalhealthzone.com Beta-Carotene Source: Prima Communications, Inc.www.personalhealthzone.com Betaxolol Source: Healthnotes, Inc. www.healthnotes.com Bisoprolol Source: Healthnotes, Inc. www.healthnotes.com Black Cohosh Source: Prima Communications, Inc.www.personalhealthzone.com Black Cohosh Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10009,00.html Black Haw Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Blue Cohosh Alternative names: Caulophyllum thalictroides Source: Healthnotes, Inc. www.healthnotes.com Blue-Green Algae Source: Healthnotes, Inc. www.healthnotes.com Borago Alternative names: Borage; Borago officinalis Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Brahmi Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com
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Brewer's Yeast Alternative names: Nutritional Yeast Source: Integrative Medicine Communications; www.drkoop.com Brewer's Yeast Alternative names: Nutritional Yeast Source: Integrative Medicine Communications; www.drkoop.com Bromelain Source: Healthnotes, Inc. www.healthnotes.com Butcher's broom Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10010,00.html Caffeine Source: Healthnotes, Inc. www.healthnotes.com Calciferol Alternative names: Vitamin D Source: Integrative Medicine Communications; www.drkoop.com Calcitrol Alternative names: Vitamin D Source: Integrative Medicine Communications; www.drkoop.com Candesartan Source: Healthnotes, Inc. www.healthnotes.com Capsaicin Alternative names: Cayenne Source: Integrative Medicine Communications; www.drkoop.com Capsicum frutescens Alternative names: Cayenne Source: Integrative Medicine Communications; www.drkoop.com Captopril Source: Healthnotes, Inc. www.healthnotes.com Cardiac Glycosides Source: Integrative Medicine Communications; www.drkoop.com Carnosine Source: Healthnotes, Inc. www.healthnotes.com Carvedilol Source: Healthnotes, Inc. www.healthnotes.com
252 Blood Pressure
Cayenne Alternative names: Capsicum frutescens, Capsicum spp., Capsaicin, Chili Pepper, Red Pepper Source: Integrative Medicine Communications; www.drkoop.com Celery Seed Alternative names: Apium graveolens Source: Integrative Medicine Communications; www.drkoop.com Centella Source: Integrative Medicine Communications; www.drkoop.com Centella asiatica Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com Chili Pepper Alternative names: Cayenne Source: Integrative Medicine Communications; www.drkoop.com Chinese Angelica Source: Integrative Medicine Communications; www.drkoop.com Chitosan Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10016,00.html Cholecalciferol Alternative names: Vitamin D Source: Integrative Medicine Communications; www.drkoop.com Clonidine Source: Healthnotes, Inc. www.healthnotes.com Coenzyme Q Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,768,00.html Coenzyme Q10 Source: Healthnotes, Inc. www.healthnotes.com Coenzyme Q10 Alternative names: CoQ10 Source: Integrative Medicine Communications; www.drkoop.com Coenzyme Q10 (CoQ10) Source: Prima Communications, Inc.www.personalhealthzone.com
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Coleus Alternative names: Coleus forskohlii Source: Healthnotes, Inc. www.healthnotes.com Coleus forskohlii Source: Prima Communications, Inc.www.personalhealthzone.com CoQ10 Alternative names: Coenzyme Q10 Source: Integrative Medicine Communications; www.drkoop.com Corydalis Alternative names: Corydalis turtschaninovii, Corydalis yanhusuo Source: Healthnotes, Inc. www.healthnotes.com Crataegus Alternative names: Hawthorn; Crataegus oxyacantha L. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Cyclosporine Source: Healthnotes, Inc. www.healthnotes.com Cysteine Source: Integrative Medicine Communications; www.drkoop.com Cysteine Source: Integrative Medicine Communications; www.drkoop.com Dandelion Alternative names: Taraxacum officinale Source: Integrative Medicine Communications; www.drkoop.com Danggui Alternative names: Angelica sinensis, Chinese Angelica, Dang Gui, Danngui, Dong Qua, Tang Kuei, Tan Kue Bai zhi(Note: Dong quai should not be confused with Angelica root or Angelica seed.) Source: Integrative Medicine Communications; www.drkoop.com Dehydroepiandrosterone (DHEA) Source: Healthnotes, Inc. www.healthnotes.com Dehydroepiandrosterone (DHEA) Source: Integrative Medicine Communications; www.drkoop.com Devil's claw Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,970,00.html DHEA Source: Integrative Medicine Communications; www.drkoop.com
254 Blood Pressure
Diltiazem Source: Healthnotes, Inc. www.healthnotes.com Diuretics Source: Healthnotes, Inc. www.healthnotes.com Docosahexaenoic Acid Source: Healthnotes, Inc. www.healthnotes.com Dong Quai Alternative names: Angelica sinensis Source: Healthnotes, Inc. www.healthnotes.com Dong Quai Alternative names: Angelica sinensis, Chinese Angelica, Dang Gui, Danngui, Dong Qua, Tang Kuei, Tan Kue Bai zhi(Note: Dong quai should not be confused with Angelica root or Angelica seed.) Source: Integrative Medicine Communications; www.drkoop.com Dong quai (angelica) Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,774,00.html Doxazosin Source: Healthnotes, Inc. www.healthnotes.com EDTA Source: Integrative Medicine Communications; www.drkoop.com Eicosapentaenoic Acid (EPA) Source: Integrative Medicine Communications; www.drkoop.com Eleuthero Source: Healthnotes, Inc. www.healthnotes.com Eleuthero Source: Integrative Medicine Communications; www.drkoop.com Eleutherococcus senticosus Source: Integrative Medicine Communications; www.drkoop.com Enalapril Source: Healthnotes, Inc. www.healthnotes.com EPA Source: Integrative Medicine Communications; www.drkoop.com Ephedra Alternative names: Ephedra sinica, Ephedra intermedia, Ephedra equisetina Source: Healthnotes, Inc. www.healthnotes.com
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Ephedra Alternative names: Ephedra sinensis Source: Integrative Medicine Communications; www.drkoop.com Ephedra Alternative names: Ephedra sinensis, Ma huang Source: Integrative Medicine Communications; www.drkoop.com Ephedra Source: Prima Communications, Inc.www.personalhealthzone.com Ephedra (Ma huang) Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,777,00.html Ephedra sinensis Alternative names: Ephedra Source: Integrative Medicine Communications; www.drkoop.com Erocalciferol Alternative names: Vitamin D Source: Integrative Medicine Communications; www.drkoop.com Ethylenediaminetetraacetic Acid (EDTA) Source: Integrative Medicine Communications; www.drkoop.com Eucalyptus Alternative names: Eucalyptus globulus Source: Healthnotes, Inc. www.healthnotes.com Eucalyptus Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,778,00.html Eugenia Clove Alternative names: Cloves; Eugenia sp. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Felodipine Source: Healthnotes, Inc. www.healthnotes.com Fennel Source: Healthnotes, Inc. www.healthnotes.com Fiber Source: Healthnotes, Inc. www.healthnotes.com Fibric Acid Derivatives Source: Integrative Medicine Communications; www.drkoop.com
256 Blood Pressure
Flavonoids Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,782,00.html Foeniculum Alternative names: Fennel; Foeniculum vulgare Mill Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Forskolin Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10025,00.html GABA Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10027,00.html Gamma-Linolenic Acid (GLA) Source: Integrative Medicine Communications; www.drkoop.com Ginkgo Alternative names: Ginkgo biloba Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Ginkgo Source: Prima Communications, Inc.www.personalhealthzone.com Ginkgo Biloba Alternative names: Maidenhair Tree Source: Integrative Medicine Communications; www.drkoop.com Ginseng Source: Prima Communications, Inc.www.personalhealthzone.com Ginseng (Panax) Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10029,00.html Ginseng, American Alternative names: Panax quinquefolium Source: Integrative Medicine Communications; www.drkoop.com GLA Source: Integrative Medicine Communications; www.drkoop.com Glucosamine Source: Healthnotes, Inc. www.healthnotes.com
Alternative Medicine 257
Glutathione Source: Healthnotes, Inc. www.healthnotes.com Glycyrrhiza glabra Alternative names: Licorice Source: Integrative Medicine Communications; www.drkoop.com Glycyrrhiza1 Alternative names: Licorice; Glycyrrhiza glabra L. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Goldenseal Alternative names: Hydrastis canadensis Source: Integrative Medicine Communications; www.drkoop.com Goldenseal Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,791,00.html Gotu Kola Alternative names: Centella asiatica Source: Healthnotes, Inc. www.healthnotes.com Gotu Kola Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com Green Tea Alternative names: Camellia sinensis Source: Healthnotes, Inc. www.healthnotes.com Green tea Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10032,00.html Grindelia Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Guanfacine Source: Healthnotes, Inc. www.healthnotes.com Gymnema Alternative names: Gurmar; Gymnema sylvestre Source: Alternative Medicine Foundation, Inc. www.amfoundation.org
258 Blood Pressure
Hawthorn Alternative names: Crataegus laevigata, Crataegus oxyacantha, Crataegus monogyna Source: Healthnotes, Inc. www.healthnotes.com Hawthorn Source: Prima Communications, Inc.www.personalhealthzone.com Hawthorn Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10035,00.html Herbal decongestant Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,949,00.html Hibiscus Alternative names: Hibiscus, Roselle; Hibiscus sp. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Huang-qi Source: Integrative Medicine Communications; www.drkoop.com Huperzine A Source: Prima Communications, Inc.www.personalhealthzone.com Huperzine A Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10038,00.html Hydralazine Source: Healthnotes, Inc. www.healthnotes.com Hydrastis canadensis Source: Integrative Medicine Communications; www.drkoop.com Hydrocotyle Source: Integrative Medicine Communications; www.drkoop.com Hypericum perforatum Alternative names: St. John's Wort Source: Integrative Medicine Communications; www.drkoop.com Indapamide Source: Healthnotes, Inc. www.healthnotes.com Indian Pennywort Source: Integrative Medicine Communications; www.drkoop.com
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Indian Tobacco Source: Integrative Medicine Communications; www.drkoop.com Inhalant, Systemic, and Topical Corticosteroids Source: Integrative Medicine Communications; www.drkoop.com Irbesartan Source: Healthnotes, Inc. www.healthnotes.com Isoflavones Source: Prima Communications, Inc.www.personalhealthzone.com Ispaghula Source: Integrative Medicine Communications; www.drkoop.com Kava Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,798,00.html Klamathweed Alternative names: St. John's Wort Source: Integrative Medicine Communications; www.drkoop.com Kudzu Alternative names: Pueraria lobata Source: Healthnotes, Inc. www.healthnotes.com Kudzu Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,858,00.html Labetalol Source: Healthnotes, Inc. www.healthnotes.com Lavandula Alternative names: Lavender; Lavandula sp. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Licorice Alternative names: Glycyrrhiza glabra, Glycyrrhiza uralensis Source: Healthnotes, Inc. www.healthnotes.com Licorice Alternative names: Glycyrrhiza glabra, Spanish Licorice Source: Integrative Medicine Communications; www.drkoop.com Licorice Source: Prima Communications, Inc.www.personalhealthzone.com
260 Blood Pressure
Licorice Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,801,00.html Linden Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Lisinopril Source: Healthnotes, Inc. www.healthnotes.com Lobelia Alternative names: Lobelia inflata, Indian Tobacco Source: Integrative Medicine Communications; www.drkoop.com Lobelia Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Lobelia inflata Source: Integrative Medicine Communications; www.drkoop.com Loop Diuretics Source: Healthnotes, Inc. www.healthnotes.com Loop Diuretics Source: Integrative Medicine Communications; www.drkoop.com Losartan Source: Healthnotes, Inc. www.healthnotes.com L-Tyrosine Source: Healthnotes, Inc. www.healthnotes.com Ma huang Source: Integrative Medicine Communications; www.drkoop.com Ma huang Alternative names: Ephedra Source: Integrative Medicine Communications; www.drkoop.com Ma Huang Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Maidenhair Tree Alternative names: Ginkgo Biloba Source: Integrative Medicine Communications; www.drkoop.com
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Maitake Alternative names: Grifola frondosa Source: Healthnotes, Inc. www.healthnotes.com Maitake Source: Prima Communications, Inc.www.personalhealthzone.com Marsh Pennywort Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com Melatonin Source: Healthnotes, Inc. www.healthnotes.com Melatonin Source: Integrative Medicine Communications; www.drkoop.com Melatonin Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,804,00.html Methyldopa Source: Healthnotes, Inc. www.healthnotes.com Methyldopa Alternative names: Aldomet Source: Prima Communications, Inc.www.personalhealthzone.com Metoprolol Source: Healthnotes, Inc. www.healthnotes.com Milk-Vetch Root Source: Integrative Medicine Communications; www.drkoop.com Miscellaneous Preparations Source: Integrative Medicine Communications; www.drkoop.com Mistletoe Alternative names: Viscum album Source: Healthnotes, Inc. www.healthnotes.com Mistletoe Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10109,00.html Mixed Amphetamines Source: Healthnotes, Inc. www.healthnotes.com
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Moexipril Source: Healthnotes, Inc. www.healthnotes.com Monophasic, Biphasic, and Triphasic Preparations Source: Integrative Medicine Communications; www.drkoop.com Musa Banana Alternative names: Plantain, Banana; Musa sp. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Nadolol Source: Healthnotes, Inc. www.healthnotes.com Naringin Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10089,00.html Nettle Source: Prima Communications, Inc.www.personalhealthzone.com Nettle Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10048,00.html Nifedipine Source: Healthnotes, Inc. www.healthnotes.com Ocimum Alternative names: Basil, Albahaca; Ocimum basilicum Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Olive Leaf Alternative names: Olea europa Source: Healthnotes, Inc. www.healthnotes.com Oral Hypoglycemics Source: Prima Communications, Inc.www.personalhealthzone.com Panax Alternative names: Ginseng; Panax ginseng Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Panax ginseng Source: Integrative Medicine Communications; www.drkoop.com Panax quinquefolium Source: Integrative Medicine Communications; www.drkoop.com Passion Flower Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca
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Phenelzine Source: Healthnotes, Inc. www.healthnotes.com Phenothiazine Derivatives Source: Integrative Medicine Communications; www.drkoop.com Phenylalanine Source: Prima Communications, Inc.www.personalhealthzone.com Phosphorus Source: Integrative Medicine Communications; www.drkoop.com Phyllanthus/Ayurvedic liver support combination Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10050,00.html Plantago isphagula Source: Integrative Medicine Communications; www.drkoop.com Prazosin Source: Healthnotes, Inc. www.healthnotes.com Propranolol Source: Healthnotes, Inc. www.healthnotes.com Psyllium Alternative names: Plantago ovata, Plantago ispaghula Source: Healthnotes, Inc. www.healthnotes.com Psyllium Alternative names: Ispaghula,Plantago isphagula Source: Integrative Medicine Communications; www.drkoop.com Quinapril Source: Healthnotes, Inc. www.healthnotes.com Ramipril Source: Healthnotes, Inc. www.healthnotes.com Red Pepper Alternative names: Cayenne Source: Integrative Medicine Communications; www.drkoop.com Reishi Alternative names: Ganoderma lucidum Source: Healthnotes, Inc. www.healthnotes.com Ribes Alternative names: Black Currant; Ribes nigrum L. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org
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Rue Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Selegiline Source: Healthnotes, Inc. www.healthnotes.com Siberian Ginseng Alternative names: Eleutherococcus senticosus, Acanthopanax senticosus, Eleuthero Source: Integrative Medicine Communications; www.drkoop.com Siberian Ginseng Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,821,00.html Silybum Alternative names: Milk Thistle; Silybum marianum (L.) Gaertn. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Spanish Licorice Alternative names: Licorice Source: Integrative Medicine Communications; www.drkoop.com St. John's Wort Alternative names: Hypericum perforatum, Klamathweed Source: Integrative Medicine Communications; www.drkoop.com Sulfonylureas Source: Integrative Medicine Communications; www.drkoop.com Tang Kuei Source: Integrative Medicine Communications; www.drkoop.com Taraxacum officinale Source: Integrative Medicine Communications; www.drkoop.com Taurine Source: Healthnotes, Inc. www.healthnotes.com Taurine Source: Prima Communications, Inc.www.personalhealthzone.com Taurine Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10059,00.html Terazosin Source: Healthnotes, Inc. www.healthnotes.com
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Thiazide Diuretics Source: Healthnotes, Inc. www.healthnotes.com Thiazide Diuretics Source: Integrative Medicine Communications; www.drkoop.com Thioxanthene Derivatives Source: Integrative Medicine Communications; www.drkoop.com Timolol Source: Healthnotes, Inc. www.healthnotes.com Triamterene Source: Healthnotes, Inc. www.healthnotes.com Tricyclic Antidepressants (TCAs) Source: Integrative Medicine Communications; www.drkoop.com Triotann-S Pediatric Source: Healthnotes, Inc. www.healthnotes.com Tyrosine Source: Integrative Medicine Communications; www.drkoop.com Uncaria asian Alternative names: Asian species; Uncaria sp. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org Uva ursi Alternative names: Arctostaphylos uva-ursi Source: Healthnotes, Inc. www.healthnotes.com Uva Ursi Alternative names: Arctostaphylos uva ursi, Bearberry, Beargrape Source: Integrative Medicine Communications; www.drkoop.com Valerian Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Valsartan Source: Healthnotes, Inc. www.healthnotes.com Vasodilators Source: Integrative Medicine Communications; www.drkoop.com Verapamil Source: Healthnotes, Inc. www.healthnotes.com Withania Ashwagandha Alternative names: Ashwagandha; Withania somnifera L. Source: Alternative Medicine Foundation, Inc. www.amfoundation.org
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Yarrow Alternative names: Achillea millefolium, Milfoil Source: Integrative Medicine Communications; www.drkoop.com Yarrow Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Yohimbe Alternative names: Pausinystalia yohimbe Source: Healthnotes, Inc. www.healthnotes.com Yohimbe Source: Prima Communications, Inc.www.personalhealthzone.com Yohimbe Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,830,00.html Zingiber Alternative names: Ginger; Zingiber officinale Roscoe Source: Alternative Medicine Foundation, Inc. www.amfoundation.org
General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. DISSERTATIONS ON BLOOD PRESSURE Overview In this chapter, we will give you a bibliography on recent dissertations relating to blood pressure. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “blood pressure” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on blood pressure, we have not necessarily excluded non-medical dissertations in this bibliography.
Dissertations on Blood Pressure ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to blood pressure. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •
24-hour Ambulatory Blood Pressure: Relation to the Insulin Resistance Syndrome and Cardiovascular Disease by Bjorklund, Kristina; Phd from Uppsala Universitet (sweden), 2002, 62 pages http://wwwlib.umi.com/dissertations/fullcit/f661569
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A Biocultural Analysis of Blood Pressure Variation among the Black Caribs and Creoles of St. Vincent, West Indies (hypertension) by Hutchinson, Janice Faye, Phd from University of Kansas, 1984, 295 pages http://wwwlib.umi.com/dissertations/fullcit/8424370
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A Biosocial Study of High Blood Pressure among Underground Mineworkers in a South African Gold Mine by Molapo, Matsheliso Palesa; Phd from Emory University, 2001, 331 pages http://wwwlib.umi.com/dissertations/fullcit/3018820
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A Biosociological Problem: Blood Pressure and Sociocultural Incongruity by Borkman, Thomasina Jo Smith, Phd from Columbia University, 1969, 261 pages http://wwwlib.umi.com/dissertations/fullcit/7006939
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A Hierarchical Linear Model Analysis of Very Low Birth Weight Infant Blood Pressure by Arheart, Kristopher Lee, Edd from Memphis State University, 1993, 159 pages http://wwwlib.umi.com/dissertations/fullcit/9402972
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A High Blood Pressure Education Program for Sixth Graders: Impact on Parents by Walker, Peter, Edd from University of Virginia, 1980, 207 pages http://wwwlib.umi.com/dissertations/fullcit/8102615
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A Study of the Relationship between the Chemical Sensitivity of Smooth Muscle and the Blood Pressure of Genetically Hypertensive Rats by Laher, Ismail; Phd from Memorial University of Newfoundland (canada), 1983 http://wwwlib.umi.com/dissertations/fullcit/NK63532
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A Test of Stress Theory in Medical Context: Relationships between Status Inconsistency and Pre-clinical Levels of Systemic Blood Pressure and Serum Lipoproteins of Children. by Clancy, Patricia, Phd from Tulane University, 1975, 377 pages http://wwwlib.umi.com/dissertations/fullcit/7613584
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Acute Blood Pressure and Heart Rate Responses to a Weight Training Circuit (isometrics, Hemodynamic, Isotonics) by Rodgers, Sandra Lemoine, Phd from The University of Southern Mississippi, 1984, 121 pages http://wwwlib.umi.com/dissertations/fullcit/8518338
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Acute Blood Pressure Responses to Static and Dynamic Exercise: Racial Differences by Wright, Reuben Leon, Phd from Old Dominion University, 1998, 127 pages http://wwwlib.umi.com/dissertations/fullcit/9828962
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Ambulatory Blood Pressure and Blood Pressure Responses to Tests in Predicting Future Blood Pressure Level and Left Ventricular Mass after 10 Years of Follow-up by Jokiniitty, Jaana Marketta; Md from Tampereen Yliopisto (finland), 2002, 188 pages http://wwwlib.umi.com/dissertations/fullcit/f238497
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An Investigation of Biological, Psychosocial and Sociocultural Influences upon the Blood Pressures of Adolescents in Corpus Christi, Texas by Ready, Timothy Paul, Phd from Michigan State University, 1981, 414 pages http://wwwlib.umi.com/dissertations/fullcit/8126545
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Aspects of Sodium Metabolism: Implications for Population Variation in Blood Pressure. by Gleibermann, Lillian Korabel, Phd from The University of Michigan, 1975, 137 pages http://wwwlib.umi.com/dissertations/fullcit/7529228
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Black and White Adolescents' Perceptions of Blood Pressure and Cholesterol by Desmond, Sharon M., Phd from The University of Toledo, 1989, 195 pages http://wwwlib.umi.com/dissertations/fullcit/8926628
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Blood Pressure and Body Size, Body Composition, and Subcutaneous Fat in Black American Adolescents by Valleroy, Linda Ann, Phd from University of Pennsylvania, 1987, 268 pages http://wwwlib.umi.com/dissertations/fullcit/8714144
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Blood Pressure and Body Weight during Pregnancy and Oral Contraceptive Treatment by Chernick, Beryl A; Advdeg from The University of Western Ontario (canada), 1967 http://wwwlib.umi.com/dissertations/fullcit/NK01260
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Blood Pressure and Lifestyle Change among the Manus of Papua New Guinea: a Migrant Study by Schall, Joan Irene, Phd from University of Pennsylvania, 1991, 585 pages http://wwwlib.umi.com/dissertations/fullcit/9125749
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Blood Pressure and Risk of Myocardial Infarction and Mortality in Washington County, Maryland by Manzi, Jane V. R. Marsh; Phd from The Johns Hopkins University, 2002, 174 pages http://wwwlib.umi.com/dissertations/fullcit/3046506
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Blood Pressure and the Declining Significance of Race among African Americans by Vargas Fouquette, Clemencia M., Phd from Arizona State University, 1994, 104 pages http://wwwlib.umi.com/dissertations/fullcit/9428878
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Blood Pressure in Juvenile Yucatec Maya: Maturation, Urbanization and Familial Tendency (mexico) by Kelley, Jane Claiborne Harmon, Phd from Southern Illinois University at Carbondale, 1987, 135 pages http://wwwlib.umi.com/dissertations/fullcit/8712829
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Blood Pressure Response to Isometric Exercise in Multiracial Children by Bourell, Judith A., Edd from Boston University, 1985, 128 pages http://wwwlib.umi.com/dissertations/fullcit/8602331
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Blood Pressure, Blood Pressure Development and Potential Risk Factors for Hypertension with Special Reference to Metabolic Factors and Kidney Function by Kristjansson, Karl; Meddr from Goteborgs Universitet (sweden), 2002, 104 pages http://wwwlib.umi.com/dissertations/fullcit/f660673
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Caffeine: Effects on Blood Pressure, Heart Rate and Short-term Muscular Endurance in Static Exercise of Muscle Groups of Varying Mass by Bailey, Mark L., Phd from Indiana University, 1989, 144 pages http://wwwlib.umi.com/dissertations/fullcit/9020702
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Cardiovascular Responses to Spontaneous Blood Pressure Fluctuations: Age and Gender Effects by O'leary, Deborah Diane; Phd from University of Waterloo (canada), 2002, 198 pages http://wwwlib.umi.com/dissertations/fullcit/NQ70863
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Chronic and Acute Blood Pressure, Heart-rate and Metabolic Responses to a Total Isokinetic Exercise Regimen. by Barnes, Darvin Earl, Edd from University of Arkansas, 1977, 101 pages http://wwwlib.umi.com/dissertations/fullcit/7723329
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Cognitive Functioning Level of Blood Pressure Measurement of Sophomore and Master's Degree Students in Nursing. by Davidson, Nita Williamson, Phd from The University of Alabama, 1978, 140 pages http://wwwlib.umi.com/dissertations/fullcit/7905401
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Commitment to Running, Exercise Setting, and Anxiety Reduction (blood Pressure) by Seemann, Jeffrey Clinton, Phd from The University of Toledo, 1986, 123 pages http://wwwlib.umi.com/dissertations/fullcit/8708657
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Diastolic Blood Pressure and Heart Rate in Relation to Anger and Fear and Personality Traits by Bakal, Donald A; Phd from The University of Manitoba (canada), 1971 http://wwwlib.umi.com/dissertations/fullcit/NK10380
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Diet, Activity and Cardiovascular Disease Risk Factors in Western Samoan Men (cholesterol, Blood Pressure, Obesity) by Pelletier, David Louis, Phd from The Pennsylvania State University, 1984, 390 pages http://wwwlib.umi.com/dissertations/fullcit/8429123
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Effects of Aerobic Fitness Level and Parental History of Hypertension on Cardiovascular Reactivity to Mental Arithmetic (psychological Stress, Blood Pressure) by Nixon, Patricia Ann, Phd from University of Pittsburgh, 1986, 79 pages http://wwwlib.umi.com/dissertations/fullcit/8701978
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Effects of Nicotine Vaccination on Blood Pressure and Grip Strength by Rice, Shelia Renee; Ma from University of Houston-clear Lake, 2002, 93 pages http://wwwlib.umi.com/dissertations/fullcit/1413710
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Effects of Swim Training on Blood Pressure and Other Cardiovascular Risk Factors in Individuals with Hypertension by Tanaka, Hirofumi, Phd from The University of Tennessee, 1995, 115 pages http://wwwlib.umi.com/dissertations/fullcit/9609322
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Effects of Sympathomimetic Amines on Blood Pressure and Heart Rate in the Chronically Cannulated Fetal Lamb, the Newborn Lamb and the Adult Sheep by Harris, William Henry; Phd from University of Calgary (canada), 1976 http://wwwlib.umi.com/dissertations/fullcit/NK30524
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Further Localization of a Blood Pressure Quantitative Trait Loci on Rat Chromosome 10 by Zhang, Xiaotong; Msbs from Medical College of Ohio at Toledo, 2003, 121 pages http://wwwlib.umi.com/dissertations/fullcit/1413734
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Genetic, Anthropometric, and Blood Pressure Variability in a Southern, Rural, Black Population (mississippi, Body Mass Index) by O'neil, Karen Elizabeth, Phd from University of Illinois at Urbana-champaign, 1986, 286 pages http://wwwlib.umi.com/dissertations/fullcit/8701584
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Hematological Changes in Response to Exposure to Moderate Altitudes (hemoglobin, Red Blood Cells, Systemic Blood Pressure) by Berry, Michael Joseph, Phd from Texas A&m University, 1983, 119 pages http://wwwlib.umi.com/dissertations/fullcit/8408403
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Implication of Cyclic Amp in the Physiopathology of Labile High Blood Pressure by Hamet, Pavel; Phd from Mcgill University (canada), 1972 http://wwwlib.umi.com/dissertations/fullcit/NK11836
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Influence of Age and Aerobic Fitness on Peripheral Factors Affecting Oxygen Use (blood Pressure) by Proctor, David Nathan, Phd from Kent State University, 1994, 197 pages http://wwwlib.umi.com/dissertations/fullcit/9422988
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Intracultural Variation in Blood Pressure in Beira, Mozambique by Barkey, Nanette Louise; Phd from University of Florida, 2002, 226 pages http://wwwlib.umi.com/dissertations/fullcit/3083967
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Is Birthweight Related to Current Weight, Blood Pressure, and Left Ventricular Mass among Black and White Normotensive Adolescents? by Hagan Hughes, Melissa Ann; Phd from University of Pittsburgh, 2002, 162 pages http://wwwlib.umi.com/dissertations/fullcit/3066954
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Localization of a Blood Pressure Quantitative Trait Locus (qtl) to a 1.7cm Interval on Rat Chromosome 9 by Meng, Haijin; Phd from Medical College of Ohio at Toledo, 2002, 158 pages http://wwwlib.umi.com/dissertations/fullcit/3045011
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Mechanisms of the Beneficial Effect of Estrogen on Subclinical Atherosclerosis: Lipids, Carbohydrate Metabolism and Blood Pressure by Karim, Roksana; Ms from University of Southern California, 2002, 29 pages http://wwwlib.umi.com/dissertations/fullcit/1411792
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Medicinal Plant Use and High Blood Pressure on St. Kitts, West Indies. by Stevenson, David Richter, Phd from The Ohio State University, 1979, 143 pages http://wwwlib.umi.com/dissertations/fullcit/7922566
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New Approaches to Heart Rate and Blood Pressure Variability Analysis to Probe Underlying Cardiovascular Control Mechanisms by Xiao, Jianhong; Phd from Rutgers the State U. of N.j. - New Brunswick and U.m.d.n.j., 2002, 162 pages http://wwwlib.umi.com/dissertations/fullcit/3066799
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Patients' Knowledge and Beliefs about Hypertension and Their Reported Compliance with Treatment Regimens As Related to Blood Pressure Control. by Wolle, Joan M., Phd from University of Maryland College Park, 1977, 174 pages http://wwwlib.umi.com/dissertations/fullcit/7808197
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Personality Coping Style and Ambulatory Blood Pressure in Working Men and Women by Lebenberg, Ivette Cheryl; Phd from Yeshiva University, 2002, 100 pages http://wwwlib.umi.com/dissertations/fullcit/3040410
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Precursors of Neonatal Irritability in Firstborns: Prenatal Maternal Stress and Timing of Marriage (social Support, Prenatal Blood Pressure) by Sprott, Julie Evelyn, Phd from The University of New Mexico, 1986, 226 pages http://wwwlib.umi.com/dissertations/fullcit/8620996
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Predictors of Ambulatory Post-exercise Hypotension and Heart Rate Recovery in Adolescents with Elevated and Normal Casual Blood Pressure Using Hierarchical Linear Modeling by Falk, Daniel Evan; Phd from University of Miami, 2002, 168 pages http://wwwlib.umi.com/dissertations/fullcit/3050734
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Predictors of Nocturnal Blood Pressure Blunting in Adolescents by Alhanati, Leslie Anne; Phd from University of Miami, 2002, 89 pages http://wwwlib.umi.com/dissertations/fullcit/3071283
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Racism, Racial Identity, and Blood Pressure by Ferguson, Lucie Lancaster; Phd from University of Virginia, 2002, 192 pages http://wwwlib.umi.com/dissertations/fullcit/3056831
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Relationship between the Blood Pressure Levels of Elementary School Children and Selected Host and Environmental Factors. by Gentry, Carole Diane, Phd from University of Kansas, 1975, 385 pages http://wwwlib.umi.com/dissertations/fullcit/7616723
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Response of Blood Pressure to Relaxation and Subliminal Suggestion (selfregulation, Psychophysiology) by Mofield, Jeanne Patricia, Phd from Ball State University, 1985, 93 pages http://wwwlib.umi.com/dissertations/fullcit/8525183
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Self-concept, Psychological Androgyny, and Physical Health Status of Transescents (blood Pressure, Middle Schools, Height/weight) by Theobald, Margaret Ann, Edd from Illinois State University, 1986, 93 pages http://wwwlib.umi.com/dissertations/fullcit/8705742
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Sociocultural Determinants of Nutrient Intake and Arterial Blood Pressure among Cambodian Refugees in Utah (migration, Acculturation, Diet) by Burke, Georgine Severson, Phd from The University of Connecticut, 1986, 230 pages http://wwwlib.umi.com/dissertations/fullcit/8710261
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Strategy to Improve Blood Pressure Control and Medication Adherence by Powell, Kathryn Wirtz; Dnsc from Rush University, College of Nursing, 2002, 224 pages http://wwwlib.umi.com/dissertations/fullcit/3066089
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Systolic Blood Pressure Response to Exercise: Cross-sectional Analysis of a Clinical Cohort by Grimes, Glenn Richard, Edd from University of Houston, 1982, 80 pages http://wwwlib.umi.com/dissertations/fullcit/8307015
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The Combined Effects of Aerobic Exercise and Dietary Omega-3 Fatty Acids on Plasma Lipids, Platelets and Physiological Parameters in Hyperlipidemic Subjects (triglycerides, Eicosapentaenoic Acid, Cholesterol, Oxygen Consumption, Blood Pressure) by Warner, James Grant, Jr., Edd from West Virginia University, 1986, 250 pages http://wwwlib.umi.com/dissertations/fullcit/8627737
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The Effect of a Ten-week Resistance Training Program on Body Composition and Blood Pressure in Women by Meissner, Margaret Mary; Ms from D'youville College, 2002, 149 pages http://wwwlib.umi.com/dissertations/fullcit/1408499
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The Effect of Calcium Supplementation on Blood Pressure of Healthy Adult Black Males and White Males (parathyroid Hormone, Urine Biochemicals) by Lyle, Roseann Marisa, Phd from Purdue University, 1986, 251 pages http://wwwlib.umi.com/dissertations/fullcit/8700929
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The Effect of Isokinetic Exercise on Human Heart Rate and Blood Pressure by Magee, David J; Phd from University of Alberta (canada), 1980 http://wwwlib.umi.com/dissertations/fullcit/NK49028
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The Effects of a Physical Fitness Program on Body Composition, Flexibility, Heart Rate, Blood Pressure, and Anxiety Levels of Senior Citizens by Parks, Charles James, Edd from The University of Alabama, 1979, 95 pages http://wwwlib.umi.com/dissertations/fullcit/8015588
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The Effects of a Selected Health Education Intervention upon the Compliance Behavior of Individuals Diagnosed As Having High Blood Pressure by Kardas, Edward Joseph, Phd from The Ohio State University, 1987, 137 pages http://wwwlib.umi.com/dissertations/fullcit/8717658
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The Effects of a Stage-specific Education/counseling Program for Increasing Exercise Self-efficacy in Women with Elevated Blood Pressure by Daley, Linda Kubalak, Phd from The Ohio State University, 1998, 190 pages http://wwwlib.umi.com/dissertations/fullcit/9911177
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The Effects of a Stress Reduction Program on Type a Behavior Pattern, Blood Pressure, Muscle Tension, and Relaxation Practice Time by Kamholtz, John Dennis, Edd from State University of New York at Buffalo, 1979, 188 pages http://wwwlib.umi.com/dissertations/fullcit/8005679
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The Effects of Age and Fitness on Intraocular Pressure at Rest and Following a Maximal Exercise Bout (ionometer, Aerobic Exercise, Systolic Blood Pressure, Vo2 Max) by Sikes, Stephen Charles, Phd from Indiana University, 1985, 67 pages http://wwwlib.umi.com/dissertations/fullcit/8525372
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The Effects of Coping Desensitization Training on the Attenuation of Blood Pressure in Essential Hypertension by Sprague, David Wayne, Phd from The Pennsylvania State University, 1988, 181 pages http://wwwlib.umi.com/dissertations/fullcit/8826822
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The Effects of Expressive Writing on Blood Pressure, Psychosocial Adjustment, and Heart Rate Variability in High Normal to Moderate High Blood Pressure by Beckwith, Kimberly Michelle; Phd from Alliant International University, San Diego, 2003, 164 pages http://wwwlib.umi.com/dissertations/fullcit/3080395
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The Effects of Graduated Exercise at the Piano on the Pianist's Cardiac Output, Forearm Blood Flow, Heart Rate, and Blood Pressure (electrical Impedance, Smoking, Conditioning) by Parr, Sharon M., Da from Ball State University, 1985, 218 pages http://wwwlib.umi.com/dissertations/fullcit/8518673
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The Effects of Isotonic and Isometric Exercises on Heart Rate and Blood Pressure and Their Relationships to Physical Work Capacity in College Men. by James, Sam Ed, Edd from University of North Texas, 1973, 113 pages http://wwwlib.umi.com/dissertations/fullcit/7404038
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The Effects of Low Level Aerobic Activity upon Systolic Blood Pressure Heart Rate and Depression Levels among the Elderly by Holder, Jason Daniels, Edd from Boston University School of Education, 1982, 107 pages http://wwwlib.umi.com/dissertations/fullcit/8309743
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The Effects of Open Focus Meditation Versus Progressive Muscle Relaxation on Blood Pressure, Heart Rate, and Peripheral Skin Temperature by Sanderlin, Martha Anderson, Phd from Kansas State University, 1991, 137 pages http://wwwlib.umi.com/dissertations/fullcit/9122750
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The Effects of Singing on Blood Pressure in Classically Trained Singers by Broadwater, Kimberly Jaye; Dma from Louisiana State University and Agricultural & Mechanical College, 2002, 68 pages http://wwwlib.umi.com/dissertations/fullcit/3049194
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The G894-t894 Exon 7 Polymorphism in the Endothelial Nitric Oxide Synthase Gene and Blood Pressure in a Cohort of Lead-exposed Workers from Korea by Lustberg, Mark E. Phd from University of Maryland, Baltimore, 2002, 225 pages http://wwwlib.umi.com/dissertations/fullcit/3048468
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The Genetic Determinants and Environmental Covariates of Blood Pressure among Mennonites of Kansas and Nebraska by Puppala, Sobha Rachel; Phd from University of Kansas, 2001, 124 pages http://wwwlib.umi.com/dissertations/fullcit/3018528
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The Influence of Drug Dosing Interval on Patient Compliance with Antihypertensive Agents and the Effect of Non-compliance on Blood Pressure Control by Girvin, Briegeen G. Phd from Queen's University of Belfast (northern Ireland), 2002, 150 pages http://wwwlib.umi.com/dissertations/fullcit/f662049
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The John Henryism and the Framingham Type a Scales: Relationships with Blood Pressure in Black and White Elderly Individuals (hard-driving, Personality, South Carolina) by Weinrich, Sally Powers, Phd from University of South Carolina, 1986, 194 pages http://wwwlib.umi.com/dissertations/fullcit/8615937
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The Perception of Physical Symptom and Blood Pressure in Selected Individuals by Barr, Marilynn, Phd from Texas Woman's University, 1986, 101 pages http://wwwlib.umi.com/dissertations/fullcit/8715143
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The Post-exercise Blood Pressure Response to Acute Exercise in Borderline Hypertensive Women by Inbar, Galit, Phd from Indiana University, 1992, 212 pages http://wwwlib.umi.com/dissertations/fullcit/9310333
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The Relationship among Blood Pressure, Percent Body Fat, and Self-concept in Fifthgrade Children in Oklahoma by Seiger, Lon Howard, Edd from Oklahoma State University, 1985, 106 pages http://wwwlib.umi.com/dissertations/fullcit/8603575
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The Relationship among Heat Illness, Age, Blood Pressure Pulse Rate, Vo2 Max, and Percentage of Body Fat in Football Players during Pre-season Practice (oxygen Volume) by Kimball, Patricia Stanaland, Edd from University of Miami, 1983, 116 pages http://wwwlib.umi.com/dissertations/fullcit/8321420
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The Relationship of Blood Pressure Levels to the Chronic Inhibition of Aggression by Meyer, Robert George, Phd from Michigan State University, 1967, 94 pages http://wwwlib.umi.com/dissertations/fullcit/6714526
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The Relationship of Total Cholesterol to Physiological and Behavioral Variables in Hispanic and Non-hispanic Third-grade Children (physiological Variables, Blood Pressure) by Rodean, Janet Lee, Edd from University of Northern Colorado, 1991, 315 pages http://wwwlib.umi.com/dissertations/fullcit/9202432
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The Reliability of Resting and Exercise-stimulated Blood Pressure Measurements of Healthy Five and Six-year-old Children (five-year-old) by Krase, Suzanne Lillian, Edd from Columbia University Teachers College, 1989, 88 pages http://wwwlib.umi.com/dissertations/fullcit/9002614
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The Renin-angiotensin System, Catecholamines and Blood Pressure in the Pekin Duck, Anas Platyrhynchos by Wilson, John Xavier; Phd from University of Toronto (canada), 1982 http://wwwlib.umi.com/dissertations/fullcit/NK55711
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The Role of Age-associated Changes in Skeletal Muscle on Blood Pressure Maintenance in the Upright Position by Masterson, Michelle Marie; Phd from The University of Toledo, 2003, 89 pages http://wwwlib.umi.com/dissertations/fullcit/3085578
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Two Educational Approaches to a Primary Prevention Hypertension Lesson Series: a Comparative Analysis (patient Education, Nursing, Blood Pressure) by Kirkpatrick, Mary Kinsland, Edd from North Carolina State University, 1984, 155 pages http://wwwlib.umi.com/dissertations/fullcit/8500237
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Voluntary Control of Diastolic Blood Pressure in Man While under Alpha Wave Production. by Mogen, Bruce Ollie, Edd from University of South Dakota, 1976, 87 pages http://wwwlib.umi.com/dissertations/fullcit/7703450
Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
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CHAPTER 5. CLINICAL TRIALS AND BLOOD PRESSURE Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning blood pressure.
Recent Trials on Blood Pressure The following is a list of recent trials dedicated to blood pressure.8 Further information on a trial is available at the Web site indicated. •
A Study to Prevent Complications of High Blood Pressure Caused by Hepatitis in Patients with Cirrhosis Condition(s): Hypertension, Portal; Liver Cirrhosis; Esophageal and Gastric Varices Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); Yale University Purpose - Excerpt: Objectives: I. Evaluate the efficacy of a certain drug in preventing intestinal complications in patients with cirrhosis and high blood pressure in the hepatic portal vein. II. Evaluate vein pressure measurements to predict the development of internal bleeding. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004641
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Amino Acids in Urine, Diet, and Blood Pressure: International Population Study Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is no longer recruiting patients.
8
These are listed at www.ClinicalTrials.gov.
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Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To analyze the relationship of dietary variables to urinary excretion of amino acids and the relationships of specific urinary amino acids to blood pressure. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006406 •
Blood Pressure Control in Juveniles - Longitudinal Study Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is no longer recruiting patients. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To correlate dietary factors and changes in pressor substances, including aldosterone and norepinephrine, with blood pressure during growth and sexual development from childhood through adolescence. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005181
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Dietary Patterns, Sodium Intake and Blood Pressure (DASH - Sodium) Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension; Vascular Diseases Study Status: This study is no longer recruiting patients. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To compare the effects of three levels of dietary sodium and two patterns of diet (a control diet and an intervention diet high in fruits, vegetables, and low fat dairy products and low in fat) on blood pressure in individuals with higher than optimal blood pressure or with Stage 1 hypertension. DASH - Sodium built on and extended the results of the NHLBI-initiated Dietary Approaches to Stop Hypertension (DASH) study. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000608
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Exercise and Blood Pressure in Children: A Meta-Analysis Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is no longer recruiting patients. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To use the meta-analytic approach to examine the effects of aerobic exercise on resting systolic and diastolic blood pressure in children. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005521
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Family Blood Pressure Program - GenNet Network Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is no longer recruiting patients. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To identify new genetic loci regulating blood pressure in hypertensive rats and in case-controls from relevant human populations. The study consists of a four grant network, which in turn is part of an NHLBI initiative, the Family Blood Pressure Program consisting of four networks. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005268
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Family Blood Pressure Program - GENOA Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension; Coronary Arteriosclerosis Study Status: This study is no longer recruiting patients. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To localize, identify, and evaluate common polymorphic variation in genes involved in determining interindividual differences in blood pressure (BP) levels and essential hypertension status in three racial groups: African-Americans, MexicanAmericans, and Non-Hispanic Whites. The study consists of a six grant network, which in turn is part of an NHLBI initiative, the Family Blood Pressure Program consisting of four networks. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005269
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Family Blood Pressure Program - HyperGEN Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is no longer recruiting patients. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To map and identify the major genetic determinants of hypertension and to study possible interactions between genetic and non-genetic factors in defined populations. HyperGEN consists of a nine grant network, which in turn is part of an NHLBI initiative, the Family Blood Pressure Program consisting of four networks. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005267
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Family Blood Pressure Program - SAPPHIRe Network Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension
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Study Status: This study is no longer recruiting patients. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To map the major genetic loci underlying hypertension in approximately 1700 sibling pairs of Asian-Pacific Chinese and Japanese origin. The study consists of a two grant network, which in turn is part of an NHLBI initiative, the Family Blood Pressure Program consisting of four networks. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005270 •
Identifying Genes Involved in Abnormal Blood Pressure - Hypertension SCOR Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is no longer recruiting patients. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To seek out genes or genetic markers which identify subjects more vulnerable to hypertension under the influence of environmental factors. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005325
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PREMIER: Lifestyle Interventions for Blood Pressure Control Condition(s): Heart Diseases; Hypertension Study Status: This study is no longer recruiting patients. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To compare the effectiveness of advice versus two multicomponent lifestyle interventions to control blood pressure in participants with Stage 1 hypertension or higher than optimal blood pressure. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000616
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Adolescent Blood Pressure Variation and Ventricular Mass Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To evaluate possible early neurogenic influence in essential hypertension by monitoring heart growth in adolescents over a two year interval. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005200
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Ambulatory Blood Pressure and Behavior Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To determine ways in which behavioral factors influenced the diagnosis and development of hypertension in adult working populations. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005170
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Ambulatory Blood Pressure and Prognosis Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To continue a prospective study of the ability of ambulatory blood pressure to predict cardiovascular morbidity in patients with mild hypertension. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005363
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Biobehavioral Mechanisms of Blood Pressure Regulation Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To investigate the role of biobehavioral factors in the pathogenesis of concentric left ventricular hypertrophy. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005366
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Birth Weight Effect on Blood Pressure in Late Childhood Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To investigate the relationship of birth weight and childhood blood pressure. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006322
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Blood Pressure and Diurnal Variation in Sodium, Potassium, and Water Excretion Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To determine if hypertensives and normotensives of similar ages had, on average, different ratios of 24-hour to overnight excretion of sodium, potassium, and water. Also, to determine the number of 24-hour collections needed to characterize individuals with respect to the ratios of 24-hour to overnight excretion and to determine if the ratios of 24-hour to overnight excretion vary by age and other factors related to blood pressure. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005204
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Blood Pressure Control--Racial and Psychosocial Influences Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To examine racial and psychosocial influences on blood pressure control. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005685
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Blood Pressure Tracking--Childhood to Young Adulthood Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To extend analyses of blood pressure (BP) tracking to a period that spanned childhood and young adulthood. Data were used from the same cohort of 339 children who had been followed for nine to twelve years in a previous study. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005421
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Calcium Intake, Metabolism, and Gestational Blood Pressure Condition(s): Cardiovascular Diseases; Heart Diseases Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI)
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Purpose - Excerpt: To determine if low dietary calcium intake and disturbances in maternal calcium metabolism were associated with increases in blood pressure in late pregnancy. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005206 •
Clinical Trial of Dietary Protein on Blood Pressure Condition(s): Cardiovascular Diseases; Hypertension; Heart Diseases Study Status: This study is not yet open for patient recruitment. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To examine the effect of dietary protein supplementation on blood pressure. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00046566
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Diet Modification and Blood Pressure in Young People Condition(s): Cardiovascular Diseases; Heart Diseases Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To determine the effects of diet modification on blood pressure, blood cholesterol, and bone density in healthy young people. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005167
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Divergence of Blood Pressure By Race in Adolescent Girls Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension; Obesity Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To continue examinations of 670 girls enrolled in the National Growth and Health Study (NGHS) for four more years, adding measurements of total peripheral resistance, cardiac output, DEXA scans for fat-free mass and fat mass, left ventricular mass and geometry, circulating blood volume, whole blood viscosity, and left ventricular contractility. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005470
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Effects of Rosiglitazone on Blood Vessels in Patients with High Blood Pressure and High Cholesterol Condition(s): Hypercholestrolemia; Hypertension Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: Cells in the lining of blood vessels produce various substances that cause the vessels to dilate (relax) and constrict (tighten), thereby regulating blood flow. In patients with high blood pressure and high cholesterol, the blood vessels do not dilate properly. This study will investigate the effects of rosiglitazone-a drug used to improve the action of insulin in diabetic patients-on blood flow by examining its effects on endothelin (a substance that causes vessel constriction), and other substances produced by the vessel-lining cells. Adults with blood pressure recordings of 140/90 mmHg or higher on at least three separate days or with a blood cholesterol level of at least 240 mg/dl may be eligible for this study. Candidates will be screened with a medical history and physical examination, blood pressure recordings, blood and urine tests. This "crossover" study involves two separate treatment periods; that is, participants will take either rosiglitazone or placebo (an inactive look-alike pill) once a day for 8 weeks, then no drug for 4 weeks, and then the alternative treatment for the next 8 weeks. Patients will continue to take their high blood pressure medicines during the first 6 weeks of each treatment period. They will stop the medication 2 weeks before the following procedures, which are done at the end of each 8-week treatment period: Strain gauge plethysmography-A small catheter is placed through a needle into an artery at the bend of the arm for measuring blood pressure and drawing blood samples during the study. Pressure cuffs are placed on the wrist and upper arm, and a strain gauge (a rubber band device) is placed around the forearm to measure forearm blood flow. When the cuffs are inflated, blood flows into the arm, stretching the strain gauge at a rate proportional to the flow, and the measurement is recorded. Small doses of four drugs-acetylcholine, bradykinin, sodium nitroprusside and BQ-123-are given through the catheter. Acetylcholine slows the heart rate. Bradykinin stimulates the release of a substance that causes blood vessels to dilate and can lower blood pressure. Sodium nitroprusside causes blood vessels to dilate and is used to treat high blood pressure and heart failure. BQ-123 blocks the blood vessel-constricting activity of endothelin. Brachial ultrasound reactivity study-A baseline ultrasound image (picture produced using sound waves) of the brachial artery (artery located at the bend of the arm) is taken and blood flow measurements are recorded. Then, a pressure cuff is placed around the upper forearm, inflated for 5 minutes to stop blood flow to the forearm, and then released. Images of the artery and flow measurements are repeated. After a 15-minute rest, new baseline images are taken and flow measurements obtained. A small amount of nitroglycerin is then sprayed under the tongue and after 3 minutes, blood flow measurements and brachial artery images are recorded once more. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006071
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Effects of Salt Intake on the Nervous Systems of Patients with Salt-Sensitive High Blood Pressure Condition(s): Hyperaldosteronism; Hypertension Study Status: This study is completed.
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Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: Some patients with high blood pressure can experience an increase of blood pressure by 10 percent or more by taking in salt. These patients are referred to as having "salt-sensitive" (SS) hypertension. Previous studies conducted on patients with salt sensitive hypertension suggest that their portion of the nervous system responsible for maintaining normal blood pressure (autonomic nervous system) may respond differently to salt than patients with non-salt sensitive (NSS) hypertension. This study is designed to examine the response of the nervous system to high doses of salt in patients with salt-sensitive hypertension and patients with non-salt sensitive hypertension. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001176 •
Epidemiology of Blood Pressure, Insulin, Salt Transport Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension; Obesity Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To determine the roles of insulin, lipids, body weight and ion transport in blood pressure regulation. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005249
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Evaluation of Childhood Blood Pressure and Lipid Screening Condition(s): Cardiovascular Hypertension
Diseases;
Heart
Diseases;
Hypercholesterolemia;
Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To help clarify the validity, reliability, and utility of blood pressure (BP) and lipid screening in childhood. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005439 •
Gubbio Study Five-year Follow-up: Lithium Countertransport, Blood Pressure, and Other Variables Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension; Coronary Disease Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI); Merck Research Laboratories Purpose - Excerpt: To conduct a five-year follow-up of the population of Gubbio, a town in north central Italy, in order to determine the relationship of baseline sodium-
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stimulated lithium countertransport to subsequent change in blood pressure and incidence of hypertension. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005232 •
High Blood Pressure in the Young Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To continue a longitudinal study of blood pressure and blood pressure correlates in a population of 1,140 young adults, first seen in 1973 as adolescents, aged 14-19 years. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005138
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Insulin Resistance and Blood Pressure Regulation in Blacks Condition(s): Cardiovascular Diseases; Hypertension; Heart Diseases; Insulin Resistance Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To determine the role of insulin resistance in peripheral vascular dynamics, sodium sensitivity, and blood pressure regulation in a young representative Black population and in a group of young Blacks at high risk for hypertension. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005164
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INTERSALT: International Study of Sodium, Potassium, and Blood Pressure Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI); Wellcome Trust Purpose - Excerpt: To coordinate an international study on the relationships between population mean sodium and potassium intake and blood pressure. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005763
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Job Strain, Ambulatory Blood Pressure and Hypertension Condition(s): Cardiovascular Diseases; Cerebrovascular Accident; Hypertension; Heart Diseases Study Status: This study is completed.
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Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To analyze the association between an objective measure of "job strain" and risk of stroke, and change in ambulatory blood pressure. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005472 •
Lithium Countertransport and Blood Pressure In CARDIA and TOMHS Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To conduct ancillary studies of sodium-stimulated lithium countertransport in the Chicago components of the Coronary Heart Disease Risk Development in Young Adults (CARDIA) cohort and in the Treatment of Mild Hypertension Study (TOMHS) cohort. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005213
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Longitudinal Studies of Blood Pressure in the Elderly Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To study further the association between blood pressure mortality among those who participated in both the Hypertension Detection and Follow-up Program (HDFP) screen and the East Boston Established Populations for Epidemiologic Studies in the Elderly (EPESE) study. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005409
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Longitudinal Twin Study - Cohort Study of Blood Pressure Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To analyze the genetic and environmental contributions of juvenile hemodynamic determinants of blood pressure, including cardiac output and systemic vascular pressure, to adult cardiovascular risk. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005161
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Maturational Changes in Cardiac Structures -- Blood Pressure Relationship -- SCOR in Hypertension Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To examine a school-based population of children for maturational changes in blood pressure and cardiac structures. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005469
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Minneapolis Children's Blood Pressure Study Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension; Obesity Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To examine environmental and familial correlates of childhood blood pressure in order to predict elevated blood pressure in young adulthood. Also, to investigate the phenomena of tracking of blood pressure and obesity from childhood to young adulthood. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005141
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Physical Training and Blood Pressure in High Risk Youths Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension; Obesity Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To determine the effects of physical activity on blood pressure and body fat in children varying in ethnicity, gender, and health status. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005695
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Potassium and Sodium to Control Blood Pressure in Hypertensives Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension; Vascular Diseases Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To examine the role of dietary sodium reduction with and without potassium supplementation in controlling blood pressure in hypertensive men. Phase(s): Phase III Study Type: Interventional
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Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000509 •
Sodium-Potassium Blood Pressure Trial in Children Condition(s): Cardiovascular Diseases; Heart Diseases; Hypertension; Vascular Diseases Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To examine the effects of nutritional intervention on the rate of rise of blood pressure in late childhood and early adolescence. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000521
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Study of Drugs for High Blood Pressure and High Cholesterol in American Indians with Type 2 Diabetes at High Risk of Kidney or Heart Disease Condition(s): Diabetic Nephropathy Study Status: This study is completed. Sponsor(s): National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); Hennepin County Medical Center - Minneapolis Purpose - Excerpt: Objectives: I. Establish a long-term working relationship between clinical investigators and the Minnesota American Indian community. II. Compare the effectiveness of lisinopril (an angiotensin-converting enzyme inhibitor) and nifedipine (a calcium channel blocker) in preventing nephropathy and vascular disease in Minnesota American Indians with non-insulin-dependent diabetes mellitus and microalbuminuria. III. Compare the effectiveness of simvastatin (a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor) with lipid-lowering strategies recommended by the National Cholesterol Education Program in preventing nephropathy and vascular diseases in these patients. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004266
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Suppressed Anger, Blood Pressure and Mortality Follow-up Condition(s): Cardiovascular Diseases; Heart Diseases; Coronary Disease; Hypertension Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To re-examine the relationship between suppressed anger, elevated blood pressure and all-cause as well as coronary heart disease (CHD) mortality using data from the Life Change Event Study (LCES) conducted on a representative sample of the Tecumseh Community Health Study (TCHS), n=696, men and women, aged 30-69 in 1971-1972. Study Type: Observational
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Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005458 •
Women's Use of Alternative Medicine: A Multiethnic Study Condition(s): Uterine Fibroids; Osteoporosis; Urinary Tract Infection; High Blood Pressure; Heart Disease; Arthritis; Depression; Headaches Study Status: This study is completed. Sponsor(s): National Center for Complementary and Alternative Medicine (NCCAM) Purpose - Excerpt: The purpose of this study is to examine socio-cultural factors of women's use of complementary and alternative medicine (CAM). The effects of socioeconomic status, social networks and acculturation on CAM use will be assessed among white, African-, Mexican-, and Chinese-American women. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00067249
Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “blood pressure” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •
For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/
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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html
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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/
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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm
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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm
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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm
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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp
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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm
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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/
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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm
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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm
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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm
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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm
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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm
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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials
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CHAPTER 6. PATENTS ON BLOOD PRESSURE Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “blood pressure” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on blood pressure, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Blood Pressure By performing a patent search focusing on blood pressure, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 9Adapted from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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example of the type of information that you can expect to obtain from a patent search on blood pressure: •
1-[3-(6-fluoro-1,2-benzisoxazol-3-yl)propyl]-4-(substituted) reducing blood pressure
piperazines
useful
for
Inventor(s): Davis; Larry (Sergeantsville, NJ), Klein; Joseph T. (Somerville, NJ) Assignee(s): Hoechst-Roussel Pharmaceuticals Inc. (Somerville, NJ) Patent Number: 4,609,658 Date filed: June 7, 1985 Abstract: Novel 1-[3-(6-fluoro-1,2-benzisoxazol-3-yl)propyl]-4-(substituted)piperazines, processes for the preparation thereof, and methods of treating psychoses, alleviating pain, and reducing blood pressure, employing compounds and compositions thereof are disclosed. Excerpt(s): As used through the specification and appended claims, the term "alkyl" refers to a straight or branched chain hydrocarbon radical containing no unsaturation and having 1 to 7 carbon atoms such as methyl, ethyl, 1-propyl, 2-propyl, 1-butyl, 1pentyl, 2-pentyl, 3-hexyl, 4-heptyl and the like; the term "alkoxy" refers to a monovalent substituent which consists of an alkyl group linked through an ether oxygen and having its free valence bond from the ether oxygen such as methoxy, ethoxy, propoxy, butoxy, 1,1-dimethylethoxy, pentoxy, 3-methylpentoxy, 2-ethylpentoxy and the like; the term "halogen" refers to a member of the family consisting of chlorine, fluorine, bromine or iodine. The term "lower" as applied to any of the aforementioned groups refers to a group having a carbon skeleton containing up to and including 5 carbon atoms. The compounds of the present invention which lack an element of symmetry exist as optical antipodes and as the racemic forms thereof. The optical antipode may be prepared from the corresponding racemic forms by standard optical resolution techniques, involving, for example, the separation of diastereomeric salts of those instant compounds characterized by the presence of a basic amino group and an optically active acid, or by the synthesis from optically active precursors. The present invention comprehends all optical isomers and racemic forms thereof. The formulas of the compounds shown herein are intended to encompass all possible optical isomers of the compounds so depicted. Web site: http://www.delphion.com/details?pn=US04609658__ •
2-(Optionally-substituted)benzylperhydroazepines for analgesia and lowering blood pressure Inventor(s): Eistetter; Klaus (Constance, DE) Assignee(s): Byk Gulden Lomberg Chemische Fabrik GmbH (Constance, DE) Patent Number: 4,221,788 Date filed: July 27, 1977 Abstract: Title compounds and their acid-addition salts are physiologically acceptable or are readily converted to physiologically-acceptable counterparts by established procedures. They are pharmacologically active on the central nervous system (CNS) and are thus useful, when administered to warm-blooded animals, to induce central stimulation, to increase vigilance and to promote normal and pathologically-inhibited
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drive. They are also useful as analgesics and as blood-pressure-reducing agents for warm-blooded animals. These compounds are prepared, e.g., by reducing an appropriate 2-benzylazacycloheptane and are compounded into normal dosage-form medicament compositions. Excerpt(s): The subject matter of this invention bears a relationship to that of a concurrently-filed application (Ser. No. 819,460) having a common inventor. In the course of work regarding elimination reactions, L.P.A. Fery and L. Wilputte-Steinert reported [Bull. Soc. Chim. Belg. 73 (1964) 154-165] the formation of 1-methyl-2benzylhexamethylenimine without ascribing any useful activity to this compound. The compound was formed in such a small quantity that it could be identified only as a derivative in the form of the picrate and methiodide. In German (laid-open) Patent Specification DT-OS No. 2,548,053 saturated.alpha.-substituted benzyl-1benzhydrylazaheterocyclic compounds are claimed, but only.alpha.-substituted benzyl1-benzhydrylazetidines are described; these are intended for use in treating obesity. Web site: http://www.delphion.com/details?pn=US04221788__ •
4,5-Dihydro-6-(4-pyridinyl)-3-pyridazinol and salts, their preparation and use as blood pressure lowering agents Inventor(s): Lesher; George Y. (Schodack, NY), Dickinson; William B. (Albany, NY) Assignee(s): Sterling Drug Inc. (New York, NY) Patent Number: 4,298,609 Date filed: August 30, 1979 Abstract: 4,5-Dihydro-6-(4-pyridinyl)-3-pyridazinol or pharmaceutically-acceptable acid-addition salt thereof is useful as a blood pressure lowering agent. 4,5-Dihydro-6-(4pyridinyl)-3-pyridazinol is prepared by reacting.gamma.-oxo-.gamma.-(4pyridinyl)butyronitrile with a hydrazine salt of a strong inorganic or organic sulfonic acid. Said 4,5-dihydro-6-(4-pyridinyl)-3-pyridazinol or pharmaceutically-acceptable salt thereof is shown as the active ingredient in pharmaceutical compositions for lowering blood pressure and in the method for lowering blood pressure in a patient having elevated blood pressure. Excerpt(s): The instantly claimed 4,5-dihydro-6-(4-pyridinyl)-3-pyridazinol, a blood pressure lowering agent, also is useful as an intermediate in the preparation of 6-(4pyridinyl)-3-pyridazinol which is disclosed and claimed in copending application Ser. No. 71,065, filed on Aug. 30, 1979 and now abandoned in favor of its copending continuation-in-part application Ser. No. 144,576, filed Apr. 28, 1980. This invention relates to 4,5-dihydro-6-substituted-3-pyridazinols, their use as blood pressure lowering agents, and their preparation. The Yoshitomi Pharmaceutical Ind., Ltd. Japanese Patent Application Disclosure No. 19,987/79, published Feb. 15, 1979 and based on Application No. 85,192/77, filed July 15, 1977, discloses, inter alia, the preparation of 4,5-dihydro-6(4-pyridinyl)-3(2H)-pyridazinone by refluxing for two hours an ethanolic solution of 3(isonicotinoyl)propanoic acid [same as.gamma.-oxo-.gamma.-(4-pyridinyl)butyric acid] and hydrazine hydrate. 4,5-Dihydro-6-(4-pyridinyl)-3(2H)-pyridazinone and closely related 4,5-dihydro-6-(4- or 3- or 2-pyridinyl)-5-R-3(2H)-pyridazinones, where R is H or lower alkyl, are said (page 2 of English translation) to be "useful not only as medicines such as hypotensive and antithrombus agents because they have pharmacological actions such as hypotensive, blood platelet coagulation-inhibitory and membranestabilizing actions, but also as intermediates for the synthesis of such medicines".
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Web site: http://www.delphion.com/details?pn=US04298609__ •
Acquisition of arterial response process for pulsating blood flow and its blood pressure measuring method Inventor(s): Takeda; Fumihide (Hiroshima, JP) Assignee(s): Takeda Engineering Consultant Inc. (Hiroshima, JP) Patent Number: 5,222,020 Date filed: April 13, 1990 Abstract: Using a non-invasive blood pressure measuring apparatus that comprises a cuff, a pressurizing unit and bleeding valve, methods to acquire the arterial response to pulsating blood flow through an artery against the bleeding cuff's pressure are described. There are also described method for displaying in real time the entire arterial response on a display unit such as a CRT or LCD, which show the physical and psychological environment where a subject is placed. With the acquired data, accurate systolic and diastolic readings sensitive to environmental change are determined while monitoring in real time the entire arterial response. Remote monitoring of blood pressure can be done by transmitting the acquired data via telephone lines or directly to medical personnel or other instruments. Excerpt(s): In the field of non-invasive blood pressure measurement using a cuff, pressurizing unit and bleeding valves, this invention relates to a method of acquiring a response to the pulsating blood flow which produces stretching of the arterial wall against the bleeding cuff's pressure. The method includes displaying the cuff's fluctuating pressure on a display unit in terms of a variation in the height of the mercury column of a mercury manometer. The arterial wall stretching includes that which occurs before and after each systolic and diastolic pressure detection and between the two detections. The invention further relates to a method of measuring blood pressure by monitoring and recording the arterial response. Apparatus according to the invention can display the simulated motion of a needle indicator of an aneroid manometer in addition to displaying the mercury column. Thus the invention does not require the manometers used previously in auscultatory methods. The invention can also graphically display in real time the arterial wall's subtle motion, which can not be detected by the auscultatory method with a stethoscope and a microphone. The wall motion is displayed in the form of time varying physical quantities such as acceleration, velocity and the like. This invention can therefore be used as the auscultatory method while monitoring the information being displayed. For acquiring the arterial response to the pulsating blood flow by non-invasive blood pressure measurement with a cuff, a pressurizing unit and bleeding valves, there have been the following available methods: displaying only the intensity level of the Korotkoff's sounds graphically by using a microphone, and displaying the cuff's oscillating pressure wave whose constant bleeding rate is filtered out. Web site: http://www.delphion.com/details?pn=US05222020__
Patents 297
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Active element selection for continuous blood pressure monitor transducer Inventor(s): Wenzel; Dennis J. (San Antonio, TX), Winter; Dean C. (San Antonio, TX), Honeyager; Kevin S. (San Antonio, TX) Assignee(s): Colin Electronics Co., Ltd. (Komaki, JP) Patent Number: 4,893,631 Date filed: February 25, 1988 Abstract: A method for monitoring a transducer array of individual pressure or force sensitive elements and for selecting the element within the array which most tracks the actual pulse waveform in an underlying artery, thus providing the most accurate measurement of the patient's blood pressure. The outputs of all of the transducer elements are employed in locating the particular element which is centrally located over the artery. A limited number of elements exhibiting local minima of diastolic pressure is first chosen. Then, pulse amplitude outputs from the limited number of transducer elements are employed in selecting that element within the limited-number group which is to be used for obtaining blood pressure measurements. The method provided by the present invention selects from the limited-number group of elements that element about which is centered the greatest spatially weighted average of a predetermined number of pulse amplitude values. Excerpt(s): The present invention relates generally to the field of continuous noninvasive measurement of blood pressure. More specifically, the present invention provides a method and apparatus for monitoring a transducer array of individual pressure or force sensitive elements and for selecting the element within the array which most tracks the actual pulse waveform in an underlying artery, thus providing the most accurate mesurement of the patient's blood pressure. There has been considerable interest in recent years in the development of a monitoring system for obtaining a continuous measurement of a patient's blood pressure. One of the most promising techniques for obtaining such a continuous measurement involves the use of an arterial tonometer comprising an array of small pressure sensing elements fabricated in a silicon "chip." The use of such an array of sensor elements for blood pressure measurements is disclosed generally in the following U.S. Patents: U.S. Pat. No. 3,123,068 to R.P. Bigliano, 3,219,035 to G. L. Pressman, P. M. Newgard and John J. Eige, 3,880,145 to E. F. Blick, 4,269,193 to Eckerle, and 4,423,738 to P.M. Newgard, and in an article by G. L. Pressman and P. M. Newgard entitled "A Transducer for the Continuous External Measurement of Arterial Blood Pressure" (IEEE Trans. Bio-Med. Elec., April 1963, pp. 73-81). In a typical tonometric technique for monitoring blood pressure, a transducer which includes an array of pressure sensitive elements is positioned over a superficial artery, and a holddown force is applied to the transducer so as to flatten the wall of the underlying artery without occluding the artery. The pressure sensitive elements in the array have at least one dimension smaller than the lumen of the underlying artery in which blood pressure is measured, and the transducer is positioned such that more than one of the individual pressure-sensitive elements is over at least a portion of the underlying artery. The output from one of the pressure sensitive elements is selected for monitoring blood pressure. The element that is substantially centered over the artery has a signal output that provides an accurate measure of intraarterial blood pressure. However, for the other transducer elements, the signal outputs generally do not provide as accurate a measure of intraarterial blood pressure as the output from the centered element. Generally, the offset upon which systolic and diastolic pressures depend will not be measured accurately using transducer elements that are not centered over the artery. In some prior art arrangements the pressure sensitive element having the maximum pulse
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amplitude output is selected, and in other arragnements the elements having a local minimum of diastolic or systolic pressure which element is within substantially one artery diameter of the element which generates the waveform of maximum pulse amplitude is selected. The latter method is shown in the above-mentioned J. S. Eckerle Patent No. 4,269,193. the selection method disclosed in Patent No. 4,269,193 generally identifies the correct transducer element to be used. However, pressure readings provided by individual elements of a transducer array may not be perfectly accurate due to any number of factors. Even small errors in the pressure reading may result in the selection of an incorrect transducer element using the system disclosed in Patent No. 4,269,193, in which case the blodd pressure measurements are inaccurate. A method for determining the correct transducer element for measuring blood pressure is disclosed in copending application Ser. No. 927,843 assigned to SRI International. The method disclosed in present invention represents an improvement on the method disclosed in the above-referenced patent application. Web site: http://www.delphion.com/details?pn=US04893631__ •
Adaptive incremental blood pressure monitor Inventor(s): Hood, Jr. Rush W. (Tampa, FL), Medero; Richard (Lutz, FL) Assignee(s): Critikon, Inc. (Tampa, FL) Patent Number: 4,461,266 Date filed: April 29, 1982 Abstract: An adaptive monitor and method for rapidly determining blood pressure, selects an initial cuff pressure to be applied to an artery of the test subject and then measures the amplitude of pressure pulses caused by the pumping of blood by the subject's heart. The cuff pressure is incrementally increased while the pulse amplitudes are monitored in order to obtain blood pressure readings by the oscillometric method. If the pulse amplitudes decrease for increases in pressure above the initial value, it is taken as an indication that mean arterial pressure is below the initial cuff pressure. Thus the cuff pressure is substantially decreased to a new initial value and the process is restarted. If it should be found upon a determination of the mean arterial pressure and the systolic pressure, that the initial or new cuff pressure was not low enough to determined diastolic pressure, the cuff pressure is automatically decreased in one large step to a level below the initial pressure and is then decreased in steps until diastolic pressure is located. Excerpt(s): This invention relates to the automated measurement of blood pressure and, more particularly, to the automated measurement of blood pressure by the oscillometric method. The heart muscles of animals periodically contract to force blood through the arteries of the animal. As a result, irregularly-shaped pressure pulses exist in these arteries and cause them to flex or oscillate. The base line pressure for these pulses is known as the diastolic pressure and the peak pressure for these pulses is known as the systolic pressure A further pressure value, known as the "mean arterial pressure" (MAP), represents a time-weighted average of the pulse pressure. In the past, various techniques and devices have been used for measuring one or more of these blood pressure values. The most common method involves applying a pressure cuff about the upper arm of a test subject and inflating it so as to stop the flow of blood in the brachial artery. The pressure is then slowly relieved while a stethoscope is used on the distal portion of the artery to listen for pulsating sounds, known as Korotkoff sounds, that accompany the reestablishment of blood flow in the artery. As the pressure in the cuff is
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reduced further, the Korotkoff sounds eventually disappear. The cuff pressure at which the Korotkoff sounds first appear during deflation of the cuff is a measure of the systolic pressure and the pressure at which these sounds disappear is a measure of the diastolic pressure. This method of blood pressure detection is generally known as the ausculatory method. Various devices are well known in the prior art for automatically performing blood pressure measurements by the ausculatory method. These devices employ a pump to automatically inflate a pressure cuff and a microphone to convert the Korotkoff sounds into electrical signals which are easily detected by various types of circuits. Other techniques have also been used to detect blood pressure from outside the subject's body, e.g., via Doppler shifts in ultrasonic waves reflected by the artery wall. In addition, there are intrusive devices that are inserted directly into the blood vessels for measurement of the pressure. However, the most commonly used method for measuring blood pressure, other than the ausculatory method, is the oscillometric method. Web site: http://www.delphion.com/details?pn=US04461266__ •
Adjustable blood pressure cuff and method of measuring blood pressure Inventor(s): Marks; Lloyd A. (727 Great Springs Rd., Bryn Mawr, PA 19010) Assignee(s): none reported Patent Number: 5,243,991 Date filed: November 6, 1991 Abstract: A flexible blood pressure cuff for use in measuring the blood pressure of a patient, includes an inflatable bladder having a first side and a second side. One of the bladder sides is provided with hook and loop fasteners for adjustably and removably retaining at least a portion of one of the two bladder sides against a remaining portion of the one bladder side when the bladder is folded over itself. The effective inflatable width of the bladder is thereby adjusted to accommodate the circumference of the limb of the patient so that accurate blood pressure measurements may be obtained for each patient. According to the method, the blood pressure cuff is folded over itself to produce a cuff having an effective inflatable width which is adjusted according to the circumference of the limb of the patient whose blood pressure is to be measured. Excerpt(s): The present invention relates to an apparatus for and a method of measuring blood pressure and more particularly to an adjustable blood pressure cuff and method of using the cuff to measure blood pressure in proportion to the circumference of the limb where the measurement is taken. A search of the prior art failed to reveal the adjustable blood pressure cuff or the method of measuring blood pressure according to the present invention. The following U.S. patents were uncovered which relate to blood pressure measurement or other medical devices: U.S. Pat. No. 3,570,495 to Wright; U.S. Pat. No. 4,210,154 to Klein; U.S. Pat. No. 4,572,205 to Sjonell; and U.S. Pat. No. 4,901,732 to Williams. In particular, the patents to Williams, Klein and Sjonell are typical of the familiar blood pressure cuff which relies on the detection of Korotkoff sounds as the inflated cuff is deflated from above systolic pressure to below diastolic pressure. Other non-invasive techniques which employ an inflatable cuff include automated blood pressure devices which use the plethysmographic pulse transmitted from the inflated cuff or bladder; and the use of Doppler ultrasound. In the former technique, the cuff is deflated from suprasystolic pressures, the pulse amplitude appears at systolic pressure, reaches a maximum at or about mean pressure, and then decreases and disappears at diastolic pressure. In the latter technique, the sounds produced from movement of the
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blood pressure wall are absent when the cuff is inflated above systolic pressure and present at inflations below systolic pressure. It bears repeating that all of the abovedescribed techniques use an inflatable cuff. Web site: http://www.delphion.com/details?pn=US05243991__ •
Adjustable blood pressure cuff and method of using same Inventor(s): Marks; Lloyd A. (727 Great Springs Rd., Bryn Mawr, PA 19010) Assignee(s): none reported Patent Number: 5,746,213 Date filed: February 24, 1995 Abstract: An adjustable and disposable blood pressure cuff comprises a bladder provided with adhesive layers on both sides thereof which are covered by peelable strips. According to the method of using the cuff, selected strips or portions thereof on one side of the cuff are peeled away and removed. The cuff is then folded and adhesively secured to itself at the optimum width for the circumference of the limb of the patient. Selected strips or portions thereof on the other side of the cuff are peeled away and removed so that the cuff may be adhesively secured about the limb of a patient. In a second embodiment, a hook-and-loop fastener piece replaces the adhesive layer on the other side of the cuff for securing the cuff about the limb of a patient. Excerpt(s): The present invention relates to a method of and an apparatus for measuring blood pressure and more particularly to an improved adjustable blood pressure cuff and a method of using the cuff to measure blood pressure in proportion to the circumference of the limb upon which the blood pressure is measured. In my prior U.S. Pat. No. 5,243,991, the disclosure of which is incorporated herein by reference, there is disclosed an adjustable blood pressure cuff and a method of measuring blood pressure. My prior cuff and method avoid the errors resulting from using a blood pressure cuff having an improper width in relation to the circumference of the limb of the patient whose blood pressure is to be measured. That is accomplished by providing a flexible bladder which is foldable upon and removably retained to itself by means of hook-and-loop fasteners, such as Velcro.RTM. fasteners, attached to both sides of the bladder. In this way, a cuff width, such as 0.4 times the circumference of the limb as recommended by the American Heart Association, can be set by folding over and removably securing the hook-andloop fasteners to achieve the appropriate cuff width. An additional feature of my prior invention is the provision of an index line on the cuff having a cuff width to limb circumference ratio of 0.4:1. Using this index line, the proper fold line can be easily determined for any given limb circumference. While my prior invention solves a longfelt need in the art for a blood pressure cuff which is easily adjustable for use on a variety of patients, regardless of the size of the limbs of the patient, it would be desirable to provide such a blood pressure cuff that may be adjusted for use with a particular patient and then disposed of after one or several uses on that patient and that minimizes the use of the relatively expensive hook-and-loop fasteners which also tend to collect lint. In medical technology, the concept of disposability of medical devices used in patient care is well-known. The disposability of some medical devices, however, is limited by the initial cost of the devices so that it is simply impractical to make some medical devices disposable. It would be desirable therefore to produce a blood pressure cuff of relatively inexpensive and simple construction so that it may be disposed of after one or several uses.
Patents 301
Web site: http://www.delphion.com/details?pn=US05746213__ •
Air evacuation valve for blood pressure measuring device Inventor(s): Speidel; Blasius (Hochmeisterstrasse 244, 7455 Jungingen, DT) Assignee(s): none reported Patent Number: 4,013,265 Date filed: July 30, 1974 Abstract: A blood pressure measuring device with a quick-evacuation air valve, where the cone-shaped valve plunger has a bypass channel reaching from the pressureless side to a point on the sealing surface of the plunger which, at the maximum normal opening stroke of the latter remains within the throttling range of the valve, but which after an additional opening motion against an abruptly higher spring bias, is opened to the pressure side, thereby rapidly evacuating the device. A detent serves to hold the actuating lever of the valve in its quick-evacuation position. Excerpt(s): The present invention relates to blood pressure measuring devices of the type having an inflatable measuring sleeve, and in particular to blood pressure measuring devices which are equipped with a manually operable valve for the evacuation of the air from the measuring sleeve. Blood pressure measuring devices of the type mentioned above are known from the prior art. One such device is described in the Offenlegungsschrift (German Printed Application) No. 2,118,295. This device features an air evacuation valve which is operable under finger pressure, using a thumb, for example, thereby making it possible to operate both manual pump and the evacuation valve with one hand only. This arrangement permits a convenient and sensitive control of the measuring device, so that the pressure inside the measuring sleeve can be lowered at the exact desired speed. With this instrument, it is no longer necessary to remove the pump and to place it aside. Rather, the pump itself will serve as a convenient handle for the compact valve housing mounted adjacent thereto. The standard blood pressure test consists of measuring the systolic and diastolic pressures, the procedure being normally terminated as soon as the diastolic pressure has been ascertained. At this point, the measuring sleeve is still subjected to a considerable amount of pressure, which has to be lowered to zero, before the measuring sleeve is free of pressure and tension for removal from the limb on which the blood pressure test has been performed. This elimination of the residual air pressure from the measuring sleeve makes it necessary to maintain the spring-loaded plunger of the evacuation valve open, until such time as all the air is escaped from the measuring sleeve. However, because the pressure decrease follows an exponential function, the escape of air consumes a comparatively great amount of time, especially in the lower pressure range. With the intent of relieving the technician operating the blood pressure measuring device, it has been suggested, in a proposed solution which is not part of the prior art, to provide a locking means in conjunction with the actuating member of the valve plunger so as to maintain the latter in its open position, until the locking means is released. This solution does relieve the operating technician who, during this time, could for instance record the measured blood pressure values. However, the patient on which the blood pressure test has been performed must wait all this time with the measuring sleeve still attached, until the latter is completely free of pressure, before it can be removed from his limb. Web site: http://www.delphion.com/details?pn=US04013265__
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Airflow control manifold for automatic blood pressure monitoring device Inventor(s): Anderson; R. Carver (Seattle, WA), Eaton; Glen (Sultan, WA) Assignee(s): SpaceLabs, Inc. (Redmond, WA) Patent Number: 5,464,019 Date filed: August 11, 1992 Abstract: A blood pressure monitoring device utilizing an integrally formed, substantially unitary manifold is shown and described. The manifold has an air inlet port for communicating with an air pump, and two cuff ports, one to be coupled to a blood pressure cuff, the other to be used to sample ambient pressure. The manifold further includes a transducer port for communicating with a pressure transducer and four valve seats, for receiving high- and low-pressure distribution valves, and high- and low-pressure relief valves. The distribution valves utilize solenoids, and therefore have two positions, namely, energized and de-energized. When the solenoids are energized, communication is allowed between a first plenum chamber and the cuff ports, the first plenum chamber also being in communication with the high-pressure relief valve and the air inlet port. Simultaneously, communication between the cuff ports and atmosphere is sealed off. In contrast, when the solenoids are in their de-energized position, communication between the first plenum chamber and the cuff ports is sealed off, allowing communication between the cuff ports and atmosphere. The manifold further includes a second plenum chamber that is in communication with a lowpressure relief valve and a second cuff port, and is selectively in communication with the first plenum chamber, the two plenum chambers being in communication when the low-pressure distribution valve is in an energized position. Excerpt(s): This invention relates to blood pressure monitoring, and more particularly, to an integrally formed manifold that interacts with and connects the elements of an automatic blood pressure monitoring device. Blood pressure is normally measured by placing a blood pressure cuff around the arm of a patient over the brachial artery. The cuff typically includes an inflatable bladder placed in an outer casing. The bladder is inflated to compress the arm of the patient, thereby pinching off the flow of blood through the brachial artery. The pressure in the bladder is gradually reduced while listening for sounds caused by the flow of blood through the brachial artery and measuring the air pressure in the bladder. When blood flow is detected during systole, the air pressure in the bladder is recorded as the systolic blood pressure. Similarly, when blood flow is detected during diastole, the air pressure in the bladder is recorded as the diastolic blood pressure. Although the most common device for measuring blood pressure using the above-described procedure is the familiar manually pumped cuff using a mercury manometer as the pressure measuring device, automated patient monitoring systems are also in common use. Web site: http://www.delphion.com/details?pn=US05464019__
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Alarm actuation arrangement for an automatic blood pressure recorder Inventor(s): Lee; Arnold S. J. (Englewood, NJ) Assignee(s): Milstein Medical Research Foundation, Inc. (New York, NY) Patent Number: 4,050,452 Date filed: April 21, 1976
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Abstract: An alarm actuating circuit associated with an automatic blood pressure recorder is triggered when a patient's systolic or diastolic pressure does not fall within a prescribed range. The recorder is associated with a pneumatic regulator including a constant-volume reference chamber and associated pressure-sensitive inflation and deflation valves to effect a precise linear depressurization of an inflatable cuff which has been applied to the patient and pressurized to a value higher than the patient's systolic pressure. Pulses obtained from an ultrasonic or other suitable detector sensitive to movements of the patient's arterial wall in synchronism with the blood flow surges as the cuff is depressurized below the patient's systolic pressure are integrated and then translated into variable-duration marking impulses. Such impulses are successively applied to the actuating input of a pen or other marker associated with an X-Y recording chart, the pen being linearly scanned along one chart axis at the constant depressurization rate of the cuff. During such scan, the pen records, on the chart, a linear pattern of marks each of which has a length corresponding to the duration of the marking impulse then applied to its actuating input. Excerpt(s): This invention relates to improvements in automatic blood pressure measurement machines, and is particularly concerned with an automatically operating machine for taking a plurality of blood pressure measurements and graphically recording the measurements in such form that a trained observer can readily determine changes in the condition of the patient as well as readily distinguishing valid pressure measurements from artifacts in each such measurement. In the past a number of inventors have sought to provide machines that automatically detect blood pressure and automatically indicate and/or record the detected measurements in such manner that a physician or other trained observer can rapidly determine the systolic and diastolic pressures at a glance from the recording and can easily distinguish the valid pressure markings from artifacts. The prior art has also sought to provide machines that periodically take a series of such measurements at spaced time intervals in an automatic manner and record such measurements in a comparatively disposed arrangement such that an observer can quickly determine changes in the condition of the patient from the different measurements. Such continuing record data is particularly desirable for use in hospital operating rooms and in intensive care units at hospitals. In an earlier patent of the present inventor, U.S. Pat. No. 3,146,777 a machine of this general type is provided in which each blood pressure measurement is graphically recorded as a series of single valued spaced dashes along a line; and with a plurality of such time spaced measurements being recorded in substantially parallel lines disposed transversely along a moving record. This recording enables a physician to very rapidly distinguish changes in the condition of the patient. Web site: http://www.delphion.com/details?pn=US04050452__ •
Ambulatory blood pressure apparatus Inventor(s): Sorensen; Jay R. (Beaverton, OR), LaPerna; Joseph D. (Beaverton, OR) Assignee(s): SpaceLabs, Inc. (Bothell, WA) Patent Number: 4,706,684 Date filed: June 30, 1986 Abstract: An ambulatory blood pressure monitor comprises a cuff coupled by a single fluid passageway to a manifold which in turn is coupled to a pump, valve and pressure transducer. The manifold comprises a larger main chamber in fluid communication with a smaller secondary chamber through a small channel in a wall separating the chambers.
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The pump, cuff and valve are in fluid communication with one another directly through the main chamber while the pressure transducer is coupled to the cuff through the secondary chamber. Excerpt(s): The present invention relates to an automatic blood pressure monitoring apparatus, more particularly, to ambulatory blood pressure monitoring. A number of portable monitoring devices are used in medical monitoring. One well known device is the so-called Holter monitor which is an EKG monitor which typically uses a magnetic tape recording to record EKG signals from a patient over extended periods of time. Another is a portable monitor for obtaining blood pressure readings over extended periods of time. An example of such a monitor is the Model 5200 ambulatory blood pressure monitor sold by SpaceLabs, Inc. of Redmond, WA. The Model 5200 comprises a blood pressure cuff, an air pump for activating the blood pressure cuff, a pressure transducer for generating electrical signals representative of the pressure in said cuff, circuitry and means for processing the electrical signals and a removable RAM package for storing the blood pressure data resulting from processing the electrical signals. Web site: http://www.delphion.com/details?pn=US04706684__ •
Ambulatory ECG triggered blood pressure monitoring system and method therefor Inventor(s): Gallant; Stuart L. (Owings Mills, MD), Caron; Paul R. (Laurel, MD), Palmer; Walter E. (Catonsville, MD) Assignee(s): Stuart Medical Inc. (Owings Mills, MD) Patent Number: 5,322,069 Date filed: May 24, 1993 Abstract: An ambulatory patient monitoring system (100) is provided for measuring and storing predetermined diagnostic parameters of a patient. The monitoring system includes a personal type computer (120) which may be selectively coupled to the portable portion (102) of system (100). Portable portion (102) may include one or more monitoring modules, such as ECG monitoring unit (110) and blood pressure monitoring unit (210). When ECG monitoring unit (110) and blood pressure monitoring unit (210) are disposed in side-by-side relationship and with respective optical interfaces (50, 254) in optical alignment, the two units operate in concert. ECG monitoring unit (110) supplies an R-wave gating signal to blood pressure monitoring unit (210) for establishing a window in which the receipt of a Korotkoff sound is expected. Additionally, the ECG unit (110) may trigger the blood pressure unit (210) to take a reading responsive to unit (110) identifying a predetermined abnormality in the ECG signal. Alternately, ECG monitoring unit (110) and blood pressure monitoring unit (210) may be used independently of one another as separate monitoring devices. Excerpt(s): This invention directs itself to ambulatory monitoring systems for measuring and storing diagnostic parameters. In particular, this invention directs itself to a modular monitoring system, wherein modular monitoring units can be used either independently of one another, or utilized together with at least one module communicating to another through an optical interface. More in particular, this invention directs itself to a system wherein the patient's ECG waveform is monitored and analyzed to identify particular abnormalities, both the ECG waveform and analysis data being stored in a non-volatile memory. Further, this system is directed to a blood pressure monitoring module for taking measurements responsive to a selectively variable repetition rate, selectively actuated for predetermined time intervals, and at
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times triggered by the ECG monitoring unit, when both are being utilized. More in particular, this invention pertains to an ambulatory monitoring system wherein each of the monitoring unit modules includes a serial interface for coupling with a personaltype computer to allow the physician to program predetermined parameters, observe measurements in real time, and download measurement data stored in the memory of each of the modules. Further, this invention directs itself to ambulatory monitoring units having means for conserving power to enable the units to operate for over twenty-four hours on battery power. Such power conserving means may take the form of a system to vary the operational speed of the monitoring unit's microprocessor, or alternately shutting down the operation of the unit's microprocessor for predetermined periods of time. Ambulatory monitoring systems are well known in the art. The best prior art known to the Applicants include U.S. Pat. Nos. 4,053,951; 4,211,238; 4,216,779; 4,501,279; 4,503,859; 4,519,398; 4,531,527; 4,566,463; 4,580,576; 4,583,551; 4,592,018; 4,617,937; 4,653,022; 4,667,682; 4,677,984; and, 4,679,144. Some prior art systems, such as that disclosed in U.S. Pat. Nos. 4,211,238; 4,216,779; and, 4,519,398 are directed to ambulatory monitoring systems for both blood pressure and a patient's ECG. In such systems the ECG signal is continuously monitored and stored in a memory or on a magnetic tape. The blood pressure measurement may be made at particular time intervals, with only a provision for manually initiating a measurement at intermediate times. Such blood pressure measurements are stored with the continuous ECG signal, however, there is no provision for the ECG unit triggering a blood pressure measurement. Web site: http://www.delphion.com/details?pn=US05322069__ •
Anticonvulsant derivatives useful in lowering blood pressure Inventor(s): Cottrell; Sandra C. (Doylestown, PA) Assignee(s): Ortho-McNeil Pharmceutical, Inc. (Raritan, NJ) Patent Number: 6,201,010 Date filed: March 30, 2000 Abstract: Anticonvulsant derivatives useful in lowering blood pressure in overweight individuals. Excerpt(s): are structurally novel antiepileptic compounds that are highly effective anticonvulsants in animal tests (Maryanoff, B. E., Nortey, S. O., Gardocki, J. F., Shank, R. P. and Dodgson, S. P. J. Med. Chem. 30, 880-887, 1987; Maryanoff, B. E., Costanzo, M. J., Shank, R. P., Schupsky, J. J., Ortegon, M. E., and Vaught J. L. Bioorganic & Medicinal Chemistry Letters 3, 2653-2656, 1993). These compounds are covered by U.S. Pat. No. 4,513,006. One of these compounds 2,3:4,5-bis-O-(1-methylethylidene)-.beta.-Dfructopyranose sulfamate known as topiramate has been demonstrated in clinical trials of human epilepsy to be effective as adjunctive therapy or as monotherapy in treating simple and complex partial seizures and secondarily generalized seizures (E. FAUGHT, B. J. WILDER, R. E. RAMSEY, R. A. REIFE, L D. KRAMER, G. W. PLEDGER, R. M. KARIM et. al., Epilepsia 36 (S4) 33, 1995; S. K. SACHDEO, R. C. SACHDEO, R. A. REIFE, P. LIM and G. PLEDGER, Epilepsia 36 (S4) 33, 1995), and is currently marketed for the treatment of simple and complex partial seizure epilepsy with or without secondary generalized seizures in approximately twenty countries including the United States, and applications for regulatory approval are presently pending in several additional countries throughout the world. Compounds of Formula I were initially found to possess anticonvulsant activity in the traditional maximal electroshock seizure (MES) test in mice (SHANK, R. P., GARDOCKI, J. F., VAUGHT, J. L., DAVIS, C. B.,
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SCHUPSKY, J. J., RAFFA, R. B., DODGSON, S. J., NORTEY, S. O., and MARYANOFF, B. E., Epilepsia 35 450-460, 1994). Subsequent studies revealed that Compounds of Formula I were also highly effective in the MES test in rats. More recently topiramate was found to effectively block seizures in several rodent models of epilepsy (J. NAKAMURA, S. TAMURA, T. KANDA, A. ISHII, K. ISHIHARA, T. SERIKAWA, J. YAMADA, and M. SASA, Eur. J. Pharmacol. 254 83-89, 1994), and in an animal model of kindled epilepsy (A. WAUQUIER and S. ZHOU, Epilepsy Res. 24, 73-77, 1996). Clinical studies on topiramate have revealed previously unrecognized pharmacological properties which suggest that topiramate will be effective in lowering blood pressure, both systolic and disstolic, in humans, particularly in overweight individuals. Web site: http://www.delphion.com/details?pn=US06201010__ •
Apparatus and a method for non-invasive measurement of the arterial blood pressure Inventor(s): Forstner; Klaus (Asperg/Wurttemberg, DE) Assignee(s): Microlife Corporation (TW) Patent Number: 6,231,517 Date filed: May 24, 1999 Abstract: An apparatus (21) which measures the arterial blood pressure at the human wrist (1) is provided with a cuff (22) having a shape adapted to be placed in a predetermined position around the wrist (1). The cuff (22) has one or two inflatable measuring bladders (23a, 23b). The bladders (23a, 23b) are arranged and have a size in such a way that each bladder (23a, 23b) covers only one of either the radial (2) and the ulnar (3) artery. Excerpt(s): The invention relates to an apparatus and a method for non-invasive measurement of the arterial blood pressure according to the preamble of the independent patent claims. Oscillometric blood pressure measurement was clinically introduced at the beginning of the 1980s. Although primarily intended to meet clinical requirements, the technology was additionally adapted to home-use devices with progress in both digital processing and memory technology. These advantages allowed the construction of inexpensive and highly transportable blood pressure measuring systems, widely applied in home use. The oscillometric technology was originally developed to be applied at the brachial artery. This specific artery is also the site of the clinical reference measurement, performed by physicians and nurses. The brachial artery is covered by the biceps and triceps brachial muscles and is compressed in a welldefined manner by the cuff's compression at the upper limb. Since the brachium is located at the heart's level, the application site sufficiently fulfils the need of measuring at the correct position. Web site: http://www.delphion.com/details?pn=US06231517__
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Apparatus and a process for measuring the blood pressure by an indirect method Inventor(s): Berger; Henri (90, Boulevard de Latour-Maubourg, 75007 Paris, FR), Lapyre; Didier (Pacy sur Eure, FR) Assignee(s): Berger; Henri (Paris, FR) Patent Number: 4,646,749 Date filed: July 26, 1984 Abstract: The invention provides a process and apparatus for externally measuring the arterial blood pressure of the patient by using at least one force sensor intended to be held pressed in the anatomical gutter of the radial artery with a constant force less than that created by the diastolic pressure of the blood flow in the radial artery, by detecting (21, 25, 27, 30) the maxima and the minima of the pressure signals, calculating (29,32,33) the average of the ratios R of these maxima and minima, increasing the application force until the blood flow (diastolic pressure P.sub.D) is disturbed, calculating the systolic pressure P.sub.S =P.sub.D.times.R.sub.m and displaying (17) the values P.sub.S and P.sub.D. Excerpt(s): The present invention relates to an apparatus and a process for measuring the blood pressure by an indirect method without drawing blood (that is to say for example without introducing a catheter). The conventional operating method for determining the boold pressure, called the RIVA-ROCCI method, consists in blocking part of the circulatory system of the sick person by exerting on his arm a pressure greater than the systolic pressure so as to prevent the blood from flowing towards the fore-arm, then in very slowly releasing this pressure while reading from a pressure gauge the two values at which the KOROTKOV noises appear, grow fainter then disappear. When the noises appear, the peak pressure or systolic pressure is noted; when the noises disappear, the minimum preassure or diastolic pressure is noted. Web site: http://www.delphion.com/details?pn=US04646749__
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Apparatus and method for blood pressure monitoring Inventor(s): Choucair; Maged (4001 W. McNichols, Detroit, MI 48221), Kordyban; Eugene (19154 Charest, Detroit, MI 48234) Assignee(s): none reported Patent Number: 5,267,566 Date filed: October 6, 1992 Abstract: A method and apparatus for monitoring blood pressure by a transducer engaging a flexible part of a body near capillaries and remote from an artery. The transducer provides an electrical signal when actuated by blood pressure pulses or changes in the capillaries. The transducer is releasably secured to the body by a gripping means preferably in the form of a clothespin. The transducer includes a strip with two strain gages disposed one on each respective side of the strip such that the blood pressure pulses flex the strip causing a change in the electrical resistance of the gages. Preferably, the apparatus has electronic circuitry to convert the change in the resistance of the strain gages to a voltage signal indicative of blood pressure and devices for recording and displaying blood pressure. Excerpt(s): This invention relates to blood pressure monitoring devices and, more particularly, to a device which is noninvasive and which is not affected by movement of
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the skin. Blood pressure varies with each heart beat, and varies between high and low levels, most commonly known as systolic and diastolic pressures. The monitoring of pressure that blood exerts on the walls of arteries is the most popular prior art method used to determine blood pressure. Pressures are commonly obtained by using a stethoscope and a sphygmomanometer, in the method known as the cuff method. It is not convenient to monitor pressure and/or the change in pressure over a long period of time by use of the sphygmomanometer because it is labor intensive as it entails measuring the blood pressure by comparing the pressure in the main artery of the arm with the pressure in an inflatable cuff wrapped around the arm. The sphygmomanometer restricts muscle movement, is uncomfortable and chafes the skin. Prior art devices for automatically monitoring blood pressure include U.S. Pat. No. 2,549,049 which describes a diaphragm type blood pressure gage which has a flexible membrane sensor in contact with the skin directly over an artery. The membrane is equipped with a monitor which generates an output related to blood pressure. This method basically requires monitoring a change in the position of the membrane by arterial distension due to variation of blood pressure. A problem arises because it is difficult to accurately position the membrane over the artery, calibrate the device, and account for the effect of tissue elasticity, density and/or skin displacement. In addition, certain drugs reduce blood pressure while at the same time increasing arterial distention. Web site: http://www.delphion.com/details?pn=US05267566__ •
Apparatus and method for blood pressure pulse waveform contour analysis Inventor(s): Bratteli; Christopher W. (Fridley, MN), Cohn; Jay N. (Minneapolis, MN), Finkelstein; Stanley M. (St. Louis Park, MN), Morgan; Dennis J. (Crystal, MN) Assignee(s): Hypertension Diagnostics, Inc. (Eagan, MN) Patent Number: 6,394,958 Date filed: November 5, 1999 Abstract: Methods and apparatus for processing an arterial blood pressure waveform to extract clinically useful information on the state of the cardiovascular system are disclosed herein. In order to obtain the parameters of the modified Windkessel model, the diastolic portion of a subject's blood pressure waveform is scanned over a plurality of ranges and the range that produces the best fit of data and lowest error estimates are selected. In addition, multiple empirically determined starting values of the `A` parameters are used to find the best fit of the model data to the actual arterial blood pressure waveform data. Excerpt(s): This invention relates to the field of medical diagnosis, and more specifically, to a method and apparatus for blood pressure pulse waveform contour analysis. U.S. Pat. No. 5,211,177 (incorporated herein by reference) discloses method and apparatus for measuring properties of the human vasculature using an electrical analog model of vascular impedance. These properties include the compliance of large and small vessels, and systemic resistance. These measurements and others obtained from the model can in turn be used to diagnose states of health or disease, and to assess the effectiveness of treatment regimes. For example, see Finkelstein S. M., Collins V. R., Cohn J. N., Arterial vascular compliance response to vasodilators by Fourier and pulse contour analysis, Hypertension 1988:12:380-387, the entire disclosure of which is incorporated herein by reference. The simplest model for representing the time-varying pressure behavior of the arterial blood pressure waveform during the diastolic decay phase of the cardiac
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cycle is a first-order model. The analog model that represents this behavior contains a single "active" element (capacitance) and a passive element (resistance). The model only accounts for the pure exponential decay present in the waveform. An improvement to this model that better accounts for the observed shape of the diastolic decay in humans is a third-order model, for example, the modified Windkessel model. The analog model that represents this behavior contains three active elements, two capacitors (compliance) separated by an inductor (inertance of the blood) and a passive resistance (systemic vascular resistance) element. This is the model preferred in the system of U.S. '177, and employed in the approach of the example embodiment of the present invention described herein. Web site: http://www.delphion.com/details?pn=US06394958__ •
Apparatus and method for continuous measurement of portal blood pressure Inventor(s): Zimmon; David S. (Port Washington, NY) Assignee(s): Zimmon Science Corp. (Port Washington, NY) Patent Number: 6,315,733 Date filed: January 14, 2000 Abstract: A method and a device for the intermittent or continuous measurement of portal blood pressure using a tamponade balloon inserted into the esophagus and stomach and a sensor positioned on the bridle, tamponade shaft or esophageal balloon. The tamponade balloons mounted over a tube are placed across the diaphragmatic hiatus and are gradually inflated through a lumen that runs from the balloons to a position that is external from the patient. The measured pressure within the tamponade is increased until the blood flow in the collateral portal veins that traverse the diaphragm are occluded. The cessation of the blood flow into the esophageal varices is signaled when the sensor identifies a change in diameter of the varices, a change in the color of the esophageal wall, or a change in velocity of blood flow. The measured tamponade pressure at the nadir of variceal blood flow is equivalent to portal blood pressure. Excerpt(s): This invention pertains to a method and a device for the continuous measurement of portal blood pressure. The method and device use an inflatable tamponade balloon inserted into the esophagus and a sensor to monitor the portal blood pressure. U.S. Pat. No. 5,653,240 to Zimmon, the disclosure of which is herein incorporated by reference, discloses a method and device for measuring portal blood pressure. That invention provides a device and a technically simple method for measuring portal venous pressure in patients with esophageal varices and or portal systemic collateral veins during upper gastrointestinal endoscopy or without endoscopy by positioning the tamponade and sensor with an instrument passed from the mouth into the stomach to provide a rail for introduction and removal. These instruments include an oral-gastric tube, balloon introducer, wire guided dilator, bougie or other similar device. The oral-gastric tube method allows the measurement of portal pressure after tamponade for bleeding without the need for expensive and technically demanding gastrointestinal endoscopy. Such measurements are essential to evaluate the patient's response to drug therapy and determine the therapeutic action required for prevention of recurrent bleeding. An advantage of the above mentioned invention is that in the non-bleeding patient, it allows endoscopic surveillance of esophageal varices combined with measurement of portal venous pressure as a single procedure using only conscious sedation. However, the use of a large endoscope such as used in the patent
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mentioned above to observe the collapse of esophageal varices is cumbersome and difficult for the patient, since it requires sedation. It would be desirable to find a method for measuring portal blood pressure that eliminates the need for endoscopy and makes the use of tamponade with sensors available to those without endoscopic skills. Web site: http://www.delphion.com/details?pn=US06315733__ •
Apparatus and method for determining onset times of pulses and use thereof in computing interarterial blood pressure electromechanical interval Inventor(s): Reynolds; Charles A. (West Haven, CT), Mentelos; Richard A. (Hamden, CT), Lewis; Donald E. (San Gabriel, CA) Assignee(s): American Home Products Corporation (New York, NY) Patent Number: 4,023,563 Date filed: September 22, 1975 Abstract: Apparatus and a method for determining the onset of an interarterial blood pressure pulse and measuring the time delay preceding the onset from the corresponding electrical heartbeart triggering signal wherein the blood pressure pulse is converted to an electrical input signal which is split into two identical components, one being delayed in time, inverted and amplified after which it is added to the other. A timer measures the duration between the electrical heartbeat actuating signal and the point at which the sum of the blood pressure component signals reaches a peak and subtracts from that result the time delay applied to the one component to yield the electromechanical interval between the electrical heartbeat signal and onset of the blood pressure pulse. Excerpt(s): It is known that certain functions of living organisms and also of electrical and mechanical apparatus, are characterized by events which occur in specific time sequences and that the time relationships among such events are indicative of the satisfactory performance of the functions. Thus, by comparing the times between occurrence of two events characteristic of a function with a statistically normal time for the duration between such events it can be determined whether the function is being properly performed. If the measured time deviates from the normal time, diagnosis as to the cause of malfunction may be made. One of the many possible areas in which event interval measurement may be employed for monitoring and diagnosis is in the care of the newborn infant. It has been found that electromechanical interval is an excellent indicator of neonatal distress. The electromechanical interval is the time between the myocardial electrical impulse (ECG) transmitted to the neonatal heart, commonly shown on the electrocardiogram, and the onset of the absolute blood pressure pulse resulting from the heartbeat. Although the electrical heart signal causes no problem for detection, this is not true of the blood pressure signal. The blood pressure signal is characteristically a noisy one subject to variations in amplitude and onset slope. It is also affected by variations in the blood pressure base line, i.e., the average blood pressure. Thus, in order to accurately measure the electromechanical interval a method for determining blood pressure pulse onset and apparatus necessary for execution of the method are required. The above-mentioned problems are overcome by the method and apparatus of this invention for detecting interarterial blood pressure onset. The invention relates to apparatus and a method for determining the time of blood pressure onset irrespective of variations in absolute blood pressure pulse amplitude and slope by measuring the elapsed time from the electrocardiogram representative of the electrical heartbeat actuating signal to blood pressure pulse onset. More specifically, the invention
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includes electrical circuitry for splitting an electrical signal representative of the blood pressure pulse into two components, delaying, inverting and amplifying one of the components, and then recombining the delayed, inverted, and amplified component with the unaltered component, the sum of the two components having a peak at a point in time equal to the sum of the time of actual onset of the blood pressure pulse measured from the R-wave of the ECG and the delay period applied to the amplified blood pressure pulse component. To determine the actual time of onset, the delay period is subtracted from the time at which the component sum peaks, the result being the electromechanical interval of the neonate. Web site: http://www.delphion.com/details?pn=US04023563__ •
Apparatus and method for improving the performance of an automatic blood pressure cuff Inventor(s): Pillsbury; Terrance L. (Keizer, OR) Assignee(s): SpaceLabs Medical, Inc. (Redmond, WA) Patent Number: 5,277,187 Date filed: October 15, 1991 Abstract: An improved blood pressure measuring device includes a filter intermediate the pressure cuff and the bleed valve to prevent dust, dirt, and other debris from clogging the bleed valve and causing significant damage to the blood pressure measuring device. Further, a data processor assembly is operated in accordance with a method designed to compensate the blood pressure measurement for any resistance added to the pneumatic system as a result of the air filter. The data processor assembly further determines when the filter is clogged thereby indicating that the measurement can no longer be accepted as accurate and the device may be dangerous to the patient. Excerpt(s): The subject invention is directed toward automatic blood pressure cuffs and, more particularly, toward apparatus and method for improving the performance of a blood pressure cuff. Devices for automatically measuring blood pressure have become increasingly more popular. These devices typically allow a user to obtain quick blood pressure measurements without requiring a stethoscope or medical personnel. Further, due to the automated nature of these devices, the user does not need to participate in making the measurement except to put a conventional blood pressure cuff to his arm and start the measurement. Most automated blood pressure measuring devices currently available rely upon a processor controlled pneumatic system to increase the pressure of the cuff enough to occlude the brachial artery. Once the cuff has attained a pressure sufficient to substantially occlude the brachial artery, the processor controlled pneumatic system slowly decreases the pressure of the cuff, either continuously or in increments. As the pressure of the cuff is reduced, the processor controlled pneumatic system records the pressure of the cuff at regular increments. Web site: http://www.delphion.com/details?pn=US05277187__
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Apparatus and method for measurement and control of blood pressure Inventor(s): Bourland; Joe D. (West Lafayette, IN), Geddes; Leslie A. (West Lafayette, IN), Babbs; Charles F. (West Lafayette, IN), Tacker, Jr. Willis A. (West Lafayette, IN) Assignee(s): Purdue Research Foundation (West Lafayette, IN) Patent Number: 4,425,920 Date filed: October 24, 1980 Abstract: Apparatus and method for measurement and control of blood pressure are disclosed. Blood pressure is indirectly continually monitored without use of a pressure transducer by sensing the pulse transit time to different sites in an artery, which transit time is inversely related to blood pressure, and developing pulses therefrom which are utilized to form arterial pulse waves, the comparison between which provide an indication of measured blood pressure. This indication is used to control blood pressure by controlling automatic release of a suitable drug into the body in amounts and over a time period as needed. The unit for measuring blood pressure includes two sets of electrodes positioned adjacent to but outside an artery at two sites (with the electrodes implanted or outside the body). Each electrode set is connected with an alternating current generator to supply alternating current at a low level to the electrodes and with demodulators to produce pulses due to a change of impedance offered to the supplied alternating current at each site. Each demodulator is connected with a detector to sense pulse arrival, and the detectors are connected with a time-interval measuring circuit. The system for control of blood pressure includes a blood pressure measuring unit that is connected with an electronic processing unit which controls a drug dispensing unit implanted in the body or attached outside the body. Excerpt(s): This invention relates to apparatus and method for measurement and control of blood pressure. One of the major medical problems today is that associated with lack of control of blood pressure in humans; indeed hypertension is a leading cause of disease and death in the United States. It has been reported that over fifteen percent of the United States population has hypertension at present, controlled by intermittent oral therapy or emergency intravenous medication. For control of blood pressure, accurate and dependable measurement of blood pressure is necessary to both determine the presence of a problem and for monitoring the pressure to assure alleviation or control of such a problem. For best results, the measurement of blood pressure should be continuous. At present, however, blood pressure measurement is normally an intermittent process due to the constraints imposed by the pressure transducers available for utilization, which include a pressure cuff outside the body, which cuff cannot be maintained for long period of time on a human, or by an implanted transducer. Web site: http://www.delphion.com/details?pn=US04425920__
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Apparatus and method for measuring an induced perturbation to determine blood pressure Inventor(s): Caro; Richard G. (San Francisco, CA), Sher; Mark H. (San Francisco, CA) Assignee(s): Vital Insite, Inc. (So. San Francisco, CA) Patent Number: 5,590,649 Date filed: April 15, 1994
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Abstract: A monitor for continuously determining a patient's physiological parameter includes a means for obtaining a periodic calibration measurement of the patient's physiological parameter. An exciter, positioned over an artery of the patient induces an exciter waveform into the patient's arterial blood. A noninvasive sensor, positioned over the artery, senses a hemoparameter and provides a noninvasive sensor signal output representative of the hemoparameter. A processor receives the calibration measurement and noninvasive sensor signal output. The processor determines a DC offset based on the calibration measurement and processes the noninvasive sensor signal to continuously determine the patient's physiological parameter. A method includes steps for performing the present invention. In the preferred embodiment, the physiological parameter measured is blood pressure, however, the present invention can also be used to analyze and track other physiological parameters such as vascular wall compliance, strength of ventricular contractions, vascular resistance, fluid volume, cardiac output, myocardial contractility and other related parameters. Excerpt(s): The present invention relates to an apparatus and method for noninvasively providing a continuous measure of a patient's blood pressure and other clinically important parameters. Blood pressure is the force within the arterial system of an individual that ensures the flow of blood and delivery of oxygen and nutrients to the tissue. Prolonged reduction or loss of pressure severely limits the amount of tissue perfusion and could therefore result in damage to or even death of the tissue. Although some tissues can tolerate hypoperfusion for long periods of time, the brain, heart and kidneys are very sensitive to a reduction in blood flow. Thus, during and after surgery, blood pressure is a frequently monitored vital sign. Blood pressure is affected, during and after surgery, by the type of surgery and physiological factors such as the body's reaction to the surgery. Moreover, blood pressure is manipulated and controlled, during and after surgery, using various medications. Often, these physiological factors and the given medications can result in a situation of rapidly changing blood pressure requiring immediate blood pressure measurement, and corrective action. Because of changes in the patient's blood pressure, constant monitoring is important. The traditional method of measuring blood pressure is with a stethoscope, occlusive cuff and pressure manometer. However, this technique is slow, subjective in nature, requires the intervention of a skilled clinician and does not provide timely readings frequently required in critical situations. Web site: http://www.delphion.com/details?pn=US05590649__ •
Apparatus and method for measuring blood pressure Inventor(s): Nunn; Donald E. (Glendora, CA), Beveridge; Robert W. (Cosa Mesa, CA) Assignee(s): C.R. Bard, Inc. (Murray Hill, NJ) Patent Number: 4,427,013 Date filed: June 8, 1983 Abstract: A blood pressure measuring device is disclosed which uses an inflatable cuff to apply external pressure to a patient's body member. The device detects and measures amplitude of pressure oscillations induced in the cuff by blood flow in the body member as the cuff pressure is decreased in steps from a magnitude above the expected systolic pressure to a magnitude below the expected diastolic blood pressure. The means arterial blood pressure is measured at the step at which the pressure oscillations reach a maximum. Systolic blood pressure is determined by making a first linear approximation to a plurality of amplitude measurements occurring below the expected systolic
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pressure and making a second linear approximation to a plurality of points occurring above the expected systolic pressure. The systolic pressure is calculated by setting the two approximations equal. Diastolic blood pressure is determined by detecting the cuff pressure which results in an equivalent oscillation magnitude to that determined for the systolic pressure. Excerpt(s): This invention relates in general to blood pressure measuring apparatus and, in particular, to blood pressure measuring devices which measure arterial blood pressure by oscillometry--the monitoring of pressure oscillations produced by arterial blood pulsations within a pressurized air cuff. The value determined by this equation may be inaccurate in shock cases, in an operating room environment, or where certain diseases are involved due to changes in the blood pulse waveform. There are presently several methods of measuring the various values of arterial blood pressure which are in common use. The most accurate method is direct measurement of arterial pressure by using an arterial cannula. However, invasive techniques are often inconvenient and may give rise to considerable patient discomfort. Web site: http://www.delphion.com/details?pn=US04427013__ •
Apparatus and method for noninvasive blood pressure measurement Inventor(s): Kaspari; William J. (Portola Valley, CA), Stern; Roger A. (Cupertino, CA) Assignee(s): Vital Insite, Incorporated (Portola Valley, CA) Patent Number: 5,533,511 Date filed: January 5, 1994 Abstract: A blood pressure monitor for determining a patient's blood pressure comprises a processor attached to a first input device for receiving an initial input representing the patient's absolute blood pressure, and a noninvasive sensor attached to the patient for measuring at least one physiological function. The processor executes a procedure for evaluating the initial input and the sensed physiological function to determine the patient's blood pressure. A method for determining a patient's blood pressure comprises the steps of storing an initial input representing a patient's absolute blood pressure, noninvasively sensing at least one of the patient's physiological functions, and evaluating the initial input and the sensed input to determine the patient's blood pressure. The present invention can also be used to analyze and track other physiological variables such as vascular wall compliance, changes in the strength of ventricular contractions, changes in vascular resistance, changes in fluid volume, changes in cardiac output, myocardial contractility and other related factors. Excerpt(s): The present invention relates generally to an apparatus and method for analyzing the waveshape of an electrical waveform using pattern recognition techniques. More particularly, it relates to an apparatus and method of using these techniques to analyze a signal obtained from a noninvasive arterial sensor to provide a continuous (beat-to-beat) measure of an individual's blood pressure and other clinically important parameters. Blood pressure is the force within the arterial system of an individual that ensures the flow of blood and delivery of oxygen and nutrients to the tissue. Prolonged reduction or loss of pressure severely limits the amount of tissue perfusion and could therefore result in damage to or even death of the tissue. Although some tissues can tolerate hypoperfusion for fairly long periods of time, the brain, heart and kidneys are very sensitive to a reduction in blood flow. Thus, during surgery, blood pressure is a frequently monitored vital sign. During and after surgery, blood pressure
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is affected by the type of surgery and physiological factors such as the body's response to the surgery. Moreover, during and after surgery, blood pressure is manipulated and controlled using various medications. Often, these physiological factors and the given medications result in a situation requiring immediate blood pressure measurement, and corrective action. The most commonly used method of controlling an individual's blood pressure, particularly during surgery and in the critical period following surgery, is with vasoactive medications. These agents control the individual's blood pressure primarily by altering the resistance to blood flow in the peripheral arteries. For example, a vasodilating agent reduces peripheral resistance by increasing arterial compliance, and thereby reduces blood pressure. Conversely, a vasoconstrictor increases peripheral resistance by decreasing arterial compliance, and thereby increases blood pressure. Alternatively, inotropic agents can adjust the strength of the heart's contractions to modify blood pressure. Web site: http://www.delphion.com/details?pn=US05533511__ •
Apparatus and process for determining systolic blood pressure, diastolic blood pressure, mean arterial blood pressure, pulse rate, pulse wave shape, respiratory pattern, and respiratory rate Inventor(s): Callahan; Wayne (Brentwood, TN), Harriman; Walter (Sanford, NC) Assignee(s): Health Monitors, Inc. (Brentwood, TN) Patent Number: 5,094,244 Date filed: August 25, 1989 Abstract: An apparatus and process for automatically measuring systolic, diastolic and mean arterial blood pressure. Two cuffs, one located closer to the heart (proximal) than the second (distal), are provided. Each cuff is attached to a small manifold which has three ports. One port is connected to the cuff, one port is connected to a pressure sensor, and the last port is connected to a valve to a high pressure air source. Throughout blood pressure monitoring, a constant mass of air is maintained within the cuff by inflating the cuff and closing the cuff valve. The sensors are connected to a microcomputer so that the static pressure component and the dynamic pressure component of cuff pressure can be stored and plotted. Mean arterial pressure is read from both distal and proximal cuff sensors. Diastolic blood pressure is determined by recording the proximal static cuff pressure at which a maximum dynamic distal amplitude is observed. Systolic blood pressure is determined by recording the proximal static pressure at which a minimum dynamic distal amplitude is observed. Excerpt(s): This invention relates to the automatic, non-invasive measurement of blood pressure and vital signs through the use of an oscillometric method. Specifically, it relates to a monitor capable of measuring blood pressure, pulse, and respiration rate through the finger. The measurement of blood pressure is an important tool for the medical professional. The term "blood pressure" is a relative term whose precise meaning depends very much on the method used. Blood pressure is the force exerted by the blood against the inner walls of the blood vessels. It is determined by the flow of blood and the resistance to that flow. Blood pressure is comprised of three parts: the systolic, diastolic, and mean blood pressure. Systolic pressure is the maximum arterial pressure. Diastolic is the minimum arterial pressure. Mean blood pressure is the static pressure that is equivalent to an average pressure. It is found by dividing the area under a single pulse wave by the width of the pulse.
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Web site: http://www.delphion.com/details?pn=US05094244__ •
Apparatus for automatically measuring blood pressure Inventor(s): Kato; Yoichi (Nara, JP) Assignee(s): Sharp Kabushiki Kaisha (Osaka, JP) Patent Number: 5,029,589 Date filed: July 3, 1989 Abstract: In a hematomanometer in which the blood pressure values are detected while increasing the cuff pressure, the cuff pressure is increased to a predetermined value, the minimum blood pressure is presumed. When the presumed value is greater than a first reference value which is larger than the predetermined value, the measurement of the blood pressure is conducted while increasing the cuff pressure. When the presumed value is greater than the first reference value, the cuff pressure is decreased to a second reference value which is smaller than the predetermined value, and then the measurement of the blood pressure is conducted while increasing the cuff pressure. Excerpt(s): This invention relates to an apparatus for automatically measuring blood pressure such as so-called electronic hematomanometer in which blood pressure is measured by the oscillometric method. In the oscillometric method, blood pressure is measured on the basis of minute pressure pulses (pulse wave) which are transmitted to a cuff in accompanying with fluctuation of blood pressure of a body to be measured. A conventional hematomanometer employing this oscillometric method measures the maximum and minimum blood pressures as follows: At first, the pressure of a cuff is raised at a single stroke to a high pressure level which exceeds the maximum blood pressure of a subject. Thereafter, the air in the cuff is gradually discharged to reduce the pressure of the cuff. On the way of this discharge, the pulse wave is detected by a pulse pressure sensor to determine the maximum and minimum blood pressure values. A hematomanometer of the pressure-raising type has various advantages. For example, as the maximum and minimum blood pressure values are measured while increasing the pressure of a cuff, the time required for compressing the arm of a subject by a cuff of a high pressure can be reduced, thereby eliminating an unnecessary sense of tight binding and pain caused thereby. It is not necessary to set the pressure of a cuff to be raised, in advance of the measurement of blood pressure, resulting in making the hematomanometers easy to operate. As amplitudes of the pulse waves are detected while the pressure-raising operation is halted, moreover, the detected signals are not affected by noises, so that the minimum blood pressure value can be accurately detected even when the minimum blood pressure is low (i.e., the amplitudes of the pulse wave in the vicinity of the minimum blood pressure are low). Web site: http://www.delphion.com/details?pn=US05029589__
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Apparatus for detecting blood pressure and electrocardiographic waveforms Inventor(s): Inukai; Hidekatsu (Nagoya, JP), Sakai, deceased; Hiroshi (late of Komaki, JP) Assignee(s): Colin Corporation (Komaki, JP) Patent Number: 5,865,761 Date filed: May 5, 1997
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Abstract: An apparatus that detects both the blood pressure and the electrocardiographic waveform of a living subject and that can be quickly and easily fitted to the living subject includes a cuff that is wrapped around a portion of the living subject for detecting the subject's blood pressure, and a flexible electrocardio electrode on the inner surface of the cuff for detecting the electrocardiographic waveform generated by the living subject's cardiac muscle. When the cuff is wrapped around a portion of the living subject, the electrocardiographic electrode is automatically fitted and correctly positioned on the living subject. Because the electrocardio electrode does not have to be separately fitted and attached to the living subject, the "set up" time is significantly reduced. Thus, the apparatus of this invention is especially useful in emergency medical situations, where rapid measurements are required. Excerpt(s): This invention relates to blood pressure measuring devices. More specifically, this invention is directed to an apparatus for detecting both the blood pressure and electrocardiographic waveform of a living subject. The blood pressure of a living subject is typically measured with the use of a cuff that is wrapped around a portion of the living subject. The cuff applies pressure to the living subject and the living subject's blood pressure is measured using a well known oscillometric method, which is based on detecting changes in the amplitude of a synchronous wave pulsation as the pressure applied by the cuff is gradually released. In certain medical situations, it is desirable to obtain both the blood pressure and an electrocardiogram of the living subject. In order to obtain an electrocardiogram, the electrocardiographic waveform, generated as a result of the action potential of the subject's cardiac muscle, must be detected. The electrocardiographic waveform is typically detected with electrocardio electrodes that are attached to the living subject. Web site: http://www.delphion.com/details?pn=US05865761__ •
Apparatus for identifying artifact in automatic blood pressure measurements Inventor(s): Walloch; Richard A. (Beaverton, OR) Assignee(s): SpaceLabs, Inc. (Redmond, WA) Patent Number: 4,974,597 Date filed: October 5, 1988 Abstract: A system for identifying artifact in automatic blood pressure measuring system. The system determines whether a single blood pressure signal, such as an oscillometric pulse or Korotkoff sound, occurs for each QRS complex of an ECG waveform in order to verify that the blood pressure signal is valid. In the event that multiple blood pressure signals occur between successive QRS complexes, at least some of the blood pressure signals are determined to be induced by artifact. Excerpt(s): This invention relates to the automatic measurement of blood pressure and, more particularly, to identifying false blood pressure signals induced by artifact. Automatic blood pressure systems are commonly used to periodically measure the blood pressure of a patient. In most automatic blood pressure measuring systems, a pressure cuff is attached to a patient's arm adjacent a blood vessel. The cuff is periodically pressurized with an applied pressure that is high enough to occlude the blood vessel. The cuff pressure is then gradually reduced, either continuously or in increments. As the pressure is reduced to systolic pressure, blood begins to flow through the blood vessel beneath the cuff. As blood begins to flow through the blood vessel beneath the cuff, it produces Korotkoff sounds that are conventionally detected
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by either a stethoscope or an electronic microphone. In automatic measurement techniques, a microphone is used as a sensor which applies the signals corresponding to the Korotkoff sounds to a measurement unit. The measurement unit generally includes a processor programmed with software that is capable of determining whether the signal generated by the microphone has the characteristics of a Korotkoff sound. As a result, the systems are capable of determining whether the signals are truly indicative of a patient's blood pressure or whether they are induced by artifact, such as patient movement. Web site: http://www.delphion.com/details?pn=US04974597__ •
Apparatus for inflating cuff for blood pressure monitoring system Inventor(s): Perry; William D. (San Antonio, TX), Heihn; Donald H. (San Antonio, TX), Peel; H. Herbert (San Antonio, TX) Assignee(s): Nippon Colin Co., Ltd. (Komaki, JP) Patent Number: 4,800,892 Date filed: July 21, 1986 Abstract: An inflation system for providing rapid, linear inflation of a container, such as an occlusion cuff used in connection with a blood pressure monitoring system. The invention system provides an automatic fast-fill of the cuff to a predetermined pressure level, followed by a smooth, linear pressurization profile which is independent of the volume of the cuff. An efficient electronic actuation system allows the system to inflate the cuff many times using the power supplied by a low power battery. A pressure relief system is provided to automatically terminate operation of the inflation system once systolic pressure has been detected or if the pressure in the system rises above a predetermined level. The system is extremely lightweight and compact, thus allowing a patient to carry the system on his person without undue fatigue. Excerpt(s): The present invention relates generally to inflation systems for occlusion cuffs used in connection with blood pressure monitoring systems. In particular, the present invention provides a method and apparatus for automatically controlling the inflation of an occlusion cuff used in monitoring systems for measuring blood pressure. Manual measurements of blood pressure are usually taken on the downramp of the cuff pressurization cycle. In this procedure, an occlusion cuff is rapidly inflated to a pressure level above that at which systolic pressure is expected to occur. Once the maximum pressure has been reached, the pressure in the cuff is slowly decreased while the operator listens for changes in the sound characteristics of the pulse, which changes can be correlated with systolic and diastolic pressure. Although the cuff inflation system described above can be used to obtain accurate indications of blood pressure, it has a number of drawbacks. In particular, the manual inflation system requires that the cuff be inflated significantly above the expected systolic pressure of the patient. Since the patient's systolic pressure is not known in advance, the cuff is often inflated to an unnecessarily high level which can cause discomfort or even tissue damage to the patient. In addition, the uncertainty over the necessary level of inflation often results in the need to reinflate the cuff several times to obtain an accurate reading of blood pressure. Web site: http://www.delphion.com/details?pn=US04800892__
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Apparatus for measurement of blood pressure with electronic amplification system for Karotkoff sounds Inventor(s): Bui; Hoanh (12803 Linda La., Stafford, TX 77477) Assignee(s): none reported Patent Number: 5,406,953 Date filed: June 24, 1991 Abstract: An instrument for measuring the blood pressure and for checking the heart rate. It comprises of an electronic circuit for detecting, filtering, and amplifying the full steam of Korotkoff sounds which is produced as electrical signals from an acoustic pickup applied to the brachial artery. Korotkoff sounds are heard directly via the instrument's loud speaker, thus eliminating the need for the conventional stethoscope. Evaluation of blood pressure is easily and efficiently carried out by an individual with little skill or training and without the aid of a second person. Excerpt(s): This invention relates to an improvement of the conventional technique and apparatus for measurement of blood pressure by adding an electronic amplification system which makes the Korotkoff sounds audible directly to the operator, thus eliminating the need for a stethoscope and enabling an individual to check his/her own blood pressure without the aid of a second person. As generally accepted, the most reliable method to measure the blood pressure is by indirect auscultation. The technique consists of using an air pressure cuff as an artery occlusion device and a stethoscope for detecting the Korotkoff sounds. The inflatable cuff is applied surrounding the upper portion of the patient's arm. A hand-held air pump is used to quickly inflate the cuff to a pressure above the presumed systolic pressure by about 20-30 mmHg. Thereafter, the pressure in the cuff is gradually decreased at a rate of 2-3 mmHg/seconds by means of a bleeding valve. A point is reached at which the occluded artery begins to open briefly during each cardiac systole. At this point, the air pressure in the cuff is considered equal to the blood pressure in the brachial artery and is accepted in the medical art as systolic blood pressure. As the pressure in the cuff continues to drop, a point is reached at which the brachial artery becomes fully open during the entire cardiac cycle. The heart is at rest at this time. This pressure is understood as diastolic blood pressure. Web site: http://www.delphion.com/details?pn=US05406953__
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Apparatus for measuring blood pressure Inventor(s): Hon; Edward H. (Bradbury, CA), Hon; Edward D. (Bradbury, CA) Assignee(s): The Hon Group (Encino, CA) Patent Number: 4,993,422 Date filed: December 19, 1988 Abstract: Apparatus for continuously measuring blood pressure, preferably in the situs of the wrist is disclosed. A hand and wrist support structure maintains the hand and wrist in a substantially fixed relationship. A pressure monitoring apparatus consisting of a sensing device and structure for maintaining the sensor over the radial artery of a user so as to measure the blood pressure is disclosed. Excerpt(s): This invention relates to an apparatus for continuously and non-invasively measuring blood pressure. In particular, the invention finds use as part of a general system for measurement of blood pressure based on repetitive evaluation of the
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pressure fluctuation, and in particular the patterns of the radial artery and therefore reflects the arterial blood pressure of the general circulation. The apparatus of the present invention enables continuous monitoring of blood pressure patterns over extended periods of time. This is needed in the evaluation of circulatory function and ambulatory monitoring of cardiac function, and is useful for hypertension studies and for obtaining records of circulation. Web site: http://www.delphion.com/details?pn=US04993422__ •
Apparatus for measuring blood pressure Inventor(s): Close; Alan (Woking, GB), Hamilton; Guy (Woking, GB), Wright; Martin (Rickmansworth, GB) Assignee(s): Tripod Industries Company Limited (GB3) Patent Number: 5,002,061 Date filed: July 28, 1988 Abstract: The invention relates to apparatus for measuring blood pressure by providing an inflatable cuff and pulse sensing means for fixing to a digit such as, for example, a finger or toe, and electrical control circuit means for converting a sense pulsed into a visual or audible indication, pneumatic means for transmitting the sensed pulse to the converting means and pressure means for measuring the pressure exerted in the cuff, the arrangement being such that with the cuff in a operative position on the body, progressive inflation/deflation of the cuff is effected until pulse sensing means just detect the presence of the pulse thus providing an indication of the systolic blood pressure. The invention includes novel variable capacitors for pneumatic coupling to the pulse sensor and comprising a housing, a diaphragm disposed across the housing, a base plate disposed on the side of the diaphragm opposite from said pneumatic connection, and electrical connecting means provided to the base plate so that changes in the volume occur the cavity defined by the base plate and the diaphragm due to pressure changes in the pneumatic system above the diaphragm, resulting in changes in capacitance and sensing of the pulse within the pneumatic system to be determined. Excerpt(s): The present invention relates to apparatus for measuring blood pressure. Hitherto, blood pressure has been measured by providing an inflatable cuff which is wrapped around the upper arm, and inflated. The pressure within the cuff is monitored by means of a mercury manometer. In use, the device is wrapped around the upper arm of a patient and a pulse is detected using a stethoscope usually from the artery in the elbow. The cuff is inflated until the pulse is no longer audible and then the pressure is slowly released and the pressure at which the pulse just becomes discernable is noted. This is known as the systolic blood pressure. The pressure is further released progressively until the audibility of the pulse changes and the effect of the pulse becomes more muffled. The pressure at which this occurs is known as the diastolic blood pressure. Web site: http://www.delphion.com/details?pn=US05002061__
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Apparatus for measuring blood pressure Inventor(s): Negishi; Kazuaki (Tokyo, JP) Assignee(s): Fukuda Denshi Co., Ltd. (Tokyo, JP) Patent Number: 5,201,319 Date filed: June 24, 1992 Abstract: An apparatus for measuring blood pressure having a pole and a receiver is disclosed. The pole is fixed perpendicular to a floor. The receiver supports a subject's arm on which a cuff is wrapped around. The cuff is connected to a sphygmomanometer. Moreover, the receiver slides up and down along the pole as the body of the subject moves up and down. Excerpt(s): The present invention relates to a method of measuring blood pressure and an apparatus for carring out the method. More particularly, the invention relates to a method and an apparatus of measuring blood pressure of a subject changing from a squatting state to a standing state. Generally, blood pressure is pressure which blood applies to an artery system receiving blood which has been output owing to contraction of the left ventricle of the heart. Web site: http://www.delphion.com/details?pn=US05201319__
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Arm simulator for an oscillometric blood pressure monitor Inventor(s): Glover; Wayne (Odessa, FL), Medero; Richard (Lutz, FL) Assignee(s): Critikon, Inc. (Tampa, FL) Patent Number: 4,464,123 Date filed: July 6, 1982 Abstract: A device for simulating the pressure readings obtained from the arm of a living subject whose blood pressure levels are being determined by an oscillometric blood pressure monitor, includes a pulse pressure chamber for generating pressure pulses at a rate equivalent to a preselected pulse rate. The input to the pressure chamber is attached to the pressure cuff of the monitor and the output is connected to the pressure transducer of the monitor. In order to balance the pressure across the chamber and to apply the full cuff pressure to the monitor transducer, a normally-open valve is connected across the pressure chamber. This valve, however, is closed when the chamber creates a pressure pulse so that the pulse is added to the applied cuff pressure at the monitor transducer. A processor generates electrical signals that control the amplitude of the pressure pulses created by the chamber, depending on preselected values for simulated systolic, mean arterial and diastolic pressures. Excerpt(s): This invention relates to the automated measurement of blood pressure by the oscillometric method and, more particularly, to devices for calibrating oscillometric blood pressure monitors. The measurement of the blood pressure of human beings is usually accomplished by applying a variable pressure through a pressure cuff to the brachial artery in the upper arm of the test subject. As the pressure is varied, the sound of the blood flow through the artery or the pressure pulses generated by the artery are usually measured and used as indications of various blood pressure values. These two techniques, known as the ausculatory and oscillometric methods, respectively, can both be automated. With an automated ausculatory blood pressure monitor, a pump inflates the cuff such that the brachial artery, is occluded. Then the pressure is reduced in
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increments by the monitor and an audio transducer or microphone located on the arm of the subject adjacent the distal portion of the occluded artery converts the sound produced when blood flow is reestablished into electrical signals. These sound signals, known as "Korotkoff" or "K-sounds", are first detected when the cuff pressure is at a level known as the "systolic" pressure. The monitor continues to reduce the cuff pressure until these K-sounds disappear. The cuff pressure level where this occurs is known as the "diastolic" pressure. Once the systolic and diastolic pressures have been determined, the monitor deflates the cuff to zero pressure. Web site: http://www.delphion.com/details?pn=US04464123__ •
Artifact detection based on heart rate in a method and apparatus for indirect blood pressure measurement Inventor(s): Wallach; Richard A. (Tigard, OR), Nelson; Craig H. (Hillsboro, OR) Assignee(s): SpaceLabs, Inc. (Bothell, WA) Patent Number: 4,777,959 Date filed: September 17, 1986 Abstract: A method and apparatus for the indirect measurement of blood pressure is disclosed. Pressure is applied to a cuff attached to a patient adjacent a blood vessel and a quantity representative of the patient's blood pressure is measured as the applied pressure is changed. A first table of values of the quantity as the applied pressure is changed is formed. Values of the first table are selected as spurious high and low values in response to predetermined criteria and new values assigned to the selected values which reduces the error in calculating systolic and diastolic blood pressures from the table. A second table of heart rate values as the applied pressure is changed is formed. Selected heart rate values are set to zero based on predetermined criteria and the locations of the zeros are compared with the locations of systolic, diastolic and maximum values in first table to determine whether to reject or abort the blood pressure reading. Excerpt(s): The present invention relates to blood pressure measurement, in particular to a method and apparatus for the indirect measurement of blood pressure. In most automatic indirect methods of blood pressure measurement, a pressure cuff is attached to a patient's arm adjacent a blood vessel, the cuff is pressurized with an applied pressure which is high enough to occlude the blood vessel and the applied pressure is gradually reduced. As the pressure is reduced to below systole and then diastole, blood begins to flow through the blood vessel creating the well known Korotkoff sounds and pulsatile pressures (oscillations) in the blood vessel. The sounds can be detected by a microphone and the pressure oscillations by a pressure transducer. The sensor, whether a microphone or pressure transducer, measures a quantity which is representative of the patient's blood pressure. A table is then formed of values of the quantity measured at various applied pressures (oscillometric values) as the applied pressure is gradually changed. Using the table the systolic and diastolic blood pressures are determined. In some blood pressure measurement systems where the applied pressure is bled down in steps, at each step the peak amplitude of the oscillations is detected. By measuring the time elapsing between successive peaks the heart rate can be calculated. A table can be formed of the calculated heart rate versus applied pressure. Web site: http://www.delphion.com/details?pn=US04777959__
Patents 323
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Automated blood pressure monitoring instrument Inventor(s): Sainomoto; Yoshinori (Ikeda, JP), Kitagawa; Fumio (Neyagawa, JP) Assignee(s): Matsushita Electric Works, Ltd. (Osaka, JP) Patent Number: 4,592,366 Date filed: April 16, 1984 Abstract: An automated blood pressure monitoring instrument including a noise level detector which enables the instrument to have the sound sensing performance analogous to the human ear. Sounds, including Korotkoff sounds, emitted from the occluded artery of a subject person are transduced into corresponding electric signals to be fed through a filter to the said noise level detector. At the noise level detector, a noise level is calculated from the incoming signals in such a manner as to exclude from this calculation values of expected Korotkoff sound levels and the like which are normally thought to be much higher than an estimated or assumed level of noises associated with the body in the normal blood pressure measurement. The noise level thus detected will vary depending upon the conditions of a subject person as well as varies from person to person, and therefore acts as an effective reference for identifying the Korotkoff sounds. Also included in the instrument is a comparator which discriminates the Korotkoff sounds from the incoming sounds by comparison of their sound levels with a Korotkoff sound reference level which is proportional to said noise level and is naturally a variable level characteristic to the conditions of the subject person. This enables the instrument to discern the differences in the incoming sound signals as the human ear might, thus providing an accurate and effective measurement. When the comparator judges that the incoming sound signals have the level exceeding the above Korotkoff sound reference level, it generates a Korotkoff sound signal representative of the Korotkoff sound. A display is included in the instrument for responding to the appearance and disappearance of the Korotkoff sound signal for providing systolic and diastolic blood pressure indications respectively. Excerpt(s): This invention is directed to an automated blood pressure monitoring instrument, more particularly to a non-invasive detection instrument for automatically measuring arterial blood pressures by an indirect auscultation technique. There have been provided a wide variety of blood pressure measuring instruments based on listening for the Korotkoff sounds. The common technique with the use of such instrument is to place an inflatable cuff around the arm of a user and to occlude the artery in the arm by increasing the pressure within the cuff above an expected systolic pressure by about 20 to 30 mmHg. Thereafter, the pressure in the cuff is allowed to bleed down slowly at a ratio of about 2 to 3 mmHg/sec for detecting the Korotkoff sounds by means of a pressure transducer such as a microphone or the like. The pressures in the cuff at the time of the appearance and disappearance is then recognized by the instrument to be the indications of the systolic and diastolic pressures. However, such prior art instruments have long suffered problems that the detection by the instruments is not always in exact coincidence with the detection by doctors or the like personnel who have been acquainted with the blood pressure measurement using a conventional stethoscope together with a mercury manometer and that detection based upon the human ear has long been widely established and recognized as the standard reference for indicating the systolic and diastolic pressures. There is an inability for the artificial sound sensing means to automatically adjust a critical level, while such automatic critical level adjusting ability is inherent to the human ear and is most reliable for recognizing incoming sounds of important intensity by relative comparison thereof with the self-adjusting critical level in such a way as not to be substantially affected by
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possible noises. In other words, the human ear has the filtering function for a target sound in such a manner as to ignore possible noises, thus recognizing the target sound as having a larger level difference between the target and noises than actually exists. This lack in self adjusting ability of the critical level may also be the cause of mistaking the noises for the Korotkoff sounds when the noise is larger and therefore may result in erroneous blood pressure measurements. In fact, there has never been provided a blood pressure monitoring instrument capable of automatically adjusting its critical level depending upon a level of noises inevitably emanated from the occluded artery and/or the body during the measurement. Accordingly, it is most desirable to present an automated blood pressure monitoring instrument capable of ignoring the noises so as to provide an accurate measurement approximating the measurement by skilled personnel. In addition, the above inconsistency between the blood pressure measurement by the prior art automated instrument and by the human ear can be reasonable explained also in terms of the fact that the skilled personnel rely on a conventional stethoscope to listen for the Korotkoff sounds while the automated instrument receives the Korotkoff sounds through the sound sensing means such as the microphone placed rather directly on a suitable portion of the body. Therefore, this structural difference with respect to the sound conducting path should be taken into account for approximating the measurement by the automated instrument to that by the auscultation technique with the conventional stethoscope. In connection with the above, a particular attention should be directed to the difference in frequency response between the artificial sound sensing means employed and the human ear for obtaining the measurement results as close as those by the skilled personnel. Web site: http://www.delphion.com/details?pn=US04592366__ •
Automated diastolic blood pressure monitor with data enhancement Inventor(s): Ramsey, III; Maynard (Tampa, FL), Medero; Richard (Lutz, FL), Hood, Jr. Rush W. (Tampa, FL) Assignee(s): Critikon, Inc. (Tampa, FL) Patent Number: 4,638,810 Date filed: July 5, 1985 Abstract: A blood pressure cuff is applied about a subject's artery, and inflated above the systolic level thus fully occluding the artery for a full heart cycle. The cuff pressure is thereafter reduced to permit an increasing flow through the progressively less occluded artery, and a measure of the peak amplitudes of the successively encountered blood flow (oscillatory complex) pulses stored in memory. Also retained is the cuff pressure obtaining for each stored complex peak. In accordance with varying aspects of the present invention, the stored complex peak-representing data ensemble is corrected for aberrations; and improved data processing operates on the stored (and advantageously corrected) pulse peak data and the corresponding cuff pressure information to determine the subject's diastolic arterial blood pressure. Excerpt(s): This invention relates to automated blood pressure measuring apparatus and, more particularly, to stored program controlled monitors employing the oscillometric method of detection characterized by data purification and enhanced systolic, diastolic and mean blood pressure determination. Reference is hereby made to the following concurrently filed co-pending commonly assigned patent applications: IMPROVED SPHYGMOMANOMETRIC CUFF PRESSURIZING SYSTEM, Ramsey et al., Ser. No. 751,835; OSCILLOMETRIC BLOOD PRESSURE MONITOR EMPLOYING
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NON-UNIFORM PRESSURE DECREMENTING STEPS, Ramsey et al. Ser. No. 751,840; IMPROVED AUTOMATED MEAN ARTERIAL BLOOD PRESSURE MONITOR WITH DATA ENHANCEMENT, Ramsey et al., Ser. No. 751,826; IMPROVED AUTOMATED SYSTOLIC BLOOD PRESSURE MONITOR WITH DATA ENHANCEMENT, Ramsey et al., Ser. No. 751,827. Automated blood pressure monitoring has rapidly become an accepted and, in many cases, essential aspect of human and veterinary treatment. Such monitors are now a conventional part of the patient environment in emergency rooms, intensive and critical care units, and in the operating theatre. Web site: http://www.delphion.com/details?pn=US04638810__ •
Automated hemodialysis control based upon patient blood pressure and heart rate Inventor(s): Lipps; Ben J. (Lafayette, CA) Assignee(s): Henry Ford Hospital (Detroit, MI) Patent Number: 4,718,891 Date filed: May 6, 1986 Abstract: A method and system for continuously monitoring patient heart rate and blood pressure during hemodialysis and for automatically controlling fluid extraction rate and/or dialysate sodium concentration in the event that blood pressure and/or heart rate indicate onset or impending onset of a patient hypotensive episode. A decrease in patient blood pressure below preselected systolic and/or diastolic low alarm limits automatically initiates a second mode of therapeutic intervention wherein sodium concentration in the dialysate is increased for a predetermined time duration. Upon detection of such low blood pressure alarm, or upon detection of an increase in patient heart rate above a preselected alarm limit, the extraction rate of fluids from the patient through the ultrafiltration membrane is reduced in a first mode of therapeutic intervention by reducing such fluid extraction rate to a minimum level. Blood pressure and heart rate are thereafter monitored during this second mode of intervention to return ultrafiltration flow rate to its desired or goal level as blood pressure and heart rate indicate return of patient vital signs toward their initial levels. Excerpt(s): The present invention is directed to controlled hemodialysis techniques, and more particularly to automated control of dialysate composition and/or patient fluid extraction rate to prevent patient hypotension. Hypotension during hemodialysis is a common occurrence, and results in significant patient discomfort and inefficient use of dialysis time and monitoring personnel. The causes of dialysis-related hypotension are several in origin, and in general result from an inability to increase peripheral resistance and cardiac output during hemodialysis. It has been the practice in the art to monitor the blood pressure of a dialysis patient, either manually or automatically, at periodic intervals and to initiate therapeutic intervention by monitoring personnel in the event of a hypotensive episode. If an episode occurs between monitoring intervals or is not detected by manual or automated blood pressure monitoring, the dialysis monitoring personnel are usually not aware of a potential problem until the patient has a massive reaction and exhibits substantial distress. In any event, the several maneuvers heretofore employed to manage and correct a hypotensive episode, including injection of sodium solution into the patient's bloodstream and/or reducing fluid extraction rate, require manual intervention by dialysis personnel and continued actual observation and monitoring of the patient until the episode is corrected. A high ratio of dialysis personnel to patients is therefore required. It is therefore an object of the present invention to provide a fully automated method and apparatus for continuously
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monitoring patient vital signs during hemodialysis and automatically initiating therapeutic intervention upon occurrence of a hypotensive episode without requiring manual intervention by dialysis personnel. Web site: http://www.delphion.com/details?pn=US04718891__ •
Automated infusion apparatus for blood pressure control and method Inventor(s): McNally; Robert T. (Secane, PA), Engelman; Karl (Cherry Hill, NJ), Noordergraaf; Abraham (Haverford, PA) Assignee(s): Trustees of the University of Pennsylvania (Philadelphia, PA) Patent Number: 4,080,966 Date filed: August 12, 1976 Abstract: A reliable and inexpensive method has been developed to continually regulate the blood pressure of mammals at virtually any desired level. The pressure thus regulated may be maintained within 10 mm Hg tolerances. The method may be carried out by a closed loop apparatus with which (1) the actual blood pressure is continually measured, (2) a function of the actual blood pressure is compared with a desired blood pressure, (3) any difference between the blood pressure expressed by the function of the actual blood pressure and the desired blood pressure is converted into an error signal, (4) the error signal is converted into proportional and derivative functions which in turn (5) control the rate of pumping of a supply of a liquid hypertensive agent or a hypotensive agent into the circulatory system of the mammal. Excerpt(s): This invention relates to the regulation of blood pressure, and particularly to apparatus and methods for the continuous regulation of blood pressure by controlled infusion of drugs which combat hypertension and hypotension. Several drugs are known and commercially available which when administered in proper dosages have the primary effect of regulating the blood pressure. As is set forth in greater detail hereinafter, such drugs may be used either to alter cardiac output (either by changing the capacity of the heart or intravascular volume), or to alter peripheral resistance or state of contraction of the arteriolar resistance vessels. Hypotensive agents act by reducing one or several of these parameters, and hypertensive agents result in opposite effects. In either event, the rate of onset and degree of effectiveness of drugs to achieve satisfactory pressure levels is substantially dependent upon the mode of administration and pharmacodynamics of the drug used. Conventionally, drugs for the regulation of blood pressure are administered by continuous intravenous drip or pump, intramuscular or intravenous injection, or orally. All such methods, however, involve severe difficulties in controlling undesired rise and decay of drug concentration within the patient, which changes may be exponential in character. Web site: http://www.delphion.com/details?pn=US04080966__
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Automated mean arterial blood pressure monitor with data enhancement Inventor(s): Ramsey, III; Maynard (Tampa, FL), Medero; Richard (Lutz, FL), Hood, Jr. Rush W. (Tampa, FL) Assignee(s): Critikon, Inc. (Tampa, FL) Patent Number: 4,754,761 Date filed: October 27, 1986 Abstract: A blood pressure cuff is applied about a subject's artery, and inflated above the systolic level thus fully occluding the artery for a full heart cycle. The cuff pressure is thereafter reduced to permit an increasing flow through the progressively less occluded artery, and a measure of the peak amplitudes of the successively encountered blood flow (oscillatory complex) pulses stored in memory. Also retained is the cuff pressure obtaining for each stored complex peak. In accordance with varying aspects of the present invention, the stored complex peak-representing data ensemble is corrected for aberrations; and improved data processing operates on the stored (and advantageously corrected) pulse peak data and the corresponding cuff pressure information to determine the subject's mean arterial blood pressure. Excerpt(s): This invention relates to automated blood pressure measuring apparatus and, more particularly, to stored program controlled monitors employing the oscillometric method of detection characterized by data purification and enhanced systolic, diastolic and mean blood pressure determination. Reference is hereby made to the following concurrently filed co-pending commonly assigned patent applications: IMPROVED SPHYGMOMANOMETRIC CUFF PRESSURIZING SYSTEM, Ramsey et al., Ser. No. 751,835; OSCILLOMETRIC BLOOD PRESSURE MONITOR EMPLOYING NON-UNIFORM PRESSURE DECREMENTING STEPS, Ramsey et al., Ser. No. 751,840 a divisional application therefrom is being filed concurrently herewith; IMPROVED AUTOMATED SYSTOLIC BLOOD PRESSURE MONITOR WITH DATA ENHANCEMENT, Ramsey, et al., Ser. No. 751,827; IMPROVED AUTOMATED DIASTOLIC BLOOD PRESSURE MONITOR WITH DATA ENHANCEMENT, Ramsey, et al., Ser. No. 751,825. Automated blood pressure monitoring has rapidly become an accepted and, in many cases, essential aspect of human and veterinary treatment. Such monitors are now a conventional part of the patient environment in emergency rooms, intensive and critical care units, and in the operating theatre. Web site: http://www.delphion.com/details?pn=US04754761__
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Automatic air deflation regulator for use in an instrument for measuring blood pressure Inventor(s): Ezekiel; Frederick D. (Lexington, MA), Aisenberg; Sol (Natick, MA) Assignee(s): Gulf & Western Industries, Inc. (New York, NY) Patent Number: 4,198,031 Date filed: April 17, 1978 Abstract: An automatic air deflation valve is provided for use with a sphygmomanometer type blood pressure measuring instrument. The valve comprises a housing having an air flow channel extending through the longitudinal extent thereof and at least one air deflation port extending outwardly from said channel. The port includes a deformable diaphragm supported only on its outer edges and having a
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central aperture extending through the thickness thereof. The diaphragm is adapted to deform in accordance with the air pressure applied against it from said channel to automatically adjust the size and shape of said aperture, thus producing a constant air deflation rate therethrough. Excerpt(s): The present invention relates generally to an automatic air deflation regulator for use in a blood pressure measuring instrument and, more particularly, to such a regulator which includes a deformable diaphragm having an aperture adapted to increase and decrease in size as a function of the air pressure applied against the diaphragm. In conventional sphygmomanometer blood pressure instruments, an inflatable cuff is affixed around the extremity of an individual whose blood pressure is to be measured. The cuff is inflated sufficiently to constrict the flow of arterial blood passing through the extremity and then the pressure in the cuff is decreased at a controlled and known rate of deflation until such time as the Korotkoff sound is first heard through a stethoscope or other monitoring device. Deflation continues until the Korotkoff sound ceases. The pressure at the commencement of the sound is noted and recorded as the systolic pressure and at the time it stops as the diastolic pressure. As it is of utmost importance to maintain a constant rate of deflation, so that the pressure decreases linearly with time, deflation in such instruments is normally controlled by a valve through which air is released at a constant rate. As can readily be appreciated, when the valve has a fixed orifice, air will escape at higher pressures much more rapidly than at lower pressures and this results in a decreasing rate of deflation. This can and does result in inaccurate blood pressure readings. To compensate for this, most blood pressure measuring instruments rely on a manually adjustable release valve which permits constant adjustment of the size of the orifice to accommodate for a decrease in air pressure to maintain this fixed or constant deflation rate. Such manually adjustable valves, however, require operation by physicians, nurses or other trained technicians since a degree of skill is required in order to properly adjust the valve to achieve a constant deflation rate. Web site: http://www.delphion.com/details?pn=US04198031__ •
Automatic arterial blood pressure recorder Inventor(s): Lee; Arnold S. (2008 Cotner Ave., Los Angeles, CA 90025) Assignee(s): none reported Patent Number: 4,790,325 Date filed: July 16, 1987 Abstract: One aspect of the present invention involves a blood pressure recorder system of the type having an inflatable cuff, a pressurized gas source and an inflation valve. The system includes a cuff pressure trigger unit which senses the gas pressure in the cuff. When the duration of significant gas pressure in the cuff exceeds a predetermined time, the cuff pressure sensor facilitates relieving pressure in the cuff. The system also includes a safety system for insuring that the cuff pressure trigger unit is operative. The safety system is independent of changes in the input power.Also disclosed is an improved doppler ultrasonic blood pressure transducer and a novel method for automatically positioning a blood pressure transducer adjacent a skin surface. Excerpt(s): The present invention relates to the field of blood pressure recording systems. In particular, the present invention relates to a system for recording blood pressure wherein cuff pressure is automatically relieved if its duration or duty cycle
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exceeds a predetermined time. The present invention further relates to an improved ultrasonic arterial wall motion transducer and an improved method of coupling said ultrasonic transducer to a subject. There are several impediments to the unattended use of an automatic blood pressure recorder having an inflatable cuff, for example, a recorder of the type generally exemplified by U.S. Pat. Nos. 4,027,662 and 4,069,815. If the recorder malfunctions and causes the cuff pressure to exceed the patient's blood pressure for too long a period, the patient could suffer irreparable damage. The damage caused by prolonged (about one hour in some cases) cuff inflation could well cause a complete loss of the limb. Such damage would be identical to a tourniquet being left on the arm for about an hour. In patients with defective circulation, far less time could result in harm. Even if the cuff is regularly deflated, if the proportion of time in inflation is more than about 35%, harm may result. In modern automatic indirect arterial pressure instruments, the cycling of the cuff pressure is typically controlled by a combination of electric/electronic/pneumatic elements powered by line voltage, a rechargeable battery or compressed gas. The power source could break down, or supply the wrong power; a component of the system may not function. A safety system which will be reliable in protecting the subject in light of all possible combinations of malfunction and defective/deficient power has in the past been, and is presently, needed. Web site: http://www.delphion.com/details?pn=US04790325__ •
Automatic arterial blood pressure recorder system Inventor(s): Lee; Arnold St. J. (2008 Cotner Ave., Los Angeles, CA 90025) Assignee(s): none reported Patent Number: 4,841,980 Date filed: November 25, 1985 Abstract: One aspect of the present invention involves a blood pressure recorder system of the type having an inflatable cuff, a pressurized gas source and an inflation valve. The system includes a cuff pressure trigger unit which senses the gas pressure in the cuff. When the duration of significant gas pressure in the cuff exceeds a predetermined time, the cuff pressure sensor facilitates relieving pressure in the cuff. The system also includes a safety system for insuring that the cuff pressure trigger unit is operative. The safety system is independent of changes in the input power.Also disclosed is an improved doppler ultrasonic blood pressure transducer and a novel method for automatically positioning a blood pressure transducer adjacent a skin surface. Excerpt(s): The present invention relates to the field of blood pressure recording systems. In particular, the present invention relates to a system for recording blood pressure wherein cuff pressure is automatically relieved if its duration or duty cycle exceeds a predetermined time. The present invention further relates to an improved ultrasonic arterial wall motion transducer and an improved method of coupling said ultrasonic transducer to a subject. There are several impediments to the unattended use of an automatic blood pressure recorder having an inflatable cuff, for example, a recorder of the type generally exemplified by U.S. Pat. Nos. 4,027,662 and 4,069,815. If the recorder malfunctions and causes the cuff pressure to exceed the patient's blood pressure for too long a period, the patient could suffer irreparable damage. The damage caused by prolonged (about one hour in some cases) cuff inflation could well cause a complete loss of the limb. Such damage would be identical to a tourniquet being left on the arm for about an hour. In patients with defective circulation, far less time could result in harm. Even if the cuff is regularly deflated, if the proportion of time in inflation
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is more than about 35%, harm may result. In modern automatic indirect arterial pressure instruments, the cycling of the cuff pressure is typically controlled by a combination of electric/electronic/pneumatic elements powered by line voltage, a rechargeable battery or compressed gas. The power source could break down, or supply the wrong power; a component of the system may not function. A safety system which will be reliable in protecting the subject in light of all possible combinations of malfunction and defective/deficient power has in the past been, and is presently, needed. Web site: http://www.delphion.com/details?pn=US04841980__ •
Automatic blood pressure cuff applicator Inventor(s): Keller; Robert B. (Ann Arbor, MI) Assignee(s): Weisman & Allen (Madison Heights, MI) Patent Number: 4,109,646 Date filed: December 20, 1976 Abstract: An arrangement is disclosed for automatically applying to a body member a flexible inflatable cuff of the type used in taking blood pressure measurements. The arrangement includes a rotatable drum supported between a pair of end plates which have openings formed therein allowing the body member of the subject to pass through the interior of the rotatable drum. A cuff is positioned within the drum in an extended or unwound position, with one end thereof restrained against movement with the drum by virtue of a pair of ties secured to the respective end plates and also to one end of the cuff while the other end of the cuff is adapted to be carried with the drum during rotation thereof by virtue of a flexible element connected to the other end of the cuff and passing through the drum wall and about the periphery thereof with a garter spring connected both to the flexible element and to the drum outer surface. Rotation of the drum produces encirclement of the subject's body member with the garter spring allowing extension of the flexible element into the interior of the drum as the cuff is wound onto the body member with a pressure sensitive securement provided to secure the lapped cuff ends together upon rotation of the drum sufficiently to produce such overlap. Reverse rotation of the drum releases the securement and unwinds the cuff. Excerpt(s): This invention concerns blood pressure measurements of the sort involving the application of an occluding cuff to an extremity of the subject in which the blood pressure measurement is to be performed and more particularly concerns apparatus for automatically accomplishing such cuff application. Due to the widespread incidence of blood pressure abnormalities, particularly high blood pressure, in the population at large and due to the insidious onset of such abnormalities and their potentially highly destructive effects on the health of the afflicted individual, it has been heretofore seen as highly desirable that some mass screening system should be devised so as to enable regular and widespread monitoring of the blood pressure conditions of members of the populace. Automation of the testing procedure has been seen as desirable since traditional clinical methods of performing such measurements involve substantial time expenditure by skilled personnel such as doctors, nurses and other clinicians. The performance of such blood pressure measurements involve a fairly sophisticated technique of inflating an occluding pressure cuff encircling an extremity of the subject, usually the upper arm, with a stethoscope used to listen to the blood flow in the arteries downstream of the occluding pressure cuff. The pressure cuff is initially inflated sufficiently to totally block blood flow to the extremity remote from the point of application of the cuff, and the cuff pressure is subsequently allowed to decline
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gradually to a point wherein unrestricted blood flow can occur. The clinician by utilizing the stethoscope is able to detect certain characteristic sounds (referred to as "Korotkoff sounds") occurring at cuff pressures corresponding to systolic and diastolic pressure points, in order to determine these pressure values. Many efforts have been exerted to automate the detection of such systolic and diastolic pressure points in conjunction with an inflatable cuff of the type described. Copending Patent application Ser. No. 714,097, filed Aug. 13, 1976, discloses one such arrangement. Web site: http://www.delphion.com/details?pn=US04109646__ •
Automatic blood pressure measurement device with threshold compensation circuitry and method for performing the same Inventor(s): Asmar; Raymond A. (1 Fairmont Dr., Danbury, CT 06810), Canavan; John (Bee Brook Rd., Washington Depot, CT 06794) Assignee(s): none reported Patent Number: 4,469,107 Date filed: June 1, 1981 Abstract: A blood pressure measurement apparatus comprises electronic circuitry which converts an output from a pressure transducer into a digital display for both the systolic and diastolic blood pressure of an individual. The output of the pressure transducer contains an electrical DC voltage component with a superimposed AC voltage component during arterial blood flow. Sample and hold and logarithmic scaling circuits are used to properly sense the AC voltage over a wide range of values so as to eliminate improper sensing due to noise. A digital output display shows the individual's systolic blood pressure while another display shows the current transducer reading which becomes set upon reaching the diastolic pressure. Control circuitry is used to sense occurrence of the systolic and diastolic pressures.In one embodiment, the circuitry is enclosed in a wristwatch type case which also includes a constrictable band and an integral air bulb, resulting in an easily portable wrist-worn blood pressure measuring device. In another embodiment, the electronic circuitry is incorporated into a standard sphygmomanometer cuff to provide an automatic blood pressure measuring device. Excerpt(s): The present invention relates to blood pressure measurement devices and in particular to devices which can automatically determine the systolic and diastolic pressures of an individual without the need for third party assistance. This invention relates to blood pressure measurement devices, and particularly to blood pressure measurement devices that function automatically. As is well known, the blood pressure of an individual varies during each ventricular heart beat from a high or systolic pressure to a rest or diastolic pressure. Such pressures are typically 120 millimeters of mercury (mm Hg) and 80 mm Hg for a healthy adult. Web site: http://www.delphion.com/details?pn=US04469107__
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Automatic blood pressure measurement in hyperbaric chamber Inventor(s): Qian; Zhenhai (Branford, CT), Cousineau; Robert (Hamden, CT) Assignee(s): CAS Medical Systems, Inc. (Branford, CT) Patent Number: 5,220,502 Date filed: October 10, 1990 Abstract: Blood pressure measurements are performed on subjects disposed in hyperbaric chambers. The measurements are made by an automatic blood pressure monitoring instrument having a differential pressure transducer component. The pressure on the reference side of the pressure transducer is equal to the pressure in the hyperbaric chamber. The reference pressure is derived from a pressure source which equals the pressure in the hyperbaric chamber, but which pressure source does not contain the high purity oxygen gas in the hyperbaric chamber. Excerpt(s): This invention relates to the automatic measurement of the blood pressure of a subject who is confined to a hyperbaric chamber. Hyperbaric chambers have been used for treating Caisson disease, or "bends" in deep sea divers, tunnel crew personnel, and the like persons exposed to high pressure environments. These chambers contain high purity oxygen at super atmospheric pressure, typically 3 ATM or greater. Recently, it has been discovered that subjects who have undergone skin grafts will be benefitted by being placed in a hyperbaric chamber because the grafts heal faster in this high pressure pure oxygen environment. This latter use of the hyperbaric chamber requires that the subject remain in the chamber for longer periods of time than the Caisson disease treatment, and also involves subjects whose vital signs must be closely monitored. Web site: http://www.delphion.com/details?pn=US05220502__
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Automatic blood pressure measuring and recording system Inventor(s): Cornwell; Lionel B. (52 Madison Springs Dr., Madison, CT 06443) Assignee(s): none reported Patent Number: 4,178,918 Date filed: September 15, 1977 Abstract: A noninvasive blood pressure measuring and recording system includes an inflatable cuff for encircling a portion of the human body, a pump for inflating and deflating the cuff for selectively occluding an arterial vessel, a detector for detecting flow variation through the arterial vessel as cuff pressure is decreased, and a recorder for recording cuff pressure values corresponding to the detected flow variation. The pump is a reversible single stroke sleeve diaphragm pump pneumatically coupled to the cuff and provides a selected, repeatable linear rate of pressure change for accurate, repeatable measurements through an automatically controllable motor operating at a selected constant speed to actuate the pump. A speed control changes the linear rate of pressure change in response to detected flow variations to enhance accuracy of measurement of selected variations, such as those identified with the systolic and diastolic pressures. A variable volume ballast tank may be pneumatically coupled to the cuff and pump to accommodate different cuff sizes. Pressure and flow variation signals may be utilized to simply and easily provide one or more different representations or
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measurements of detected flow variations, including additional aural representation concurrent with the measurement process for aural diagnosis. Excerpt(s): This invention relates to an automatically operated non-invasive blood pressure measuring and recording system, and more particularly to a system of the type which includes an inflatable cuff for encircling a portion of the human body, usually the arm, means for inflating and deflation the cuff for selectively occluding an arterial vessel, means such as a microphone for detecting flow variations through the vessel as the cuff is delfated, e.g., those variations giving rise to Korotkov sounds identified with the systolic and diastolic pressures, and means for recording arm cuff pressure values in correspondence with the detected flow variations to provide a measurement record. In known blood pressure systems the inflation of the pressure cuff is obtained by the operation of either a hand operated pump or an electric pump which is turned off when the desired pressure is reached. Deflation is accomplished with an air escape valve controlled either manually or with a servomechanism, as disclosed in U.S. Pat. No. 3,905,353, to provide a more or less constant rate of pressure drop. These known techniques have not been fully satisfactory, as they either are substantially nonlinear or require complicated means to approach linearity, and as they are affected by ambient conditions and do not provide the reproducability of pressure drop necessary for accurate, repeatable measurements. In addition, such techniques are not readily adaptable to provide a slower linear rate of pressure drop in the particular regions where systolic and diastolic pressures are detected, as suggested for improved measurement accuracy in U.S. Pat. No. 3,814,083 (col. 3, 1. 28-40). Finally, such inflation and deflation techniques do not lend themselves easily to automatic control over a full inflation and deflation cycle, which is desirable from the standpoints of reproducability of measurement and ease of operation. In addition, known blood pressure systems provide a limited amount of measurement and diagnostic information, either in the form of chart traces of flow variations to be interpreted visually (e.g., U.S. Pat. Nos. 3,811,439, 3,867,926 and 3,878,834), in the form of readouts, either digital or analog, of systolic and diastolic pressures (e.g., U.S. Pat. Nos. 3,085,567, 3,396,405, 3,905,354, 3,623,476 and 3,500,822), or in the form of aural signals to be interpreted traditionally by a physician for the onset and disappearance of Korotkov sounds. Known systems heretofore have not provided multiple sources of information simply and easily, and have not included any arrangement permitting a diagnosis of the action of the artery,e.g., for detection of murmurs and the like, in connection with the blood pressure measurement. Web site: http://www.delphion.com/details?pn=US04178918__ •
Automatic blood pressure measuring apparatus Inventor(s): Ito; Hisashi (Komaki, JP) Assignee(s): Colin Corporation (Aichi-ken, JP) Patent Number: 6,482,164 Date filed: February 8, 2001 Abstract: An apparatus for automatically measuring a blood pressure of a female subject, including a blood-pressure measuring device which includes an inflatable cuff adapted to apply a pressing force to a body portion of the subject and automatically measures, by changing the pressing force of the cuff, a blood pressure of the female subject at a predetermined measurement period, a labor-pain-signal detecting device which detects, from the female subject, a labor-pain signal which changes in relation to a
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labor pain of the subject, and a blood-pressure-measurement starting device for operating the blood-pressure measuring device to start a blood-pressure measurement, when the predetermined measurement period has elapsed and when the labor-pain signal detected by the labor-pain-signal detecting device falls within a reference range. Excerpt(s): The present invention relates to an automatic blood pressure measuring apparatus which can accurately measure a blood pressure of a female subject even at the time of childbirth. There is known an automatic blood pressure (BP) measuring apparatus which monitors BP values of a living subject by periodically changing an air pressure of an inflatable cuff applied to a body portion of the subject at a predetermined measurement period and detecting a pressure pulse wave produced in the cuff during the change of air pressure of the cuff. It is known that the BP values measured using the inflatable cuff are reliable. Meanwhile, it is medically important to monitor BP values of a female subject at the time of childbirth. However, in the case where the abovementioned BP measuring apparatus is used to monitor, using the cuff, BP values of a female subject who heavily moves her body each time she feels a labor pain (i.e., uterine contraction), the BP measuring apparatus may not accurately measure the BP values of the subject because of her heavy physical motion. Web site: http://www.delphion.com/details?pn=US06482164__ •
Automatic blood pressure measuring apparatus Inventor(s): Hirano; Hitoshi (Gifu, JP), Kondo; Yoshimasa (Komaki, JP), Uemura; Masahiro (Komaki, JP) Assignee(s): Colin Electronics Co., Ltd. (JP) Patent Number: 5,031,630 Date filed: November 28, 1989 Abstract: An automatic blood pressure measuring apparatus, including an inflatable cuff having an elongate configuration, the inflatable cuff being wound around a body portion of a subject, for pressing an arterial vessel of the subject via a body surface over the arterial vessel, a detecting device for detecting at least one Korotkoff sound produced from the arterial vessel as the pressing force of the inflatable cuff applied to the arterial vessel is varied, and a determining device for determining at least one blood pressure value of the subject based on the detected at least one Korotkoff sound, the detecting device being located in a middle area, as viewed in a direction of width of the inflatable cuff, of an inner surface of the inflatable cuff which surface contacts the body portion of the subject. Excerpt(s): The present invention generally relates to an automatic blood pressure measuring apparatus, and particularly to such an apparatus which measures blood pressure of a subject based on Korotkoff sounds produced from an arterial vessel of the subject. There is known an automatic blood pressure measuring instrument which includes (a) an inflatable cuff having an elongate configuration, the inflatable cuff being wound around a body portion of a subject, for pressing an arterial vessel of the subject via a body surface over the arterial vessel, (b) a detector such as a microphone, for detecting at least one Korotkoff sound produced from the arterial vessel as the pressing force of the inflatable cuff applied to the arterial vessel is varied, and determining system for determining at least one blood pressure value of the subject based on the detected at least one Korotkoff sound. In the above-indicated conventional instrument, the microphone or other Korotkoff sounds detector is positioned in a distal end area of
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the cuff which area is more remote from the heart of the subject than the other, proximal end area of the cuff. Accordingly, for example in the event that the subject is in a condition of shock and his or her pulsation is not strong enough, it has conventionally been experienced that the microphone cannot detect Korotkoff sounds with sufficiently great magnitudes, and therefore that accurate blood pressure measurement is difficult. Web site: http://www.delphion.com/details?pn=US05031630__ •
Automatic blood pressure measuring apparatus having pressure chamber-relieving means Inventor(s): Kawamura; Norio (Nagoya, JP), Kaida; Noriyuki (Kakamigahara, JP) Assignee(s): Colin Electronics Co., Ltd. (JP) Patent Number: 5,031,631 Date filed: August 18, 1989 Abstract: An apparatus for automatically measuring a blood pressure of a subject, including a device for defining an inflatable pressure chamber, the device being set on a body portion of the subject, a flexible piping, a device for supplying a pressurized fluid to the inflatable pressure chamber via the flexible piping so as to increase fluid pressure in the pressure chamber and thereby press the body portion of the subject, and a relief device for discharging the pressurized fluid in the inflatable pressure chamber, into atmosphere, if the fluid pressure in the pressure chamber exceeds a predetermined value, the relief means being supported by the means for defining the pressure chamber. Excerpt(s): The present invention generally relates to an automatic blood pressure (BP) measuring apparatus and particularly to such an apparatus which has an inflatable pressure chamber for pressing a body portion of a subject. There is known an automatic BP measuring apparatus of the type having (a) a pressing device which has an inflatable pressure chamber and which is set around a body portion of a subject, (b) a flexible hose, (c) a supply device for supplying pressurized fluid to the inflatable pressure chamber via the flexible hose so as to increase fluid pressure in the pressure chamber and thereby press the body portion of the subject, and (d) a relief-valve device for discharging the pressurized fluid in the inflatable pressure chamber if the fluid pressure in the pressure chamber exceeds a predetermined value as the pressurized fluid is supplied to the pressure chamber. However, in the BP measuring apparatus of the above-described type, the relief-valve device is associated with the main body of the apparatus which is spaced apart from the pressing device or inflatable pressure chamber via the flexible hose provided therebetween. Accordingly, if the flexible hose is bent double, the relief-valve device may erroneously be operated, that is, placed in its operative position in which the device permits a decrease in the fluid pressure in the inflatable pressure chamber, though the fluid pressure in the pressure chamber may not have exceeded the predetermined value. In the case where the relief-valve device is provided with a manually operated reset mechanism for restoring the device from its operative position to its inoperative position, the operator or subject must operate the reset mechanism each time the relief-valve device is changed from its inoperative position to its operative position due to bending of the flexible hose. Web site: http://www.delphion.com/details?pn=US05031631__
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Automatic blood pressure measuring device Inventor(s): LaViola; John (Orange, CT), Librett; Kevin S. (Westport, CT) Assignee(s): Cas Medical Systems, Inc. (Branford, CT) Patent Number: 4,972,840 Date filed: January 11, 1990 Abstract: A method and apparatus for determining mean blood pressure involves the use of a pre-programmed microprocessor which interprets pressure oscillation values from a pressure cuff affixed to a subject's limb. The pressure cuff is inflated to a value above apparent systolic pressure and then deflated in steps. The steps are all substantially equal mmHg declinations in cuff pressure. At each step cuff ocsillation values are taken and stored. The greatest cuff oscillation and its associated cuff pressure are noted, along with the next greatest cuff oscillations and associated cuff pressures on either side of the greatest oscillation. The actual mean blood pressure is then determined by forming a window adjacent to the greatest oscillation and calculating, on which side of the greatest oscilation, within the window, the mean pressure is disposed. Excerpt(s): This application discloses an improvement of a blood pressure measuring device disclosed in application Ser. No. 892,848, filed Aug. 1, 1986 now U.S. Pat. No. 4,796,184, granted Jan. 3, 1989 and assigned to the assignee of this application; and copending application Ser. No. 024,662, filed Mar. 11, 1987 and assigned to the assignee of this application. More particularly, this invention relates to an improved blood pressure measuring device which can provide more accurate determinations of mean arterial blood pressure. The measurement of systolic, diastolic and mean arterial blood pressure values by measuring cuff pressure oscillations caused by blood vessel pulses during stepwise deflation of the cuff is a known technique. Methodology and apparatus for automatically performing this general procedure are disclosed in U.S. Pat. No. 4,349,034 granted Sept. 14, 1982 to M. Ramsey and U.S. Pat. No. 4,360,029 granted Nov. 23, 1982 to M. Ramsey. These patent disclosures relate to a technique which uses a computer controlled device to inflate a pressure cuff, stepwise deflate the cuff, measure and store cuff pressure oscillations occurring at each deflation plateau, and determine which cuff pressure oscillation was the largest. The device then identifies the cuff pressure at which the largest oscillation took place as the mean blood pressure. Provisions are made for rejecting artifact cuff pressure oscillations which can result from subject movement, accidental contact with the pressure cuff, and the like. A device similar to that disclosed in the aforesaid patents is described in an article authored by Joseph Erlanger, M.D., published in The Johns Hopkins Hospital Reports, Vo. XII by the Johns Hopkins Press (1904). In the Elanger device, the cuff was automatically inflated to an initial pressure above mean, and then stepwise deflated to a pressure below mean. Cuff pressure oscillations were sensed and traced onto a rotating drum sheet by a floating pen. Artifact oscillations are apparent upon viewing the trace. Web site: http://www.delphion.com/details?pn=US04972840__
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Automatic blood pressure measuring device and method Inventor(s): Bahr; Dennis E. (Middletown, WI), Clark; Kenneth R. (Cottage Grove, WI), Post; Kendall E. (Madison, WI) Assignee(s): Cas Medical Systems, Inc. (Branford, CT) Patent Number: 4,796,184 Date filed: August 1, 1986 Abstract: The device measures blood pressure automatically using the oscillometric technique. The device includes a pressure cuff which is automatically inflated to an initial pressure which is calculated to be above the subject's systolic pressure. The cuff is then deflated stepwise in preset pressure increments while cuff pressure oscillations are sensed at each cuff pressure level and stored in a computer incorporated into the device. Cuff deflation is continued until the cuff pressure is below the subject's diastolic pressure whereupon the cuff is automatically deflated. The computer then fits a calculated parabolic curve onto the greatest cuff pressure oscillation and onto a lesser oscillation on each side of the greatest oscillation. From the thusly derived curve, the computer determines the mean blood pressure, and the systolic and diastolic blood pressures. Excerpt(s): This invention relates to an improved device for automatically measuring mean, systolic and diastolic blood pressures by the oscillometric technique. More particularly, the device of this invention takes actual cuff oscillations resulting from blood vessel wall movement and fits a parabolic curve onto selected ones of these cuff oscillations and then uses the resultant curve to calculate the statistically true mean, systolic, and diastolic blood pressures. The measurement of systolic, diastolic and mean blood pressure values by measuring cuff pressure oscillations caused by blood vessel pulses during stepwise deflation of the cuff is a known technique. Methodology and apparatus for automatically performing this general technique are disclosd in U.S. Pat. No. 4,349,034 granted Sept. 14, 1982 to M. Ramsey and U.S. Pat. No. 4,360,029 granted Nov. 23, 1982 to M. Ramsey. These patent disclosures relate to a technique which uses a computer controlled device to inflate a pressure cuff, stepwise deflate the cuff, measure and store cuff pressure oscillations occurring at each deflation plateau, and determine which cuff pressure oscillation was the largest. The device then identifies the cuff pressure at which the largest oscillation took place as the mean blood pressure. Provisions are made for rejecting artifact cuff pressure oscillations which can result from subject movement, accidental contact with the pressure cuff, and the like. A device similar to that disclosed in the aforesaid patents is described in an article authored by Joseph Erlanger, M.D., published in The Johns Hopkins Hospital Reports Vol. XII by the Johns Hopkins Press (1904). In the Erlanger device, the cuff was automatically inflated to an initial pressure above mean, and then stepwise deflated to a pressure below mean. Cuff pressure oscillations were sensed and traced onto a rotating drum sheet by a floating pen. Artifact oscillations will be apparent upon viewing the trace. Web site: http://www.delphion.com/details?pn=US04796184__
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Automatic blood pressure measuring system Inventor(s): Aung; Ye (Komaki, JP), Nishibayashi; Hideo (Inuyama, JP) Assignee(s): Colin Electronics Co., Ltd. (Aichi-ken, JP) Patent Number: 5,791,348 Date filed: January 26, 1996 Abstract: An automatic blood pressure measuring system employs an oscillometric method, a cuff applying pressure to an arterial vessel and then gradually reducing the pressure. On a distal side of the cuff, as seen from the heart of the subject, a pulse wave sensor presses against a distal section of the vessel. If the pulse wave sensor detects a pulse wave from the distal section of the vessel after the force applied by the cuff reaches a first target value, indicating that the initial pressure was insufficiently low, the force is increased to a second target value. After determining a relationship between the blood pressure and the magnitude of the pulse wave detected by the pulse wave sensor, blood pressure can be monitored by the pulse wave sensor. Excerpt(s): The present invention relates to an automatic blood pressure measuring system of the oscillometric type and more particularly to such an apparatus which is adapted to measure a blood pressure of a living subject when the pressing force applied to an artery of the subject is decreased. There is known an automatic blood pressure measuring system for measuring a blood pressure of a living subject by the oscillometric method in which a blood pressure of the subject is determined by utilizing a pulse wave consisting of pulses produced from an artery of the subject in synchronism with heartbeat of the subject. The known apparatus includes (a) a pressing device pressing a body portion of a subject and thereby pressing an artery extending in the body portion of the subject, (b) pressure regulating means regulating the pressing force or pressure produced by the pressing device, and (c) determining means controlling the regulating means to increase the pressure of the pressing device to a target pressure (for example, 180 mmHg, or a pressure higher by a suitable amount than a systolic blood pressure of the subject measured in a preceding cycle), collecting pulses of a pulse wave which are produced from the artery and transmitted to the pressing device when the pressure applied to the artery is decreased from the target pressure, and determining a blood pressure of the subject by using the collected pulses. This apparatus is adapted to determine, as a mean blood pressure of the subject, a pressure applied to the artery at the time of detection of a pulse having the greatest amplitude of the amplitudes of the pulses collected during the pressure decreasing operation. In addition, the apparatus determines, as a systolic blood pressure of the subject, a pressure applied to the artery at the time of an inflection point of a curve representing variation of the pulse amplitudes with respect to the pressure applied to the artery which point is located on a higherpressure side of the mean blood pressure, and as a diastolic blood pressure a pressure at the time of an inflection point of the curve which point is located on a lower-pressure side of the mean blood pressure. However, the known oscillometric blood pressure measuring apparatus suffers from the problem that, if an actual systolic blood pressure of the subject is higher than the target pressure, or if the actual systolic blood pressure is lower than the target pressure but higher than a pressure at the time when the determining means starts collecting the pulses of the pulse wave transmitted to the pressing device during the pressure decreasing operation, the apparatus cannot measure the systolic blood pressure of the subject because the target pressure is insufficiently low. In the case where the apparatus is of a type which determines a systolic blood pressure immediately after determining a mean blood pressure during the pressure decreasing operation, the apparatus cannot identify that the target pressure
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is insufficiently low until the pressure applied to the artery is decreased to a level equal to the mean blood pressure. Meanwhile, in the case where the apparatus is of a type which determines a blood pressure by using the pulse wave data obtained during the pressure decreasing operation after the pressure decreasing operation has been completed, the apparatus cannot identify that the target pressure is insufficient until the pressure decreasing operation is completed. Therefore, if the target pressure is insufficient, both of these apparatus are required to effect the blood pressure measuring operation again. This leads to increasing the time necessary for completing the blood pressure measuring operation. Web site: http://www.delphion.com/details?pn=US05791348__ •
Automatic blood pressure monitor employing artifact rejection method and apparatus Inventor(s): Walloch; Richard A. (Aloha, OR) Assignee(s): SpaceLabs Medical, Inc. (Redmond, WA) Patent Number: 5,337,750 Date filed: July 30, 1992 Abstract: A blood pressure monitor capable of measuring blood pressure in the presence of artifact. One embodiment of the blood pressure monitor uses a detector to generate a trigger signal on the occurrence of the R-wave or other point on the ECG waveform. Oscillometric waveform samples taken at the same time after each trigger signal are then summed with each other over many heartbeats to generate an average oscillometric waveform that is used to determine blood pressure by conventional means. Another embodiment of the blood pressure monitor stores oscillometric waveform samples over many heartbeats. The monitor then assumes that the period of the heartbeat has a variety of durations, and it derives respective sets of composite samples by summing the stored samples having the same temporal relationship to the start of each assumed period. The set of composite samples corresponding the a waveform that best matches an actual oscillometric wave is then used to determine blood pressure by conventional means. Excerpt(s): This invention relates to automatic blood pressure monitors, and more particularly, to an automatic blood pressure monitor minimizing the deleterious effects of artifacts. Automatic blood pressure monitors are commonly used to periodically measure the blood pressure of a patient. In most automatic blood pressure monitors, a pressure cuff is attached to a patient's arm over the brachial artery. The cuff is first pressurized with an applied pressure that is high enough to substantially occlude the brachial artery. The cuff pressure is then gradually reduced, either continuously or in increments. As the pressure is reduced to systolic pressure, the flow of blood through the brachial artery beneath the cuff increases substantially. When the blood flows through the brachial artery following each contraction of the heart, it imparts a pulsatile movement to the wall of the artery. This pulsatile movement is coupled to a blood pressure cuff extending over the artery as minute changes in the cuff pressure, which are known as oscillometric pulses. Automatic blood pressure monitors employing the oscillometric method measure and record the amplitude of the oscillometric pulses at a number of cuff pressures. After the blood pressure measurement had been completed, a table contains the oscillometric pulse amplitudes recorded at each cuff pressure. Web site: http://www.delphion.com/details?pn=US05337750__
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Automatic blood pressure monitor having reduced data loss sensitivity to cuff pressure changes Inventor(s): Brooks; James R. (Washington, OR) Assignee(s): SpaceLabs Medical, Inc. (Redmond, WA) Patent Number: 5,280,790 Date filed: January 25, 1993 Abstract: An automatic blood pressure monitor having a blood pressure cuff, an air pump applying pressurized air to the cuff, an air valve selectively venting the cuff, and a pressure transducer generating an output signal having a D.C. component indicative of the steady-state pressure in the cuff, and an A.C. component indicative of oscillometric pulses. The pressure transducer output is amplified and applied to an analog-to-digital converter which generates a digital word indicative of the steady-state cuff pressure. The amplified pressure transducer output is also applied to one input of a differential amplifier having an output that is applied to an analog-to-digital converter having a limited operating range. The other input of the amplifier receives an offset signal from a voltage source to offset the amplified pressure transducer output so that the output of the differential amplifier will not exceed the operating range of the analogto-digital converter. Excerpt(s): This invention relates to automatic blood pressure monitors, and more particularly, to an automatic blood pressure monitor that minimizes the loss of oscillometric data caused by changes in the cuff pressure. Automatic blood pressure monitors are commonly used to periodically measure the blood pressure of a patient. In most automatic blood pressure monitors, a pressure cuff is attached to a patient's arm over the brachial artery. The cuff is first pressurized with an applied pressure that is high enough to substantially occlude the brachial artery. The cuff pressure is then gradually reduced, either continuously or in increments. As the pressure is reduced to systolic pressure, the flow of blood through the brachial artery beneath the cuff increases substantially. When the blood flows through the brachial artery following each contraction of the heart, it imparts a pulsatile movement to the wall of the artery. This pulsatile movement is coupled to a blood pressure cuff extending over the artery as minute changes in the cuff pressure, which are known as oscillometric pulses. Automatic blood pressure monitors employing the oscillometric method measure and record the amplitude of the oscillometric pulses at a number of cuff pressures. After the blood pressure measurement had been completed, a table contains the oscillometric pulse amplitudes recorded at each cuff pressure. Web site: http://www.delphion.com/details?pn=US05280790__
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Automatic blood pressure monitor with a dual-speed control circuit for the DC inflation pump motor Inventor(s): Newell; Scott (Ipswich, MA) Assignee(s): Siemens Medical Systems, Inc. (Iselin, NJ) Patent Number: 5,517,999 Date filed: May 26, 1994 Abstract: An automatic blood pressure monitor has a dual-speed control circuit which is used to control the speed of a DC motor that powers the inflation cuff. The control
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circuit limits the motor current, permitting operation from a limited power source (such as a battery). The control circuit also includes structure for electrically braking the motor; the motor is braked after a time delay which commences after motor power is cut off. Excerpt(s): The invention relates to automatic blood pressure monitors, and more particularly relates to the inflation pump used to inflate the inflation cuff. In its most immediate sense, the invention relates to circuitry which is used to control a DC motor that powers the inflation pump, and which is capable of properly inflating even the small inflation cuffs used for neonates. In an automatic blood pressure monitor, an inflation cuff is slipped onto e.g. the patient's upper arm and inflated to a pressure which exceeds the patient's systolic pressure. This collapses the main artery in the patient's arm and cuts off blood flow to the lower arm. Then, the inflation cuff is slowly deflated while the pressure inside the cuff is monitored using a pressure transducer. The patient's systolic and diastolic pressures can then be determined by monitoring the output of the pressure transducer (which responds to variations in cuff pressure caused by the patient's pulse) and correlating that output with the pressure within the cuff. While the cuff must be inflated to an inflation pressure which exceeds the systolic pressure, the excess should not be great because this unnecessarily prolongs the measurement process and also unnecessarily stresses the patient's arm. To accurately control the inflation process and cease cuff inflation at an appropriate pressure, it is advantageous to have the pump deliver air at more than one rate. This is because automatic blood pressure monitors are used with cuffs that vary greatly in size; a large cuff may be large enough to encompass the human thigh, while a neonatal cuff may be so small as to just fit over an adult's little finger. The rate of inflation of a neonatal cuff should be only a small fraction--perhaps 1/5--of the rate of inflation of a large cuff. Web site: http://www.delphion.com/details?pn=US05517999__ •
Automatic blood pressure monitoring system Inventor(s): Niwa; Minoru (Nagoya, JP), Yokoe; Hifumi (Kasugai, JP) Assignee(s): Nippon Colin Co., Ltd. (Aichi, JP) Patent Number: 4,780,824 Date filed: December 29, 1986 Abstract: An automatic blood pressure monitoring system includes a device which detects the degree of saturation of oxygen in the blood at a peripheral part of the body. The detecting device generates a signal if the degree of saturation is detected to be abnormal. A control device operates a blood pressure measuring device in response to the signal indicating abnormal oxygen saturation. In a second embodiment, a trigger device periodically generates a signal to operate the blood pressure measuring device. When an abnormal oxygen saturation is detected, a signal operates the blood pressure measuring device and the triggering interval is shortened. Excerpt(s): The present invention relates in general to an automatic blood pressure monitoring system, and in particular to such a system which automatically obtains a measure of an blood pressure upon detection of abnormality in the degree of saturation of oxygen in the blood of a subject being monitored. There is known in the art an automatic blood pressure monitoring system having an inflatable cuff which is wound around a part of a subject or living body to be monitored, so as to oppress the part, and also having determining means which determines a measure of blood pressure based on
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fluctuations of pulse waves that are caused in association with variation in the pressure in the inflatable cuff. In order to capture such fluctuations of the pulse waves, a variety of indications or signs are utilized such as: appearance and disappearance of Korotkov's sounds which are heard at the part of the subject, while the cuff is deflated; change in the magnitude of oscillations of the pressure in the cuff which are caused in synchronous relationship with heartbeats of the subject; or change in the magnitude of pulsations on the surface of the wall of an artery that are detected by means of ultrasonic wave. A conventional automatic monitoring system of such a type is adapted to obtain blood pressure measurements, according to starting signals supplied periodically, for the purpose of, for example, monitoring a patient (subject) during or after a surgical operation procedure. In the above-identified type of automatic monitoring system, a measure of blood pressure is not necessarily obtained at the time the subject being monitored is brought into an abnormal state with respect to the degree of saturation of oxygen in the blood, due to shock or cyanosis, since such measurement is conducted at regular intervals of time. That is, the conventional system is not able to obtain a measure of blood pressure at the time the measure is clinically needed for monitoring the condition of the subject. An automatic monitoring system for monitoring a subject's blood pressure during or after a surgical operation, is required from the clinical viewpoint to be able to obtain a measure of blood pressure at the very time the subject is brought into an abnormal state. Web site: http://www.delphion.com/details?pn=US04780824__ •
Automatic blood pressure system Inventor(s): Hill; Jeremy R. (Weston, CT), Malinouskas; Donald (Monroe, CT) Assignee(s): United States Surgical Corporation (Norwalk, CT) Patent Number: 4,328,810 Date filed: October 3, 1979 Abstract: A blood pressure system which cycles through an inflation cycle and a deflation cycle during which systolic and diastolic pressure in a patient is automatically measured. The blood pressure system basically comprises a pressure cuff system for accomplishing occlusion and the subsequent opening of an artery in a patient being monitored, and an electrical system for controlling the pressure cuff system and for displaying the systolic and diastolic measurements. In order to automatically carry out the inflation and deflation cycle of the blood pressure system, a dedicated controller is employed. A microphone, contained within the blood pressure cuff produces an electrical signal indicative of pulsatile activity within the artery. A K-sound detector receives the signal and relays information to the dedicated controller. In the blood pressure system, K-sound detection continually takes place during both the inflation and deflation cycles of the instrument. Excerpt(s): This invention relates to a system for automatically measuring and monitoring systolic and diastolic blood pressure in the human body by employing noninvasive techniques. The standard clinical method for the non-invasive measurement of blood pressure employs a device called a sphygmomanometer which comprises an inflatable cuff connected to a manometer tube in which the height of a column of mercury indicates the pressure in the cuff. The cuff is wrapped around a limb, usually the upper arm, and inflated until the pulse in the artery of the limb is suppressed because the artery is squeezed shut. The cuff is then gradually deflated, so that blood begins to flow through the artery again. The turbulent flow of the blood within the
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artery causes a characteristic sound known as a Korotkoff sound or K-sound. The pressure indicated by the manometer at that instant corresponds to the systolic blood pressure. With further deflation of the cuff, the turbulent flow in the now fully opened artery becomes so-called "laminar flow" and the sound ceases. The pressure measured at that instant corresponds to the diastolic blood pressure. There are any number of prior art devices which have automated the procedure described above. Typically, these blood pressure measuring systems consist of a microphone for sensing Korotkoff sounds, a cuff pressurization source, electronic circuitry for processing Korotkoff sounds, and a technique for displaying systolic and diastolic blood pressure values. Web site: http://www.delphion.com/details?pn=US04328810__ •
Automatic blood pressure system with servo controlled inflation and deflation Inventor(s): Hill; Jeremy R. (Weston, CT), Malinouskas; Donald (Monroe, CT) Assignee(s): United States Surgical Corporation (Norwalk, CT) Patent Number: 4,493,326 Date filed: January 29, 1982 Abstract: A blood pressure system which cycles through an inflation cycle and a deflation cycle during which systolic and diastolic blood pressure in a patient is automatically measured. The blood pressure system basically comprises an inflatable pressure cuff system for accomplishing occlusion and the subsequent opening of an artery in a patient being monitored, and an electrical system for increasing and decreasing the pressure in the cuff under servo loop control and for displaying the systolic and diastolic measurements. A pressure transducer produces an electrical signal indicative of the actual pressure in the cuff. A solenoid valve permits selective pressure decrease during the deflation cycle. A rotary vane compression pump provides pressure increase during the inflation cycle. During the inflation cycle, pressure increase in the cuff is accomplished by a servo control loop comprising the transducer, the pump, and an inflate/deflate controller. During the deflation cycle, pressure decrease in the cuff is accomplished by a servo control loop comprising the transducer, the controller, and the solenoid valve. In both the inflation cycle and the deflation cycle, the controller receives the signal from the transducer and produces an error signal indicative of the difference between the actual rate of change of pressure in the cuff and a desired rate of change of pressure. Additional circuitry in the controller variably duty cycle modulates the error signal to produce a control signal. In the inflation cycle, the control signal actuates the pump to increase the pressure. In the deflation cycle, the control signal actuates the solenoid valve to decrease the pressure. Excerpt(s): This invention relates to a system for automatically measuring and monitoring systolic and diastolic blood pressure in the human body by employing noninvasive techniques. The standard clinical method for the non-invasive measurement of blood pressure employs a device called a sphygmomanometer which comprises an inflatable cuff connected to a manometer tube in which the height of a column of mercury indicates the pressure in the cuff. The cuff is wrapped around a limb, usually the upper arm, and inflated until the pulse in the artery of the limb is suppressed because the artery is squeezed shut. The cuff is then gradually deflated, so that blood begins to flow through the artery again. The turbulent flow of the blood within the artery causes a characteristic sound known as a Korotkoff sound of K-sound. The pressure indicated by the manometer at that instant corresponds to the systolic blood pressure. With further deflation of the cuff, the turbulent flow in the now fully opened
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artery becomes so-called "laminar flow" and the sound ceases. The pressure measured at that instant corresponds to the diastolic blood pressure. There are any number of prior art devices which have automated the procedure described above. Typically, these blood pressure measuring systems consist of a microphone for sensing Korotkoff sounds, a cuff pressurization source, electronic circuitry for processing Korotkoff sounds, and a technique for displaying systolic and diastolic blood pressure values. Web site: http://www.delphion.com/details?pn=US04493326__ •
Automatic blood-pressure measuring apparatus Inventor(s): Ito; Hisashi (Komaki, JP) Assignee(s): Colin Corporation (Komaki, JP) Patent Number: 6,561,985 Date filed: November 2, 2001 Abstract: An apparatus for automatically measuring a blood pressure of a living subject, including in inflatable cuff which is adapted to be wound around a portion of the subject, a cuff pulse wave including heartbeat-synchronous pulses occurring to the cuff while a pressure in the cuff is changed, a blood-pressure determining device for determining a blood pressure of the subject based on a change of respective amplitudes of the heartbeat-synchronous pulses of the cuff pulse wave, a display device which has a two-dimensional screen consisting of picture elements, and an amplitude displaying device for successively displaying, on the two-dimensional screen of the display device and while the pressure of the cuff is changed, the amplitude of each of the heartbeatsynchronous pulses of the cuff pulse wave, such that the amplitude of the each heartbeat-synchronous pulse of the cuff pulse wave is comparable with at least one prior amplitude of at least one prior heartbeat-synchronous pulse of the cuff pulse wave. Excerpt(s): The present invention relates to improvements of an apparatus for automatically measuring a blood pressure of a living subject. There is known an oscillometric-type automatic blood-pressure measuring apparatus which automatically measures a blood pressure of a living subject according to an oscillometric method. The oscillometric-type automatic blood-pressure measuring apparatus includes an inflatable cuff which is adapted to be wound around a prescribed portion of the subject, obtains a cuff pulse wave occurring to the cuff while a pressing pressure of the cuff is slowly changed, and determines a blood pressure of the subject based on the change of respective amplitudes of respective heartbeat-synchronous pulses of the cuff pulse wave. However, the above automatic blood-pressure measuring apparatus may measure an erroneous blood pressure of the subject, because of a physical motion of the subject during the blood-pressure measuring operation, occurrence of an arrhythmic pulse to the cuff, or noise produced by its peripheral devices. Hence, a blood-pressure measuring apparatus disclosed in Japanese Patent Document No. 2-25610 displays an array of respective amplitudes of respective heartbeat-synchronous pulses, arranged in an order of occurrence of the pulses, in a two-dimensional graph defined by a first axis indicative of pressing pressure of cuff as a first parameter and a second axis indicative of amplitude of cuff pulse wave as a second parameter, so that a degree of reliability of measured blood pressure may be judged by an operator. From the array of amplitudes being displayed, it is possible to observe a magnitude of each of the amplitudes or the manner of distribution of the amplitudes, and thereby judge the reliability of measured blood pressure. If it is judged from the displayed array of amplitudes that the reliability of measured blood pressure is insufficient, the blood-pressure measuring apparatus
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may be operated again to carry out another blood-pressure measuring operation and thereby obtain a reliable blood pressure. Web site: http://www.delphion.com/details?pn=US06561985__ •
Automatic cuff mechanism for blood pressure measuring system Inventor(s): Lichowsky; Abraham (Los Angeles, CA), Bauman; Jack I. (Santa Monica, CA) Assignee(s): Ambitex Company (Los Angeles, CA), Medical Monitors, Inc. (Los Angeles, CA) Patent Number: 3,935,984 Date filed: September 9, 1974 Abstract: An automatic cuff for use with blood pressure measuring apparatus includes a cylindrical member within which a person may position his arm. A flexible band is positioned circumferentially about the inner wall of the cylinder and connected to a cable extending from the cylinder such that pulling on the cable circumferentially contracts the band in the manner of a tightening spiral. The band supports an air chamber on its inner wall and after a person's arm is snugly engaged by the band, further contraction is stopped and fluid is pumped in the fluid chamber to provide additional force in closing off circulation. After the air pressure is gradually decreased, release of the person's arm is accomplished by releasing the pulling force on the cable so that the flexible band circumferentially expands under its own natural bias. Excerpt(s): This invention relates to automatic blood pressure measuring apparatus and more particularly to the cuff portion of such apparatus for temporarily closing off blood circulation in a portion of a person's body, for example, an arm or leg, in accord with sequencing steps in automatically taking a person's blood pressure. In copending patent applicaton Ser. No. 443,442 filed Feb. 19, 1974 and entitled "BLOOD PRESSURE MEASURING SYSTEM" there is disclosed a system for automatically taking a person's blood pressure. One of the steps involved in the process includes wrapping the person's arm in a cuff which includes a fluid chamber for temporarily cutting off blood flow circulation. While a conventional type cuff could be used with the apparatus described in the aforementioned application provided suitable fluid line connections were made to the apparatus as well as provision for a suitable acoustic pulse pick-up means, it would be desirable to provide a completely automatic arrangement for providing the necessary blood circulation cut off. With such an automatic cuff applicator, consistent snug engagement of the person's arm could be realized all to the end that more consistent results can be realized. A desirable feature of any type of automatic cuff applicator would be the provision of suitable acoustic pulse detecting means for connection into the overall blood pressure measuring system. Web site: http://www.delphion.com/details?pn=US03935984__
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Automatic identification of cuff size in automated blood pressure monitors Inventor(s): Hood, Jr. Rush W. (Tampa, FL) Assignee(s): Critikon, Inc. (Tampa, FL) Patent Number: 4,501,280 Date filed: April 6, 1983 Abstract: Automated blood pressure monitors utilizing a pressurized cuff are adapted automatically to work with a variety of cuff sizes, including neonatal. An acoustical pressure pulse is generated at the monitor, propagated to and through the cuff, and back to a pressure transducer in the monitor. The total time of propagation is indicative of the cuff size being utilized. Excerpt(s): This invention relates to automated blood pressure monitoring, and more particularly to noninvasive automated monitors which utilize a selectively inflatable cuff to sense blood pressure. Automated blood pressure monitoring has become an indispensible tool in many aspects of medicine, perhaps the most important of which are those associated with the critical care patient. Increasingly, anesthesiologists utilize such monitors throughout surgical procedures, and the automated monitors are virtually universally used in critical care units, neonatal and adult intensive care units, and emergency treatment centers. The most prevalent class of noninvasive blood pressure monitors utilize the so-called oscillometric method, and feature an inflatable cuff which is fitted over a limb of the patient, for example at the brachial artery. Through a complex system of inflation and/or deflation steps, the monitor senses arterial pressure changes and generates such information as mean arterial pressure, systolic pressure, diastolic pressure, and heart rate. Typically, the cuff size is adapted roughly to the anticipated arm size of the patients, and even though each typical cuff size permits some significant range of adjustability, the respective cuff sizes may be, on a volume basis, widely variant one from the other. Although given types of monitors operate with similar rationale regardless of the cuff size employed, it has been uncommon for any given unit to operate with more than one type or size of cuff and corresponding selective inflation volumes and pressures. Generally, this has been for the protection of neonates, who would be seriously injured if a cuff were to be inflated to the pressure levels required in the operation of sensing adult pressure. Hence, for the most part, commercial automated monitors have been designed to operate either for the neonate, or for adults, but not for both. Rarely, a given unit designed for both has been fitted with an operator actuated switch to select between neonatal and adult modes of operation; such units, however, have been regarded with considerable reluctance, since operator inadvertence could easily result in the application of the adult pressure parameters to the neonate. Web site: http://www.delphion.com/details?pn=US04501280__
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Automatic indirect non-invasive apparatus and method for determining diastolic blood pressure by calibrating an oscillation waveform Inventor(s): Hersh; Lawrence T. (Tampa, FL) Assignee(s): GE Medical Systems Information Technologies, Inc. (Milwaukee, WI) Patent Number: 6,517,495 Date filed: September 10, 2001
Patents 347
Abstract: Blood pressure of an human being is read by a process that places a cuff around a portion of the human being's body. The cuff is inflated to a predefined pressure which occludes the flow of blood and then the cuff is deflated in a controlled manner. At a plurality of deflation pressure levels, pressure oscillations that occur in the cuff are measured to produce a series of measurements representing the waveform of the oscillations. The systolic pressure and mean arterial pressure are derived from the measurements in conventional manners. A portion of the waveform for one cardiac cycle is analyzed by locating points which correspond to the occurrence of the systolic and mean arterial pressures. The diastolic pressure, which occurs at the minimum point of the waveform, is derived from those points and the systolic and mean arterial pressures. Excerpt(s): Not applicable. Not applicable. The invention generally relates to oscillometeric blood pressure determining techniques, and more particularly to determining the diastolic pressure using that technique. Web site: http://www.delphion.com/details?pn=US06517495__ •
Automatic mean blood pressure reading device Inventor(s): Ramsey, III; Maynard (Tampa, FL) Assignee(s): Johnson & Johnson (New Brunswick, NJ) Patent Number: 4,349,034 Date filed: March 31, 1980 Abstract: A method for producing information indicative of the mean blood pressure of a living creature through indirect measurement, practiced in a system comprising an inflatable cuff, a pump connected to the cuff, a deflating valve connected to the cuff, measuring apparatus connected to the cuff adapted to measure cuff pressure and pressure oscillations occurring in the cuff caused by the heartbeat of the living creature and control apparatus connected to the pressure measuring apparatus, pump and deflating valve. Deflation of the cuff occurs in pressure increments, with processing being done at each given increment to evaluate plural successive pulsations for purposes of artifact rejection and identification of a true pulsation. Excerpt(s): The invention generally relates to pressure indicating devices of the type used for the measurement of body fluid pressures and more particularly to an indirect non-invasive automatic mean blood pressure reading device. The pressures of fluids in the vessels of all living things are indications of many facts which are of great value to those engaged in medical, biological and related fields. In the case of humans, the pressure in the vascular system is measured for many reasons, including diagnosis in pathology, laboratory routine for certain ailments, ascertainment of the progress of therapy, etc. As an example, the determination of venous blood pressure is an essential element in the diagnosis of a patient suspected of cardiac disease. Normal human venous blood pressure ranges between 10-120 millimeters water, whereas elevations of venous blood pressure above that range are found in cases of congestive heart failure. True mean arterial pressure is not the arithmetic average of the systolic and diastolic pressure. Mean pressure depends on the amplitude and contour of the arterial pressure wave. Thus for example, if a person has a systolic pressure of 100 and a diastolic pressure of 50, the mean pressure would not be 75 but would be closer to 63 because the pulsation of the blood does not spend much time at the high systolic point as it retreats quickly from this peak pressure so that most of the pulsation time is spent at a lower
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pressure near the diastolic pressure. Thus if a total arterial wave form is ascertained, or its mean, a better picture of the patient's condition is presented to the physician. The presentation of only the systolic and diastolic pressure to a physician does not enable the physician to make a truly accurate assessment of the patient's arterial wave form. All that is really indicated by the pressure is that when the heart contracts, for some variable period of time the pressure in the artery goes up to systolic pressure. Thus the physician cannot determine if the pressure is for a tenth of a second, only that a particular pressure has been reached for some unknown instant. However, as to the actual pressure that the capillaries are encountering, the fluctuations are all, or practically all damped out. Thus by knowing the mean pressure the physician is better able to determine the pressure head that is driving blood through the capillaries. Web site: http://www.delphion.com/details?pn=US04349034__ •
Automatic noninvasive blood pressure monitor Inventor(s): Penaz; Jan (Brno, CS) Assignee(s): University J.E. Purkyne v Brne (Brno, CS) Patent Number: 4,869,261 Date filed: March 22, 1988 Abstract: An automatic noninvasive blood pressure monitor with a continuous correction of the setpoint and of the gain without interruptions of the blood pressure measurement has a pressure vibration generator, the frequency of vibration being higher than that of the highest harmonic component of blood pressure wave, and a correction circuit, the input of which is connected either directly or through at least one amplifier of the basic servosystem to the sensor of the plethysmographic gauge and output of which is fed to the input of the circuit for correction of the setpoint of the basic servosystem. Excerpt(s): The invention relates to an automatic noninvasive blood pressure monitor, i.e. an instrument for measuring the blood pressure in man on arteries being compressible from the surface by means of a pressure cuff or a pelotte equipped with a plethysmographic gauge, such as an impedance or a photo-electric one, which gauge is connected through at least one amplifier and a phase corrector to an electro-pressure transducer. All these components constitute the closed loop of a servosystem which continuously and instantaneously changes the pressure in the cuff and maintains thus the volume of the artery at a value corresponding to the zero tension of the arterial wall. The pressure within the cuff thus follows the instantaneous value of intraarterial pressure. In such instruments automatic setting and correction of the setpoint and gain is also possible. Similar instruments are known from the patent literature, e.g. Czechoslovak patent specification No. 133205, U.S. patent specification No. 4,510,940, as well as from articles in medical and technical journals. The instruments known up to now, however, either have no automatic initial setting of the setpoint and gain, or have no correction of these parameters during the measurement. Although an instrument with such a correction has been proposed, the correction is performed during shortlasting interruption of the measurement. Another instrument proposed is equipped with an additional cuff placed on another circulatory region so that a pair of cuffs is necessary. The proposed instruments permit measurement of the blood pressure on arteries of the finger or of another region which can easily be transilluminated, however continuous blood pressure measuring is impossible on other arteries especially on larger ones. It is therefore a primary object of the present invention to provide an automatic
Patents 349
noninvasive blood pressure monitor with a continuous correction of the setpoint and of the gain without interruptions of the blood pressure measurement. Web site: http://www.delphion.com/details?pn=US04869261__ •
Automatic non-invasive blood pressure reading device Inventor(s): Ruiter; Karl A. (La Canada, CA) Assignee(s): Medical Data Electronics, Inc. (Arleta, CA) Patent Number: 4,922,918 Date filed: April 17, 1989 Abstract: An improved method and apparatus for non-invasive determination of blood pressure is disclosed. The oscillometric technique is employed, wherein a valve representative of the blood pressure is derived from a signal representative of the pressure oscillations in a cuff, where the value is derived for a plurality of cuff pressures, and where the cuff pressure corresponding to the maximum of the values derived from the pressure oscillations is taken to be the mean arterial pressure. The instant method uses as the value the complementary oscillation index which is defined to be the area bounded by a line connecting successive peaks in the signal and the signal beneath the line, divided by the time between peaks. Apparatus employing both digital and analog circuitry is employed. Excerpt(s): This invention relates in general to the field of blood pressure measuring devices, and in particular to non-invasive blood pressure measuring devices which operate by oscillometry. The need to accurately, reliably and easily determine a patient's blood pressure has long been recognized as a goal. Typically, the blood pressure varies with time in a series of irregularly shaped pulses. The diastolic pressure is the baseline pressure for these pulses. The systolic pressure is defined to be the peak pressure for these pulses. Another useful measure of the pressure is the mean arterial pressure, that is, the time weighted average of the pulses. Ordinarily, the mean arterial pressure is not the arithmetic average of the systolic and diastolic pressures, but rather, is lower than the arithmetic average because the pulses tend to be weighted towards the bases than the peaks. Various methods have been known to the art for determining blood pressure. Broadly, measurement methods may be categorized as either intrusive or non-intrusive. Intrusive blood pressure measuring devices are inserted directly into the blood vessel to make blood pressure measurements. While this method provides accurate blood pressure measurements, it tends to be somewhat painful and requires the attention of a skilled operator. Web site: http://www.delphion.com/details?pn=US04922918__
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Automatic oscillometric apparatus and method for measuring blood pressure Inventor(s): Booth; John W. (Tampa, FL), Friedman; Bruce A. (Tampa, FL) Assignee(s): GE Medical Systems Information Technologies, Inc. (Milwaukee, WI) Patent Number: 6,440,080 Date filed: September 25, 2001 Abstract: Blood pressure of an human being is read by a process that places a cuff around a portion of the human being's body. The cuff is inflated to a predefined
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pressure which occludes the flood of blood and then the cuff is deflated in a controlled manner. At a plurality of deflation pressure levels, pressure pulses that occur in the cuff are integrated to produce a plurality of integral values. A diastolic pressure of the human being is derived in response to the deflation pressure level at which occurred the integral value that is greatest in magnitude. Excerpt(s): Not applicable. Not applicable. The invention generally relates to oscillometric blood pressure determining techniques, and more particularly to determining the diastolic pressure using that technique. Web site: http://www.delphion.com/details?pn=US06440080__ •
Automatic positioning system for continuous blood pressure monitor transducer Inventor(s): Perry; William D. (San Antonio, TX), Winter; Dean C. (San Antonio, TX) Assignee(s): Nippon Colin Co., Ltd. (Komaki, JP) Patent Number: 4,830,017 Date filed: February 25, 1988 Abstract: A system for automatically positioning a blood pressure monitor transducer in a desired position relative to an underlying artery. The positioning system comprises a positioniong motor which drives a gear assembly. The gear assembly is operatively engaged with a lead screw having a follower mounted thereto in threaded engagement therewith. The follower is secured to a strap which is routed through a roller system. As the motor is activated in response to output signals from the sensor mounted within transducer housing, the lead screw will rotate, thereby effectuating lateral movement of the transducer housing and sensor along a path defined by the strap. Excerpt(s): The present invention relates generally to a method and apparatus for continuous noninvasive measurement of blood pressure. More specifically, the present invention provides a method and apparatus for maintaining a continuous blood pressure monitor transducer properly positioned over an underlying artery in order to ensure that at least one of the pressure sensing elements in the transducer tracks the actual pulse waveform in the underlying artery, thus providing the most accurate measurement of the patient's blood pressure. There has been considerable interest in recent years in the development of a monitoring system for obtaining a continuous measurement of a patient's blood pressure. One of the most promising techniques for obtaining such a continuous measurement involves the use of an arterial tonometer comprising an array of small pressure sensing elements fabricated in a silicon "chip." The use of such an array of sensor elements for blood pressure measurements is disclosed generally in the following U.S. Patents.: U.S. Pat. Nos. 3,123,068 to R. P. Bigliano, 3,219,035 to G. L. Pressman, P. M. Newgard and John J. Eige, 3,880,145 to E. F. Blick, 4,269,193 to Eckerle, and 4,423,738 to P. M. Newgard, and in an article by G. L. Pressman and P. M. Newgard entitled "A Transducer for the Continuous External Measurement of Arterial Blood Pressure" (IEEE Trans. Bio-Med. Elec., April 1963, pp. 77-81). In a typical tonometric technique for monitoring blood pressure, a transducer which includes an array of pressure sensitive elements is positioned over a superficial artery, and a hold-down force is applied to the transducer so as to flatten the wall of the underlying artery without occluding the artery. The pressure sensitive elements in the array have at least one dimension smaller than the lumen of the underlying artery in which blood pressure is measured, and the transducer is positioned such that more than one of the individual pressure-sensitive elements is over at least a portion of the
Patents 351
underlying artery. The output from one of the pressure sensitive elements is selected for monitoring blood pressure. The element that is substantially centered over the artery has a signal output that provides an accurate measure of intraarterial blood pressure. However, for the other transducer elements the signal outputs generally do not provide as accurate a measure of intraarterial blood pressure as the output from the centered element. Generally, the offset upon which systolic and diastolic pressures depend will not be measured accurately using transducer elements that are not centered over the artery. One method for selecting the pressure sensitive element for monitoring blood pressure is disclosed in the above mentioned U.S. Pat. No. 4,269,193 issued to J. S. Eckerle. In addition, an improved method for selecting the correct pressure sensitive element for measuring blood pressure is disclosed in a patent application entitled "Active Element Selection for Continuous Blood Pressure Monitor Transducer" filed on even date herewith. Web site: http://www.delphion.com/details?pn=US04830017__ •
Automatic, continuous and indirect blood pressure measurement apparatus Inventor(s): Kisioka; Kazuya (Tomisatomura, JP), Yamakoshi; Kenichi (Sapporo, JP) Assignee(s): Ueda Electronic Works Limited (JP) Patent Number: 4,524,777 Date filed: May 5, 1983 Abstract: An apparatus which can measure the blood pressure automatically, continuously and indirectly, is provided. The apparatus is implemented basing upon the theory of volume compensation method and is provided with a cuff, an external force applying device, and pressure and volume sensors. The pressure of liquid contained in the cuff represents the instantaneous blood pressure under the servo control or feedback control of a volume plethysmogram. The apparatus has been improved by enabling an automatic measurement and by providing a DC level adjustment and first gain control circuit. The circuit is supplied with an output from the volume sensor, and the output is subjected to DC level adjustment and amplitude control. In addition to the above, the apparatus is automatically operated under control of a micro processor. Excerpt(s): This invention relates to an apparatus for measuring the blood pressure automatically, continuously and indirectly. It is known in the art that the blood pressure can be measured by applying the external pressure to an artery to be measured by an occluding cuff. This method is referred to as an auscultatory method. In this case, if the external pressure is higher than the systolic blood pressure, the bloodflow in the distal part of the cuff does not exist, and if the external pressure is kept between the systolic and diastolic blood pressure, the detection of Korotkoff sounds can be obtained by a proper transducer which is placed in the distal end of the cuff. Futhermore, if the external pressure is lower than the diastolic blood pressure, even though the bloodflow exists, its sound is not heard or is very weak. Therefore, the generally used sphygmomanometer can continuously measure only one of the systolic or diastolic blood pressures. However, the need to measure both the systolic and diastolic blood pressures for every heart beat could not be fully satisfied, if an instrument which obtains only either one of the systolic and diastolic blood pressures, is used. Web site: http://www.delphion.com/details?pn=US04524777__
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Battery-operated device, in particular a blood pressure measuring device Inventor(s): Kern; Alfred (Inning a.A., DE), Schirrmacher; Roland (Graefelfing, DE) Assignee(s): Microlife Investments Corporation (TW) Patent Number: 6,206,836 Date filed: August 6, 1999 Abstract: A battery-operated device, for example, a blood pressure measuring device, consists essentially of a housing (2) and a compartment (3) to accommodate batteries. The compartment (3) is rotatably hinge-connected to the housing (2). The compartment (3) can be pivoted between an insertion position (E) for receiving batteries and an operating position (B). The device (1) has a standing surface (15). The compartment (3) for accommodating batteries is arranged so that the outside surface (4) of the compartment (3) in the operating position (B) forms part of one of the side walls (16a, 16b, 16c), and the inside (8) of compartment (3) is open at the top to receive batteries in the insertion position (E). Excerpt(s): This invention concerns a battery-operated device, in particular a blood pressure measuring device. Battery-operated devices are used today in a variety of different applications. Such devices generally have a housing with a compartment to accommodate batteries in one location. In most cases, a cover is provided by means of which the battery compartment can be closed. In addition to devices of electronic entertainment, computers or measurement instruments, medical diagnostic devices for home use today are often battery-operated. For example, there are known blood pressure measuring devices with which electric power supplied by batteries is used to operate a pump as well as the electronic analysis and display units. Handling can often be a problem when using batteries, especially with such medical devices which are often used by the elderly, and in particular, the conventional flaps that are used to close the battery compartment are often difficult to handle. There is also the problem that the flap may be attached improperly, so that the batteries can drop out again. Web site: http://www.delphion.com/details?pn=US06206836__
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Bladderless blood pressure cuff Inventor(s): Ledford; James (Asheville, NC), Drake; Robert (Hendersonville, NC), Ellenburg; Lafoy (Seneca, SC), Jarvis; Gary (Arden, NC), Peart; Edward L. (Arden, NC) Assignee(s): Welch Allyn, Inc. (Skaneateles, NY) Patent Number: 6,036,718 Date filed: July 2, 1998 Abstract: A blood pressure cuff having a pair of flexible gas-impermeable sheets wherein each of the sheets has an inner and an outer side and wherein the inner sides are placed in contact and the edges of the sheets are fused along a periphery thereof to form an interior chamber. At least one hook fastener portion is disposed on one outer side of one of the sheets and at least one loop portion is disposed on an outer side of the other of the sheets. A conduit means is attached to one of the flexible sheets for connecting to a source of pressurized fluid for allowing inflation and deflation of the interior chamber. The sheets are fused together by RF welding along a perimeter of one outer side of one of the sheets. The hook fastener portion, the loop portion, and the conduit means are each RF welded to an outer side of one of said sheets.
Patents 353
Excerpt(s): This invention relates to a blood pressure monitoring device and specifically relates to an improved cuff for a sphygmomanometer and a method of manufacturing the same. The measurement of blood pressure is a strong tool in the diagnosis of many medical conditions and diseases, for example heart disease. The measurement of blood pressure is performed as part of a standard physical examination and the blood pressure of seriously ill patients is monitored on a very frequent basis. The blood pressure of a patient is usually determined by the use of a sphygmomanometer. The sphygmomanometer is used by wrapping an inflatable cuff around an arm or leg. The cuff is inflated by a pneumatic bulb that is connected to the cuff by a tube or tubes. The cuff is inflated to provide a certain amount of pressure on the artery in the arm or leg, typically just enough pressure to restrict the blood flow in a major artery in the arm or leg. The health care provider utilizes a stethoscope to listen for blood flow in the artery while the cuff is slowly deflated. The cuff is deflated by allowing air to slowly flow out of the tube. The health care provider hears the blood flow resume while simultaneously reading a gauge on the sphygmomanometer which has predetermined pressure measurements thereon. The pressure in the cuff is continuously reduced until the health care provider can no longer hear the blood flow. The health care provider thereby determines the systolic and diastolic blood pressure of the patient. There are numerous configurations of blood pressure cuffs that are known in the art, including the cuff described in U.S. Pat. No. 5,101,830 to Duffy et al., which describes a polyurethane coated nylon sheet folded medially to form the pressure cuff. The urethane coated surface forms the inner surface of the inflation chamber. A hook and loop fastener assembly is fused to the cuff and an inflation fitting is also fused to the interior of the pressure chamber. Web site: http://www.delphion.com/details?pn=US06036718__ •
Blood pressure alarm system for dialysis machines Inventor(s): Yin; Chieh-Kung (Lindenhurst, IL) Assignee(s): Baxter Travenol Laboratories, Inc. (Deerfield, IL) Patent Number: 4,148,314 Date filed: October 18, 1976 Abstract: There is disclosed herein a blood pressure alarm system for use in a dialysis machine whereby alarms may be activated, and a blood pump deactivated if the actual blood pressure increases above or decreases below predetermined levels. The levels are determined by setting a particular blood pressure point and setting the amount by which the pressure can vary above and below the set point; the range of variation is sometimes referred to as the alarm window. A digital memory is provided for storing the set point and preventing variation of the set point with time. Excerpt(s): This invention relates to dialysis machines of the type used in artificial kidney systems, and more particularly, to a blood pressure alarm system for use therein. In a dialysis machine water and concentrate are mixed to provide dialysis solution which is delivered to a dialyzer through which both blood and dialysis solution flow on opposite sides of a semipermeable membrane. Waste products from the blood pass through the membrane into the dialysis solution for disposal. Normally dialysis takes approximately 4-6 hours. Dialysis machines are equipped with both arterial and venous blood pressure alarm systems for activating an alarm and for deactivating a blood pump in the extracorporeal blood circuit in the event that the blood pressure in the blood circuit exceeds or falls below predetermined values. This is sometimes referred to as an
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alarm window. Proper monitoring of both the arterial and venous pressure is important since failure or errors in monitoring can result in blood loss from the patient. Web site: http://www.delphion.com/details?pn=US04148314__ •
Blood pressure and heart rate measuring watch Inventor(s): Broadwater; Ronald L. (2428 Eastridge Rd., Timonium, MD 21903), Haynes; Russell R. (Morgantown, WV), Mitry; Samah A. (Star City, WV) Assignee(s): Tech Engineering & Design (Morgantown, WV), Broadwater, Sr. Ronald L. (Timonium, MO) Patent Number: 4,331,154 Date filed: October 15, 1979 Abstract: A digital watch is employed to measure systolic and diastolic blood pressure as well as heart rate. The band of the watch supports a piezoelectric transducer that is held in contact with the wrist adjacent to the radial artery when a switch on the band is activated. The watch contains electronic circuitry that derives a binary representation of the maximum or systolic pressure and the minimum or diastolic pressure that is generated at the artery by blood pressure pulses which can be displayed. Electronic circuitry is also provided to generate and address corresponding to the time interval T between successive measured heart beats. The address is used to access a memory device that contains a stored list of heart rates in cycles per minute. The contents of the memory at the address T corresponds to the reciprocal of T, in units of pulses per minute and a representation of the contents of the memory can be displayed. Excerpt(s): The invention relates to a wrist watch for measuring blood pressure and heart rate and, more particularly, to such a watch including relatively simple digital circuitry for measuring systolic and diastolic pressure and for measuring heart rate quickly and accurately. Heart rate and blood pressure are important factors in determining the state of a person's health and the physical condition of a person's body in response to physical or emotional stress. A periodic monitoring of these physical parameters is particularly important for individuals having cardiac afflictions or high blood pressure. However, physically healthy individuals may also desire to periodically monitor their heart rate and blood pressure in stress situations, for example when engaging in strenuous exercise. Thus, there is a need for an apparatus that will conveniently and quickly measure the heart rate and blood pressure of an individual and that will not require an undue amount of training to operate. Also, it is important that such an apparatus be compact and unobtrusive in use so that it may be easily used in a variety of circumstances. Web site: http://www.delphion.com/details?pn=US04331154__
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Blood pressure and heart rate monitoring method and apparatus Inventor(s): Hewitt; Terry L. (Portland, OR) Assignee(s): Instromedix, Inc. (Hillsboro, OR) Patent Number: 4,967,756 Date filed: June 15, 1988
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Abstract: Improved ambulatory blood pressure and heart rate monitoring and recording apparatus and method are described. The apparatus uses an auscultatory transducer connected to a microprocessor-based circuit for sensing, validating and recording systolic and diastolic pressure in the cuff-surrounded limb of the patient, and for measuring heart rate. The improved method calculates, and records in the same blood pressure and heart rate data record, an alphanumeric figure of merit, or alternatively a numeric quality index, based upon Korotkoff sound frequency and amplitude criteria. In another improved method, the maximum pressure to which the cuff is pressurized for each measurement is made to track the individual patient's systolic blood pressure to ensure reliable blood pressure readings without unneccessary constriction of the patient's limb. Excerpt(s): Typically, ambulatory blood pressure monitoring and recording equipment continuously measures a patient's systolic and diastolic blood pressure for a given period of time. Recent advances in monitoring equipment include the ability of the patient trans-telephonically to communicate information regarding blood pressure to a remote site for permanent storage and either simultaneous or later diagnosis, rather than requiring the patient to return the equipment or a magnetic tape cassette to the physician after each recording session. A serious shortcoming of state-of-the-art equipment is the fact that the pressure cuff which locates the microphone used to pick up auscultatory signals indicative of blood pressure may be less than optimally positioned on the patient's arm, resulting in inadequate signal strength and incomplete or misleading blood pressure data. Another object of the invention is to provide such a device that is individual patient physiology- and activity-adaptive, wherein the maximum cuff pressure tracks the rise and fall of the patient's systolic blood pressure, thereby to provide only marginally higher pressure than the amount needed to occlude blood flow in the limb around which the cuff is placed. These and other objects of the invention will be understood in reference to the following detailed description of the preferred embodiment of the invention, and by reference to the accompanying drawings. Web site: http://www.delphion.com/details?pn=US04967756__ •
Blood pressure and pulse oximeter monitor Inventor(s): Friedman; Bruce A. (Tampa, FL), Bordon; Daryl L. (Temple Terrace, FL), Medero; Richard (Tampa, FL) Assignee(s): Critikon, Inc. (Tampa, FL) Patent Number: 5,309,908 Date filed: May 14, 1993 Abstract: A patient monitoring system includes a pulse oximeter sensor and an audible alarm which is not produced when a blood pressure module is taking measurements, but only during that portion of the cycle that affects the pulse oximeter reading. During such measurements, the pulses detected by the oximeter decrease below a threshold T.sub.oxim. An audible alarm is caused to receive a logic level of zero by an AND gate through the detection of measurements exceeding a minimum pressure P.sub.min on the blood pressure module. The audible alarm continues to receive such a logic level until the measurements exceed a threshold P.sub.thr. After that time, the audible alarm AND gate logic level is reset to one, so as to permit reporting of pulses missing at the oximeter. None of the other alarms, such as the actual SPO.sub.2 reading, are affected by the AND gate. Accordingly, the present invention does not affect the taking of
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important SpO.sub.2 readings during cuff inflation/deflation and, moreover, only prevents a pulse missing audible alarm from being heard for a short period of time. Excerpt(s): The invention relates to a blood pressure and pulse oximeter monitor apparatus that decreases the chance that a spurious loss of pulse signal from the pulse oximeter when the blood pressure cuff is being inflated and deflated will trigger an audible alarm. When a pulse oximeter sensor is placed on the same limb as a blood pressure cuff, inflation of the cuff above systolic pressure will eliminate the plethysmographic pulse signal in the finger. See, for example, Pulse Oximetry, Payne & Severinghaus; Springer-Verlag 1986. A pulse oximeter measures the oxygen saturation of arterial blood by comparing the ratio of red light transmission through a pulsatile vascular tissue to infrared light transmission through the same vascular tissue. The absence of either pulsatile signal will cause the pulse oximeter to alarm. The loss of a pulsatile signal can indicate that the sensor is improperly attached, that the patient has no pulse, or some intervention has temporarily eliminated pulsatile flow. Since the loss of the pulsatile signal due to the inflation of the cuff is an artifact and not an indication of a fundamental change in the physiological status of the patient, it is desirable for the oximeter not to alarm in such a case. Attempts have been made in the prior art to deal with the problem of setting off the pulse oximeter alarm during pressure cuff inflation/deflation. One technique described is in U.S. Pat. No. 4,776,339 entitled INTERLOCK FOR OXYGEN SATURATION MONITOR ANESTHESIA APPARATUS discloses a system, including an activatable control means, which is operative to respond to the inflation of the cuff to provide a signal for disabling the oxygen saturation alarm for the time during which the cuff is inflated. Such devices suffer from two major problems. First, they disable more alarms than are necessary. For example, changes in oxygen saturation during the inflation/deflation of the cuff may be physiological and not caused by an artifact, (i.e. the cuff). Second, the normal cuff inflation/deflation cycle time is between 30 and 120 seconds. The pulses detected by the oximeter sensor, however, only fall below a minimal level for a period of time significantly less than that, e.g., 10 seconds. Therefore, it is only necessary to interlock the alarm for a period of roughly 20 seconds rather than interlock against the alarm for a complete cuff inflation/deflation cycle of 30-120 seconds. During the prior art interlock cycle, important alarms may have provided useful alarm information that the system was not capturing or reacting to. Web site: http://www.delphion.com/details?pn=US05309908__ •
Blood pressure and pulse rate measuring apparatus Inventor(s): Matsuoka; Yoshifumi (Yamatotakada, JP), Matsumura; Takemasa (Toyonaka, JP), Shigematsu; Koichi (Kawanishi, JP), Oishi; Atsushi (Yaizu, JP) Assignee(s): Matsushita Electric Industrial Co., Ltd. (Osaka, JP) Patent Number: 4,105,020 Date filed: May 14, 1976 Abstract: In conventional blood pressure measuring apparatus, the simultaneous measurement of a pulse rate and a blood pressure is difficult without the use of complicated attachment devices. In this invention, a pulse rate measuring circuit is provided along with a blood pressure measurement apparatus for a simultaneous measurement of both pulse rate and blood pressure. Both measurements are derived from at least one microphone signal contained in a cuff-device. The pulse rate measuring circuit is designed to commence counting of the number of pulses after at
Patents 357
least two Korotkoff's sounds have been detected and continues counting until a predetermined number is reached while the time period required for counting the predetermined number of pulses is measured. The pulse rate is determined by dividing the predetermined number by the measured time period. Excerpt(s): This invention relates to a blood pressure measuring apparatus having an additional function of a pulse rate counting. Conventional apparatus is known which can be used for both blood pressure measurement and pulse rate counting, but no apparatus has been commercially proposed for enabling the measurement of a pulse rate during the measurement of blood pressure, without use of any special attachment. Blood pressure measuring apparatus, a pulse rate meter and other instruments have been employed for a medical examination of the human circulatory system. Usually a Riva-Rocci method is applied for the measurement of blood pressure wherein Korotkoff's sounds are detected by a microphone to determine systolic and diastolic blood pressures. On the other hand, the detection of a pulse at a finger tip and other parts of human body is applied to the pulse rate meter. When it is necessary to know the pulse rate as an aid in diagnosis in conjunction with a blood pressure measurement, the pulse rate is measured again by a pulse rate meter or by a doctor's manual examination after the measurement of blood pressure. If the blood pressure and pulse rate can be simultaneously measured without having duplicate measurements, it would be possible to make a more integrated judgement on the basis of information of the pulse rate in the diagnosis relying upon blood pressure measurement, and also it would save troublesome procedures. Therefore, a need exists for an instrument having the function of measuring both blood pressure and pulse rate. In addition, it is desirable to achieve this dual function by a simple technique in which a pulse rate measurement is added to blood pressure measurement apparatus without any increased complexity in the apparatus employed such as the addition of devices, particularly detection devices near a conventional arm band of the blood pressure measurement apparatus. Web site: http://www.delphion.com/details?pn=US04105020__ •
Blood pressure cuff Inventor(s): Golden; Richard I. (1736 Highland, Wilmette, IL 60091) Assignee(s): none reported Patent Number: 4,354,503 Date filed: December 23, 1980 Abstract: A blood pressure cuff for sensing blood pressure in a limb of the body, is adapted to fit a large range of sizes of limbs, and enables the cuff to be secured snugly in place on the limb. The cuff includes an elongated flexible band having an inflatable bladder therein and having a strap at one end and a strip at the other end. The strip cooperates with an adjacent portion of the band to form a loop for threadably receiving the strap during the wrapping operation. Excerpt(s): The present invention relates in general to blood pressure cuffs, and in particular to such blood pressure cuffs especially suitable for use in polygraphy. Many different types and kinds of blood pressure cuffs have been known in the prior art. In use, prior known cuffs have been first positioned on a limb with the measuring area of the cuff--the area containing the inflatable bladder--placed against blood vessels of the limb. The cuff is then wrapped snugly around the limb and the ends of the cuff secured so as to hold the cuff in position on the limb during the measurement. The cuff is then
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inflated, and a reading of the blood pressure taken. Blood pressure cuffs suffer from several significant problems, such as difficulty in providing a single cuff which can be fitted to a wide variety of sizes of limbs of greatly differing circumference, shifting of position of the cuff when it is tensioned and secured about a limb, and discomfort caused by the pressure of the cuff on a limb. Web site: http://www.delphion.com/details?pn=US04354503__ •
Blood pressure cuff Inventor(s): Ruff; Gray E. (Hillsboro, OR) Assignee(s): SpaceLabs, Inc. (Bothell, WA) Patent Number: 4,716,906 Date filed: June 30, 1986 Abstract: A blood pressure cuff particularly for use with ambulatory blood pressure products and suitable for use on either the left or right limbs of the patient is disclosed. The cuff includes an elongated, flexible band having a body side face and an outward face and a compartment. It further includes an inflatable bladder having a centerline and adapted for placement within the compartment in either a first position or a second position rotated 180.degree. from the first position. The bladder includes a portion coupled on one side of the centerline and adapted to protrude through an opening in the band when the bladder is in either the first or second position. The opening comprises two separate openings on either side of the centerline. First and second indicia placed adjacent the openings on the outward face of the band identify the position of the protruding portion for use on either the left or right side limb. Excerpt(s): The present invention relates to blood pressure cuffs used for taking blood pressure measurements, more particularly, to cuffs used with the limbs of human patients. Blood pressure cuffs are well known in the prior art and comprise an elongated flexible band having a predetermined length and width, a body side face and a outward face. The band is adapted to be wrapped around a limb, such as an arm or leg, to measure blood pressure. Attachment means such as VELCRO.TM. is provided with the band to hold the band on the limb. The front and back faces of the band are joined together around their peripheries to form a compartment into which an inflatable bladder is inserted. A hose portion coupled to the bladder and usually integrally formed therewith extend out from the compartment through an opening in the periphery. Web site: http://www.delphion.com/details?pn=US04716906__
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Blood pressure cuff Inventor(s): Nagai; Toshihiko (Komaki, JP), Nakagawa; Tsuneo (Komaki, JP) Assignee(s): Nippon Colin Co., Ltd. (Komaki, JP) Patent Number: 4,838,276 Date filed: December 2, 1987 Abstract: An improved blood pressure occlusion cuff which is easily attached to the patient's arm and which is comfortable for use over extended periods of time. The preferred embodiment of the invention blood pressure cuff comprises a flexible band, a buckle for releasably securing said band to a person's limb, structure for pressurizing
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said band to cause it to apply pressure to said limb and for sensing pressure variations related to the flow between said buckle and said limb when said band is secured to said limb. Excerpt(s): The present invention relates generally to the field of blood pressure measurement systems. More specifically, the present invention provides an improved pressurizable occlusion cuff which is easily attached to the patient's arm and which is comfortable for use with repeated measurements. One of the most common systems for obtaining an indirect indication of a patient's blood pressure is a system which measures pressure variations in a pressurized cuff placed on a patient's arm. Such a cuff is typically wrapped around the patient's arm and is pressurized while pressure variations or acoustic sounds relates to blood flow through a blood vessel are monitored to determined the patient's blood pressure. Occlusion cuffs which have previously been available for such measurements are often difficult to attach the patient's arm and are often uncomfortable. In particular, it is very common to experience discomfort resulting from a portion of the skin in the arm becoming trapped in the fastening means used to secure the cuff to the arm. Such discomfort is especially acute when the cuff is used for an extended period of time. Web site: http://www.delphion.com/details?pn=US04838276__ •
Blood pressure cuff Inventor(s): Reeves; Johnnie R. (Phoenix, AZ) Assignee(s): American Medical Screening Ltd. (Phoenix, AZ) Patent Number: 6,213,953 Date filed: December 27, 1999 Abstract: An improved ausculatory blood pressure cuff, of the type used in self-testing locations, operates with no moving parts other than the inflatable bladder. No springs or mechanical motors are used to close the bladder portion of the machine around the arm of the user. A generally cylindrically shaped housing is mounted on a base support. The housing has an opening where it is mounted onto the base support; and a hollow fabric sleeve, having a first portion releasably attached to the interior of the cylindrical housing and having a second portion spaced from the first portion located on the interior of the housing, is placed in the housing. An inflatable bladder is located in the space between the two portions of the hollow sleeve; and air is supplied under pressure to inflate the bladder to predetermined pressures. When this is done, the bladder and sleeve expand to constrict the space in the cylindrical housing to close the bladder and sleeve about the arm of a user. Excerpt(s): Blood pressure measuring devices are in widespread use to permit persons to undertake self-testing of blood pressure. Typically, these devices are installed in pharmacies, grocery stores, medical clinic lobbies and the like. The machines for taking and displaying the blood pressure data include a pressurization cuff, which is designed to encircle the upper arm of the person undergoing the test. In the past, the pressurization cuff was mounted in a generally cylindrically shaped housing on a spring which biased the cuff to its widest opening within the housing. After the person using the machine inserted his or her arm, the operating sequence for the blood pressure measurement was initiated. The sequence began with an electric motor winding a cloth band, attached to the spring, to tighten the spring carrying the blood pressure cuff around the arm of the person using the device. When the motor had tightened the cuff
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around the arm, the sequence for inflating a bladder in the cuff and sensing the blood pressure effected by pneumatic pressure in the bladder was accomplished. The prior art device described above includes a number of components which, after repeated usage, result in the need for continuing maintenance and replacement of worn parts. The electric motor includes a solenoid and clutch for effecting its operation. These parts wear out. Provision must be made to sense the tightness of the cuff effected by the winding of the cloth band on a shaft by the motor. The cloth band, because it is wound and unwound in and out of the device frequently, exhibits wear over a period of time. The continuous flexing and releasing of the springs also creates a potential for mechanical failure. In addition, the space which necessarily must be provided between one end of the cuff and the end which is moved by means of the winding and unwinding operation of the motor, creates a potential for pinching the flesh of obese or elderly persons in the gap where the flexible cloth band is pulled past the fixed end of the cuff. Web site: http://www.delphion.com/details?pn=US06213953__ •
Blood pressure cuff automatic deflation device Inventor(s): Gorelick; Donald E. (43 Royal Crest Dr., Nashua, NH 03060) Assignee(s): none reported Patent Number: 4,116,230 Date filed: September 10, 1976 Abstract: A novel device for automatically deflating a blood pressure cuff with a standard two way valve is disclosed. An adjustable deflation rate consistent with normally accepted medical practice of two or three millimeters per heartbeat may be maintained. A two state valve and associated control circuitry for maintaining a constant deflation rate are described. This allows accurate sensing of Korotkoff sounds at different pressure levels. Excerpt(s): This invention generally relates to the medical arts and particularly concerns an automatic method for determining blood pressure. The medical arts have long recognized the need to measure arterial blood pressure as an indication of the general health of a patient. The "auscultatory" method of blood pressure determination practiced by most physicians requires an inflatable blood pressure cuff, a pressure gauge and a stethoscope. The cuff is inflated until all blood flow in a limb has been stopped. Then the pressure is slowly released, by means of a manually operated needle valve, while the operator listens for Korotkoff sounds with a stethoscope placed on the skin over the occluded artery. The first Korotkoff sound usually appears at the systolic pressure, when the blood just begins to spurt through the occluded artery. The Korotkoff sounds continue, usually one occuring with each heartbeat until the pressure in the cuff is equivalent to the diastolic pressure. At this time, free blood flow is restored, and no further Korotkoff sounds are heard. This procedure is time consuming and requires a skilled attendant to accurately measure blood pressure. For this reason, the prior art has developed a multitude of instrumentation for automatic or semiautomatic determination of blood pressure. Such instrumentation may be applied internally and externally to the patient. An example of an internal blood pressure monitor includes those devices wherein penetration of the skin by means of a needle or the like through the arterial wall is effected. The pressure of the arterial pulse thereby being directly measured via a suitable pressure transducer. Such internal techniques risk the discomfort and infection of the patient and are certainly unsuitable for routine blood pressure checks. Externally applied instrumentation normally consists of a blood
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pressure cuff which is to apply pressure to the limb of the patient so that the arterial flow will be restricted. A suitable transducer similar to a stethoscope used in manual operation is then used to distinguish Korotkoff sounds which occur when the cuff pressure is between systolic and diastolic pressures. Many of these instruments require cuff inflation and deflation by a skilled operator by means of a bulb with a check valve for inflation and a needle valve for deflation. Recommended deflation rates for most accurate blood pressure measurement is between two and three millimeters of Mercury per heartbeat. To attain these rates an operator must continually adjust the needle valve because of the change in cuff volume. This requires the operators complete attention during the bleed procedure. Typically, some automatic blood pressure machines will have a light or audible signal emitted with each Korotkoff sound, so by remembering at what point of pressure the sounds appeared and disappeared the blood pressure may be noted. More sophisticated equipment automatically inflates the cuff and deflates the cuff at a fairly consistent rate by means of a pressure pump and a variable orifice bleed valve. The disadvantage of this method is the high cost of the variable orifice valve and control circuitry. The pressure deflation cycle is shown as it appears when it is controlled by the preferred inventive embodiment. After the inflation period, there is a delay 23 of a few seconds useful for determining if the pressure is above systolic (by the absence of Korotkoff sounds). The bleed begins after this, and the valve controlled by the control module is opened to allow a short pulse of air flow from the cuff thereby reducing the pressure in the cuff by a finite amount. The valve here is shown to have opened every 1.25 seconds 24 until the first systolic sound 28 appears and is detected by a Korotkoff sound processor. The period of 1.25 seconds or similar is chosen to reduce any possibilities that a valve opening may coincide with more than one Korotkoff sound, because each valve opening applies artifacts to the Korotkoff sound transducer which are often indistinguishable from Korotkoff sounds. After the first Korotkoff sound is detected, the valve openings are triggered by each successive Korotkoff sound. Web site: http://www.delphion.com/details?pn=US04116230__ •
Blood pressure cuff calibration system Inventor(s): Walker; Elijah C. (Takoma Park, MD) Assignee(s): The United States of America as represented by the Department of Health (Washington, DC) Patent Number: 4,471,646 Date filed: September 3, 1982 Abstract: An apparatus for measuring the pressure-transmitting characteristics of a blood pressure cuff in terms of delivered cuff pressure. It consists of a somewhat flexible cylindrical supporting tube containing a non-compressible liquid, connected to a pressure transducer. The cuff is wrapped around the tube, and the remaining exposed area of the tube is covered by a rigid cylindrical tube to prevent bulging of the supporting tube when cuff pressure is applied thereto. The cuff is pressurized while simultaneously recording its pressure and the transducer detected pressure. The resulting X-Y curve is compared with one taken of the supporting tube alone. Excerpt(s): This invention relates to blood pressure cuffs, and more particularly to a system for measuring the pressure-transmitting characteristics of cuffs employed for the measurement of arterial blood pressure. In blood pressure measuring systems as now employed there is a great need to ensure that all the components of the system are operating properly. In particular, in systems of the type using an inflatable cuff it is
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necessary to determine, independently of use on a patient, how well any individual cuff operates, and if there are any defects, such as leakage, clogging, excessive stiffness, or the like. Thus far, no satisfactory apparatus is available for determining how much pressure from the cuff is being delivered to the surface of an appendage such as a human arm or an animal limb. Once the pressure transmission characteristics of a cuff are known, then its calibration curve can be used to provide a better determination of blood pressure. Accordingly, an object of the invention is to overcome the deficiencies and disadvantages of the prior art, such as indicated above. Web site: http://www.delphion.com/details?pn=US04471646__ •
Blood pressure cuff cover Inventor(s): Napolitano; John M. (1 Teresa Ct., Moonachie, NJ 07074), Baker, III; Harry B. (251 Innes Rd., Wood-Ridge, NJ 07075) Assignee(s): none reported Patent Number: 5,651,368 Date filed: July 10, 1995 Abstract: A cover for enclosing a blood pressure cuff. The inventive device includes a cuff envelope for receiving the blood pressure cuff. A window panel extends through the cuff envelope for permitting viewing of a gauge of the cuff therethrough. A conduit envelope extends from the cuff envelope and terminates in a bulb envelope for receiving the conduit and bulb extending from the cuff. Hook and loop fasteners are coupled to the cuff envelope for permitting securement of the protected blood pressure cuff about a limb of an individual. Excerpt(s): The present invention relates to medical devices and more particularly pertains to a blood pressure cuff cover for enclosing a blood pressure cuff. The use of medical devices is known in the prior art. More specifically, medical devices heretofore devised and utilized are known to consist basically of familiar, expected and obvious structural configurations, notwithstanding the myriad of designs encompassed by the crowded prior art which have been developed for the fulfillment of countless objectives and requirements. Known prior art medical devices include U.S. Pat. No. 3,760,795; U.S. Pat. No. 3,773,036; U.S. Pat. No. 4,548,249; U.S. Pat. No. 4,967,758; U.S. Pat. No. 5,201,758; and U.S. Pat. No. 5,228,448. Web site: http://www.delphion.com/details?pn=US05651368__
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Blood pressure cuff for sphygmomanometer Inventor(s): Che; Tae Young (Seoul, KR), Jeung; Jong In (Anyang, KR), Son; Won Sub (Taejon, KR) Assignee(s): Sein Electronics Co., Ltd. (KR) Patent Number: 6,290,653 Date filed: October 5, 1999 Abstract: Disclosed is a blood pressure cuff for a sphygmomanometer, adapted for attachment to the upper arm of a user to effect blood pressure measurement for the user. The blood pressure cuff comprises an air bag disposed in the blood pressure cuff which has both ends coupled with each other to define a closed loop; an attachment tab
Patents 363
extending from a side of the blood pressure cuff; a Velcro brand hook and loop fastener strip secured to a surface of the attachment tab; and a complementary Velcro brand hook and loop fastener strip secured to an outer surface of the blood pressure cuff such that it can be engaged with the Velcro brand hook and loop fastener strip. Excerpt(s): The present invention relates to a blood pressure cuff for a sphygmomanometer, and more particularly, the present invention relates to a blood pressure cuff which is adapted for being used in an independent-measurement type sphygmomanometer. The human body performs metabolism through blood, and therefore, it is necessary to frequently measure a blood pressure to confirm a condition of one's health. Generally, the term `blood pressure` means an arterial blood pressure of the brachial artery. The conventional blood pressure measuring method is typically implemented by wrapping a blood pressure cuff around the upper arm containing an artery, inflating the blood pressure cuff to a predetermined pressure thereby to occlude the artery, gradually reducing the pressure to allow increased blood flow through the artery, and measuring blood pressures at the times when the Korotkov sounds are generated and vanished as blood flow is restarted in the brachial artery thereby to determine a maximum blood pressure and a minimum blood pressure. Web site: http://www.delphion.com/details?pn=US06290653__ •
Blood pressure cuff harness Inventor(s): Ruff; Gray E. (Hillsboro, OR), Millay; Jack (Beaverton, OR) Assignee(s): SpaceLabs, Inc. (Bothell, WA) Patent Number: 4,844,306 Date filed: October 2, 1987 Abstract: A harness is provided for holding a blood pressure cuff in the correct position on the arm when being worn for extended periods of time. The harness has a support member that attaches by clasps directly to the cuff on the person's arm. The support member extends from the cuff to the shoulder region of the user so that the weight of the cuff is carried by the shoulder rather than by the arm through contact pressure from the cuff itself. The support member prevents slippage or rotation of the cuff throughout the monitoring period. A strap is provided that attaches to the support member at the shoulder region and runs under the other arm of the user to hold the support member in the correct position. Excerpt(s): This invention relates to a medical support harness, and more particularly, to a harness for holding a blood pressure cuff in the proper position on the arm for extended periods. The blood pressure of a person is presently used as an important factor in determining the overall health of an individual. Further, it is often important either to record the blood pressure of an individual at a given time during the day or to record the variations in blood pressure throughout the day. Presently, blood pressure testing devices are available that are worn for extended periods, such as 24 to 48 hours. The blood pressure is taken and recorded on a regular basis throughout this extended period. In a typical blood pressure monitoring program, the patient wears a blood pressure cuff the entire monitoring period. An electronic system tests and records the blood pressure of the person every 20 or so minutes throughout the monitoring period. A small air pressure pump, electronic control, sensors and recorder are provided which pump up the cuff and record the blood pressure at the selected timed intervals. The cuff often has sensors to perform the function of determining the blood pressure. It is
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therefore important that the cuff not rotate excessively so that the sensors and bladder are in the correct position to obtain an accurate reading of the blood pressure. Web site: http://www.delphion.com/details?pn=US04844306__ •
Blood pressure cuff with integral acoustic pickup cup Inventor(s): Sorensen; Jay R. (Aloha, OR) Assignee(s): SpaceLabs, Inc. (Bothell, WA) Patent Number: 4,890,625 Date filed: March 24, 1988 Abstract: A blood pressure cuff having an internal acoustic pickup cup. In one embodiment, the cup communicates with the interior of the blood pressure cuff bladder through an aperture that is sufficiently large to allow pressure equalization between the interior of the bladder and the cup and sufficiently small to prevent Karotkoff sounds from being coupled from the cup to the interior of the bladder. A single pneumatic tube extends from the cup and through the wall of the bladder to a first enclosure that is coupled to a second enclosure through a conduit. The first enclosure contains a microphone for converting the acoustic signals picked up by the cup into a corresponding electrical signal. The second enclosure contains a pressure transducer for providing an electrical signal indicative of the pressure in the bladder. In a second embodiment, the cup and bladder are isolated from each other and separate tubes extend from the bladder and the cup to separate enclosures. The enclosure communicating through one of the conduits with the cup contains a microphone, while the enclosure communicating through the other tube with the bladder contains a pressure transducer. Excerpt(s): This invention relates to blood pressure monitoring, and more particularly, to a blood pressure cuff having a built-in acoustic pickup cuff for detecting acoustic signals generated by blood flow in arteries beneath the cuff. Blood pressure is normally measured by placing a blood pressure cuff around the arm of a patient over the brachial artery. The cuff typically includes an inflatable bladder placed in an outer casing. The bladder is inflated to compress the arm of the patient, thereby pinching off the flow of blood through the brachial artery. The pressure in the bladder is gradually reduced while listening for sounds caused by the flow of blood through the brachial artery and measuring the air pressure in the bladder. When blood flow is detected during systole, the air pressure in the bladder is recorded as the systolic blood pressure. Similarly, when blood flow is detected during diastole, the air pressure in the bladder is recorded as the diastolic blood pressure. The most common device for measuring blood pressure using the above-described procedure is the familiar manually pumped cuff using a mercury manometer as the pressure measuring device. After the cuff is inflated with air, the pressure in the cuff is gradually reduced while a stethoscope is used to detect the flow of blood in the brachial artery beneath the cuff. Web site: http://www.delphion.com/details?pn=US04890625__
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Blood pressure cuff with tension indicator Inventor(s): Montagnino; James G. (St Charles, IL), Castracane; Mark A. (Hattiesburgh, MI) Assignee(s): Sunbeam Products, Inc. (Boca Raton, FL) Patent Number: 6,245,024 Date filed: January 13, 2000 Abstract: A blood pressure cuff which, when the cuff is being applied to the patient, automatically indicates when the proper amount of tension in the cuff has been reached. The blood pressure cuff includes a tension sensor disposed on an end which the user grips, constructed of elastomeric or elastic material, including accordion-like ridges. The ridges include a graphic which is partially or substantially hidden when less then the proper amount of tension is applied to the blood pressure cuff, and which is substantially viewable when the proper amount of tension is applied to the blood pressure cuff. The tension sensor may include an indicator area which is substantially hidden by a set of folds until a pre-set amount of tension is applied. Excerpt(s): The present invention relates to blood pressure cuffs; more specifically to blood pressure cuffs providing an indication of the proper tension for blood pressure measurement. A common method of measuring the blood pressure of a human patient involves wrapping an inflatable cuff around the patient's arm. An operator inflates the cuff thereby applying pressure to the arm. The operator then slowly deflates the cuff while measuring the blood pressure. The blood pressure may be measured by, for example, listening to blood flow using a stethoscope as the cuff is deflated. It is common for such blood pressure cuffs to be provided to a patient who must periodically monitor his or her own blood pressure at home. In such a case the patient must be trained in the proper use of the blood pressure measuring device. Such an inflatable cuff typically includes an inflatable bladder formed, for example, of an elastic sheet such as a rubber sheet or a vinyl sheet contained within a non-stretch belt-like bag. The belt-like bag may be constructed of cloth or other material. Typically, the inflatable bladder is disposed towards one end of the belt-like bag, and extends approximately half way towards the center of the blood pressure cuff, so that a portion of the belt-like bag not surrounding the inflatable bladder may wrapped around the patient's arm to secure the cuff to the arm. The bladder may be constructed of air-tight, flexible, bio-compatible material such as PVC. Velcro.TM. patches or other connection means may be used to secure one portion of the belt-like bag to itself. Web site: http://www.delphion.com/details?pn=US06245024__
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Blood pressure depressor Inventor(s): Zhu; Qiang (Zhongshan Garden, Room E.F, 9th Floor, No. 2 Building, Hangzhou, ZJ 310014, CN) Assignee(s): none reported Patent Number: 5,891,181 Date filed: September 15, 1997 Abstract: The present invention relates to a blood pressure depressor for depressing the hypertension in the human body. The device consists mainly of integrated circuits and several resisters, capacitors, light emitting diodes, ear electrodes, hand electrode, pocket
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and piezoelectric ceramic buzzer. Through a metal electrode contacted with a specific sensitive point of the human body a bioelectric current flows to a charge-discharge circuit which is connected with a electronic analogue switch circuit, an oscillating/frequency dividing circuit and an adjustable timing automatic alarm circuit to thereby attain the hypotensive and curative effect. It has a simple configuration and a convenient usage, and the blood pressure of a patient may be depressed by 10-40 mmHg through the use of it for 10 minutes. The cure rate reaches above 95% which shows a prominent curative effect, so that the device becomes a good doctor of the hypertension patients. It has no influence to the blood pressure of a normal person. Excerpt(s): The present invention relates to a blood pressure depressor (hypotensive device) which can depress the hypertension as so called high blood pressure in the human body. To overcome above disadvantages, therefore, it is a primary object of the present invention to provide a blood pressure depressor of opening paragraph mentioned type which has a simple construction and a prominent curative effect, with optimal charge-discharge period can be simply operated, so that the trouble with the manual switching operation which is intermittent but lasts a long time span, can be eliminated. It is another object of the present invention to provide a blood pressure depressor having both the optimal constant charge-discharge period and the automatic alarm function with adjustable timing. Web site: http://www.delphion.com/details?pn=US05891181__ •
Blood pressure detecting device Inventor(s): Yanagi; Shinsaku (Kyoto, JP), Miyawaki; Yoshinori (Kyoto, JP), Togoe; Yasuyuki (Kyoto, JP) Assignee(s): Omron Corporation (Kyoto, JP) Patent Number: 5,873,834 Date filed: March 6, 1997 Abstract: The blood pressure detecting device includes a blood pressure meter, a physiological detector, and a processing unit. The processing unit stores an equation to convert the value of the physiological data to the corresponding blood pressure value. To determine the equation during calibration, the patient's physiological data is measured several times in the course of normal activities in order to obtain an actual blood pressure value for each patient. To determine the equation during measurement mode, the patient measures the physiological data value as above, and then a customized equation stored in memory will convert the physiological value to the patient's blood pressure value. Therefore, the more calibration data are collected for an individual patient, the more accurate the equation will be made, and thus a more accurate measurement will be made. Excerpt(s): The invention relates to a blood pressure detecting device that uses the relationship between blood pressure and other physiological data to estimate the blood pressure of a patient. A conventional blood pressure detecting device may use physiological data such as the transit speed of a pulse to estimate a patient's blood pressure. In this indirect method, the blood pressure is estimated based on a known relationship between the blood pressure and the physiological data. The known relationship is based on blood pressure and physiological data for a large group of patients. This relationship may be calibrated to a patient by measuring the physiological data (e.g., the pulse transit speed) and the blood pressure of the patient while the patient
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is resting and while the patient is exercising actively. Embodiments of the invention may include one or more of the following features. The physiological data may include a set of pulsewave transit time values, a set of cardiac pulse rate values, or a set of secondderivative pulsewave height values. The blood pressure value may include systolic pressure values or diastolic pressure values. Web site: http://www.delphion.com/details?pn=US05873834__ •
Blood pressure determining apparatus and method of determining excitation frequency used in the same Inventor(s): Hagiwara; Hisashi (Yokohama, JP), Fukukita; Hiroshi (Tokyo, JP), Hasegawa; Kinya (Sagamihara, JP), Nishimura; Yushi (Yokohama, JP) Assignee(s): Matsushita Electric Industrial Co., Ltd. (JP) Patent Number: 6,354,998 Date filed: July 14, 2000 Abstract: A blood pressure determining apparatus is provided which applies oscillations to the blood vessel of a subject through an exciter to determine the blood pressure based on the frequency of the oscillations propagated through the blood vessel measured by an oscillation sensor. The apparatus monitors an output of the oscillation sensor when the exciter applies no oscillation to the subject to determine the power spectrum of noise signals contained in the output and sets the frequency of oscillations to be applied to the blood vessel to any value within a band of the power spectrum in which the power of noise is small. This enables the blood pressure to be determined without influence of any electric disturbances from peripheral devices. Excerpt(s): The present invention relates generally to a blood pressure measuring apparatus which applies weak oscillations to a blood vessel in a living body and measures and analyze the oscillations transmitted through the blood vessel to determine the blood pressure continuously, and more particularly to a blood pressure measuring apparatus designed to monitor the oscillations with high sensitivity regardless of electrical noises arising from ac power supply and/or other peripheral devices and an excitation frequency determining method used in the blood pressure measuring apparatus. U.S. Pat. No. 5,590,649 issued on Jan. 7, 1997 discloses a blood pressure determining system which performs a continuous non-invasive measurement of blood pressure. This system is designed to estimate the blood pressure by measuring the velocity of propagation of oscillations through a blood vessel based on the fact that the elasticity of the blood vessel changes with a change in blood pressure, and that a change in elasticity of the blood vessel causes the velocity of propagation of oscillations through the blood vessel to change. The exciter 2 and the oscillation sensor 4 are attached to the patient's forearm. The cuff 8 is installed around the patient's upper arm. The oscillator 3 outputs a signal of a frequency f to the exciter 2 to induce perturbations or oscillate the radial artery in the forearm at the frequency f The frequency f is within a range of 100 Hz to 200 Hz. The oscillation sensor 4 detects oscillations transmitted through the radial artery and converts them into an electrical signal. The amplifier 5 amplifies the output from the oscillation sensor 4 and provides it to the A/D converter 6. The A/D converter 6 converts the input into a digital signal and outputs it to the processor 7. The processor 7 performs a phase detection to determine a change in phase, as viewed from the center of an arc distribution, which indicates a change in velocity of propagation of the oscillations corresponding to a change in blood pressure. This change is calibrated by values of systolic and diastolic pressures measured through the cuff 8 and the blood
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pressure measuring device 9 to determine the blood pressure continuously. The waveform of the change is indicated on the display 10. The dc power supply 11 is connected to an ac power supply (not shown) through the plug 12 and provides a dc constant voltage to each block. Web site: http://www.delphion.com/details?pn=US06354998__ •
Blood pressure estimating apparatus Inventor(s): Inukai; Hidekatsu (Komaki, JP), Yokozeki; Akihiro (Nagoya, JP), Kawaguchi; Keizoh (Komaki, JP), Narimatsu; Kiyoyuki (Komaki, JP) Assignee(s): Colin Corporation (Komaki, JP) Patent Number: 6,527,725 Date filed: January 25, 2001 Abstract: An apparatus for estimating a blood pressure of a living subject, including a measuring device which iteratively measures a blood pressure of the subject, a first device for obtaining first information relating to velocity of propagation of pulse wave, a second device for obtaining at least one of second information relating to heart rate and third information relating to area defined by volume pulse wave, a memory which stores groups of information each group of which includes the blood pressure, the first information, and at least one of the second information and the third information, a determining device for determining an expression representing a relationship between (A) blood pressure, and (B1) first information and (B2) at least one of (B21) second information and (B22) third information, and having a first coefficient for the first information, at least one second coefficient for at least one of the second and third information, and a constant, the determining device determining the coefficients and constant of the expression by applying a multiple regression analysis to more than a predetermined number of groups of information last stored in the memory, the predetermined number being equal to a total number of the coefficients and the constant, and an estimating device for successively estimating, according to the expression, a blood pressure of the subject based on each first information and at least one of each second information and each third information. Excerpt(s): The present invention relates to a blood pressure estimating apparatus for successively estimating an intraarterial blood pressure of a living subject, based on information non-invasively obtained from the circulatory organ of the subject. There is known, as a blood pressure (BP) measuring apparatus for non-invasively measuring an intraarterial blood pressure of a living subject, a so-called Korotokoff-sound-type BP measuring apparatus or oscillometric-type BP measuring apparatus. The Korotokoffsound-type BP measuring apparatus automatically determines a blood pressure of the subject, based on a pressing pressure of a pressing band being wound around a body portion of the subject at the time of change of Korotokoff sounds produced by changing the pressing pressure of the pressing band. The oscillometric-type BP measuring apparatus automatically determines a blood pressure of the subject, based on the variation of amplitude of pulse wave produced by changing the pressing pressure of the pressing band. In an operating room, an intensive care unit, or the like, it may be needed to measure successively a blood pressure of a patient because an urgent medical treatment or cure may be needed. In the case, however, where the conventional BP measuring apparatus is used, it takes several tens of seconds from the start of blood pressure measurement to obtain a blood pressure of the patient. If an interval between successive blood pressure measurements is shortened to obtain a blood pressure at a
Patents 369
short period, congestion may occur to the body portion of the patient due to the increased frequency of pressing of the pressing band, whereby errors may occur to the measured blood pressure values. Web site: http://www.delphion.com/details?pn=US06527725__ •
Blood pressure estimating apparatus and method Inventor(s): Inukai; Hidekatsu (Nagoya, JP), Yokozeki; Akihiro (Komaki, JP), Kawaguchi; Keizoh (Komaki, JP) Assignee(s): Colin Corporation (Komaki, JP) Patent Number: 6,036,651 Date filed: May 29, 1998 Abstract: An apparatus for estimating an intraarterial blood pressure of a living subject, based on information non-invasively obtained from a circulatory organ of the subject, including: a first device for obtaining first information which relates to velocity of propagation of a pulse wave; a second device for obtaining at least one of second information which relates to heart rate and third information which relates to an area defined by a volume pulse wave; a third device for estimating, according to a predetermined relationship to between (A) blood pressure, and (B1) first information and (B2) at least one of (B21) second information and (B22) third information, the blood pressure, based on the first information and the at least one of the second information and the third information, the predetermined relationship being defined by a numerical expression including a plurality of predetermined coefficients; and a fourth device for selecting, from a plurality of groups of predetermined coefficients which correspond to a plurality of blood-pressure ranges, respectively, one group of predetermined coefficients which corresponds to a blood pressure, so that the third device estimates the blood pressure according to the numerical expression including the selected group of predetermined coefficients. Excerpt(s): The present invention relates to a blood pressure estimating apparatus and method for successively estimating an intraarterial blood pressure of a living subject, based on information non-invasively obtained from a circulatory organ of the subject. There is known, as a blood pressure- measuring apparatus for non-invasively measuring an intraarterial blood pressure of a subject, a so-called Korotokoff-sound blood pressure measuring apparatus or oscillometric blood pressure measuring apparatus. The Korotokoff-sound blood pressure measuring apparatus determines a blood pressure of the subject, based on a pressing pressure of a pressing band being wound around a portion of the subject at the time of occurrence or disappearance of Korotokoff sounds produced by changing the pressing pressure of the pressing band. The oscillometric blood pressure measuring apparatus determines a blood pressure of the subject, based on variation of amplitude of a pulse wave produced while the pressing pressure of the pressing band is changed. In an operating room, an intensive care unit, or the like, it is needed to successively measure a blood pressure of a subject when an urgent medical treatment or cure is required. In the case where the above conventional blood pressure measuring apparatus is used, it takes several tens of seconds from a start of the blood pressure measurement to obtain a blood pressure of the subject. Moreover, if an interval between successive blood pressure measurements is shortened to obtain a blood pressure at a relatively short period, congestion occurs to a body portion of the subject due to high frequency of pressing of the pressing band, whereby errors occur to the blood pressure measurements.
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Web site: http://www.delphion.com/details?pn=US06036651__ •
Blood pressure estimating apparatus and method Inventor(s): Inukai; Hidekatsu (Nagoya, JP), Yokozeki; Akihiro (Komaki, JP), Kawaguchi; Keizoh (Komaki, JP), Narimatsu; Kiyoyuki (Kasugai, JP) Assignee(s): Colin Corporation (Komaki, JP) Patent Number: 6,036,652 Date filed: May 29, 1998 Abstract: An apparatus for successively estimating an intraarterial blood pressure of a living subject, based on information non-invasively obtained from a circulatory organ of the subject, including: a first device for non-invasively obtaining, from the circulatory organ of the subject, first information which relates to velocity of propagation of a pulse wave which propagates through an artery of the subject; a second device for noninvasively obtaining, from the circulatory organ of the subject, at least one of second information which relates to heart rate of the subject and third information which relates to an area defined by a volume pulse wave from a peripheral portion of the subject; and a third device for estimating, according to a predetermined relationship between (A) blood pressure, and (B1) first information and (B2) at least one of (B21) second information and (B22) third information, the intraarterial blood pressure of the subject, based on the first information obtained by the first device and the at least one of the second information and the third information obtained by the second device. Excerpt(s): The present invention relates to a blood pressure estimating apparatus and method for successively estimating an intraarterial blood pressure of a living subject, based on information non-invasively obtained from a circulatory organ of the subject. There is known, as a blood pressure measuring apparatus for non-invasively measuring an intraarterial blood pressure of a subject, a so-called Korotokoff-sound blood pressure measuring apparatus or oscillometric blood pressure measuring apparatus. The Korotokoff-sound blood pressure measuring apparatus determines a blood pressure of the subject, based on a pressing pressure of a pressing band being wound around a portion of the subject at the time of occurrence or disappearance of Korotokoff sounds produced by changing the pressing pressure of the pressing band. The oscillometric blood pressure measuring apparatus determines a blood pressure of the subject, based on variation of amplitude of a pulse wave produced while the pressing pressure of the pressing band is changed. In an operating room, an intensive care unit, or the like, it is needed to successively measure a blood pressure of a subject when an urgent medical treatment or cure is required. In the case where the above conventional blood pressure measuring apparatus is used, it takes several tens of seconds from a start of the blood pressure measurement to obtain a blood pressure of the subject. Moreover, if an interval between successive blood pressure measurements is shortened to obtain a blood pressure at a relatively short period, congestion occurs to a body portion of the subject due to high frequency of pressing of the pressing band, whereby errors occur to the blood pressure measurements. Web site: http://www.delphion.com/details?pn=US06036652__
Patents 371
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Blood pressure gauge Inventor(s): Crestas; Hans (Regensdorf, CH), Zimmerman; Edwin (Ostermundigen, CH) Assignee(s): U.S. Philips Corporation (New York, NY) Patent Number: 4,161,173 Date filed: October 12, 1976 Abstract: A device for measuring blood pressure comprising a circuit having two signal paths one of which can guide the alternating current components and the other of which can guide the direct current component of the blood pressure signal, said signal paths comprising amplification and/or attenuation members so that the mutual ratio of the alternating current components and the direct current component is varied. The device furthermore comprises a summing device to recombine the two previously treated parts of the blood pressure signal and an amplifier or attenuator to make the overall amplification of the direct current component (average value) equal to unity. Excerpt(s): The invention relates to a device for measuring blood pressure comprising a measuring part for forming an electrical blood pressure signal dependent on the blood pressure value. The measuring part or device generally comprises a transducer which converts the blood pressure into an electrical signal and an amplifier to make the blood pressure signal suitable, for example, for an oscillograph or a recording device. Both the average value and the shape of the blood pressure curve made visible in this manner provide valuable information which enable the physician to make a diagnosis. It has been proven in practice that the physician often feels the need of being able to study the variations in the blood pressure on an enlarged scale so as to be able to better study certain details. At the same time it is of importance that the average value of the displayed curve and the zero point remain unvaried. As a result of this it is not possible to simply amplify the blood pressure signal a number of times so as to more clearly show the fluctuations. In that case, actually, the whole curve would land in a different place on the display screen or recording paper. Web site: http://www.delphion.com/details?pn=US04161173__
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Blood pressure indicator Inventor(s): Peters; Rudolph W. (5786 Balmoral Drive, Oakland, CA 94619) Assignee(s): none reported Patent Number: 4,007,734 Date filed: June 2, 1975 Abstract: A blood pressure indicator adapted for self-examination includes a blood pressure arm cuff having an inflatable bladder, and a pair of pressure sensing switches impinging on the bladder and set to audibly or visually indicate the maximum systolic and diastolic pressure permissible. The bladder is inflatable by a flexible bulb connected thereto through a hose and a unidirectional flow valve which maintains inflation of the bladder. As air leaks out of the bladder, the patient notes when the pulse returns to the brachial artery, in relation to the indications given by the switches to ascertain whether the blood pressure falls within the permissible tolerances. Excerpt(s): In recent years medical research has shown a definite correlation between a number of serious ailments and the presence of hypertension in the sufferers of these ailments. It has also become apparent that the onset of hypertension very often precedes
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these ailments, such as cardio-vascular disease, kidney disease, and the like. Therefor it is vitally important to determine which individuals suffer from hypertension, and to monitor and control their high blood pressure. For those persons known to suffer from hypertension, an important element in treatment is the periodic and frequent monitoring of their blood pressure to determine the effects of psychological and physiological stress, medication, and the like. This is usually accomplished by requiring the patient to visit frequently a clinic or physician's office to have his/her blood pressure measured. It would be more desirable and convenient for the patient to self-monitor periodically the blood pressure. However, a sphygmomanometer is too elaborate and complex for many individuals to operate with a sufficient degree of reliability. The present invention generally comprises a blood pressure indicating device with which an individual may easily determine whether his/her blood pressure falls within predetermined upper and lower limits. It includes a cuff adapted to be wrapped and secured about an arm, an inflatable bladder within the cuff, and a rubber bulb for inflating the bladder through a flexible tube. A unidirectional flow valve in the bulb maintains inflation of the bladder, and a fixed bleed port allows the pressure in the bladder to decrease slowly and smoothly. Web site: http://www.delphion.com/details?pn=US04007734__ •
Blood pressure indicator gauge Inventor(s): Speidel; Blasius (Hochmeisterstrasse 244, 7453 Jungingen, DT) Assignee(s): none reported Patent Number: 4,036,061 Date filed: June 17, 1975 Abstract: A two-pointer blood pressure indicator gauge with pointer blocking solenoids for the indication of the systolic and diastolic pressures, the gauge having a blocking member or a brake disc directly attached to each of the two pointer shafts, and in which the armature of each solenoid, or a solenoid-actuated brake lever, cooperates with the associated brake member or brake disc, respectively, thereby blocking the spring-driven return motion of the pointers. The pointer for the higher pressure, being dragged by the other pointer during pressure buildup, against a separate spring, is blocked first, allowing the pointer for the lower pressure to continue its return movement until it, too, is blocked. Excerpt(s): The present invention relates to indicator gauges, and more particularly to blood pressure indicator gauges employed in conjunction with blood pressure measuring equipment, where a blood pressure measuring sleeve is applied to a limb and the pressure values and other variables are transmitted to a monitoring console. The special pressure indicator gauge of the invention is adapted for the measurement and recording of two different pressure values by means of two independent pointers which can be blocked at given reading values in response to appropriate signals. Blood pressure gauges of the above-mentioned type are known in the prior art. They generally feature a rotatable pointer on a pointer shaft to which is attached a return string opposing the movement of the pointer in response to an increase in pressure in a pressure capsule whose expansion drives the pointer shaft via a suitable lever and gear transmission. Such a gauge may further include pointer blocking means consisting of a solenoid and of a blocking member connected to the gear transmission and reaching into the field of the solenoid, for the latter to stop and hold the rotating assembly. For blood pressure measuring purposes, this type of gauge is normally specially adapted to have
Patents 373
two pointers, in order to indicate and record the systolic and diastolic blood pressures of a patient. As the blood pressure measuring sleeve is pressurized, the same pressure also expands the measuring capsule, and this expansion is transmitted to the pointers by means of a suitable translating drive. The latter normally includes a lever converter whose movements are transmitted by a drive arm to a gear segment of large radius which, by engaging a small gear on the pointer shaft, moves the latter in accordance with the pressure acting inside the measuring capsule. The pressure translating drive may further include a drive pin extending laterally from the gear segment and reaching into engagement with a similar second gear segment, engaging a second small gear on the shaft of a second pointer. The shaft of this second pointer is a hollow shaft arranged concentrically with the shaft of the first pointer and located axially between the pointer and gear of the first shaft. In most cases, the hollow shaft is journalled on the shaft of the first pointer. Each pointer is further associated with blocking means consisting of a segment-shaped flat blocking member attached to the large-radius gear segment, and of a blocking solenoid arranged near the periphery of the blocking member, the blocking solenoid being electrically controllable by means of suitable switches. If, following the pressurization of the blood pressure measuring sleeve to a sufficiently high starting value, the pressure in the sleeve and in the measuring capsule is reduced at a controlled rate, both pointers will return under the action of their return springs in accordance with the motions of the translating mechanism, until the blocking solenoid for the second pointer is energized in response to a control signal from the blood pressure measuring device, thereby blocking the second pointer, while the first pointer, continuing its movement, is later similarly blocked by means of its associated blocking solenoid. The blocked positions of the two pointers indicate the systolic pressure and the diastolic pressure, respectively. Web site: http://www.delphion.com/details?pn=US04036061__ •
Blood pressure instrument Inventor(s): Paavola; Oiva A. (3024 W. 26th St., Erie, PA 16506), Fearnot; Neal (832 Ashland St., W. LaFayette, IN 47906) Assignee(s): none reported Patent Number: 4,473,080 Date filed: December 24, 1981 Abstract: An instrument for measuring blood pressure by sensing the Korotkoff sounds which prevail only between the systolic and diastolic point. The instrument used is essentially a hand-held device. The instrument has a pressure-sensitive element made up of a flexible material containing fluid and crystal transducer supported on the flexible material which responds to the Korotkoff sounds. The sensor is made in a unique geometrical structure shaped to fit between bones and tendons over an artery. The crystal operates through an amplifier, a high pass filter and low pass filter through a comparator to a one shot enabling means connected to a panel meter. The pressure on the fluid in the sensed by a pressure sensor that is in contact with the fluid in the sensor which is connected to the panel digital meter. The digital display shows the pressure exerted on the artery at each Korotkoff sound. A LED shows that pulses are present. The pressure sensed by the pressure transducer at the time the sounds appear at the systolic point and again at the time they disappear at the diastolic point. Excerpt(s): Related U.S. petents are: U.S. Pat. Nos. 3,814,083; 3,930,494; 3,807,388; 3,123,068; 3,773,038; 3,742,937; 3,572,316; 3,230,950; 1,802,685; 1,900,285; 3,623,476.
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Related foreign Patents are: German No. 509,637; German No. 469,703. A. The need for band pass charateristics of the Korotkoff sound amplifier. Since the radial (or brachial) pulse has frequency components extending into the audible range, it can be confused with Korotkoff sounds. The sounds from the radial pulse are present from systolic pressure to far below diastolic. Korotkoff sounds are only present when the artery is partially occluded with a pressure between systolic and diastolic pressures. Therefore, for accurate (or even repeatable) measurements of diastolic pressure, stringent requirements exist on the low frequency cutoff of the band pass filter. Web site: http://www.delphion.com/details?pn=US04473080__ •
Blood pressure measure system Inventor(s): Kawahara; Yoshimi (Kohnan, JP) Assignee(s): Colin Electronics Co., Ltd. (Aichi, JP) Patent Number: 5,261,413 Date filed: July 26, 1991 Abstract: A blood pressure monitor system including a pressing device for pressing a body portion of a subject, a measuring device for increasing the pressing force of the pressing device to a predetermined level, subsequently varying the pressing force, and measuring a blood pressure of the subject during the variation of the pressing force, the measuring device repeating the blood pressure measurement, a setting device for setting a frequency at which the measuring device repeats the blood pressure measurement, and a changing device for changing a rate of increase of the pressing force depending upon the measurement frequency set by the setting device. A blood pressure measure system including a pressing device for pressing a body portion of a subject, an automatic regulating device for step-wise increasing the pressing force of the pressing device to a predetermined level, the step-wise increase of the pressing force including alternate first and second periods, the pressing force being increased in each of the first periods and maintained in each of the second periods, and a measuring device for measuring a blood pressure of the subject while the pressing force is decreased after the step-wise increase. Excerpt(s): The present invention relates to a blood pressure monitor or measuring device. There is known a blood pressure monitor system including (a) a pressing device such as a cuff for pressing a body portion of a subject, and (b) a measuring device for increasing the pressing force of the pressing device to a predetermined level, subsequently varying the pressing force, and measuring a blood pressure of the subject based on Korotkoff sounds or pulse waves obtained during the variation of the pressing force, the measuring device repeating the blood pressure measurement at a pre-set period. In the case where frequent blood pressure measurements from a patient are necessary, for example, during or after a surgical operation, the measurement period is set at a short time on the monitor system. On the other hand, for a patient under a stable condition, for example, in a general ward, the measurement period is set at a long time. For a patient such as during or after a surgical operation, it is desirable, in addition to the use of a short measurement period, to increase the pressing force (e.g., cuff pressure) quickly so as to measure blood pressure as fast as possible in each of the periodic measurement cycles. Web site: http://www.delphion.com/details?pn=US05261413__
Patents 375
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Blood pressure measurement Inventor(s): Stott; Frank D. (Oxford, GB) Assignee(s): National Research Development Corporation (London, GB2) Patent Number: 4,730,621 Date filed: December 3, 1985 Abstract: Blood pressure measurement apparatus comprises means for variably occluding a body zone by progressive application of external pressure between levels respectively above systolic and below diastolic, means for detecting variations in blood volume in said zone during variable occlusion thereof, and means responsive to the occluding and detecting means to indicate as systolic and diastolic pressures the values of said external pressure respectively when the maximum and minimum detected volume levels are each about half way between zero and the maximum level following the last minimum which does not depart significantly from zero. The blood volume variations are preferably determined by reference to light transmission through the zone, suitably infrared, but other measures are suitable as determined by strain gauge, proton magnetic resonance or microwave absorbtion. Excerpt(s): The normal method of measuring blood pressure by non-invasive means entails the use of an inflatable cuff for location around the upper arm and some means for detecting the flow of blood at a location distal to the cuff. The cuff is inflated to a pressure at which the embraced tissue is compressed and all blood vessels therein, including the arteries, are occluded. The pressure in the cuff is then gradually reduced and the arteries start to open transiently to allow blood flow as soon as the cuff pressure falls below the peak systolic level. Thereafter, the arteries remain patent for an increasing proportion of the cardiac cycle as the cuff pressure is further reduced, until the pressure falls below the diastolic level. Following this last event, the arteries remain patent throughout the cycle and the flow of blood is determined only by the normal pressure cycle. The distally located detecting means, which is commonly a stethoscope or an electronic equivalent, readily enables the first onset of blood flow to be detected at systolic pressure. However, at diastolic pressure the change in flow is much more subtle and difficult to detect because the flow approaches its unobstructed level at this time in an asymptotic manner. In the result, measurements of diastolic pressure are commonly inaccurate and of poor reproducibility. In accordance with other proposals for measuring blood pressure, a cuff or equivalent device can be employed in association, at the same sit, with some means for detecting variations in the blood volume in the body zone embraced by the cuff as that zone is variably occluded. One such proposal (Wood et al, Staff Meetings of the Mayo Clinic, July 5, 1950, pages 398-405) suggests that systolic and diastolic pressure measurements are given by the cuff pressure when the detector respectively shows a first output and then a maximum output as the cuff pressure is continuously decreased from a level above systolic to one below diastolic. However, the results given with this proposal are such as to suggest no marked improvement over conventional methods of measuring blood pressure by non-invasive means. Again, the measurement of diastolic pressure is of poor accuracy. Web site: http://www.delphion.com/details?pn=US04730621__
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Blood pressure measurement apparatus Inventor(s): Yamaguchi; Keiji (Shimizu, JP) Assignee(s): Terumo Corporation (Tokyo, JP) Patent Number: 4,768,519 Date filed: May 15, 1986 Abstract: Disclosed is a blood pressure measurement apparatus in which a waveform discrimination method is used in the recognition of Korotkoff sounds in the measurement of blood pressure by auscultation. In processing executed by the apparatus, the minimum point or maximum point (C3) of a signal waveform indicative of the sound of vibration produced by a blood vessel is detected, and a maximum value or minimum value point (C2) is detected within a predetermined time region (t.sub.1) the final instant of which is the point (C3). If a level difference between the point (C2) and the point (C3) is within a predetermined range, there is detected a minimum value or maximum value point (C1) within a predetermined time region (t.sub.2) the final instant of which is (C2). If a level difference between the point (C1) and the point (C2) is within a predetermined range, there is detected a maximum value or minimum value point (C4) within a predetermined time region (t.sub.3) the starting instant of which is the point (C3). It is then discriminated whether a level difference between the point (C4) and the point (C3) falls within a predetermined range. Control proceeds in successive fashion when each of these conditions is satisfied, with a Korotkoff sound being recognized in the signal waveform when all of these conditions are satisfied. Excerpt(s): This invention relates to a blood pressure measurement apparatus and method in which a waveform discrimination method is used in the recognition of Korotkoff sounds in the measurement of blood pressure by auscultation. In the detection of Korotkoff sounds according to the prior art, the most widespread approach is a discrimination method using a filter and comparator. This is referred to as the filter comparator method. Another approach used much less widely is a discrimination method, namely a pattern recognition method, which is based on the waveform of the Korotkoff sounds. It is known that the spectral distribution of Korotkoff sounds generally has a frequency component different from body movement and external noise. The filter comparator method utilizes this fact and measures blood pressure by filtering a signal detected by a microphone attached to a pressure cuff fastened to a patient's arm, reducing the amplitude of frequency components other than the frequency component of the Korotkoff sounds, then comparing the frequency component of the Korotkoff sounds with a preset threshold value by means of a voltage comparator, and discriminating this frequency component based on its magnitude. Web site: http://www.delphion.com/details?pn=US04768519__
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Blood pressure measurement apparatus and associated method Inventor(s): Takeda; Fumihide (Minamiku, JP) Assignee(s): Takeda Engineering Consultant Inc. (JP) Patent Number: 5,626,141 Date filed: June 2, 1995 Abstract: Using an improved noninvasive blood pressure measuring apparatus, dynamic parameters (like stretching and contracting velocity, acceleration, force, power
Patents 377
and energy) of human arterial wall motion against both the lowering and increasing pressure of an occlusive cuff are detected. They can be displayed along with other physiological signals like aortic pressure AP and ECG taken from other instruments through a data receiving unit. Then this apparatus with ECG makes it possible to noninvasively detect some abnormalities between the mechanical and electrical cardiac cycle on heart function. The apparatus also detects systolic (SYS) and diastolic (DIA) pressure while increasing the cuff pressure. The apparatus can also examine a non-local information on blood circulation by simultaneously using a second occlusive cuff. Since this apparatus is capable of acquiring any physiological signal coupled with a commonly practiced noninvasive brachial artery blood pressure measurement, it will be also useful for quick and mass clinical testing. Excerpt(s): In the field of noninvasive blood pressure measurement using a cuff, pressurizing unit and bleeding valves, this invention relates to a method of acquiring a response to the pulsating blood flow which produces stretching of the arterial wall against the bleeding cuff's pressure. The method includes displaying the cuff's fluctuating pressure on a display unit in terms of a variation in the height of the mercury column of a mercury manometer. The arterial wall stretching includes that which occurs before and after each systolic and diastolic pressure detection and between the two detections. The invention further relates to a method of measuring blood pressure by monitoring and recording the arterial response. Apparatus according to the invention can display the simulated motion of a needle indicator of an aneroid manometer in addition to displaying the mercury column. Thus, the invention does not require the manometers used previously in auscultatory methods. The invention can also graphically display in real time the arterial wall's subtle motion, which cannot be detected by the auscultatory method with a stethoscope and a microphone. The wall motion is displayed in the form of time varying physical quantities such as acceleration, velocity and the like. This invention can therefore be used as the auscultatory method while monitoring the information being displayed. For acquiring the arterial response to the pulsating blood flow by noninvasive blood pressure measurement with a cuff, a pressurizing unit and bleeding valves, there have been the following available methods: displaying only the intensity level of the Korotkoff's sounds graphically by using a microphone, and displaying the cuff's oscillating pressure wave whose constant bleeding rate is filtered out. Web site: http://www.delphion.com/details?pn=US05626141__ •
Blood pressure measurement device with a sensor locator Inventor(s): Archibald; G. Kent (Vadnais Heights, MN), Curran; Timothy (Ramsey, MN), Danielson; Orland H. (Roseville, MN), Poliac; Marius O. (St. Paul, MN), Thede; Roger C. (Afton, MN) Assignee(s): Medwave, Inc. (Arden Hills, MN) Patent Number: 6,159,157 Date filed: April 23, 1999 Abstract: A blood pressure measurement device with a sensor locator for placing a noninvasive blood pressure measurement device over an underlying artery, the sensor locator having a plurality of extending fingers spaced from each other coupled to the non-invasive blood pressure measurement device.
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Excerpt(s): The present invention relates to systems for measuring arterial blood pressure. In particular, the invention relates to a method and apparatus for conveniently positioning a non-invasive blood pressure measurement device over an underlying artery for accurate measurement. Blood pressure has been typically measured by one of four basic methods: invasive, oscillometric, auscultatory and tonometric. The invasive method, otherwise known as an arterial line (A-Line), involves insertion of a needle into the artery. A transducer connected by a fluid column is used to determine exact arterial pressure. With proper instrumentation, systolic, mean and diastolic pressure may be determined. This method is difficult to set up, is expensive and involves medical risks. Set up of the invasive or A-line method poses problems. Resonance often occurs and causes significant errors. Also, if a blood clot forms on the end of the catheter, or the end of the catheter is located against the arterial wall, a large error may result. To eliminate or reduce these errors, the set up must be adjusted frequently. A skilled medical practitioner is required to insert the needle into the artery. This contributes to the expense of this method. Medical complications are also possible, such as infection or nerve damage. The other methods of measuring blood pressure are non-invasive. The oscillometric method measures the amplitude of pressure oscillations in an inflated cuff. The cuff is placed against a cooperating artery of the patient and thereafter pressurized or inflated to a predetermined amount. The cuff is then deflated slowly and the pressure within the cuff is continually monitored. As the cuff is deflated, the pressure within the cuff exhibits a pressure versus time waveform. The waveform can be separated into two components, a decaying component and an oscillating component. The decaying component represents the mean of the cuff pressure while the oscillating component represents the cardiac cycle. The oscillating component is in the form of an envelope starting at zero when the cuff is inflated to a level beyond the patient's systolic blood pressure and then increasing to a peak value where the mean pressure of the cuff is equal to the patient's mean blood pressure. Once the envelope increases to a peak value, the envelope then decays as the cuff pressure continues to decrease. Web site: http://www.delphion.com/details?pn=US06159157__ •
Blood pressure measurement from the hand Inventor(s): Hynson; James M. (1674 32nd Ave., San Francisco, CA 94122), Katz; Jeffrey A. (1440 Madera Way, Millbrae, CA 94030) Assignee(s): none reported Patent Number: 6,162,181 Date filed: August 16, 1999 Abstract: A method and assembly oscillometrically measures systolic, mean and diastolic blood pressures by inflating a form fitting cuff disposed over the Palmar Arch of the hand, and subsequently deflating the cuff stepwise, The arterial blood supply to the hand, which is very rich, lies relatively close to the surface of the palm. Cuff pressure oscillations can be sensed with an inflatable glove or mitten type cuff. A full or partial glove, mitten, or the like, with openings for reception of portions of the fingers and thumb can be used. Inflation of the cuff allows the assembly to be used to measure arterial blood pressure on either hand of a patient. Excerpt(s): This invention relates to blood pressure ("BP") measurement and more particularly to a method and apparatus to measure BP by utilizing the hand. The measurement of systolic, diastolic, and mean blood pressure values by measuring cuff pressure oscillations caused by patient blood vessel pulses during deflation of the cuff is
Patents 379
a known technique. Oscillometric blood pressure measurement is taken at numerous anatomical sites in the body including the upper arm, forearm, wrist, finger, ankle, calf and thigh. These sites are roughly cylindrical in shape and easily lend themselves to placement of a wrap-around rectangular inflatable cuff to intermittently restrict blood flow. At cuff pressures above systolic pressure, minimal blood flow occurs and no pressure oscillations are received in a monitoring device. As cuff pressure is decreased, blood vessel oscillations are sensed in the monitoring device and the amplitude of these oscillations becomes larger. The cuff pressure at which oscillations are largest is typically considered to correlate with mean pressure. As pressure in the cuff is decreased further, oscillations become smaller and eventually are no longer present. Mean, systolic and diastolic pressures are sensed and determined by computer analysis in the monitoring device of the changes in the oscillation amplitudes during cuff deflation as is known in the art. Web site: http://www.delphion.com/details?pn=US06162181__ •
Blood pressure measurement system Inventor(s): Bluth; Charles (Incline Village, NV), Bluth; James (Verdi, NV) Assignee(s): Computerized Screening, Inc. (Sparks, NV) Patent Number: 6,511,435 Date filed: April 14, 2000 Abstract: A blood pressure measurement device and associated operating method utilize a measurement algorithm based on a plurality of measurements, supplying a unique ability to increase diagnostic and analytical success in detection. In an illustrative implementation, three measurement techniques are used in combination to improve overall measurement accuracy. A first of the three techniques is an ascultatory technique. A sound measurement acquired from a microphone located in the measurement cuff detects start and end Korotkoff sounds using a combination of filters. The auscultatory technique is a conventional method that is recommended by the American Heart Association and is similar to manual techniques used by a nurse or technician. The auscultatory technique and associated filtering techniques are well known by those having ordinary skill in the art. A second technique is an oscillometric technique that is commonly found in many low-cost blood pressure measurement devices. A pressure cuff is used to measure pressure oscillations, which are detected and monitored using mean pressure, and systolic and diastolic pressure ratios to identify systolic and diastolic blood pressure. A third technique, called a pattern recognition technique, measures a sound envelope and incorporates pattern recognition to identify systolic and diastolic pressures. A signal from the pressure sensor is used in addition to the three techniques to quantify the regions of sound under analysis. Excerpt(s): The field of medicine has long employed health care screening to diagnose and tract patients' health. An annual physical examination is a well-known part of patient medical care. A number of portable monitoring devices are used in medical monitoring. One well known device is the so-called Holter monitor which is an EKG monitor which typically uses a magnetic tape recorder to record EKG signals from a patient over extended periods of time. Another is a monitor for obtaining blood pressure readings over extended periods of time. Hospitals, health clinics, and pharmacies, in addition to an active role is supplying medical supplies and pharmaceuticals, have actively promoted various health care screenings and wellness programs. Programs are sometimes offered with the help of other health care providers or coordinated on a
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national basis with groups such as the American Lung Association, the American Diabetes Association and the American Podiatric Medical Association. Web site: http://www.delphion.com/details?pn=US06511435__ •
Blood pressure measurement system for filtering low-frequency, high-amplitude noise Inventor(s): Samaras; George M. (Columbia, MD), Falk; Steven M. (Washington, DC) Assignee(s): GMS Engineering Corporation (Columbia, MD) Patent Number: 4,858,616 Date filed: March 17, 1988 Abstract: A noise-immune blood pressure measurement system filters out high frequency noise and blood pulses. The system also recognizes and filters out slow, large noise signals in the range of 0.5 Hz. Such noise signals result when a patient wearing the system makes slow, large finger movements, or is slowly transported by a vehicle over a large bump, for instance. The system accurately derives systolic, mean arterial, and diastolic pressures even when used in a noisy emergency vehicle or battlefield situation. Excerpt(s): This invention concerns a blood pressure measurement system. More particularly, the invention concerns a blood pressure measurement system that filters low-frequency, high-amplitude noise to accurately measure blood pressure. Blood pressure measurement is used to generally indicate the health of a patient or the type of emergency treatment which is necessary for an accident victim or a battlefield casualty. Most blood pressure measurement systems involve listening for blood pulses of a patient with a stethoscope. Noises of an emergency vehicle or in a battlefield make these pulses difficult to hear, which makes accurate measurement of blood pressure very difficult to obtain. An occlusion pressure value sensed by the transducer 22 on the occlusion bladder 10 corresponds to systolic pressure of a patient when the sensing pressure signal from the sensing bladder 12 reaches a minimum value. The microprocessor 28 derives first, second, and third time derivatives of the sensing pressure signal from the sensing bladder 12. An occlusion pressure value from the occlusion bladder 10 corresponds to mean arterial pressure when the third time derivative of the sensing pressure signal is a positive-going, zero-crossing signal. The microprocessor 28 derives diastolic pressure from the mean arterial pressure and the systolic pressure according to a well known relationship. Web site: http://www.delphion.com/details?pn=US04858616__
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Blood pressure measuring apparatus Inventor(s): Kaspari; William J. (Portola Valley, CA), Wong; Herman (Los Altos Hills, CA), Kirch; Joseph L. (Hollister, CA) Assignee(s): Palo Alto Research Associates (Portola Valley, CA) Patent Number: 4,058,117 Date filed: October 17, 1975 Abstract: A fully automatic, non-invasive, digitally-controlled blood pressure measuring apparatus is described with LED displays for displaying systolic and diastolic blood pressure levels, an inflatable cuff for occluding an artery, a pump for inflating the cuff, a
Patents 381
cuff-mounted sensor for detecting Korotkoff sounds, adjustable gain-amplifying apparatus for maintaining linearity of the Korotkoff sound levels over a wide range of human individuals, circuits for automatically determining systolic and diastolic pressure levels and pressure release apparatus for preventing overinflation of the cuff. Excerpt(s): The present invention relates to blood pressure measuring apparatus in general and in particular to a fully automatic, non-invasive, digitally-controlled apparatus with digital registers and LED's for providing a readout of systolic and diastolic blood pressure levels. Typically, the systolic blood pressure is defined as that pressure in the vascular system which exists when the heart is active -- i.e., pumping. It is determined as corresponding to the pressure in a cuff required to effect approximately total occlusion of the brachial artery. The diastolic pressure, on the other hand, is defined as that pressure in the vascular system existing when the artery returns to its non-occluded shape. It is determined as corresponding to the pressure in a cuff when an artery becomes approximately fully patent. Whether an artery is occluded or patent is determined by the sounds or lack of sounds created by the blood coursing through the artery. These sounds, commonly called Korotkoff sounds or pulses, are measurable as the artery is partially occluded. In the course of taking a blood pressure measurement, the Korotkoff sounds are found to vary in amplitude and frequency. Moreover, the amplitude and frequency of the sounds may, and usually do, vary from individual to individual. Also, as is found when using a stethoscope, it is quite difficult to detect quantitatively a change in the sound intensity -- i.e., amplitude. Noise is frequently prominent and partly to blame for this difficulty. Web site: http://www.delphion.com/details?pn=US04058117__ •
Blood pressure measuring apparatus Inventor(s): Akira; Abe (Takatsuki, JP), Kimura; Shoji (Kameoka, JP), Yoshinori; Miyawaki (Yawata, JP) Assignee(s): Omron Tateisi Electronics, Inc. (Kyoto, JP) Patent Number: 4,337,778 Date filed: July 15, 1980 Abstract: Blood pressure measuring apparatus comprising an occluding cuff including an inflatable bladder, an air guiding passage one end of which is connected to the bladder, an air pressure control connected to the other end of the passage for inflating or deflating the bladder through the passage, a microphone within said passage for sensing Korotkoff sounds which are propagated through the passage from the bladder and for generating Korotkoff sound signals, a pressure transducer for sensing the pressure within the bladder and for generating pressure signals, and a circuit operative in response to the Korotkoff sound and pressure signals to measure the systolic and diastolic blood pressures of a patient whose blood pressure is to be measured. Excerpt(s): The present invention relates to a blood pressure measuring apparatus for measuring the systolic and diastolic blood pressures of a patient, and more particularly to an improved apparatus in which an electronic microphone for sensing Korotkoff sounds is disposed in a position remote from an occluding cuff. A blood pressure measuring apparatus is well known which comprises an occluding cuff including an inflatable bladder, a squeezable bulb for applying air pressure to the bladder, a valve for reducing the pressure within the bladder, a microphone for sensing Korotkoff sounds, a pressure transducer for sensing the pressure within the bladder to generate pressure
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signals, and an electronic circuit device for determining the blood pressures of a patient. In this prior art apparatus, the microphone is disposed within the cuff so as to sense Korotkoff sounds generated from an artery of the patient. The microphone must be very accurately positioned over the artery so that its sound sensing surface may sense the Korotkoff sounds. This positioning work requires a fair amount of skill. Generally, the cuff includes two lines. One of the lines is an air pressure tubing connecting the bladder with the pressure transducer, and the other line is a cable establishing an electrical connection between the microphone and the electronic circuit device. The cuff must be wrapped and unwrapped for every blood pressure measurement, and the cable for the microphone then interferes with the handling of the cuff and, moreover, is easy to break. It is, therefore, a primary object of the present invention to provide a blood pressure measuring apparatus comprising an occluding cuff and a measuring unit coupled to the cuff through a single air pressure tube. Web site: http://www.delphion.com/details?pn=US04337778__ •
Blood pressure measuring apparatus Inventor(s): Sugo; Yoshihiro (Tokyo, JP), Sohma; Takeshi (Tokyo, JP) Assignee(s): Nihon Kohden Corporation (Tokyo, JP) Patent Number: 5,709,212 Date filed: March 30, 1995 Abstract: A blood pressure measuring device includes: a memory for storing a standard constant.alpha. an input means for inputting a correcting blood pressure value; a time interval reference point detection section for detecting a time interval detection reference point in a pulse wave on the side of aortae; a pulse wave detection section for detecting a pulse wave on the side of peripheral blood vessels appearing with a time lag with respect to the pulse wave on the side of aortae; a pulse wave propagation time measurement section for measuring a pulse wave propagation time based on respective detected outputs from the time interval detection reference point detection means and the pulse wave detection means; an operation means for determining a constant.beta. using the blood pressure value for calibration, pulse wave propagation time, and standard constant.alpha. inputted for calibration; an operation means for calculating the blood pressure value from the pulse wave propagation time measured at a predetermined time interval for measuring a circadian blood pressure fluctuation, and the standard constants.alpha.,.beta. a memory for consecutively storing the measured pulse wave propagation time and the blood pressure value calculated from the pulse wave propagation time; and an external output connector for outputting at least the blood pressure value and pulse wave propagation time data as a result of the circadian blood pressure fluctuation measurement. Excerpt(s): The invention relates to a Holter type blood pressure measuring apparatus for measuring circadian blood pressure fluctuation and, more particularly, to a blood pressure measuring apparatus for measuring blood pressure based on pulse wave propagation time. As a noninvasive Holter type blood pressure measuring device for measuring circadian blood pressure fluctuation, a blood pressure measuring device using a cuff has heretofore been known. This blood pressure measuring device requires that the cuff be wrapped around the upper part of an arm of a subject, and this has imposed various problems. That is, the weight of the cuff is annoying to the subject; the wrapped cuff binds the daily life of the subject; the subject feels uncomfortable during
Patents 383
night with the cuff wrapped; and the subject may suffer from somnipathy due to cuff driving noise and the like. In addition, the cuff has an artifact caused by a shock. Web site: http://www.delphion.com/details?pn=US05709212__ •
Blood pressure measuring apparatus Inventor(s): Ogura; Toshihiko (Inuyama, JP) Assignee(s): Colin Corporation (Komaki, JP) Patent Number: 5,727,560 Date filed: September 17, 1996 Abstract: An apparatus for measuring a blood pressure (BP) value of a living subject, including a BP measuring device which measures, in each of measuring operations, at least one BP value of the subject including a systolic BP value of the subject, a first storing device which stores a set of temporary BP data which represents, as at least one temporary BP value, at least one BP value measured by the BP measuring device in each of a plurality of measuring operations within a predetermined time duration, thereby storing a plurality of sets of temporary BP data corresponding to the plurality of measuring operations within the time duration, and a second storing device which selects one of the sets of temporary BP data such that the selected one set of temporary BP data represents at least one temporary BP value including a lowest temporary systolic BP value of the respective temporary systolic BP values represented by the sets of temporary BP data, and stores the selected one set of temporary BP data as a set of proper BP data representing at least one proper BP value obtained within the time duration, the at least one proper BP value including the lowest temporary systolic BP value as a proper systolic BP value. Excerpt(s): The present invention relates to a blood pressure measuring apparatus which accumulatively stores measured blood pressure values. There is known an automatic blood pressure (BP) measuring apparatus including a memory device, such as a magnetic disk. The BP measuring apparatus automatically carries out BP measurements on a living person, and accumulatively stores, in the memory device, measured BP values and other related data. The BP measuring apparatus provides personal health information including the BP values, in the form of a graphic representation of a timewise trend of the BP values, thereby making it possible for the person to recognize a time-wise change of the BP values. If the person compares the current BP value with the prior BP values stored in the memory device, then he or she can judge whether the manner in which the current BP value is obtained is appropriate and/or whether his or her physical condition is normal. In the above BP measuring apparatus wherein measured BP values are accumulatively stored, all measured BP values are stored in the memory device even in the case where another or more BP measurements are carried out just for obtaining a more accurate BP value or values than the first BP value or values obtained in the first BP measurement. Thus, the limited memory capacity of the memory device is unnecessarily used. In addition, it is considerably difficult to read an accurate time-wise change of BP values from the graphic representation which contains the inaccurate or unnecessary BP values. Web site: http://www.delphion.com/details?pn=US05727560__
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Blood pressure measuring apparatus Inventor(s): Ogura; Toshihiko (Inuyama, JP), Oka; Toru (Ichinomiya, JP) Assignee(s): Colin Corporation (Komaki, JP) Patent Number: 5,836,888 Date filed: February 13, 1997 Abstract: An apparatus for measuring a blood pressure of a living subject, including a blood pressure measuring device which measures a blood pressure value of the subject, a first memory which stores a plurality of blood pressure values measured by the blood pressure measuring device, in an order of measurement of the blood pressure values, a pulse wave detecting device which detects a pulse wave produced from an arterial vessel of the subject in synchronism with heartbeat of the subject while each of the blood pressure values is measured by the blood pressure measuring device, a second memory which stores a waveform of the pulse wave detected by the pulse wave detecting device, in the order, the second memory storing the respective waveforms of the pulse waves each of which is detected by the pulse wave detecting device while a corresponding one of the blood pressure values is measured by the blood pressure measuring device, and an output device which outputs the blood pressure values stored in the first memory, in the order, and a plurality of curves respectively representing the waveforms stored in the second memory, in the order, in a side-by-side relation with each other. Excerpt(s): The present invention relates to the improvements of a blood pressure measuring apparatus which measures a blood pressure value of a living subject such as a patient. There is known an automatic blood pressure (BP) measuring apparatus which carries out BP measurements on a patient, accumulatively stores a measured BP value or values obtained in each BP measurement, and provides a graphic representation of the stored BP values arranged in the order of measurement. An example of the BP measuring apparatus is disclosed in Non-Examined Japanese Patent Application laid open under Publication No. 5(1993)-137698. The BP apparatus enables the patient to easily recognize the time change of the measured BP values and correctly judge whether he or she is in a healthy condition. When the patient feels tight in the chest, such a light attack may, however, be transient, so that the patient may fail to recognize that he or she possibly has a serious heart disease. Even if the patient may reach the recognition and consult a doctor, then the patient may no longer have any subjective symptom and may appear to the doctor to have no medical problem. In this case, the doctor may make a diagnosis based on insufficient examination data, e.g., BP values only. If the prior BP apparatus is used to obtain the BP values of the patient, however, the BP apparatus provides only the measured BP values of the patient, or only the time change of the measured BP values. With those data, the patient may suspect that he or she may have hypertension, but the patient cannot make a self-diagnosis, or the doctor cannot make a medical diagnosis, that he or she may have a heart disease. If the patient continues his or her life without receiving any medical treatments, he or she might be brought into a serious condition. Next, there is known an arm belt which is, either manually or using a winding device, wound around an upper arm of a living body or subject and which has an inflatable bag to which a pressurized air is supplied to press the arteries of the arm and measure a BP value or values of the subject. The supplying of the air to the bag is effected after the belt is wound around subject's arm, and the measurement of BP values is carried out while the air pressure of the bag is changed. It is preferred that the belt be wound around the arm such that three fingers can be inserted between the skin of the arm and the inside surface of the belt. However, since the upper arm of the subject around which the arm belt is wound is easily deformable, a certain level of skill is
Patents 385
needed for winding the belt wound the arm with a preferable pressing force and measuring a BP value or values of the subject with accuracy. Hence, there has been used a winding device which automatically winds an arm belt around an upper arm of a living subject. The automatic winding device has a cylindrical arm receiver in which the belt taking a cylindrical shape is provided, and has a drive device such as a motor for tightening the belt. After the subject inserts his or her arm into the belt inside the receiver through one end of the receiver, the drive device is operated to tighten the belt and thereby reduce the inside diameter of the cylindrical belt. Thus, the arm belt is automatically wound around the subject's upper arm. When a BP measurement is carried out using the automatic winding device, it is required that the arteries of the upper arm of the subject be uniformly pressed by the arm belt. To this end, generally, an elbow rest is provided outside the other end of the arm receiver, and the subject inserts his or her arm such that the elbow of the arm rests on the rest. The diameter of the belt is reduced when the subject is taking such a posture that the upper arm is not in contact with the inner wall of the above-mentioned one end of the receiver. That is, it is preferred that the longitudinal axis line of the upper arm of the subject be kept substantially parallel to the central axis line of the cylindrical arm receiver. However, ordering the subject to change his or her natural posture to the above-mentioned posture may result in forcing the subject to take an unnatural posture, depending upon the conformation of his or her body. This problem is exaggerated in particular for patients or aged persons who are not so free to change their postures. In the latter cases, the accuracy of BP measurements may be lowered. Web site: http://www.delphion.com/details?pn=US05836888__ •
Blood pressure measuring apparatus Inventor(s): Ichinomiya; Tsutomu (Hikone, JP), Kusunoki; Toshio (Hikone, JP), Kami; Tomohiro (Hikone, JP) Assignee(s): Matsushita Electric Works, Ltd. (Osaka, JP) Patent Number: 4,417,587 Date filed: August 20, 1981 Abstract: Apparatus is described for measuring both the systolic and diastolic blood pressure of an individual. A pressurable cuff having an additional tightening band for advantageously positioning a cuff and microphone on an artery is described. The microphone is connected to first the second filters having respective passbands for analyzing the frequency content for recovered pulse signals. The apparatus provides for automatic pressurizing and depressurizing of the cuff whereby the artery is occluded and opened to permit passage of the blood flow. The pressure at the time of receipt of signals from the filters is measured as the systolic pressure. The diastolic blood pressure is measured with apparatus in accordance with the invention by monitoring signals from one of the filters. Excerpt(s): The present invention relates to automatic blood pressure measuring devices. Specifically, an apparatus for automatically measuring and displaying values of systolic and diastolic blood pressure is described. It is known to make measurements of blood pressure based upon the Korotkoff sound method. In the Korotkoff sound method, the artery of a patient in the upper arm area is pressurized by means of a pressurizable cuff wrapped around the upper arm. The pressurization rate applied to the upper arm area is in the vicinity of 20 mm hg/second and 30 mm hg/second. The pressure applied to the arm area is increased until it is 10 mm hg to 20 mm hg higher
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than the expected systolic or maximum blood pressure, at which point the arterial flow of blood is completely cut off. In this process, the cuff pressure is decreased gradually at a rate of 2 to 8 mm hg per second until the artery is able to pass a small amount of blood. During the systolic period of the heart beat, the arterial blood flow reaches a maximum speed and passes through the slightly opened artery. As blood flows towards the arterial wall, there is an attenuation vibration in the high frequency pulse wave produced by the blood which constitutes the aforesaid Korotkoff sound. At this time, cuff pressure approximates the systolic blood pressure. Further reduction of the pressure to the arm area produces pulse waves that are in synchronism with the Korotkoff sounds, and at the point where the artery is open and the heart is in the diastolic period, the Korotkoff sounds cease. The cuff pressure at this time expresses the diastolic blood pressure permitting a reading of both the systolic and diastolic blood pressure. Prior art devices have depended upon detecting the Korotkoff sound pulse with a microphone. When the Korotkoff sound is above a specific output level, the cuff pressure is read to determine the systolic blood pressure. Corresponding to this measurement, the level of the Korotkoff sound signal is monitored to determine when it is below a predetermined level, at which time the cuff pressure is recorded at the diastolic blood pressure. The prior art improved upon detection of the Korotkoff sounds utilizing a first low-range filter, having a band pass between 30 and 50 hertz to extract the systolic Korotkoff sound signal low frequency components. Further, a second filter was employed which extracted the higher frequency components having a frequency between 80 to 120 hertz of the Korotkoff sound to measure the diastolic blood pressure. When the output from the low frequency filter ended, the pressure exerted by the cuff was recorded at the systolic blood pressure. When the output from the second filter ceased, the pressure applied by the cuff was recorded as the diastolic blood pressure. Web site: http://www.delphion.com/details?pn=US04417587__ •
Blood pressure measuring apparatus Inventor(s): Utsunomiya; Shunji (Kyoto, JP), Teramoto; Tsutomu (Takatsuki, JP), Huruta; Tadashi (Ohtsu, JP) Assignee(s): Omron Tateisi Electronics Co. (Kyoto, JP) Patent Number: 4,690,151 Date filed: November 22, 1985 Abstract: A blood pressure measuring apparatus for measuring maximum and minimum values of blood pressure comprises a bag-like arm belt for compressing an arm of a person whose blood pressure is to be measured, a power source switch, pressurizing pump for pressurizing interiorly the bag-like belt, pressure sensor for detecting pressure within the bag-like belt, K's sound sensor for detecting blood information by decreasing the pressure within the bag-like belt, blood pressure determining computer for determining maximum and minimum values of the blood pressure on the basis of output signals of the pressure sensor and the K's sound sensor, pressure value change-over switch for setting a pressure value to be established within the bag-like belt, pressure increasing pump for increasing the pressure within the baglike belt to the set pressure value, an announcer for announcing the set pressure value in the form of speech information upon closing of the power source switch, to thereby inform the set pressure value in the form of speech before the pressurizing operation is initiated. Every time when the set pressure value is renewed by the pressure value change-over switch, the speech information announcer can inform user of the renewed
Patents 387
value of the set pressure. Information of the set pressure value can thus be positively made available before performing the blood pressure measurement, whereby erroneous measurement is prevented. Excerpt(s): The present invention relates generally to a blood pressure measuring apparatus, and more particularly to the blood pressure measuring apparatus of the type in which a bag-like belt or band wound around an arm of a person is automatically pressurized. Heretofore, there is known a blood pressure measuring apparatus in which the bag-like belt or band attached to a person whose blood pressure is to be measured is pressurized by means of a pressurizing pump, and subsequently the pressure within the bag-like band is detected by means of a pressure sensor while the pressure within the band is concurrently decreased at a reduced rate through a show discharge value. On the other hand, the Korotokov's sound (hereinafter, also referred to simply as K's sound) is detected by using a K's sound sensor. The output signals of both sensors are processed by a microcomputer to derive the maximum and minimum values of the blood pressure which are then visually displayed. In the blood measuring apparatus of the type described above, it is known that the pressurization of the bag-like belt or band is performed automatically up to a preset pressure value or level. The pressure value must of course be higher than the expected maximum pressure value as measured. It is also empirically known that when the set pressure value is excessively high, difficulty may be encountered in attaching the accurate measurement. Web site: http://www.delphion.com/details?pn=US04690151__ •
Blood pressure measuring apparatus Inventor(s): Yamaguchi; Keiji (Shimizu, JP) Assignee(s): Terumo Corporation (Tokyo, JP) Patent Number: 4,712,564 Date filed: February 11, 1986 Abstract: A blood pressure measuring apparatus displays that pressurization of a pressure cuff affixed to a patient is inadquate when elapsed time from the start of cuff depressurization to the detection of an initial sound of blood flow through the patient's blood vessel is shorter than a time interval between adjacent blood flow sounds, which interval approximately coincides with the patient's pulse interval. Excerpt(s): This invention relates a blood pressure measuring apparatus capable of automatically sensing inadequate pressurization. In a blood pressure measuring apparatus which operates on the basis of the Korotkoff method, determining inadequacy of pressurization in the prior art is based on whether Korotkoff sounds are detected within a prescribed period of time following the start of blood pressure measurement, i.e., following termination of the pressurizing operation. For example, see the specification of Japanese Utility Model Publication No. 57-3296. A problem with the foregoing method of determination is that there is no assurance that the prescribed period of time is long enough to allow fail-safe detection of inadequate pressurization under all conditions. For this reason, there is always the possibility that inadequate pressurization will not be sensed in case of a low pulse rate. If it is attempted to solve this problem by making the set period of time long enough to sense inadequate pressurization without fail even for low pulse rates, then a patient with a comparatively rapid pulse must be subjected to more pressurization than necessary and will experience discomfort due to the pressure applied. Another problem involved with rapid pulses is
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that inadequate pressurization is sometimes sensed even if enough pressure is actually applied. As a result, the patient is subjected to unnecessary repressurization. Web site: http://www.delphion.com/details?pn=US04712564__ •
Blood pressure measuring apparatus Inventor(s): Yokoe; Hifumi (Kosai, JP), Harada; Chikao (Nagoya, JP) Assignee(s): Colin Electronics Co., Ltd. (JP) Patent Number: 4,947,855 Date filed: February 16, 1989 Abstract: A blood pressure measuring apparatus having a housing detachably set on a body surface of a subject, a pressure sensor accommodated in the housing such that the pressure sensor is opposed to the body surface when the housing is set on the body surface, the pressure sensor being pressed against the body surface so as to detect pulse wave produced from an arterial vessel of the subject, the pressure sensor generating pulse wave signal representing the detected pulse wave, a pressing device for pressing the pressure sensor against the body surface, and a control device for determining blood pressure in the arterial vessel based on the pulse wave signal supplied from the pressure sensor, the pressing means and the control means being accommodated in the housing. Excerpt(s): The present invention relates to a blood pressure measuring apparatus and particularly to improvements in such an apparatus which measures blood pressure based on pulse wave produced from a blood vessel of a living body. Pulse wave is generally defined as pressure wave, or oscillation of the wall of a blood vessel, produced with heart beat of a living body and transmitted through the blood vessel. There has been proposed a device for determining blood pressure based on the pulse wave. The Inventors and others filed Japanese Pat. Application No. 62-130879 on May 27, 1987 in which they disclosed a pulse wave detecting device which is capable of determining maximum and minimum blood pressure based on the detected pulse wave. The device has (a) a housing detachably set on a body surface of a subject, (b) a pressure sensor accommodated in the housing such that the pressure sensor is opposed to the body surface when the housing is set on the body surface, the pressure sensor being pressed against the body surface so as to detect pulse wave produced from an arterial vessel of the subject, the pressure sensor generating pulse wave signal representing the detected pulse wave, (c) pressing means for pressing the pressure sensor against the body surface, and (d) a control circuit for determining blood pressure in the arterial vessel based on the pulse wave signal supplied from the pressure sensor. This device permits easier blood pressure measurement than a prior device using an inflatable cuff which occludes blood flow for blood pressure measurement as a result of compressing an upper arm of a subject. The above-indicated Japanese Pat. Application was laid open under Publication No. 63-293424 on Nov. 30, 1988. However, the above-indicated pulse wave detecting device is not easy to handle or handy to carry because the pressing means and the control circuit are disposed apart from the housing and connected thereto via air piping and electric wiring, respectively. Furthermore, such air piping and/or electric wiring restricts activity of the subject to some extent. Web site: http://www.delphion.com/details?pn=US04947855__
Patents 389
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Blood pressure measuring apparatus Inventor(s): Higuchi; Tomoe (Aichi, JP), Niwa; Minoru (Nagoya, JP) Assignee(s): Colin Electronics Co., Ltd. (JP) Patent Number: 5,000,187 Date filed: February 16, 1989 Abstract: An apparatus for continuously measuring blood pressure of a subject based on magnitude variation of heartbeat-synchronous pulses produced from the subject, the apparatus including a detecting device for continuously detecting the pulses, the detecting device including an inflatable cuff to be set around a body portion of the subject, magnitude of the pulses being varied as pressure in the inflatable cuff is varied, the varying magnitude of the pulses being detected by the detecting device, a selecting device for selecting a pulse from the pulses detected at a preceding blood pressure measuring cycle, the selected pulse corresponding to maximum blood pressure determined at the preceding measuring cycle, a first determining device for determining a reference value based on at least a magnitude of the selected pulse, a second determining device for comparing, with the reference value, the varying magnitude of the heartbeat-synchronous pulses detected at a current blood pressure measuring cycle, and determining as temporary maximum blood pressure a pressure in the inflatable cuff when the varying magnitude of the currently detected pulses exceeds the reference value, and a display device for displaying the temporary blood pressure before determination of maximum blood pressure at the current blood pressure measuring cycle. Excerpt(s): The present invention relates to a continuous-type blood pressure measuring apparatus, and particularly to such an apparatus which displays temporary maximum blood pressure before displaying proper and more accurate blood pressure at the end of each of continuous blood pressure measuring cycles. There are known apparatus for continuously measuring blood pressure of a living body based on magnitude variation of heartbeat-synchronous pulses produced from the body. These apparatus include means for continuously detecting (a) Korotkoff sounds produced as pressure in an inflatable cuff set around a body portion of a subject is varied; (b) pulse wave (pressure oscillation) transmitted to an inflatable cuff; or (c) oscillation of the wall of an arterial vessel by utilizing Doppler effect. These apparatus are adapted to display maximum and minimum blood pressure at the end of each of continuous blood pressure measuring cycles. In other words, accurate blood pressure cannot be determined or displayed before a whole blood pressure measuring cycle is terminated, for example before pressure in an inflatable cuff whose level has been increased to a suitable upper level, is decreased to a suitable lower level. However, it is preferred that maximum blood pressure be displayed as temporary or estimated maximum blood pressure as early as possible prior to the end of each measuring cycle because the maximum blood pressure is more important information than other information concerning the blood pressure. In the above background, it is proposed to determine temporary maximum blood pressure (hereinafter, referred to TMBP) at each of continuous blood pressure measuring cycles (hereinafter, referred to BPMC's) by selecting a pulse from heartbeatsynchronous pulses detected at a current BPMC which pulse corresponds to the TMBP, based on a maximum difference in magnitude between each pair of adjacent ones of the currently detected, consecutive heartbeat-synchronous pulses. In this case, however, the maximum difference, based on which the TMBP is determined, may be changed as the current BPMC is progressed. Consequently, TMBP, once displayed, may be changed to another TMBP in the course of detection of the following heartbeat-synchronous pulses
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during the current BPMC. Thus, the TMBP determined in the above-indicated manner is not reliable. Web site: http://www.delphion.com/details?pn=US05000187__ •
Blood pressure measuring apparatus Inventor(s): Fujita; Hisahiro (Yamatokoriyama, JP), Kato; Yoichi (Nara, JP), Furukawa; Toshio (Nara, JP) Assignee(s): Sharp Kabushiki Kaisha (Osaka, JP) Patent Number: 5,474,076 Date filed: November 25, 1988 Abstract: A blood pressure measuring apparatus which comprises: a memory which stores the pressure value of a cuff when the cuff is to be pressurized again after the cuff has been pressurized; a comparator which, after the cuff is pressurized again, compares the pressure value of the cuff with the stored pressure value; a controller which produces an additional driving signal when the former in not greater than the latter; and a pump which pressurizes again the cuff in response to the additional driving signal. Excerpt(s): This invention relates to a blood pressure measuring apparatus such as a socalled hematomanometer, tonometer or the like. More particularly, it relates to a blood pressure measuring apparatus having a pressurizing means which is operated by a driving means such as an electric motor. A blood pressure measuring apparatus which is electronically controlled has a pump for supplying pressurized air to a pressure applying means such as a so-called cuff. The pump is driven by a small electric motor. The motor is controlled by a suitable electronic control means having a CPU. When the pressure of the cuff is insufficient, the pump is operated to restart the pressurization. Hereinafter, such a operation is referred as "repressurization". A conventional blood pressure measuring apparatus often fails to start the repressurization because of the stiffness of the pump. In the above-described apparatus, the starting properties of the motor under the condition that the cuff has been already pressurized is improved. Even when a small electric motor is used as the motor 1, consequently, it can drive the pump 4 to conduct the repressurization. Web site: http://www.delphion.com/details?pn=US05474076__
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Blood pressure measuring apparatus Inventor(s): Ohmori; Kenji (Yokohama, JP), Narimatsu; Kiyoyuki (Kasugai, JP), Kobayashi; Ikuo (Vanimo, PG) Assignee(s): Colin Corporation (Komaki, JP) Patent Number: 5,590,661 Date filed: July 29, 1994 Abstract: A blood pressure measuring apparatus including a surface-pressure sensor having a pressure sensing element in a press surface thereof to detect a pressure at the press surface pressed on subject's body surface and generate a pressure signal representing the detected surface pressure, the pressure signal containing successive pulses representing a pressure pulse wave produced from subject's artery, a pressing device which presses the sensor against the artery via the body surface, a control device
Patents 391
which changes the pressing force of the pressing device applied to the sensor, to partially flatten the artery, and obtains the successive pulses of the pressure signal during the changing of the pressing force, a first determining device for determining, in a two-dimensional orthogonal coordinate system, a first straight line approximating a level portion of (a) an upper-peak curve connecting respective upper-peak magnitudes of the successive pulses of the pressure signal and/or (b) a lower-peak curve connecting respective lower-peak magnitudes of the successive pulses, a second determining device for determining a second straight line approximating an increasing portion of (a) the upper-peak curve and/or (b) the lower-peak curve, and a blood pressure determining device for determining a systolic and/or a diastolic blood pressure of the subject based on an intersecting point of the first and second straight lines. Excerpt(s): The present invention relates to a blood pressure measuring apparatus including a surface-pressure sensor adapted to be pressed against an artery of a living body or subject via a body surface of the subject. There is known a blood pressure (BP) measuring device which non-invasively measures a BP value of a living subject based on a pulse-sound signal or a pulse-wave signal which is continuously obtained while an inflatable cuff wound around subject's body portion such as an upper arm is inflated, or is deflated after being inflated, to press the body portion. The non-invasively measured BP value is an approximation of an intra-arterial BP value directly or invasively measured from inside an artery of the subject. In the conventional BP measuring device, however, the cuff presses the subject's body portion all around with a considerably great force, so that the subject may suffer the discomfort due to the use of the cuff. Web site: http://www.delphion.com/details?pn=US05590661__ •
Blood pressure measuring apparatus Inventor(s): Ogura; Toshihiko (Inuyama, JP), Oka; Toru (Ichinomiya, JP) Assignee(s): Colin Corporation (Komaki, JP) Patent Number: 5,649,536 Date filed: February 21, 1995 Abstract: A apparatus for measuring blood pressure of a living subject, including a blood pressure measuring device which receives a heartbeat synchronous-signal wave generated by arteries of the patient, determines respective amplitudes of successive pulses of said heartbeat-synchronous signal wave, each of which corresponds to one heartbeat of the subject, and provides as a first series of pulse amplitudes, the pulse amplitudes arranged in order of generation. The device further smoothens the first series of pulses and provides a second series of smoothened pulse amplitudes, and determines a blood pressure value based on a change in the second series. The device further provides a two-dimensional output of the first and second series, where one of the two series is superimposed on the other, and/or a representation of the degree of propriety of the measurement condition during which the measurement was performed. Excerpt(s): The present invention relates to the improvements of a blood pressure measuring apparatus which measures a blood pressure value of a living subject such as a patient. There is known an automatic blood pressure (BP) measuring apparatus which carries out BP measurements on a patient, accumulatively stores a measured BP value or values obtained in each BP measurement, and provides a graphic representation of the stored BP values arranged in the order of measurement. An example of the BP measuring apparatus is disclosed in Non-Examined Japanese Patent Application laid
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open under Publication No. 5(1993)-137698. The BP apparatus enables the patient to easily recognize the time change of the measured BP values and correctly judge whether he or she is in a healthy condition. When the patient feels tight in the chest, such a light attack may, however, be transient, so that the patient may fail to recognize that he or she possibly has a serious heart disease. Even if the patient may reach the recognition and consult a doctor, then the patient may no longer have any subjective symptom and may appear to the doctor to have no medical problem. In this case, the doctor may make a diagnosis based on insufficient examination data, e.g., BP values only. If the prior BP apparatus is used to obtain the BP values of the patient, however, the BP apparatus provides only the measured BP values of the patient, or only the time change of the measured BP values. With those data, the patient may suspect that he or she may have hypertension, but the patient cannot make a self-diagnosis, or the doctor cannot make a medical diagnosis, that he or she may have a heart disease. If the patient continues his or her life without receiving any medical treatments, he or she might be brought into a serious condition. Next, there is known an arm belt which is, either manually or using a winding device, wound around an upper arm of a living body or subject and which has an inflatable bag to which a pressurized air is supplied to press the arteries of the arm and measure a BP value or values of the subject. The supplying of the air to the bag is effected after the belt is wound around subject's arm, and the measurement of BP values is carried out while the air pressure of the bag is changed. It is preferred that the belt be wound around the arm such that three fingers can be inserted between the skin of the arm and the inside surface of the belt. However, since the upper arm of the subject around which the arm belt is wound is easily deformable, a certain level of skill is needed for winding the belt wound the arm with a preferable pressing force and measuring a BP value or values of the subject with accuracy. Hence, there has been used a winding device which automatically winds an arm belt around an upper arm of a living subject. The automatic winding device has a cylindrical arm receiver in which the belt taking a cylindrical shape is provided, and has a drive device such as a motor for tightening the belt. After the subject inserts his or her arm into the belt inside the receiver through one end of the receiver, the drive device is operated to tighten the belt and thereby reduce the inside diameter of the cylindrical belt. Thus, the arm belt is automatically wound around the subject's upper arm. When a BP measurement is carried out using the automatic winding device, it is required that the arteries of the upper arm of the subject be uniformly pressed by the arm belt. To this end, generally, an elbow rest is provided outside the other end of the arm receiver, and the subject inserts his or her arm such that the elbow of the arm rests on the rest. The diameter of the belt is reduced when the subject is taking such a posture that the upper arm is not in contact with the inner wall of the above-mentioned one end of the receiver. That is, it is preferred that the longitudinal axis line of the upper arm of the subject be kept substantially parallel to the central axis line of the cylindrical arm receiver. However, ordering the subject to change his or her natural posture to the above-mentioned posture may result in forcing the subject to take an unnatural posture, depending upon the conformation of his or her body. This problem is exaggerated in particular for patients or aged persons who are not so free to change their postures. In the latter cases, the accuracy of BP measurements may be lowered. Web site: http://www.delphion.com/details?pn=US05649536__
Patents 393
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Blood pressure measuring apparatus Inventor(s): Ogura; Toshihiko (Inuyama, JP) Assignee(s): Colin Corporation (Aichi-ken, JP) Patent Number: 5,680,869 Date filed: September 17, 1996 Abstract: A blood pressure (BP) measuring apparatus including a first device for storing a set of BP data representing at least one BP value measured in a measuring operation, and a date and a time when the measuring operation is effected, thereby storing sets of BP data corresponding to measuring operations, a second device for storing a first one of the sets of BP data which belongs to a first number of sets of BP data which have early been stored by the first device, a third device for storing a second one of the sets of BP data which belongs to a second number of sets of BP data which have lately been stored by the first device, a fourth device for storing a third one of the sets of BP data which represents at least one BP value including a highest systolic BP value, a fifth device for storing a fourth one of the sets of BP data which represents at least one BP value including a lowest systolic BP value, and a recording device for recording (a) a graphic representation including first symbols each of which is indicative of the BP value represented by a corresponding one of the sets of BP data, in the order of the measuring operations, (b) a list containing the BP value, date, and time represented by each of the first to fourth sets of BP data, and (c) a second symbol in association with each of the four first symbols corresponding to the first to fourth sets of BP data, in the graphic representation. Excerpt(s): The present invention relates to a blood pressure measuring apparatus which accumulatively stores measured blood pressure values and records, on a recording medium, a list showing each measured blood pressure value with the date and time when each value is obtained, and a graphic representation of a time-wise trend of the stored pressure pressure values. There is known an automatic blood pressure (BP) measuring apparatus including a memory device such as a magnetic disc for storing measured BP values. Each time the BP measuring apparatus carries out a BP measurement on a living person, it records, on a recording sheet, a data list showing the prior BP values stored in the memory device, as well as the current BP value, together with the dates and times of measurement of those values. In addition, the measuring apparatus records, on the sheet, a graphic representation of a time-wise trend of the stored BP values, so that the person can read a time-wise change of the BP values. If the person compares the current BP value with the prior BP values in the graph, then he or she can judge whether the manner in which the current BP value is obtained is appropriate and/or whether his or her physical condition is normal. In addition, the person can read, on the data list, the BP value and the date and time which correspond to a significant change in the graph. In the above BP measuring apparatus, however, all measured BP values are stored in the memory device. Accordingly, if the number of stored BP values increases, the data list becomes so large that it needs a long time to specify a particular BP value on the list and that the amount of consumption of the recording sheet increases. In addition, since BP measurements are not periodically carried out on a person, respective symbols corresponding to the BP measurements are not uniformly plotted along a time axis in the graph. Web site: http://www.delphion.com/details?pn=US05680869__
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Blood pressure measuring apparatus Inventor(s): Miyazaki; Makoto (Kohnan, JP), Yokozeki; Akihiro (Komaki, JP), Miwa; Yoshihisa (Komaki, JP), Hayakawa; Tokuji (Komaki, JP), Harada; Chikao (Komaki, JP) Assignee(s): Colin Corporation (Komaki, JP) Patent Number: 5,730,139 Date filed: September 13, 1996 Abstract: A blood pressure measuring apparatus comprises an inflatable cuff which is adapted to be wound around a body portion of a living subject, an air pump which supplies a pressurized air to the cuff to inflate the cuff and thereby increase an air pressure in the cuff, to press a body portion of the subject, a pump-output-power control device which controls an output power of the air pump to increase an air pressure in the pump to a predetermined target pressure value, a pressure sensor that detects the pressure of the cuff, first-pump-output setting means for setting a predetermined first pump output power, a timer which measures a basic time period needed to increase the pressure in the cuff, second-pump-output power determining means for determining a second pump output power corresponding to a predetermined pressure-increase rate of the cuff, a cuff pressure decreasing device that decreases the pressure of the cuff, and a measuring device which measures at least one blood pressure value of the living subject while the pressure of the cuff is decreased from a target pressure value by the cuff pressure decreasing device. Excerpt(s): The present invention relates to an apparatus for measuring a blood pressure value of a living subject while the pressure of an inflatable cuff being wound around a body portion of the subject is changed. There is known a linear-pressure-increase bloodpressure (BP) measuring apparatus which measures a BP value of a living subject based on a pulse wave which is produced from an artery of the subject in synchronism with the heartbeat of the subject while the air pressure of an inflatable cuff being wound around a body portion of the subject is increased linearly at a predetermined rate. This BP measuring apparatus is disclosed in Laid-Open Publication No. 59(1984)-129051 of Unexamined Japanese Patent Application, for example. The above BP measuring apparatus enjoys the advantage that it can quickly deflate the cuff immediately after determining a systolic BP value of the subject. Thus, the BP measuring apparatus need not increase, in advance, the pressure of the cuff up to a predetermined target value which is sufficiently higher than a systolic BP value of the subject. Therefore, the cuff pressure is not increased up to an unnecessarily high value, or the measurement time is not unnecessarily increased. This leads to reducing the discomfort the subject feels due to the pressing of the cuff. Web site: http://www.delphion.com/details?pn=US05730139__
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Blood pressure measuring apparatus Inventor(s): Harada; Chikao (Komaki, JP), Miwa; Yoshihisa (Komaki, JP) Assignee(s): Colin Corporation (Komaki, JP) Patent Number: 5,759,157 Date filed: December 10, 1996 Abstract: When it is judged by a blood-pressure-abnormality judging means that a first blood pressure value determined by a first blood pressure determining means, based on
Patents 395
a pulse-synchronous signal produced while a pressure of a cuff is slowly increased, is abnormal, a second blood pressure value is determined by a second blood pressure determining means without needing another first blood pressure value determination. Thus, it is possible to eliminate the time necessary for decreasing and re-increasing the pressure of the cuff, thereby reducing the discomfort of the patient. Additionally, since the present blood pressure measuring apparatus can measure a second blood pressure value relatively speedily, it does not need a device for removing noise from the signal. Excerpt(s): The present invention relates to a blood pressure measuring apparatus for automatically measuring a blood pressure of a living subject based on a variation of a pulse-synchronous signal, such as a Korotkoff sound or a pulse wave, produced while a pressing pressure of a cuff applied to a portion of the living subject is slowly changed. In a conventional blood pressure measuring apparatus, a blood pressure value may be incorrectly determined based on a pulse-synchronous signal inaccurately detected due to noise resulting from, e.g., a body movement, or the like. To avoid such incorrect blood pressure measurement, it is needed to provide the blood pressure measuring apparatus with a high-performance filter circuit or a signal processing device for removing noise from the signal. Otherwise, when it is judged that a blood pressure value obtained in a blood pressure measurement is abnormal, as compared with the previously measured blood pressure values, the blood pressure measuring apparatus needs to go to the initial step of another blood pressure measurement. Since the above mentioned high-performance filter circuit or signal processing device has a high technique and a complicate construction, the blood pressure measuring apparatus including it has the disadvantage of being complicate and expensive. Additionally, when, after an incorrect blood pressure measurement, another blood pressure measurement is carried out, a patient suffers from discomfort because the pressing pressure of a cuff is applied to the patient again. Web site: http://www.delphion.com/details?pn=US05759157__ •
Blood pressure measuring apparatus Inventor(s): Voith; Paul Richard (Milwaukee, WI) Assignee(s): Marquette Electronics, Inc. (Milwaukee, WI) Patent Number: 5,840,036 Date filed: March 4, 1997 Abstract: A blood pressure measuring system includes a transducer having first and second sensors adapted to be mounted above the artery of a patient with the second sensor more distal relative to the direction of blood flow than the first sensor. A processor digitizes the signals from the first and second sensors and determines when the second signal is phase shifted about 90 degrees relative to the first signal for determining the occurrence of the Korotkoff sound. The transducer comprises a film of a material having piezoelectric properties and at least two spaced apart electrodes on one surface of the film and a third electrode on the opposite side and opposed to the two electrodes. Excerpt(s): This invention relates to blood pressure measuring methods and apparatus. During each heart beat, human blood pressure normally rises from about 80 mm of mercury, called diastolic pressure, to about 120 mm of mercury, called systolic pressure. One common method of measuring these pressures, is to inflate a cuff encircling the patient's arm to a pressure above the individual's systolic pressure normally, about 140
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mm of mercury, so that the patient's artery is collapsed and no blood flows. The pressure in the cuff is then gradually reduced to a pressure below the patient's systolic pressure, so that the artery opens and blood flow commences. This pressure is noted as the patient's systolic pressure. A contact microphone or other sensor is used to detect the commencement of arterial blood flow which occurs when the patient's blood pressure exceeds that of the cuff. The signal detected by the contact microphone is commonly called the Korotkoff "sound," although the signal power is normally below audible frequencies, that is, about 20 Hz. There is some difference of opinion as to whether the Korotkoff "sound" is generated by the opening of the artery which was previously compressed by the occluding cuff or the actual commencement of blood flow. As the pressure within the artery falls between heart beats, the artery is again occluded. This continues until the cuff pressure falls below the diastolic pressure in which case, the artery remains open. The pressure at the point where the Korotkoff "sound" ceases is the measurement of the patient's diastolic pressure. One of the problems encountered with prior art blood pressure measuring systems is that in addition to the Korotkoff sound, contact microphones and other sensing devices also detect noise signals which may result from any number of causes, such as muscular contractions and the like. One prior art method of attempting to compensate for noise signals is to employ a pair of sensors one of which is located proximal and the other distal relative to the heart. Each sensor detects the Korotkoff signal plus noise signals. The signals in the two sensors are subtracted which can have the effect of doubling the Korotkoff signal strength relative to random noise and even eliminate common mode noise but has the disadvantage of also passing any portion of the noise which is not of identical magnitude in both sensors. Web site: http://www.delphion.com/details?pn=US05840036__ •
Blood pressure measuring apparatus Inventor(s): Miyazaki; Makoto (Kohnan, JP), Yokozeki; Akihiro (Komaki, JP), Miwa; Yoshihisa (Komaki, JP), Hayakawa; Tokuji (Komaki, JP), Harada; Chikao (Komaki, JP) Assignee(s): Colin Corporation (Komaki, JP) Patent Number: 6,068,601 Date filed: January 8, 1998 Abstract: A blood pressure measuring apparatus including an inflatable cuff which is adapted to be wound around a body portion of a living subject, an air pump which supplies a pressurized air to the cuff to inflate the cuff and thereby increase an air pressure in the cuff, so that the cuff presses the body portion of the subject, an air tank which is connected to the air pump, an air restrictor which is provided between the air tank and the cuff, a deflation-control valve which is provided between the restrictor and the cuff to control an amount of discharging of the pressurized air from the cuff and thereby control deflation of the cuff, a control device which controls the air pump to supply the pressurized air to the cuff while controlling the deflation-control valve to discharge a controlled amount of the pressurized air therethrough from the cuff, so as to increase the pressure of the cuff linearly at a predetermined first rate, and a measuring device which measures at least one blood pressure value of the subject based on a pulse wave which is produced from an artery of the body portion of the subject in synchronism with a heartbeat of the subject while the pressure of the cuff is linearly increased at the first rate by the control device. Excerpt(s): The present invention relates to an apparatus for measuring a blood pressure value of a living subject while the pressure of an inflatable cuff being wound around a
Patents 397
body portion of the subject is changed. There is known a linear-pressure-increase bloodpressure (BP) measuring apparatus which measures a BP value of a living subject based on a pulse wave which is produced from an artery of the subject in synchronism with the heartbeat of the subject while the air pressure of an inflatable cuff being wound around a body portion of the subject is increased linearly at a predetermined rate. This BP measuring apparatus is disclosed in Laid-Open Publication No. 59(1984)-129051 of Unexamined Japanese Patent Application, for example. The above BP measuring apparatus enjoys the advantage that it can quickly deflate the cuff immediately after determining a systolic BP value of the subject. Thus, the BP measuring apparatus need not increase, in advance, the pressure of the cuff up to a predetermined target value which is sufficiently higher than a systolic BP value of the subject. Therefore, the cuff pressure is not increased up to an unnecessarily high value, or the measurement time is not unnecessarily increased. This leads to reducing the discomfort the subject feels due to the pressing of the cuff. Web site: http://www.delphion.com/details?pn=US06068601__ •
Blood pressure measuring apparatus Inventor(s): Dromms; Raymond P. (Liverpool, NY), Osiecki; Scott (Skaneateles, NY), Lia; Raymond A. (Auburn, NY), Vivenzio; Robert L. (Auburn, NY), Danna; Dominick (Syracuse, NY), Baxter; James M. (Jordan, NY), Stearns; Scott S. (Marietta, NY) Assignee(s): Welch Allyn, Inc. (Skaneateles, NY) Patent Number: 6,578,428 Date filed: August 14, 2001 Abstract: An inflatable sleeve for a blood pressure measuring apparatus includes a socket which is capable of receiving an engagement portion of a gage housing thereby permitting direct attachment to the sleeve and permitting fluid interconnection between the interior of the inflatable sleeve and the interior of the housing without requiring any hoses or tubing there between. The sleeve includes an artery index marker which permits the sleeve to be properly aligned on an appropriate limb of the patient. Excerpt(s): The invention relates to the field of measuring instruments, and more particularly to a shock-resistant gage housing for a pressure measuring device such as a sphygmomanometer. Pressure measuring devices such as sphygmomanometers, which are used to measure the arterial blood pressure of a patent, typically include a pneumatic bulb which inflates a pressure chamber of an attached sleeve that is fitted over a limb (i.e., an arm or a leg) of the patient. A diaphragm or bellows assembly, responsive to changes in fluid pressure of the pneumatic bulb and the sleeve pressure chamber, is positioned in a gage housing which is fluidly connected to the pressure chamber of the sleeve through flexible tubes or hoses. A pointer of a dial indicator is interconnected to the bellows assembly through a movement mechanism which is retained within the gage housing, whereby inflation of the bellows causes corresponding circumferential movement of the pointer enabling a blood pressure measurement procedure to be carried out by a caregiver. Typically, the above referred to movement mechanisms are quite intricate and complex, and are akin in terms of their manufacture and precision to Swiss watches. For example, and in one such movement mechanism, a pair of diaphragm springs are attached adjacent opposing ends of a spindle. A bottom end of the spindle is placed in contact with the bellows assembly and a twisted bronze band perpendicularly disposed at the top end of the spindle is connected in parallel by a horizontally disposed spring bent part. As the spindle deflects
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axially in response to the inflation of the bellows, the bent spring part is also caused to deflect, thereby causing the, band to twist. The pointer, attached to the bronze band, therefore is caused to rotate in relation to an adjacent dial face. Web site: http://www.delphion.com/details?pn=US06578428__ •
Blood pressure measuring apparatus and method Inventor(s): Paavola; Oiva A. (Erie, PA), Brugger; Richard D. (Erie, PA) Assignee(s): Paavola; Oiva A. (Erie, PA) Patent Number: 4,068,654 Date filed: February 17, 1976 Abstract: An instrument for measuring blood pressure by sensing the Korotkoff sounds which prevail only between the systolic and the diastolic points. The instrument used is essentially a hand held device which is held in direct contact with the skin over an artery. The instrument has a pressure-sensitive element which responds to pressure, and a crystal transducer which responds to Korotkoff sounds. A pressure is exerted on the instrument occluding the artery and stopping the Korotkoff sounds, and, as the pressure is reduced and the Korotkoff sounds commence, the crystal transducer senses the vibrations from the artery which vibrations are Korotkoff sounds. The crystal triggers a memory circuit, the contents of which are shown on the digital display. The digital display shows the pressure sensed by the strain gauge at the time the sounds appear at the systolic point and again at the diastolic point. Excerpt(s): This application is a continuation-in-part of Application Ser.No. 551,071, filed Feb. 19, 1975, which in turn is a continuation-in-part of Application Ser.No. 344,752 filed Mar. 26, 1973, both now abandoned. U.S. Pat. No. 3,773,038 shows a digital computing cardiotachometer for measuring heart rate using a transducer and an oscillator which actuate a display. U.S. Pat. No. 3,230,950 shows an apparatus and method for determining blood pressure using a cuff and a separate transducer to actuate a display device. Applicant uses a Korotkoff-sound-sensitive transducer in combination with a pressure-sensitive pickup operating through an electronic circuit actuating a digital readout. U.S. Pat. No. 3,807,388 shows a heartbeat rate monitor using an oscillator in combination with a display. The system described herein provides a pressure pad to be placed over an artery and to which sufficient pressure is exerted to occlude the artery. As the force applied to this pad is gradually reduced and Korotkoff sounds commence, the pressure, expressed in millimeters of mercury, is displayed. A local pressure region is engaged by a transducer device with a pressure pad in place of the traditional cuff. Web site: http://www.delphion.com/details?pn=US04068654__
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Blood pressure measuring appliance Inventor(s): Schmid; Walter (Fuchsweg 9, D-7914 Pfaffenhofen, DE), Schwab; Bernhard (Buxheim, DE) Assignee(s): Schmid; Walter (Pfaffenhofen, DE) Patent Number: 4,907,596 Date filed: September 23, 1986
Patents 399
Abstract: A blood pressure measuring appliance having a pulse beat detector responding to arterial pulse beats, an ECG signal detector and a time measuring apparatus which ascertains the time intervals between peaks of a predetermined type of the ECG signal detected by the ECG signal detector, preferably its R-peaks, and pulse beats in each case following the R-peaks and detected by the pulse beat detector. A display apparatus displays a datum representing the duration of the ascertained time intervals as blood pressure information. The blood pressure measuring appliance must merely be calibrated initially, for example, with the aid of a sphygmomanometer, in blood pressure values. The inflatable bag can be eliminated for further blood pressure measurements. Excerpt(s): The invention relates to a blood pressure measuring appliance, and particularly, to an appliance having a pulse beat detector responding to arterial pulse beats, an electrocardiograph signal detector and a blood pressure measuring and indicating apparatus. Blood pressure is ordinarily measured by means of an inflatable bag connected to a mercury manometer, according to the method of Riva-Rocci. The inflated bag ties off the upper arm so that the arm artery permits no more blood to flow therethrough. On reduction of the bag pressure the blood is again forced through the slowly opening artery. Then, as a result of turbulent flow, a noise occurs to which it is possible to listen with a stethoscope. The pressure read off on the manometer corresponds, on commencement of the turbulent flow, to the systolic blood pressure. When, upon further pressure reduction in the bag, the artery opens completely, the turbulent flow changes into a laminar flow and the heard sound or noise disappears. The pressure then read off on the manometer corresponds to the diastolic blood pressure. In this measuring method the accuracy of measurement depends upon the existing physiological conditions of the patient and the hearing capacity of the physician. It is known from "Medical & Biological Engineering & Computing", September 1981, pages 671, 672, that the pulse beat transit time varies with the blood pressure. This is utilized, in combination with a conventional blood pressure measurement bag, for the determination of the measurement moments for the systolic pressure and the diastolic pressure. The time is ascertained between the R-peak of an ECG signal detected by means of an ECG signal detector and the arrival of the pertinent pulse beat at the location of a pulse beat detector. The systolic pressure is read off at the moment of maximum time delay on the manometer of the bag. The measurement moment for the diastolic pressure is ascertained in dependence upon the speed of variation of the transit times of successive pulse beats. The fact is utilized that the transit time of successive pulse beats remains constant after the diastolic pressure is reached. In the known blood pressure measuring appliance the actual blood pressure measurement takes place according to the bag method of Riva-Rocci. Web site: http://www.delphion.com/details?pn=US04907596__ •
Blood pressure measuring catheter Inventor(s): Jackson; Richard R. (Eight Trinity Rd., Marblehead, MA 01947) Assignee(s): none reported Patent Number: 4,160,448 Date filed: May 23, 1977 Abstract: For determining blood pressure a cannula, insertable through a needle into the bloodstream, locates a flaccid, relaxed wall directly in the bloodstream. The relaxed nature of this wall allows direct transmission of the blood pressure to a neutral liquid in
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the cannula. The cannula transmits this liquid pressure out of the blood vessel to the remote pressure responsive indicator. Thus blood pressure can be directly measured without need of administering anticoagulants to maintain pressure-transmitting conditions. Excerpt(s): This invention relates to an improved method of recording blood pressure in a blood vessel such as an artery or vein. Ordinarily for this purpose a plastic needle or cannula is placed in the blood vessel and is either periodically or slowly continually flushed with an anticoagulant solution. The cannula transmits blood to a strain gauge external of the patient. This strain gauge is electrically coupled with a display device showing the blood pressure in the cannula. The mentioned periodic flushing is for the purpose of preventing the blood at the tip of the cannula from clotting and requires the attention of skilled personnel and is disruptive of the procedure. Flush devices have been provided to accomplish this flushing procedure automatically, but are cumbersome and expensive owing to the need for an additional separate liquid flushing cannula for each pressure-measuring site. My invention comprises a cannula for insertion into the vessel, carrying a small flacid balloon or other form of relaxed membrane exposed on one side to the blood of the vessel and on the other side to saline or other static, neutral liquid which communicates through a liquid-filled cannula to an external transducer sensitive to blood pressure. The relaxed membrane will transmit pressure pulses from the blood to the statically confined neutral liquid without backflow of blood into the cannula, thereby eliminating flush devices, or the necessity of flushing procedures. In prior blood pressure devices an elastically stretched balloon has been provided on a cannula inserted into the patient's bloodstream for other purposes. When inflated it serves to drag the cannula through the blood vessel, along with the flow of blood, or to temporarily block a blood vessel. In those instances the balloon ordinarily requires continual external fluid pressure for distension. Critical to the quite different use of the present invention is the fact that the wall material of the balloon or membrane is supple, flacid, relaxed, when used, so that it serves as a pressure transmitting membrane from the blood to the neutral pressure-transmitting fluid, and does not permit pressure difference to exist on the opposite sides of the wall. Web site: http://www.delphion.com/details?pn=US04160448__ •
Blood pressure measuring device Inventor(s): Jewett; Warren R. (Tucson, AZ) Assignee(s): Vit Vet Research Group, Inc. (Marion, IN) Patent Number: 4,417,586 Date filed: February 18, 1981 Abstract: A noninvasive blood pressure measuring device includes display means which may be digital readouts, a sphygmomanometer or other similar means, a compression cuff, a first flexible tube, a second flexible tube, an air leak valve and monitoring, control and display circuitry. Within the compression cuff is an inflatable bladder which extends in a longitudinal direction for substantially the entire length of the compression cuff. The monitoring, control and display circuitry includes a piezoelectric crystal assembly which provides electrical signals in response to air pressure levels and changes within the first flexible tube. The first tube connects this piezoelectric crystal assembly with the compression cuff and the second tube has a hand pump at one end for inflating the bladder. The air leak valve is in line with the first tube and the air leak valve has a continuously open air escape aperture of a size which
Patents 401
corresponds to a predetermined leak rate proportional to the pressure in the bladder. When a sphygmomanometer is incorporated as part of the display means, a branch tube connects the first flexible tube to the sphygmomanometer and a pair of light-emitting diodes mounted to the dial face of the sphygmomanometer indicate when sphygmomanometer readings should be taken for systolic and diastolic conditions. When digital readouts and a microprocessor are used as part of the monitoring, control and display circuitry, data such as, for example, heart rate and mean pressure in addition to systolic and diastolic pressures are automatically presented and may be read directly. Excerpt(s): This invention relates in general to blood pressure measuring devices and in particular to such devices which are automatic and do not require a stethoscope for identifying systolic and diastolic conditions and which may also provide mean pressure and heart rate in a direct reading manner. Blood pressure measurement as a medical procedure is not new nor are the basic concepts or equipment which are employed new. Conventional measurement procedures require that a compression cuff be snugly wrapped around the patient's right arm approximately one inch above the antecubital fossa location. The compression cuff includes an inflatable bladder at one end and this bladder must be applied directly over the artery with the remainder of the compression cuff being used as a wrap to secure the bladder in place. The compression cuff (actually the inflatable bladder) is inflated rapidly to a pressure above the assumed or previously determined systolic pressure. By means of a manually released valve, the cuff is deflated at a rate of two to three millimeters (mm) of mercury (Hg) per heartbeat. With the bell of a stethoscope placed snugly over the artery (thereby producing an airtight seal) the physician may either watch an aneroid dial or column of Hg of a suitable sphygmomanometer and note the pressure at which characteristic changes in the Korotkoff sounds occur. From these sounds, created by pressure controlled compression waves, the systolic and diastolic blood pressures can be determined. This conventional method has various shortcomings in terms of convenience, versatility and accuracy. It is necessary for the physician or medical personnel taking the blood pressure to accurately position the inflatable bladder over the artery, to make an air tight seal with the bell of a stethoscope over the artery, to manually control the pressure release rate and to attempt to read the corresponding pressure when particular characteristic sounds are detected through the stethoscope. Web site: http://www.delphion.com/details?pn=US04417586__ •
Blood pressure measuring device Inventor(s): Thees; Richard (Aachen, DE), Wilden; Rolf (Roetgen, DE) Assignee(s): Honeywell B.V. (Amsterdam, NL) Patent Number: 4,429,700 Date filed: February 2, 1981 Abstract: An inflatable blood pressure cuff is pressurized with a vapor which is produced by heating a fluid which has a boiling point between 290.degree. K. and 340.degree. K. with an electric heating element. The heating element may comprise a PTC resistor which is disposed within the fluid. A piezoresistive element may also be disposed in the fluid to detect pressure pulses associated with Korotkoff sound. Excerpt(s): The invention relates to a blood pressure measuring device, comprising a cuff which can be applied to a part of a body, preferably a finger, and also comprising a
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measuring device for measuring the pressure in the cuff. For the measurement of the blood pressure, the cuff is inflated until the flow of blood through the artery is blocked. When the pressure in the cuff is gradually reduced, the pulse can be detected again in the artery at a given pressure (systolic blood pressure) or a "sound" (Korotkoff's sound) which is synchronized with the pulse occurs in the artery. When the pressure in the cuff is further reduced, the Korotkoff's sound suddenly becomes softer at a given pressure (diastolic blood pressure). The blood pressure measurement mainly concerns the determination of these two blood pressure values. In known devices of this kind, the cuff is generally applied to the upper arm of the patient. However, there are also blood pressure measuring devices where the cuff is slid onto a finger (for example, see DE-OS No. 18 17 089 and 28 42 337). Blood pressure measurements can thus be performed with high accuracy when it is ensured that the finger whereto the cuff is applied is situated approximately at the level of the heart during measurement, so that static pressure differences do not have an effect. The inflation of the cuff is manually performed for some blood pressure measurements; this necessitates some experience in order to ensure that the pressure in the cuff will not be too high or too low. In other blood pressure measuring devices, it is merely necessary for the user to activate a pump which inflates the cuff. Such blood pressure measuring devices, however, are expensive. Web site: http://www.delphion.com/details?pn=US04429700__ •
Blood pressure measuring device Inventor(s): Fukura; Masashi (Kyoto, JP), Miyawaki; Yoshinori (Otsu, JP) Assignee(s): Omron Corporation (Kyoto, JP) Patent Number: 5,161,538 Date filed: August 9, 1991 Abstract: A blood pressure measuring device is provided which comprises a cuff for pressuring an artery, electronic circuitry made up of a clock, control unit, and blood pressure measuring unit for measuring blood pressure and controlling the device, and a cuff pressurizing and depressurizing unit. The basic components of the device are used to effectively give the patient, through a feeling of pressure from the cuff, information such as a signal indicating the start of measurement, by momentarily pressurizing the cuff then depressurizing it. This signal can be detected by hearing imparied patients as well as healthy patients who are in a noisy environment, but can not be noticed by others in close proximity to the patient. Excerpt(s): This application is related to a blood pressure measuring device, and more specifically to the announcement of blood pressure measuring to the patient. A blood pressure meter is conventionally provided with a cuff pressuring an artery, a pressurizing means or pump to give pressure to the cuff, an air release means for depressurizing the cuff, and a blood pressure reading means. It is also necessary to inform the patient of the start of measurement, for this a buzzer is provided to sound immediately preceding the start of measurement. In the conventional blood pressure measuring device the start, completion, or error of the measurement is announced by the sounding of a buzzer. A problem with this is that it does not enable the hearing impaired to realize that these events are taking place. Even healthy patients may have difficulties hearing the sounding of the buzzer due to noise in the environment. When the patient cannot hear the buzzer, measurement will seem to start suddenly without any indication to the patient. In other words there is a sudden feeling of pressure, which may cause movement of the patient due to the surprise of feeling the unannounced
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pressure. This movement may adversely affect the accuracy of the measurement. Further, with the use of a buzzer to announce the start of measurement, people around the patient are notified that the patient will have his blood pressure measured. This may cause undue nervousness or anxiety in the patient and in turn affect the accuracy of the measurement. Web site: http://www.delphion.com/details?pn=US05161538__ •
Blood pressure measuring device Inventor(s): Speidel; Blasius (Jungingen, DE) Assignee(s): Speidel & Keller GmbH & Co. KG (Jungingen, DE) Patent Number: 5,375,605 Date filed: February 18, 1993 Abstract: The blood pressure measuring device (10) has a bowl-shaped casing (11) in which is arranged a pressure measuring system with a measuring scale (13) and indicator. The casing (11) is closed at its upper edge by a transparent cover plate (25). This primary casing (11) is surrounded at a given distance on the outside by a protective housing (15), whereby the base (18) of the protective housing (15) is combined in one piece with the base (16) of the primary casing (11). The compressed air line is connected either through a hole (22) in the base (16) of the casing (11) or through the casing walls. In the latter case, there is a material bridge in the space between the wall of the primary casing (11) and of the protective housing (15). Excerpt(s): In most of the known sphygmomanometers the manometer is contained in a usually cup-shaped case and is mounted therein on one of the parts of the case. This case also contains the dial through which the meter shaft passes. Above the dial the pointer is mounted on the meter shaft. The dial, and the pointer are covered by a crystal which is either inserted directly on the upper margin of the case or is inserted in a separate bezel which in turn is joined to the margin of the case (EP-A-0 008 351 A2). In both cases the disk seals the interior of the case, with the parts contained therein, from the exterior. If such a sphygmomanometer falls onto a hard surface there is the danger that the case may be damaged, especially that it may be distorted. In the area of the bottom, and of the transition from the bottom to the circumferential wall, the case has of its nature a comparatively great stability of shape, so that in this area the distortions caused by dropping generally remain comparatively slight. It is different when the case strikes in the area of its top margin where the dial and the crystal become damaged. The dial may be bent or may bulge. Such deformation of the dial can be so great that the pointer can no longer move across the dial. If the case becomes deformed the dial may also snap out of its mounting. The same applies to the crystal. In the event of a particularly hard shock the spiral return spring of the manometer mechanism may become damaged, when for example one or more of its coils loop over one another and become entangled. In the case of all such damage or even destruction of individual parts, the entire sphygmomanometer becomes useless. Web site: http://www.delphion.com/details?pn=US05375605__
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Blood pressure measuring device Inventor(s): Marangoni; Daniele (Via Fantoli 16/15, I-20138 Milan, IT) Assignee(s): none reported Patent Number: 5,421,341 Date filed: February 23, 1993 Abstract: A blood pressure measuring device having a blood occluding cuff for surrounding a patient's arm in which a pump for inflating the cuff, a valve for deflating the cuff, a pressure transducer for measuring cuff pressure all are located on the cuff, and in which an electrical control and pressure signal processing device communicates with the cuff only by an electrical connection. Excerpt(s): The invention relates to an improved blood pressure monitoring device in which the pump, valve and transducer are located on the cuff which surrounds a patient's arm. Automatic blood pressure measuring devices for measuring a patient's blood pressure in certain intervals over an extended period of time or upon manual initiation by the patient or the medical staff are known for a long time either for stationary or ambulatory purposes. For ambulatory use it is necessary that the device is small and lightweight and contains a data storage system. A further major requirement for all blood pressure measuring devices is the reduction or elimination of artefacts due to relative movement between patient and recording device. In all blood pressure measuring devices known up till now a cuff surrounding the patient's arm is connected via a hose to a module containing the pressurizing system and the signal processing circuitry. In the classical embodiment a second hose is connected between a transducer which is also contained in the module and the cuff to measure the cuff pressure. A valve is connected to the pressurizing system between the pump and cuff. Web site: http://www.delphion.com/details?pn=US05421341__
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Blood pressure measuring device and a method of controlling the cuff pressure in a blood pressure measuring device Inventor(s): Rometsch; Rainer (Wildberg, DE) Assignee(s): Hewlett-Packard Company (Palo Alto, CA) Patent Number: 5,570,694 Date filed: September 8, 1994 Abstract: For controlling the cuff pressure in a blood pressure measuring device, the volume flow between a pump for filling the cuff and a valve for emptying the cuff on the one hand and the cuff on the other hand is detected by a flow sensor whose output signal is integrated by means of an integration circuit for producing an actual volume value. A computer unit for controlling the pump and the valve produces the control signals on the basis of this volume value formed by integration as well as on the basis of at least one quantity representative of the pressure/volume dependence of the cuff pressure. Excerpt(s): The present invention deals with a blood pressure measuring device and with a method of controlling the cuff pressure in a blood pressure measuring device. Especially, but not exclusively, the present invention refers to a blood pressure measuring device permitting a more precise automatic adjustment of the cuff pressure. Known blood pressure measuring devices, in which a cuff filled with air is used for
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determining the blood pressure values, operate in accordance with a corresponding method for adjusting the cuff pressure. According to this method, the cuff if first filled, e.g. by actuating a pump, until the cuff pressure value is higher than the systolic pressure. Subsequently, a controlled cuff-venting operation is carried out; in this operation, the cuff pressure normally is to be controlled in an ideal manner in such a way that it is lowered in the form of predetermined pressure steps, one measured value or a plurality of measured values being typically detected at each pressure step. The measuring process itself or rather the course of action for determining the blood pressure value itself can be performed in different ways. Automatic blood pressure measuring devices typically measure the oscillations, induced in the cuff by the artery, during continuous or stepwise venting of the cuff or during the cuff-filling operation. Web site: http://www.delphion.com/details?pn=US05570694__ •
Blood pressure measuring device and method Inventor(s): Hatschek; Rudolf A. (Fribourg, CH) Assignee(s): AVL Medical Instruments AG (Schaffhausen, CH) Patent Number: 5,309,916 Date filed: July 16, 1991 Abstract: A device for measuring blood pressure includes a sensor arrangement which is releasably attached to the exterior of a body and which is electrically conductively connected with electronic circuit. The sensor arrangement and the circuit are configured to determine, in at least one measuring region of the body, a valve which is a measure for a variable that changes periodically over time in the rhythm of the pulse beat and which is correlated with the blood pressure. This variable may, for example, be the flow velocity and/or flow quantity and/or the volume of the arterial blood and/or a crosssectional dimension and/or the flow cross section area of an arterial blood vessel. The sensor and circuit further determine a value which is a measure for the pulse wave velocity. By linking the two values together and including at least one calibration value, at least one value that is characteristic for of the blood pressure (preferably including at least the systolic blood. pressure) can be determined. The device makes it possible to measure the blood pressure of a person at least quasi-continuously with relatively little bother for the person. Excerpt(s): The invention relates to a device and a method for measuring blood pressure. The device and the method serve to measure blood pressure, namely to measure blood pressure in a non-invasive manner. The term "non-invasive" here means that the measurement is performed without an instrument being introduced into a blood vessel and is thus effected with sensor means which are disposed completely outside of the living human, or possibly animal body whose blood pressure is being measured. For a measurement according to the Riva-Rocci method, the cuff is fastened to a body segment--for example an upper arm or a finger--and is pumped up until the pressure of the air present in its cavity is sufficient to constrict the artery in the enclosed member. Then the cuff is slowly deflated. In the variant involving the detection of the Korotkoff sounds by means of a stethoscope or microphone, two values are detected and identified for the pressure in the cuff cavity during deflation of the cuff as the systolic blood pressure and the diastolic blood pressure, respectively. The pressure existing in the cuff during the first occurrence of Korotkoff sounds is associated with the systolic blood pressure. The diastolic pressure is recognized by the fact that the actual Korotkoff sounds disappear, with the sounds generated by the flowing blood becoming
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lower and less distinct or disappearing altogether. In the oscillometric variant of the method, the pressures of the air contained in the cuff and corresponding to the systolic and diastolic blood pressures are determined in that the fluctuations in the cuff pressure caused by the pulsating flow of the blood begin to appear or disappear again. Web site: http://www.delphion.com/details?pn=US05309916__ •
Blood pressure measuring device having adaptive cuff deflation rate Inventor(s): Pearce; Christopher (Redmond, WA), Lynch; Michel A. (Gainesville, FL), Davis; Richard K. (Altamonte, FL) Assignee(s): Physio-Control Corporation (Redmond, WA) Patent Number: 4,625,277 Date filed: June 4, 1984 Abstract: A device is disclosed for making blood pressure measurements using an inflatable cuff (12), wherein the cuff deflation rate is established based upon prior blood pressure measurements. The cuff is adapted for applying pressure to a patient adjacent a blood vessel. the device includes means (14, 16) for inflating and deflating the cuff, a sensor system (60) for providing sensor signals during cuff deflation that correspond to the cuff pressure and to the blood flow surges in the blood vessel, and a process controller (100). The process controller causes inflation of the cuff to a first pressure and subsequent deflation of the cuff from the first pressure to a lower second pressure at a preestablished deflation rate, the inflation and subsequent deflation of the cuff comprising one measurement cycle. The process controller also processes the sensor signals provided during a given measurement cycle in order to determine at least one blood pressure value indicative of the patient's blood pressure for that measurement cycle. The process controller includes parameter setting means for establishing the cuff deflation rate for a given measurement cycle based upon the blood pressure value determined during at least one previous measurement cycle. The parameter setting means may establish the deflation rate based upon both blood pressure and pulse rate values determined during previous measurement cycles. The deflation rate may be established so as to provide a predetermined number of blood flow surges between systolic and diastolic pressures in the given measurement cycle. Excerpt(s): The present invention relates to a noninvasive device for measuring blood pressure and, in particular, to an automatic blood pressure measuring device that includes an inflatable cuff. A well-known noninvasive technique for measuring a patient's blood pressure includes the steps of placing a cuff about the patient's limb, inflating the cuff to a pressure high enough to occlude an underlying blood vessel, and then deflating the cuff to a pressure lower than the patient's diastolic pressure. Measurements taken while the cuff pressure decreases are analyzed to determine the patient's pressure. In the oscillometric blood pressure technique, the measurements taken during cuff deflation include the total cuff pressure and the much smaller pressure fluctuations caused by blood flow surges in the underlying blood vessel. In the ausculcatory technique, the measurements taken include the total cuff pressure and the Korotkoff sounds corresponding to the blood flow surges. A third known technique makes use of an ultrasonic transducer and doppler detection means to detect the blood flow surges. In one well-known application of the oscillometric technique, the cuff is first inflated to a pressure above the patient's expected systolic pressure, and then slowly deflated over a pressure range inclusive of the patient's systolic and diastolic pressures. During cuff deflation, the total cuff pressure is measured by an appropriate
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transducer in pneumatic communication with the cuff, and the output signal from this transducer is processed to yield signals corresponding to the total cuff pressure and to the smaller pressure fluctuations caused by blood flow surges. The signal corresponding to the blood flow surges is processed to determine the times during cuff deflation at which the cuff pressure was equal to the patient's systolic and diastolic pressures. The cuff pressures at such times are then displayed or otherwise output as the patient's blood pressure values. Analogous methods are known that make use of ausculcatory or ultrasonic techniques. Web site: http://www.delphion.com/details?pn=US04625277__ •
Blood pressure measuring equipment Inventor(s): Hatschek; Rudolf A. (Fribourg, CH) Assignee(s): Asulab A.G. (Biel, CH) Patent Number: 4,459,991 Date filed: February 12, 1981 Abstract: There is disclosed blood pressure measuring equipment comprising a sleeve with an inflatable chamber and a microphone, and an appliance connected by a line with the sleeve. The appliance comprises a pressure sensor and a differentiator connected to the sensor output. The differentiator is connected with a regulator which in operation regulates a vent valve in such a manner that the pressure in the chamber during the measurement phase, in which the systolic and diastolic pressures are measured, reduces at a constant rate. A Korotkoff tone identifier, which is connected through further elements with the microphone and the differentiator, ensures that only those signals from the microphone which occur simultaneously with a heartbeatinduced pressure fluctuation are delivered as Korotkoff tones and evaluated for determination of the systolic and diastolic pressure. Excerpt(s): The present invention relates to a blood pressure measuring equipment more particularly to a sphygmometer. Blood pressure measuring equipment described in U.S. Pat. No. 2,827,040 comprises a microphone for detection of the Korotkoff tones generated by blood flowing through an artery. The microphone is connected via an amplifier, a bandpass filter and a pulse shaper with a coincidence circuit. An inflatable sleeve, which is attachable to the arm of the person to be examined, is connected with an air reservoir having an outlet nozzle which, during measurement, generates an air jet flowing past a thermistor. The thermistor, which serves for detection of pressure pulses, is similarly connected via an amplifier and a pulse shaper with the coincidence circuit. In addition, a manometer for detection of systolic pressure and a manometer for detection of diastolic pressure are provided. Each of the manometers is connected by way of a respective valve with the air reservoir. The air reservoir is connected by way of a valve with a compressor and additionally via a venting valve with the ambient atmosphere. Control equipment for actuation of the different valves is also included. During blood pressure measurement, the pressure in the air reservoir is progressively increased. Pulses are then generated in certain pressure ranges by Korotkoff tones and by pressure fluctuations and these pulses are fed to the coincidence circuit. On the first instance of coincidence of pulses from the two sources, i.e. the coincidence occurring at the lowest pressure, the manometer for measurement of diastolic pressure is temporarily connected with the air reservoir so that it measures and indicates the diastolic pressure. Thereafter, the pressure is further increased. When the pulse coincidence at the highest pressure occurs, the manometer serving for measurement of
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systolic pressure is temporarily connected with the air reservoir and the systolic pressure is then measured. Web site: http://www.delphion.com/details?pn=US04459991__ •
Blood pressure measuring instrument Inventor(s): Nakayama; Kiyoshi (Koganei, JP), Yagi; Shinichi (Hino, JP) Assignee(s): Zaidanhojin Nipponrodobunkakyokai (Tokyo, JP) Patent Number: 4,144,879 Date filed: April 15, 1977 Abstract: A pressure is applied by pressure means to a blood vessel from the outside, and gradually reduced, and the pressure resulting from movement of the blood pressure during the pressure reduction is converted by a pressure sensor into an electric signal. The converted output is differentiated twice, and it is detected that a firstpolarity pulse, a second-polarity pulse and another first-polarity pulse are generated successively in the differentiated output waveform within a predetermined period of time. The highest blood pressure is obtained with the pressure of the pressure means at the moment of first detection of three such pulses, and the lowest blood pressure is obtained with the pressure of the pressure means when the above detection is no longer achieved. The measured values are recorded in a digital form and, at the same time, the converted output waveform is recorded. Excerpt(s): This invention relates to an instrument for measuring the highest and lowest blood pressures. In conventional sphygmomanometry, an air pressure is applied to a blood-pressure cuff wound around the upper arm until the flow of the blood stops and then the pressure of the blood-pressure cuff is gradually lowered, the moment when the blood starts to flow instantly is detected as a sound through a stethoscope and the pressure of the blood-pressure cuff at this moment is designated as the highest blood pressure. The pressure of the blood-pressure cuff is then further reduced and the pressure at the moment when the sound is no longer detected, that is, when the flow of the blood becomes steady, is designated as the lowest blood pressure. Since the flow of the blood is detected by an ear, the measurement is carried out by instinct, and is subject to each operator's individual difference and an error of about.+-.10 mmHg is usually found. Even if measurement is effected by a skillful person, an error of.+-.5 mmHg usually results, and measurement by an unskillful person is entirely untrustworthy. To avoid such operator's individual difference, there has also been proposed an automatic blood pressure measuring instrument. This instrument is adapted to pick up the sound of the flow of the blood instead of an operator. That is, the sound is picked up by a microphone connected to the stethoscope, and recorded and, at the same time, the pressure of the blood-pressure cuff is recorded. From these records, the pressure at the moment when the sound was detected by the stethoscope for the first time and the pressure at the moment when the sound was no longer detected, are read out. However, this conventional instrument is very low in accuracy. That is, in the case of hearing the sound through the stethoscope, noises can be discerned according to their tones, but when the sound is converted by the microphone into an electric signal, the correct sound cannot be distinguished from such noises and external noises are picked up and recorded as they are. Accordingly, the record is not reliable and the correct sound is buried in the external noises. As a result of this, the accuracy of measurement is merely about.+-.10 mmHg, which is lower than that obtainable with the skillful person in the case of directly hearing through the stethoscope. Further, this conventional instrument
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of the type converting the sound into the corresponding electric signal has the disadvantage that the conditions for measurement such as the thickness of the arm and environments exert influence upon the records. In the prior art instrument, the blood flows a little each time the blood pressure reaches the highest pressure, and contraction of the blood vessel by the pulse-like flow of the blood is received as an acoustic signal, which is converted into an electric signal. Namely, the pressure fluctuation in the blood vessel is not detected as a direct signal but a secondary change is detected, and this also leads to the lowered accuracy of measurement. Web site: http://www.delphion.com/details?pn=US04144879__ •
Blood pressure measuring instrument having compensation circuit Inventor(s): Kubo; Kimio (Nara, JP), Miyamae; Ryuichi (Yamatokoriyama, JP) Assignee(s): Sharp Kabushiki Kaisha (Osaka, JP) Patent Number: 4,262,675 Date filed: November 30, 1978 Abstract: A sphygmomanometer includes a blood pressure detector, a compensation circuit for providing polygonal line approximation functions suitable for piezo-electric characteristics of the blood pressure detector according to compensation data externally applied thereto, and a pressure determination circuit for determining pressure values using the polygonal line approximation functions from the values measured by the blood pressure detector for a predetermined time period. Excerpt(s): The present invention relates to a blood pressure measuring instrument, e.g. a sphygmomanometer and, more particularly, to a compensation circuit for such a blood pressure measuring instrument for detecting the Korotkoff sound without suffering variations in the piezo-electric properties. In a conventional sphygmomanometer, there was provided a pressure sensor for determining the blood pressure and developing an oscillation frequency corresponding to the same. Piezo-electric elements of the pressure sensor was utilized for converting an amount of the blood pressure into the oscillation frequency. However, the piezo-electric elements inevitably suffer variations and nonlinear properties. This necessarily requires accurate examination and modifications in the pressure sensor. Accordingly, it is the primary object of the present invention to provide a highly reliable sphygmomanometer. Web site: http://www.delphion.com/details?pn=US04262675__
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Blood pressure measuring method and apparatus Inventor(s): Voith; Paul Richard (Milwaukee, WI) Assignee(s): Marquette Electronics, Inc. (Milwaukee, WI) Patent Number: 5,649,535 Date filed: January 25, 1995 Abstract: A blood pressure measuring system includes a transducer having first and second sensors adapted to be mounted above the artery of a patient with the second sensor more distal relative to the direction of blood flow than the first sensor. A processor digitizes the signals from the first and second sensors and determines when the second signal is phase shifted about 90 degrees relative to the first signal for determining the occurrence of the Korotkoff sound. The transducer comprises a film of a
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material having piezoelectric properties and at least two spaced apart electrodes on one surface of the film and a third electrode on the opposite side and opposed to the two electrodes. Excerpt(s): This invention relates to blood pressure measuring methods and apparatus. During each heart beat, human blood pressure normally rises from about 80 mm of mercury, called diastolic pressure, to about 120 mm of mercury, called systolic pressure. One common method of measuring these pressures, is to inflate a cuff encircling the patient's arm to a pressure above the individual's systolic pressure normally, about 140 mm of mercury, so that the patient's artery is collapsed and no blood flows. The pressure in the cuff is then gradually reduced to a pressure below the patient's systolic pressure, so that the artery opens and blood flow commences. This pressure is noted as the patient's systolic pressure. A contact microphone or other sensor is used to detect the commencement of arterial blood flow which occurs when the patient's blood pressure exceeds that of the cuff. The signal detected by the contact microphone is commonly called the Korotkoff "sound," although the signal power is normally below audible frequencies, that is, about 20 Hz. There is some difference of opinion as to whether the Korotkoff "sound" is generated by the opening of the artery which was previously compressed by the occluding cuff or the actual commencement of blood flow. As the pressure within the artery falls between heart beats, the artery is again occluded. This continues until the cuff pressure falls below the diastolic pressure in which case, the artery remains open. The pressure at the point where the Korotkoff "sound" ceases is the measurement of the patient's diastolic pressure. One of the problems encountered with prior art blood pressure measuring systems is that in addition to the Korotkoff sound, contact microphones and other sensing devices also detect noise signals which may result from any number of causes, such as muscular contractions and the like. One prior art method of attempting to compensate for noise signals is to employ a pair of sensors one of which is located proximal and the other distal relative to the heart. Each sensor detects the Korotkoff signal plus noise signals. The signals in the two sensors are subtracted which can have the effect of doubling the Korotkoff signal strength relative to random noise and even eliminate common mode noise but has the disadvantage of also passing any portion of the noise which is not of identical magnitude in both sensors. Web site: http://www.delphion.com/details?pn=US05649535__ •
Blood pressure measuring module Inventor(s): Flachslaender; Erwin (Calw-Stammheim, DE) Assignee(s): Hewlett-Packard Company (Palo Alto, CA) Patent Number: 5,692,512 Date filed: September 12, 1996 Abstract: Apparatus for measuring blood pressure is housed in a hermetically sealed, small casing, which is sealed in dust, water and pressure-tight manner by a film on the outside of the casing's cover and on the casing's underside. Pneumatic connecting lines are integrated into the casing cover and consequently separate the pressure-side area from the pressureless area in the casing interior. The casing interior contains a pump for filling a blood pressure cuff that is connectable to the apparatus, a valve for the controllable venting of the cuff, pneumatic connecting lines, pressure sensors and an electric control circuit and electric connecting lines. As a result of the construction according to the invention it is possible to obtain a high integration density and therefore a very small and compact blood pressure measuring module.
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Excerpt(s): The present invention relates to an apparatus for measuring blood pressure (blood pressure measuring module) for connection to a correspondingly designed display and evaluating unit. For non-invasive blood pressure measurements, use is made either of a manual blood pressure measurement or an automatic blood pressure measurement. In the known manual blood pressure measurement a cuff applied to the arm of the patient is inflated and then on release the blood pressure is measured by listening to the Korotkoff signals. In the automatic measurement on releasing the air the blood pressure is measured by observation of the high frequency fluctuations superimposed on the pressure signal (so-called oscillatory method). In the automatic method, to which the present invention relates, it is at least necessary to have an air pump, various valves and pressure sensors. These electropneumatic components are normally wired together electrically by means of individual stranded wires in the form of a cable harness. The air-carrying connections are normally in the form of hoses, so that this technology when integrating the components into a casing generally requires much space for the components and the assembly manipulations. In addition, sealing takes place with profile washers, O-rings or joint packings. For this purpose it is necessary to have space-consuming mounting flanges, screw couplings, etc. and welding processes require complicated and expensive machines, the material selection simultaneously being restricted. All this leads to complicated and costly equipment. Web site: http://www.delphion.com/details?pn=US05692512__ •
Blood pressure measuring process and apparatus Inventor(s): Sakamoto; Tamaki (Nagaokakyo, JP), Kinefuchi; Yoshio (Takatsuki, JP) Assignee(s): Omron Tateisi Electronics Co. (Kyoto, JP) Patent Number: 4,188,955 Date filed: September 12, 1977 Abstract: A process and apparatus for automatically measuring blood pressure, particularly diastolic pressure, in a shortened period of time. A first predetermined pressure range below a determined systolic level is established and, if Korotkov pulse sounds are received as cuff pressure decreases through this range, a cuff pressure corresponding to a last detected Korotkov sound is determined as a diastolic pressure when no Korotkov pulse sounds are received in a third narrow pressure range beginning at the cuff pressure coresponding to the last detected Korotkov sound. If Korotkov sounds disappear during decrease of cuff pressure through the first pressure range a cuff pressure corresponding to a last detected Korotkov sound is determined as a diastolic pressure when no Korotkov sounds are received in a second wide predetermined pressure range beginning at the cuff pressure corresponding to the last detected Korotkov sound. Excerpt(s): This invention relates to a blood pressure measuring process and apparatus for automatically measuring systolic and diastolic blood pressures. A proposed measuring apparatus for accurately and automatically measuring diastolic blood pressure of patients having an auscultatory gap is shown in the published specification No. 35798/1974 of a Japanese patent application. This reference discloses a blood pressure measurement which is discontinued if Korotkov sounds are not detected within a predetermined time period of about 7 seconds, which corresponds to a pressure decrease of 20 mmHg after the Korotkov sounds disappear. Since the measurement shown in this reference always requires a time period of 7 seconds after the detection of the last Korotkov sounds, it is disliked by patients whether or not they have an
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auscultatory gap Further, inaccurate measurement is often unavoidable since the rate of pressure decrease often varies, causing a variation in the predetermined time period. Thus, it is an object of the present invention to provide a process and apparatus for measuring the blood pressure of an individual which provides an accurate measurement of systolic and diastolic blood pressure in a short time. Web site: http://www.delphion.com/details?pn=US04188955__ •
Blood pressure measuring system Inventor(s): Hayashi; Ressei (Tokyo, JP), Hayakawa; Tokuji (Komaki, JP) Assignee(s): Colin Electronisc Co., Ltd. (JP) Patent Number: 4,995,399 Date filed: July 21, 1989 Abstract: A blood pressure measuring system for continuously measuring blood pressure values of a subject, including a measuring device for repetitively measuring a blood pressure value of the subject, a display device for indicating a time-wise trend of the measured blood pressure values, a memory device for storing a plurality of sets of data representing a plurality of predetermined time-wise trends of blood pressure, respectively, a designating device for designating one of the plurality of sets of data, and an indicating device for commanding the display device to indicate, according to the designated one set of data, a corresponding one of the plurality of predetermined timewise trends of blood pressure, together with the time-wise trend of the measured blood pressure values. Excerpt(s): The present invention generally relates to a blood pressure measuring system and particularly to such a system which continuously measures blood pressure values of a living body and indicates a time-wise trend of the measured blood pressure values. There is known a portable blood pressure measuring device which is kept on a living body or subject for a comparatively long time period, often one day (24 hours), in everyday life, so as to continuously measure blood pressure values of the subject. The measured blood pressure values are indicated or displayed to provide a one-day timewise trend of blood pressure of the subject. Comparison of the one-day blood pressure variation of the subject with a normal variation of people who have the same characteristics, such as sex and age, as those of the subject, would enable diagnosis on pathology of the blood pressure of the subject. However, the above conventional device does not permit the above comparison, since the device indicates only the one-day blood pressure variation of the subject. Thus, it has conventionally been difficult to compare the one-day blood pressure variation of a subject with a normal variation of people who have the same characteristics as the subject. In other words, it has been difficult to do prompt and reliable diagnosis on the blood pressure of the subject. Web site: http://www.delphion.com/details?pn=US04995399__
Patents 413
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Blood pressure measuring system Inventor(s): Motogi; Jun (Tokyo, JP), Sakai; Yoshio (Tokyo, JP), Takeda; Sunao (Tokyo, JP) Assignee(s): Nihon Kohden Corporation (Tokyo, JP) Patent Number: 5,699,807 Date filed: July 26, 1995 Abstract: A pressure sensor gathers discrete data representing the pulse amplitude of a pulse wave signal when a cuff pressure is increased and decreased. A RAM stores the discrete data of the pulse amplitude. A CPU processes the discrete data by using a spline function, to thereby generate the data representative of a smooth continuous line passing by points of the pulse amplitude of the discrete data. This process reduces a variation of the pulse amplitude of a pulse wave signal, to thereby minimize a variation of the blood pressure values. An inflection point of the smooth continuous line is used as a diastolic blood pressure value. Excerpt(s): The present invention relates to a blood pressure measuring system for measuring a blood pressure by using data representative of a continuous line connecting the pulse amplitude of a pulse wave signal that is detected. A conventional blood pressure monitor detects a pulse wave representative of a pulsation in an artery in the form of a variation of a pressure in a cuff, for example, and measures a diastolic blood pressure and a systolic blood pressure, and a mean blood pressure by using the cuff pressure variation. There are proposed many methods for measuring a blood pressure by using the cuff pressure variation. One of the blood pressure measuring methods of this type is disclosed in Published Unexamined Japanese Patent Application No. Sho. 62-72317, entitled "Improved Automatic Systolic Blood Pressure Monitor with Supplementally Increased Data" (U.S. Pat. Nos. 4,638,810 and 4,754,761). In the publication, the monotonously increasing and decreasing pulse amplitude of a detected pulse wave signal are used for calculating a blood pressure. Of the pulse amplitude of the pulse wave signal, the pulse amplitude that are 69% and 55% of the maximum or peak values of the amplitude thereof are selected, and the selected ones are averaged. The resultant average value is used as the diastolic blood pressure necessary for measuring a blood pressure. Web site: http://www.delphion.com/details?pn=US05699807__
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Blood pressure measuring unit Inventor(s): Sasaki; Kitoh (Tokyo, JP) Assignee(s): Signal Technology Co., Ltd. (Tokyo, JP) Patent Number: 4,896,676 Date filed: October 27, 1988 Abstract: Disclosed is a blood pressure measuring unit comprising a casing having a wrist band to be wound around a user's wrist. The casing is installed therein with a digital display device and a blood pressure measuring device, and is provided with an air pressure chamber to which cuffs are fixed in such a manner that the cuffs are communicated with the air pressure chamber. The blood pressure measuring device is composed of a pressure sensor having a pressure sensing portion, an oscillating circuit, and a processor, the pressure sensing portion being slightly allowed to project into the
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air pressure chamber, and the processor being electrically connected to the digital display device. Excerpt(s): This invention relates to a blood pressure measuring unit and, more particularly, to a blood pressure measuring unit into which a blood pressure measuring system and a wrist watch system are incorporated in the form of one integral unit. Conventionally, a wrist watch has a watch casing to which is equipped a wrist band for fitting around the wrist, and, on the other hand, within which is received a watch system. It includes an analog type, a digital type, and an analog/digital type in which both said types are concurrently used. A blood pressure meter has a wide cuff used to be wound around the upper part of an arm, the cuff being connected, on one hand, with a pump via a tube and, on the other hand, with an analog type pressure meter via another tube. A blood pressure meter of digital type also is known, which, however, is the same as the one of analog type in that it has a cuff of broad width. This blood pressure meter has a size which is as large as the size of an ordinary book. Web site: http://www.delphion.com/details?pn=US04896676__ •
Blood pressure monitor Inventor(s): Inagaki; Takashi (Kyoto, JP), Inagaki; Takashi (Kyoto, JP), Inagaki; Takashi (Kyoto, JP), Inagaki; Takashi (Kyoto, JP), Oku; Shojiro (Kyoto, JP), Oku; Shojiro (Kyoto, JP), Oku; Shojiro (Kyoto, JP), Oku; Shojiro (Kyoto, JP), Mori; Kentaro (Kyoto, JP), Mori; Kentaro (Kyoto, JP), Mori; Kentaro (Kyoto, JP), Mori; Kentaro (Kyoto, JP), Kitamura; Mitsuru (Kyoto, JP), Kitamura; Mitsuru (Kyoto, JP), Kitamura; Mitsuru (Kyoto, JP), Kitamura; Mitsuru (Kyoto, JP) Assignee(s): Omron Corporation (Kyoto, JP), Omron Corporation (Kyoto, JP), Omron Corporation (Kyoto, JP), Omron Corporation (Kyoto, JP) Patent Number: 6,344,025 Date filed: January 31, 2000 Abstract: A blood pressure monitor includes a cuff to be worn on a living body portion provided with an air component for inflating and deflating said cuff, and a main body detachably mounted on the cuff provided with an electrical component, in which the main body is electrically connected with the cuff by wire or wireless. Excerpt(s): This invention relates to an a blood pressure monitor detecting a pulse wave from a living body portion such as a wrist or an arm of a human body to measure a blood pressure, and more particularly to an improved blood pressure monitor of which main body is detachably mounted on a cuff to be worn on the wrist or the arm. This invention relates to an a blood pressure monitor detecting a pulse wave from a living body portion such as a wrist or an arm of a human body to measure a blood pressure, and more particularly to an improved blood pressure monitor of which main body is detachably mounted on a cuff to be worn on the wrist or the arm. This invention relates to an a blood pressure monitor detecting a pulse wave from a living body portion such as a wrist or an arm of a human body to measure a blood pressure, and more particularly to an improved blood pressure monitor of which main body is detachably mounted on a cuff to be worn on the wrist or the arm. This invention relates to an a blood pressure monitor detecting a pulse wave from a living body portion such as a wrist or an arm of a human body to measure a blood pressure, and more particularly to an improved blood pressure monitor of which main body is detachably mounted on a cuff to be worn on the wrist or the arm. There is well known a blood pressure monitors
Patents 415
wherein a cuff worn on a living body portion such as a wrist or an arm of a person is united with a main body of the monitor as a single unit. A first conventional blood pressure monitor is so constructed that a main body is secured to a cuff by a screw or a hook. There is well known a blood pressure monitors wherein a cuff worn on a living body portion such as a wrist or an arm of a person is united with a main body of the monitor as a single unit. A first conventional blood pressure monitor is so constructed that a main body is secured to a cuff by a screw or a hook. There is well known a blood pressure monitors wherein a cuff worn on a living body portion such as a wrist or an arm of a person is united with a main body of the monitor as a single unit. A first conventional blood pressure monitor is so constructed that a main body is secured to a cuff by a screw or a hook. There is well known a blood pressure monitors wherein a cuff worn on a living body portion such as a wrist or an arm of a person is united with a main body of the monitor as a single unit. A first conventional blood pressure monitor is so constructed that a main body is secured to a cuff by a screw or a hook. The first conventional blood pressure monitor does not allow the main body to be detached from the cuff, thereby causing disadvantages such that it is hard for a person of presbyopia to view a display disposed on the main body, to manipulate an operation portion such as a power switch and to operate the monitor when the cuff is worn on the arm. The first conventional blood pressure monitor does not allow the main body to be detached from the cuff, thereby causing disadvantages such that it is hard for a person of presbyopia to view a display disposed on the main body, to manipulate an operation portion such as a power switch and to operate the monitor when the cuff is worn on the arm. The first conventional blood pressure monitor does not allow the main body to be detached from the cuff, thereby causing disadvantages such that it is hard for a person of presbyopia to view a display disposed on the main body, to manipulate an operation portion such as a power switch and to operate the monitor when the cuff is worn on the arm. The first conventional blood pressure monitor does not allow the main body to be detached from the cuff, thereby causing disadvantages such that it is hard for a person of presbyopia to view a display disposed on the main body, to manipulate an operation portion such as a power switch and to operate the monitor when the cuff is worn on the arm. Web site: http://www.delphion.com/details?pn=US06344025__ •
Blood pressure monitor Inventor(s): Inagaki; Takashi (Kyoto, JP), Inagaki; Takashi (Kyoto, JP), Inagaki; Takashi (Kyoto, JP), Inagaki; Takashi (Kyoto, JP), Oku; Shojiro (Kyoto, JP), Oku; Shojiro (Kyoto, JP), Oku; Shojiro (Kyoto, JP), Oku; Shojiro (Kyoto, JP), Mori; Kentaro (Kyoto, JP), Mori; Kentaro (Kyoto, JP), Mori; Kentaro (Kyoto, JP), Mori; Kentaro (Kyoto, JP), Kitamura; Mitsuru (Kyoto, JP), Kitamura; Mitsuru (Kyoto, JP), Kitamura; Mitsuru (Kyoto, JP), Kitamura; Mitsuru (Kyoto, JP) Assignee(s): Omron Corporation (Kyoto, JP), Omron Corporation (Kyoto, JP), Omron Corporation (Kyoto, JP), Omron Corporation (Kyoto, JP) Patent Number: 6,344,025 Date filed: January 31, 2000 Abstract: A blood pressure monitor includes a cuff to be worn on a living body portion provided with an air component for inflating and deflating said cuff, and a main body detachably mounted on the cuff provided with an electrical component, in which the main body is electrically connected with the cuff by wire or wireless.
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Excerpt(s): This invention relates to an a blood pressure monitor detecting a pulse wave from a living body portion such as a wrist or an arm of a human body to measure a blood pressure, and more particularly to an improved blood pressure monitor of which main body is detachably mounted on a cuff to be worn on the wrist or the arm. This invention relates to an a blood pressure monitor detecting a pulse wave from a living body portion such as a wrist or an arm of a human body to measure a blood pressure, and more particularly to an improved blood pressure monitor of which main body is detachably mounted on a cuff to be worn on the wrist or the arm. This invention relates to an a blood pressure monitor detecting a pulse wave from a living body portion such as a wrist or an arm of a human body to measure a blood pressure, and more particularly to an improved blood pressure monitor of which main body is detachably mounted on a cuff to be worn on the wrist or the arm. This invention relates to an a blood pressure monitor detecting a pulse wave from a living body portion such as a wrist or an arm of a human body to measure a blood pressure, and more particularly to an improved blood pressure monitor of which main body is detachably mounted on a cuff to be worn on the wrist or the arm. There is well known a blood pressure monitors wherein a cuff worn on a living body portion such as a wrist or an arm of a person is united with a main body of the monitor as a single unit. A first conventional blood pressure monitor is so constructed that a main body is secured to a cuff by a screw or a hook. There is well known a blood pressure monitors wherein a cuff worn on a living body portion such as a wrist or an arm of a person is united with a main body of the monitor as a single unit. A first conventional blood pressure monitor is so constructed that a main body is secured to a cuff by a screw or a hook. There is well known a blood pressure monitors wherein a cuff worn on a living body portion such as a wrist or an arm of a person is united with a main body of the monitor as a single unit. A first conventional blood pressure monitor is so constructed that a main body is secured to a cuff by a screw or a hook. There is well known a blood pressure monitors wherein a cuff worn on a living body portion such as a wrist or an arm of a person is united with a main body of the monitor as a single unit. A first conventional blood pressure monitor is so constructed that a main body is secured to a cuff by a screw or a hook. The first conventional blood pressure monitor does not allow the main body to be detached from the cuff, thereby causing disadvantages such that it is hard for a person of presbyopia to view a display disposed on the main body, to manipulate an operation portion such as a power switch and to operate the monitor when the cuff is worn on the arm. The first conventional blood pressure monitor does not allow the main body to be detached from the cuff, thereby causing disadvantages such that it is hard for a person of presbyopia to view a display disposed on the main body, to manipulate an operation portion such as a power switch and to operate the monitor when the cuff is worn on the arm. The first conventional blood pressure monitor does not allow the main body to be detached from the cuff, thereby causing disadvantages such that it is hard for a person of presbyopia to view a display disposed on the main body, to manipulate an operation portion such as a power switch and to operate the monitor when the cuff is worn on the arm. The first conventional blood pressure monitor does not allow the main body to be detached from the cuff, thereby causing disadvantages such that it is hard for a person of presbyopia to view a display disposed on the main body, to manipulate an operation portion such as a power switch and to operate the monitor when the cuff is worn on the arm. Web site: http://www.delphion.com/details?pn=US06344025__
Patents 417
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Blood pressure monitor Inventor(s): Inagaki; Takashi (Kyoto, JP), Inagaki; Takashi (Kyoto, JP), Inagaki; Takashi (Kyoto, JP), Inagaki; Takashi (Kyoto, JP), Oku; Shojiro (Kyoto, JP), Oku; Shojiro (Kyoto, JP), Oku; Shojiro (Kyoto, JP), Oku; Shojiro (Kyoto, JP), Mori; Kentaro (Kyoto, JP), Mori; Kentaro (Kyoto, JP), Mori; Kentaro (Kyoto, JP), Mori; Kentaro (Kyoto, JP), Kitamura; Mitsuru (Kyoto, JP), Kitamura; Mitsuru (Kyoto, JP), Kitamura; Mitsuru (Kyoto, JP), Kitamura; Mitsuru (Kyoto, JP) Assignee(s): Omron Corporation (Kyoto, JP), Omron Corporation (Kyoto, JP), Omron Corporation (Kyoto, JP), Omron Corporation (Kyoto, JP) Patent Number: 6,344,025 Date filed: January 31, 2000 Abstract: A blood pressure monitor includes a cuff to be worn on a living body portion provided with an air component for inflating and deflating said cuff, and a main body detachably mounted on the cuff provided with an electrical component, in which the main body is electrically connected with the cuff by wire or wireless. Excerpt(s): This invention relates to an a blood pressure monitor detecting a pulse wave from a living body portion such as a wrist or an arm of a human body to measure a blood pressure, and more particularly to an improved blood pressure monitor of which main body is detachably mounted on a cuff to be worn on the wrist or the arm. This invention relates to an a blood pressure monitor detecting a pulse wave from a living body portion such as a wrist or an arm of a human body to measure a blood pressure, and more particularly to an improved blood pressure monitor of which main body is detachably mounted on a cuff to be worn on the wrist or the arm. This invention relates to an a blood pressure monitor detecting a pulse wave from a living body portion such as a wrist or an arm of a human body to measure a blood pressure, and more particularly to an improved blood pressure monitor of which main body is detachably mounted on a cuff to be worn on the wrist or the arm. This invention relates to an a blood pressure monitor detecting a pulse wave from a living body portion such as a wrist or an arm of a human body to measure a blood pressure, and more particularly to an improved blood pressure monitor of which main body is detachably mounted on a cuff to be worn on the wrist or the arm. There is well known a blood pressure monitors wherein a cuff worn on a living body portion such as a wrist or an arm of a person is united with a main body of the monitor as a single unit. A first conventional blood pressure monitor is so constructed that a main body is secured to a cuff by a screw or a hook. There is well known a blood pressure monitors wherein a cuff worn on a living body portion such as a wrist or an arm of a person is united with a main body of the monitor as a single unit. A first conventional blood pressure monitor is so constructed that a main body is secured to a cuff by a screw or a hook. There is well known a blood pressure monitors wherein a cuff worn on a living body portion such as a wrist or an arm of a person is united with a main body of the monitor as a single unit. A first conventional blood pressure monitor is so constructed that a main body is secured to a cuff by a screw or a hook. There is well known a blood pressure monitors wherein a cuff worn on a living body portion such as a wrist or an arm of a person is united with a main body of the monitor as a single unit. A first conventional blood pressure monitor is so constructed that a main body is secured to a cuff by a screw or a hook. The first conventional blood pressure monitor does not allow the main body to be detached from the cuff, thereby causing disadvantages such that it is hard for a person of presbyopia to view a display disposed on the main body, to manipulate an operation portion such as a power switch and to operate the monitor when the cuff is worn on the arm. The first
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conventional blood pressure monitor does not allow the main body to be detached from the cuff, thereby causing disadvantages such that it is hard for a person of presbyopia to view a display disposed on the main body, to manipulate an operation portion such as a power switch and to operate the monitor when the cuff is worn on the arm. The first conventional blood pressure monitor does not allow the main body to be detached from the cuff, thereby causing disadvantages such that it is hard for a person of presbyopia to view a display disposed on the main body, to manipulate an operation portion such as a power switch and to operate the monitor when the cuff is worn on the arm. The first conventional blood pressure monitor does not allow the main body to be detached from the cuff, thereby causing disadvantages such that it is hard for a person of presbyopia to view a display disposed on the main body, to manipulate an operation portion such as a power switch and to operate the monitor when the cuff is worn on the arm. Web site: http://www.delphion.com/details?pn=US06344025__ •
Blood pressure monitor Inventor(s): Inagaki; Takashi (Kyoto, JP), Inagaki; Takashi (Kyoto, JP), Inagaki; Takashi (Kyoto, JP), Inagaki; Takashi (Kyoto, JP), Oku; Shojiro (Kyoto, JP), Oku; Shojiro (Kyoto, JP), Oku; Shojiro (Kyoto, JP), Oku; Shojiro (Kyoto, JP), Mori; Kentaro (Kyoto, JP), Mori; Kentaro (Kyoto, JP), Mori; Kentaro (Kyoto, JP), Mori; Kentaro (Kyoto, JP), Kitamura; Mitsuru (Kyoto, JP), Kitamura; Mitsuru (Kyoto, JP), Kitamura; Mitsuru (Kyoto, JP), Kitamura; Mitsuru (Kyoto, JP) Assignee(s): Omron Corporation (Kyoto, JP), Omron Corporation (Kyoto, JP), Omron Corporation (Kyoto, JP), Omron Corporation (Kyoto, JP) Patent Number: 6,344,025 Date filed: January 31, 2000 Abstract: A blood pressure monitor includes a cuff to be worn on a living body portion provided with an air component for inflating and deflating said cuff, and a main body detachably mounted on the cuff provided with an electrical component, in which the main body is electrically connected with the cuff by wire or wireless. Excerpt(s): This invention relates to an a blood pressure monitor detecting a pulse wave from a living body portion such as a wrist or an arm of a human body to measure a blood pressure, and more particularly to an improved blood pressure monitor of which main body is detachably mounted on a cuff to be worn on the wrist or the arm. This invention relates to an a blood pressure monitor detecting a pulse wave from a living body portion such as a wrist or an arm of a human body to measure a blood pressure, and more particularly to an improved blood pressure monitor of which main body is detachably mounted on a cuff to be worn on the wrist or the arm. This invention relates to an a blood pressure monitor detecting a pulse wave from a living body portion such as a wrist or an arm of a human body to measure a blood pressure, and more particularly to an improved blood pressure monitor of which main body is detachably mounted on a cuff to be worn on the wrist or the arm. This invention relates to an a blood pressure monitor detecting a pulse wave from a living body portion such as a wrist or an arm of a human body to measure a blood pressure, and more particularly to an improved blood pressure monitor of which main body is detachably mounted on a cuff to be worn on the wrist or the arm. There is well known a blood pressure monitors wherein a cuff worn on a living body portion such as a wrist or an arm of a person is united with a main body of the monitor as a single unit. A first conventional blood pressure monitor is so constructed that a main body is secured to a cuff by a screw or a
Patents 419
hook. There is well known a blood pressure monitors wherein a cuff worn on a living body portion such as a wrist or an arm of a person is united with a main body of the monitor as a single unit. A first conventional blood pressure monitor is so constructed that a main body is secured to a cuff by a screw or a hook. There is well known a blood pressure monitors wherein a cuff worn on a living body portion such as a wrist or an arm of a person is united with a main body of the monitor as a single unit. A first conventional blood pressure monitor is so constructed that a main body is secured to a cuff by a screw or a hook. There is well known a blood pressure monitors wherein a cuff worn on a living body portion such as a wrist or an arm of a person is united with a main body of the monitor as a single unit. A first conventional blood pressure monitor is so constructed that a main body is secured to a cuff by a screw or a hook. The first conventional blood pressure monitor does not allow the main body to be detached from the cuff, thereby causing disadvantages such that it is hard for a person of presbyopia to view a display disposed on the main body, to manipulate an operation portion such as a power switch and to operate the monitor when the cuff is worn on the arm. The first conventional blood pressure monitor does not allow the main body to be detached from the cuff, thereby causing disadvantages such that it is hard for a person of presbyopia to view a display disposed on the main body, to manipulate an operation portion such as a power switch and to operate the monitor when the cuff is worn on the arm. The first conventional blood pressure monitor does not allow the main body to be detached from the cuff, thereby causing disadvantages such that it is hard for a person of presbyopia to view a display disposed on the main body, to manipulate an operation portion such as a power switch and to operate the monitor when the cuff is worn on the arm. The first conventional blood pressure monitor does not allow the main body to be detached from the cuff, thereby causing disadvantages such that it is hard for a person of presbyopia to view a display disposed on the main body, to manipulate an operation portion such as a power switch and to operate the monitor when the cuff is worn on the arm. Web site: http://www.delphion.com/details?pn=US06344025__ •
Blood pressure monitor Inventor(s): Inagaki; Takashi (Kyoto, JP), Kobayashi; Toshiyuki (Kyoto, JP) Assignee(s): Omron Corporation (Kyoto, JP) Patent Number: 5,687,732 Date filed: October 6, 1995 Abstract: A blood pressure monitor includes a main body provided with a power switch and an inflating switch, a cover mounted on the main body in an open-and-close fashion and on an inner wall thereof provided with a display, and a cuff secured to the main body as a single unit. When the cover is closed during not using the monitor, the power and inflating switches are covered with the cover. When the cover is opened for use, the display appears. Thus, the blood pressure monitor provides avoidance of unexpected actuation of the power and inflating switches, improvement of operation of the switches and a view angle of the display, improved assembling work of the monitor, and simplification of repair and replacement in the monitor. Excerpt(s): This invention is in the field of blood pressure monitors such as wrist-type or arm-type blood pressure monitors. The conventional blood pressure monitor, however, has the disadvantages that the power switch or the inflating switch is liable to be unexpectedly actuated to waste a source battery when the monitor is carried in a bag and the display is hard to be watched because it is small and secured to the main body.
420 Blood Pressure
If an operator using the monitor wants to watch the display during measurement, the operator's good posture for measuring has to be deformed resulting in wrong measurement. When a cuff is necessary to be removed from a main body of a conventional blood pressure monitor for maintenance, inspection, repair or component replacement, such removal is not easy and consumes time. Web site: http://www.delphion.com/details?pn=US05687732__
Patent Applications on Blood Pressure As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to blood pressure: •
Advertising method using automatic blood pressure measuring apparatus, and automatic blood pressure measuring apparatus having advertising function Inventor(s): Kitagawa, Hiroya; (Komaki-shi, JP) Correspondence: OLIFF & BERRIDGE, PLC; P.O. BOX 19928; ALEXANDRIA; VA; 22320; US Patent Application Number: 20020002341 Date filed: June 14, 2001 Abstract: An advertising method, including the step of displaying, during a bloodpressure measuring operation of an automatic blood-pressure measuring apparatus including an inflatable cuff and a display device, an advertisement on the display device. Excerpt(s): The present invention relates to an advertising method using an automatic blood-pressure measuring apparatus including an inflatable cuff, and an automatic blood-pressure measuring apparatus having the function of displaying an advertisement during a blood-pressure measuring operation. An automatic bloodpressure (BP) measuring apparatus including an inflatable cuff automatically carries out a BP measuring operation by continuously obtaining a physical single from a living subject while a pressing pressure of the cuff wound around a body portion (e.g., upper arm) of the subject is gradually lowered, and determining a BP value or values of the subject based on the obtained signal. The time needed to complete the BP measuring operation, i.e., the time duration in which the cuff presses the body portion of the subject ranges from about 30 seconds to about 1 minute. As described above, the automatic BP measuring apparatus including the cuff needs 30 seconds to 1 minute to carry out the BP measuring operation. During the BP measuring operation, the subject is bound to the cuff and accordingly cannot do anything. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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This has been a common practice outside the United States prior to December 2000.
Patents 421
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Agents for improving lipid metabolism and reducing high blood pressure Inventor(s): Abe, Takumi; (Kawagoe-shi, JP), Takada, Yukihiro; (Kawagoe-shi, JP), Kawakami, Hiroshi; (Kawagoe-shi, JP), Morita, Yoshikazu; (Kawagoe-shi, JP), Toba, Yasuhiro; (Tokyo, JP) Correspondence: KNOBBE MARTENS OLSON & BEAR LLP; 2040 MAIN STREET; FOURTEENTH FLOOR; IRVINE; CA; 91614; US Patent Application Number: 20030040475 Date filed: January 15, 2002 Abstract: A milk-derived basic protein fraction and a basic peptide fraction are provided for use as an effective component for agents for improving lipid metabolism and reducing high blood pressure which can be administered orally, are effective with a relatively small dosage, have good taste and are stable during storage. Excerpt(s): The present invention relates to agents, drinks and food products for improving lipid metabolism and reducing high blood pressure and the combination thereof that are effective in treating and preventing diseases such as fatty liver, hyperlipidemia, arteriosclerosis, obesity and hypertension. Lipid metabolism refers to catabolic (decomposing) and anabolic (accumulating) processes of lipids, mainly comprising triglicerides derived from food. Lipid metabolism generally includes energy-releasing reaction of lipids, biosynthesis of fatty acids, biosynthesis of acylglycerols, phospholipid metabolism, cholesterol metabolism, and the like ("Biochemistry for Nutrition" by Akira Misaki, Asakura Shoten, 1993, pp. 123-134). In recent years, the mortality rate from cardiovascular disease has been rapidly increasing and the correlation between the risk of getting cardiovascular disease and the blood cholesterol concentration has been pointed out. Meantime, several attempts have been made to reduce the blood cholesterol concentration by using food materials, which can be ingested in daily life. For example, soybean protein (Arteriosclerosis 1988 72:115), whey protein (Agric Biol Chem 1991 55:813; Japanese Patent Application Laid-open No. H5-176713), soybean protein hydrolyzates (J Nutr 1990 120:977), and egg yolk phospholipid (Agric Biol Chem 1989 53:2469) have been tried. Further, a method making use of lactoalbumin, collagen, soybean protein or wheat gluten and soybean lecithin in combination (Nutr Rep Int 1983 28:621) and a method making use of tissue-like soybean protein containing soybean lecithin (Ann Nutr Metab 1985 29:348), and the like have been proposed. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Apparatus and method for blood pressure pulse waveform contour analysis Inventor(s): Finkelstein, Stanley M. (St. Louis Park, MN), Cohn, Jay N. (Minneapolis, MN), Morgan, Dennis J. (Crystal, MN), Bratteli, Christopher W. (Fridley, MN) Correspondence: SCHWEGMAN, LUNDBERG, WOESSNER & KLUTH, P.A. P.O. BOX 2938; MINNEAPOLIS; MN; 55402; US Patent Application Number: 20030023173 Date filed: May 28, 2002 Abstract: Methods and apparatus for processing an arterial blood pressure waveform to extract clinically useful information on the state of the cardiovascular system are disclosed herein. In order to obtain the parameters of the modified Windkessel model,
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the diastolic portion of a subject's blood pressure waveform is scanned over a plurality of ranges and the range that produces the best fit of data and lowest error estimates are selected. In addition, multiple empirically determined starting values of the `A` parameters are used to find the best fit of the model data to the actual arterial blood pressure waveform data. Excerpt(s): This invention relates to the field of medical diagnosis, and more specifically, to a method and apparatus for blood pressure pulse waveform contour analysis. U.S. Pat. No. 5,211,177 (incorporated herein by reference) discloses method and apparatus for measuring properties of the human vasculature using an electrical analog model of vascular impedance. These properties include the compliance of large and small vessels, and systemic resistance. These measurements and others obtained from the model can in turn be used to diagnose states of health or disease, and to assess the effectiveness of treatment regimes. For example, see Finkelstein S. M., Collins V. R., Cohn J. N., Arterial vascular compliance response to vasodilators by Fourier and pulse contour analysis, Hypertension 1988:12;380-387, the entire disclosure of which is incorporated herein by reference. The simplest model for representing the time-varying pressure behavior of the arterial blood pressure waveform during the diastolic decay phase of the cardiac cycle is a first-order model. The analog model that represents this behavior contains a single "active" element (capacitance) and a passive element (resistance). The model only accounts for the pure exponential decay present in the waveform. An improvement to this model that better accounts for the observed shape of the diastolic decay in humans is a third-order model, for example, the modified Windkessel model. The analog model that represents this behavior contains three active elements, two capacitors (compliance) separated by an inductor (inertance of the blood) and a passive resistance (systemic vascular resistance) element. This is the model preferred in the system of U.S. '177, and employed in the approach of the example embodiment of the present invention described herein. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Apparatus and method for measuring blood pressure using linearly varying air pressure Inventor(s): Yoon, Gil-won; (Seoul, KR), Lee, Jong-youn; (Seoul, KR) Correspondence: LEE & STERBA, P.C. Suite 2000; 1101 Wilson Boulevard; Arlington; VA; 22209; US Patent Application Number: 20030060720 Date filed: May 28, 2002 Abstract: An apparatus and method for measuring blood pressure using linearly varying air pressure, including a compression unit; an air pump that injects air into the compression unit; a pressure sensor that senses and outputs the air pressure of the compression unit; an ADC that converts and outputs the result of the sensing as a pressure signal; a controller that calculates a current pressure value of the compression unit from the pressure signal and a linear pressure of the compression unit that is linearly dropped corresponding to the current pressure value and generates the first control signal in response to the current pressure value and a second control signal from the result of a comparison of the current pressure value and the linear pressure; a DAC that converts and outputs the second control signal as an exhaust control signal; and a proportional control valve that exhausts air from the compression unit.
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Excerpt(s): The present invention relates to the measurement of blood pressure. More particularly, the present invention relates to an apparatus and method for measuring blood pressure using linearly varying air pressure. Blood pressure is the most useful, easy-to-measure index among a variety of indices of the health of a human being. Blood pressure is used as an index for diagnosing disorders of the circulatory system including the heart and blood vessels. Additionally, when blood pressure is above a normal range, particular medical treatments may be required. Blood pressure varies with many factors. Accordingly, it is difficult to measure blood pressure accurately through only a single measurement. For example, when a blood pressure measurement is taken in a hospital, false hypertension often occurs due to the stress of a patient and results in an accurate reading. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Automatic blood pressure measuring apparatus Inventor(s): Ito, Hisashi; (Komaki-shi, JP) Correspondence: OLIFF & BERRIDGE, PLC; 277 S. WASHINGTON STREET, SUITE 500; ALEXANDRIA; VA; 22314; US Patent Application Number: 20010020133 Date filed: February 8, 2001 Abstract: An apparatus for automatically measuring a blood pressure of a female subject, including a blood-pressure measuring device which includes an inflatable cuff adapted to apply a pressing force to a body portion of the subject and automatically measures, by changing the pressing force of the cuff, a blood pressure of the female subject at a predetermined measurement period, a labor-pain-signal detecting device which detects, from the female subject, a labor-pain signal which changes in relation to a labor pain of the subject, and a blood-pressure-measurement starting device for operating the blood-pressure measuring device to start a blood-pressure measurement, when the predetermined measurement period has elapsed and when the labor-pain signal detected by the labor-pain-signal detecting device falls within a reference range. Excerpt(s): The present invention relates to an automatic blood pressure measuring apparatus which can accurately measure a blood pressure of a female subject even at the time of childbirth. There is known an automatic blood pressure (BP) measuring apparatus which monitors BP values of a living subject by periodically changing an air pressure of an inflatable cuff applied to a body portion of the subject at a predetermined measurement period and detecting a pressure pulse wave produced in the cuff during the change of air pressure of the cuff. It is known that the BP values measured using the inflatable cuff are reliable. Meanwhile, it is medically important to monitor BP values of a female subject at the time of childbirth. However, in the case where the abovementioned BP measuring apparatus is used to monitor, using the cuff, BP values of a female subject who heavily moves her body each time she feels a labor pain (i.e., uterine contraction), the BP measuring apparatus may not accurately measure the BP values of the subject because of her heavy physical motion. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Automatic blood-pressure measuring apparatus Inventor(s): Yokozeki, Akihiro; (Komaki-shi, JP) Correspondence: OLIFF & BERRIDGE, PLC; P.O. BOX 19928; ALEXANDRIA; VA; 22320; US Patent Application Number: 20020052555 Date filed: September 19, 2001 Abstract: An apparatus for automatically measuring a blood pressure of a living subject, including an inflatable cuff which is adapted to be wound around a portion of the subject, an increase-end-pressure determining device for determining, based on a cuff pulse wave occurring to the cuff when a pressure in the cuff is increased at a first rate, an increase-end pressure to which the pressure of the cuff is increased at the first rate, at which the increasing of the pressure of the cuff is ended, and from which the pressure of the cuff is decreased at a second rate lower than the first rate, and a blood-pressure determining device for determining a blood pressure of the subject based on a physical signal obtained from the subject when the pressure of the cuff is decreased at the second rate from the increase-end pressure. Excerpt(s): The present invention relates to an automatic blood-pressure measuring apparatus which automatically measures a blood pressure of a living subject based on a physical signal obtained when a pressure in a cuff is decreased. There is known an automatic blood-pressure measuring apparatus of a type which includes a cuff inflatable to press a portion of a living subject and measures a blood pressure of the subject based on a physical signal, such as a pulse wave or Korotkoff sounds, that is continuously obtained when the pressure of the cuff is slowly decreased. The pressure of the cuff needs to be increased, in advance, before the cuff pressure is slowly decreased. It is the most appropriate for the increasing of the cuff pressure to be stopped at the lowest possible pressure at which, however, the cuff can completely stop the flow of blood through the portion of the subject around which the cuff is wound. The lowest possible pressure needs to be higher than a systolic blood pressure of the subject. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Blood pressure analyzer Inventor(s): Su, Tsung-Kun; (Shijr City, TW) Correspondence: BRUCE H. TROXELL; SUITE 1404; 5205 LEESBURG PIKE; FALLS CHURCH; VA; 22041; US Patent Application Number: 20030187361 Date filed: October 23, 2002 Abstract: A blood pressure analyzer comprised of an interconnected pressure sensor, a signal processor, a microprocessor, and a display. The microprocessor is also connected to memory and a computer transmission interface. The signal processor consists of a first signal amplifier, a low pass filter, a second signal amplifier, a high pass filter, a voltage clamp, a comparator, a third signal amplifier, an accumulator circuit, and a crystal oscillator. The analyzed and calculated systolic and diasystolic blood pressure values are shown on the display and, furthermore, accurately represents pulse wave form fluctuations to afford the user a complete understanding of blood pressure conditions and thereby provide physicians a reference for the diagnosis of cardiovascular changes.
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Excerpt(s): The invention herein involves the placement of the pressure sensor 10, a thin piezo-conductive pressosensitive element, on a pulsating region of the user. When pressure is applied to the artery, a reaction is produced, at which time the thin piezoconductive pressosensitive element generates microvolts of voltage. The said voltage is amplified through the first signal amplifier 21 of the signal processor 20 and then processed by the low pass filter 22, the second signal amplifier 23, and the high pass filter 24 to derive the pulse rate and amplify the signal to a level of zero to two volts, with current controlled by the thermocouple 240 according to variances in temperature, thereby regulating the said voltage as the temperature changes; then rise the said voltage by the said voltage clamp 25; the said voltage proceeds to the comparator 26 which in conjunction with the crystal oscillator 29, the accumulator circuit 28, and the third signal amplifier 27 outputs cumulative, triangular wave voltage comparisons that are converted into a high resolution, digital pulse width modulation (PWM) signal values, the said microprocessor 30 controlling the saving into memory 50 of the digital signal values aggregated during the measurement process as well as the calculation of the said digital signal values to obtain the average value, high pressure value, and low pressure value of blood pressure; the microprocessor 30 controls the resolution at which the said digital signal values are outputted and also controls the forwarding of the said various values to the display storage device 40 such that a blood pressure pulse wave graph as well as the blood pressure average value, systolic pressure, and diasystolic pressure values of the user are shown on the display 41; or controls the transfer of the said digital signal values from the computer transmission interface 60 to a personal computer or a hospital computer to serve as an individual's record or reference for medical diagnosis. taking Pa as a base value, each An point is sequentially differentiated twice to obtain a respective Km value and each Km is compared to Pa, and when a Km is larger than Pa, the value of Pl is such that Pl=An, with the diasystolic pressure point indicated when a single pulse beat value becomes larger than the differentiated point of the average blood pressure curve. The blood pressure pulse wave data of the invention herein is derived analogically and since there are no resolution limitations, it is capable of displaying blood pressure pulse wave graphs at an even higher resolution and with greater realism. The present invention is not only capable of reading and displaying values of systolic and diasystolic pressure and, furthermore, accurately displaying pulse wave form fluctuations occurring over minute increments of time, but also designed to measure pulse beat levels, shifts in angle, and other data to provide physicians a reference for diagnosing cardiovascular changes. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Blood pressure measurement apparatus and method Inventor(s): Needham, Philip; (Berkshire, GB), Harris, Thomas John; (Surrey, GB) Correspondence: SCHWEGMAN, LUNDBERG, WOESSNER & KLUTH, P.A. P.O. BOX 2938; MINNEAPOLIS; MN; 55402; US Patent Application Number: 20030176795 Date filed: December 2, 2002 Abstract: A blood pressure measurement apparatus and method is disclosed in which the taking of blood pressure measurements of a patient is controlled in dependence upon the analysis of a signal from the patient indicative of cardiac contractions. Excerpt(s): The present invention generally relates to a blood pressure measurement apparatus and method and more particularly to a blood pressure measurement
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apparatus and method in which the taking of a blood pressure measurement of a patient is controlled on the basis of the analysis of a signal from the patient indicative of contractions of the heart of the patient. Blood pressure describes the internal pressure within the arterial system of the body and is of genera interest as a significant prognostic and diagnostic indicator. Blood pressure is described in two values, the systolic and diastolic values. These two values describe the peak and trough values within a pulse cycle. The cycle is caused by the cyclic pumping action of the heart The peak value in the cycle corresponds to the pressure achieved just after the ventricles have contracted (systole) and the trough value represents the underlying or residual pressure in the system between systole. Blood pressure is traditionally measured at the blachial artery in the upper arm Blood pressure measurements are conventionally manually taken using an inflatable sphygmomanometer cuff placed over the brachial artery on the upper arm. The cuff is inflated until the radial pulse at the wrist is no longer palpable. In this event the pressure in the cuff exceeds the arterial blood pressure. The diaphragm of a stethoscope is placed on the brachial artery just below the cuff. The cuff pressure is gradually reduced until sounds (Korotkoff sounds) can be heard. These sounds are caused by blood passing through the compressed artery at the peak of the arterial pressure cycle. At this point the arterial pressure is just greater an the cuff pressure and can be read off the pressure indicator. This is the systolic press. The cuff is then further deflated until the sounds first become muffled then disappear. At this point, blood flow is continuous in the artery as the lower pressure in the arterial pressure cycle is now just greater than the cuff pressure and can be read off the pressure indicator. This is the diastolic pressure. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Blood pressure measuring apparatus Inventor(s): Baxter, James M. (Jordan, NY), Vivenzio, Robert L. (Auburn, NY), Danna, Dominick; (Syracuse, NY), Dromms, Raymond P. (Liverpool, NY), Lia, Raymond A. (Auburn, NY), Stearns, Scott S. (Marietta, NY) Correspondence: WALL MARJAMA & BILINSKI; 101 SOUTH SALINA STREET; SUITE 400; SYRACUSE; NY; 13202; US Patent Application Number: 20030114765 Date filed: December 19, 2001 Abstract: A blood pressure measuring apparatus includes an inflatable sleeve adapted to be wrapped about a limb of a patient. The sleeve includes an interior and at least one socket provided on an exterior surface of the sleeve, the socket being fluidly connected to the interior of the sleeve. A gage is directly attached to the sleeve socket through attachment of a mating engagement portion. A pneumatic bulb is also attached fluidly to the sleeve through a receiving port which is provided on at least one of the socket and the gage. Excerpt(s): This invention is directed to the field of medical diagnostic instruments, and in particular to a preferred interconnection between a gage housing and an inflatable sleeve of a blood pressure measuring apparatus. Typical blood pressure measuring instruments include an inflatable sleeve which is wrapped about the limb (i.e., arm or leg) of a patient. A pneumatic bulb is tethered by a hose and is fully interconnected to the sleeve interior. A gage which includes a dial face having a set of indicia is separately interconnected also by means of a hose to the sleeve interior. The gage includes an interior movement mechanism which is responsive to changes in pressure within the
Patents 427
sleeve interior. The pressure changes produce circumferential movement of an indicating member attached to the movement mechanism relative to the set of indicia on the dial face of the gage. Both the gage and the pneumatic bulb are tethered individually to the sleeve which includes corresponding barbs or receiving ports which permit fluid communication with the interior of the sleeve. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Blood Pressure measuring apparatus Inventor(s): Nunome, Tomohiro; (Komaki-shi, JP) Correspondence: OLIFF & BERRIDGE, PLC; P.O. BOX 19928; ALEXANDRIA; VA; 22320; US Patent Application Number: 20020188208 Date filed: December 14, 2001 Abstract: An apparatus for measuring a blood pressure of a superior limb or an inferior limb of a living subject, including a blood-pressure measuring device which includes a measuring member adapted to be worn on a measurement portion of the superior or inferior limbs and measures a blood pressure of the measurement portion, and a pressing device which includes a pressing member adapted to be worn on the measurement portion or a distal portion of the subject relative to the measurement portion, and which presses the pressed portion with a prescribed blood-flow promoting force that is lower than a systolic blood pressure of the subject. Excerpt(s): The present invention relates to a blood pressure measuring apparatus and particularly to the art of preventing or eliminating retention of venous blood and thereby improving accuracy of blood pressure measurement. Before or after a surgical operation, a patient needs to rest on a bed without moving his or her superior or inferior limbs for a long time. If the patient does not move his or her superior or inferior limbs for a long time, then blood tends to stay in large venous sinuses that are present in muscles and are free of valves. Normally, the contractions of the muscles send the blood staying in the veins, back to the proximal side, i.e., the heart. In a special case, however, in which the patient's muscle forces are not so strong, the blood cannot flow so fast and accordingly tends to stay in the veins. In particular, blood is likely to stay in veins of legs. If blood pressure values are measured from a portion of the patient in which venous blood stays, an accurate diastolic blood pressure cannot be measured. Since, however, a conventional blood pressure measuring apparatus measures blood pressure values without taking into account whether blood stays in veins, an accurate diastolic blood pressure may not be obtained. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Blood pressure measuring device Inventor(s): Deuter, Klaus; (Unterschleissheim, DE) Correspondence: McCormick, Paulding & Huber; City Place II; 185 Asylum Street; Hartford; CT; 06103-3402; US Patent Application Number: 20010012916 Date filed: December 21, 2000
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Abstract: 9A blood pressure measuring device has a pressure cuff the inflation of which is automatically effected and controlled by an evaluation and control unit to allow a continuous monitoring of a patient's blood pressure, especially during the night without infringing on the patient's comfort and sleep. The device also includes an EKG device and a sensor for sensing the pressure in the cuff. In a first mode of operation, the control and evaluation unit calculates an estimated blood pressure value from pulse wave transmission times with each calculated pulse wave transmission time being the time elapsing between a heart beat as detected by the EKG device and a corresponding cuff pressure change detected by the pressure sensor. In the event of the appearance of blood pressure spikes while operating in the first mode, the device switches to a second operating mode during which absolute blood pressure values are determined. Excerpt(s): The invention concerns a blood pressure measuring device including an inflatable pressure cuff which is applicable to a body extremity and which is connected with an automatically operating pressurized air source and with a pressure sensor for sensing the cuff pressure and also having a control and evaluation unit connected with the pressurized air source, the pressure sensor and a controllable valve of the pressure cuff. With certain patients, such as for example diabetics, it can be necessary to supervise the blood pressure continuously during the night. It is known, that the appearance of kidney damage in diabetics is decisively dependent on the blood pressure level. The appearance of blood pressure spikes can be monitored only very incompletely with customary 24-hour blood pressure monitors because of a measurement being taken mostly only every 30 minutes because of the great encroachment on the patient during the night. The blood pressure spikes which appear are, however, largely much shorter and, therefore, fall many times in the gaps between the measurements. Moreover, known 24-hour blood pressure monitors are relatively expensive and, therefore, are unsuited for wide use as home devices. The object of the invention is basically to provide a blood pressure measuring device which is economical and of simple construction and which allows for a continuous monitoring of the blood pressure of a patient with little disturbance to the patient. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Blood pressure monitor Inventor(s): Goto, Masami; (Aichi-ken, JP), Nishibayashi, Hideo; (Inuyama-shi, JP), Narimatsu, Kiyoyuki; (Kasugai-shi, JP), Yokozeki, Akihiro; (Komaki-shi, JP) Correspondence: OLIFF & BERRIDGE, PLC; P.O. Box 19928; Alexandria; VA; 22320; US Patent Application Number: 20030092999 Date filed: January 8, 2003 Abstract: A blood pressure monitor including a cuff, a pressure sensor which detects a pressure in the cuff, a pressure regulating device which increases the pressure of the cuff, a pulse-amplitude determining device for determining an amplitude of each of pulses of a pulse wave which are produced in the cuff and detected by the pressure sensor while the cuff pressure is increased, a candidate determining device for determining, as a diastolic BP candidate, a pressure of the cuff which is detected by the pressure sensor and which corresponds to an amplitude of a first pulse of the pulses determined by the pulse-amplitude determining device, by judging whether the amplitude of the first pulse is not greater than a reference value which is smaller than an amplitude of at least one second pulse of the pulses, by a predetermined proportion of the amplitude of the second pulse, the amplitude of the second pulse being determined
Patents 429
by the pulse-amplitude determining device after the amplitude of the first pulse is determined, and a BP determining device for determining, as a monitor diastolic BP value, the cuff pressure corresponding to the amplitude of the first pulse, when the candidate determining device determines, as the diastolic BP candidate, the cuff pressure corresponding to the amplitude of the first pulse, with respect to a predetermined number of the one or more second pulses. Excerpt(s): The present invention relates to a blood pressure monitor including an inflatable cuff. There is known a blood pressure (BP) monitor which includes an inflatable cuff adapted to be wound around a body portion, e.g., upper arm, of a living subject, e.g., patient, to press the body portion. The BP monitor functions as an automatic BP measuring device which periodically measures a BP value of the subject by increasing the cuff pressure and thereby pressing the body portion of the subject. However, if the period or interval of the BP measurements effected by the BP monitor is shortened for improving the accuracy of monitoring of subject's blood pressure, the frequency of pressing of subject's body portion is increased, which causes the subject to feel discomfort. In the above-indicated background, it has been proposed to increase the pressure of an inflatable cuff being wound around a body portion of a living subject, up to a predetermined value, detect a pulse wave that is a pressure oscillation produced in the cuff, and estimate a BP value of the subject based on the magnitude of the pulse wave. This technique is disclosed in, e.g., Japanese Patent Application laid open for inspection purposes under Publication No. 61(1986)-103432, or Japanese Patent Application laid open for inspection purposes under Publication No. 60(1985)-241422. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Blood pressure monitor and a method for determining a risk rate for a disease Inventor(s): Lin, Kin Yuan; (Taipei, TW) Correspondence: SHOEMAKER AND MATTARE, LTD; SUITE 1203; 2001 JEFFERSON DAVIS HIGHWAY; ARLINGTON; VA; 22202; US Patent Application Number: 20030176796 Date filed: March 14, 2003 Abstract: A blood pressure monitor serves at the same time for measuring and displaying blood pressure values and for determining a risk rate (L, M, H, V) for suffering from a cardiovascular disease for a specific user. The blood pressure monitor comprises in addition to a conventional measuring unit (2) a user input interface (5, 6a, 6b, 14), which allows the user to enter predetermined risk factors. The data relating to the risk factors are stored in memory (7). A calculating unit (8) calculates a risk rate on the basis of the data and of the blood pressure values. The risk rate may be displayed on a display (9, RR). Excerpt(s): The invention relates to a blood pressure monitor and to a method for measuring the blood pressure and for determining a risk rate for a disease according to the preamble of the independent patent claims. In recent years, there have been a progressive decrease in cardiovascular mortality in North America, Western Europe, Japan and Australasia. At the same time, the control of hypertension in these regions has considerably improved. The risk of suffering from cardiovascular diseases, however, does not only depend on the blood pressure levels of a patient but also on a plurality of other risk factors, which may or may not be applicable to the individual patient. Known blood pressure monitors allow the user to measure the blood pressure. The risk of
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suffering from cardiovascular disease is determined by the doctor on the basis of the blood pressure values communicated to him and in consideration of the risk factors applicable to the patient. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Blood pressure monitor apparatus Inventor(s): Inukai, Hidekatsu; (Nagoya-shi, JP), Yokozeki, Akihiro; (Komaki-shi, JP), Nunome, Tomohiro; (Komaki-shi, JP), Kawaguchi, Keizoh; (Komaki-shi, JP) Correspondence: OLIFF & BERRIDGE, PLC; P.O. Box 19928; Alexandria; VA; 22320; US Patent Application Number: 20020193692 Date filed: May 8, 2002 Abstract: A blood pressure monitor apparatus for monitoring a blood pressure of a living subject, comprising: pulse-wave-propagation-velocity-relating information obtaining means for successively obtaining pulse-wave-propagation-velocity-relating information which relates to a pulse-wave propagation velocity at which a pulse wave propagates in an artery of the subject; pulse-period-relating information obtaining means for successively obtaining pulse-period-relating information which relates to a pulse period of the subject; peripheral-blood-volume-relatin- g information obtaining means for successively obtaining peripheral-blood-volume-relating information which relates to a volume of blood which flows in a peripheral body portion of the subject; and abnormality judging means for judging that the blood pressure of the subject is abnormal when at least one of the pulse-wave-propagation-veloc- ity-relating information, pulse-period-relating information, and peripheral-blood-volume-relating information does not fall within a corresponding one of a first, a second and a third reference range. Excerpt(s): The present application is based on Japanese Patent Application No. 10337697 filed Nov. 27, 1998, the contents of which are incorporated hereinto by reference. The present invention relates to a blood pressure monitor apparatus which monitors a blood pressure of a living subject based on pulse-wave-propagation-velocity-relating information which relates to a propagation velocity of a pulse wave which propagates through an artery of a subject, pulse-period-relating information which relates to a period of a pulse of a subject, and peripheral-blood-volume-relating information which relates to a volume of blood which flows in a peripheral body portion of a subject. As pulse-wave-propagation-velocity-relating information, there is known a propagation time DT during which a pulse wave propagates between predetermined two portions of an artery, or a propagation velocity V.sub.M (m/s) at which a pulse wave propagates through an artery. It is generally known that such pulse-wave-propagation-velocityrelating information is substantially proportional to a blood pressure BP (mmHg) of a living subject within a predetermined range. In view of this, there is proposed a blood pressure monitor apparatus which monitors a change or fluctuation of the blood pressure of the subject by monitoring whether or not successively obtained pulse-wavepropagation-velocity-relating information is greater than a predetermined upper reference value or smaller than a predetermined lower reference value, and judges that the blood pressure has changed and starts a blood pressure measurement using a cuff when the obtained pulse-wave-propagation-velocity-relating information is greater than the predetermined upper reference value or smaller than the predetermined lower reference value.
Patents 431
Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Blood pressure monitoring apparatus Inventor(s): Tanaka, Rie; (Tokyo, JP), Sugo, Yoshihiro; (Tokyo, JP), Hyogo, Mitsushi; (Tokyo, JP) Correspondence: SUGHRUE, MION, ZINN, MACPEAK & SEAS, PLLC; 2100 Pennsylvania Avenue, N.W. Washington; DC; 20037; US Patent Application Number: 20020002339 Date filed: May 16, 2001 Abstract: The blood pressure monitoring apparatus includes blood pressure measuring device for measuring the blood pressure employing a cuff, pulse wave propagation time measuring device for measuring the pulse wave propagation time, hemodynamics measuring device for measuring the hemodynamics, and control device for controlling the blood pressure measuring device on the basis of a change in pulse wave propagation time measured by the pulse wave propagation time measuring device and a change in hemodynamics measured by the hemodynamics measuring device, wherein the control device controls the blood pressure measuring device to measure the blood pressure on the basis of the amount of change and change trend in the pulse wave propagation time measured by the pulse wave propagation time measuring device, and the amount of change and change trend in the hemodynamics measured by the hemodynamics measuring device. Excerpt(s): The present invention relates to a blood pressure monitoring apparatus used in the fields where the continuous blood monitoring for the patient is required in the operation room, the intensive care unit, the emergency treatment room, or the artificial dialysis treatment room. Conventionally, the blood pressure monitoring apparatus for monitoring the blood pressure of the subject by measuring the blood pressure of the subject continuously is well known in which a cuff is wound around an upper arm portion or the like of the subject to make the noninvasive blood pressure measurement by an oscillometric method, or the artery of the subject is punctured to make the invasive blood pressure measurement. By the way, the conventional blood pressure monitoring apparatus had the following disadvantages. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Blood pressure monitoring device and method of manufacturing a parts mounting module of a blood pressure monitoring device Inventor(s): Hollinger, Stefan; (Kronberg, DE), Kressmann, Frank; (Schwalbach, DE), Giersiepen, Martin; (Oberursel, DE), Harttmann, Brigitte; (Niedernhausen, DE), Freund, Dirk; (Kelkheim, DE), Schnak, Fred; (Kronberg, DE), Rennefeld, Christoph; (Konigstein, DE), Hans, Rainer; (Waldems, DE), Ronneberg, Gerrit; (Darmstadt, DE), Heck, Ulrich; (Krefeld, DE) Correspondence: ERIC L. PRAHL; Fish & Richardson P.C. 225 Franklin Street; Boston; MA; 02110-2804; US Patent Application Number: 20020156382 Date filed: June 12, 2002
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Abstract: The invention is directed to a blood pressure monitoring device comprising a central parts mounting module and to a method of manufacturing this parts mounting module. According to the invention fluid channels are produced by gas injection into the interior of the parts mounting module, the walls bounding the fluid channels being completely formed by the material of the parts mounting module. The injection of gas continues for as long as a core of the parts mounting module is still in the liquid phase in the area of the fluid channel, whilst an outer area surrounding the core has already solidified, so that the pressure fluid expels the liquid core area, producing a tubular fluid channel. Excerpt(s): This invention relates to a blood pressure monitoring device with a fluid pressure system for filling a cuff with fluid under pressure and with a parts mounting module having bays for receiving components of the fluid pressure system, provision being made for at least one fluid channel integrated in the mounting module and serving the function of connecting the components. The present invention further relates to a method of manufacturing such a parts mounting module with a fluid channel extending in the interior thereof. Furthermore, the invention relates to a die for implementing the method. It is conventional practice to apply the cuff of a blood pressure monitoring device to a subject's limb, in particular to his or her upper arm or wrist, and inflate it until arterial occlusion sets in. The fluid pressure system provided for this purpose typically comprises a pump for cuff inflation, a valve for discharge of the pressure fluid, and a pressure sensor for detecting the cuff pressure from whose fluctuations caused by the blood pressure during the inflation and deflation cycles the blood pressure is then determinable by means of an evaluating unit. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Blood pressure monitoring device with inclination sensor Inventor(s): Heck, Ulrich; (Krefeld, DE), Ronneberg, Gerrit; (Darmstadt, DE), Hollinger, Stefan; (Kronberg, DE), Schnak, Fred; (Kronberg, DE), Freund, Dirk; (Kelkheim, DE), Giersiepen, Martin; (Oberursel, DE), Harttmann, Brigitte; (Niedernhausen, DE), Kressmann, Frank; (Schwalbach, DE) Correspondence: ERIC L. PRAHL; Fish & Richardson P.C. 225 Franklin Street; Boston; MA; 02110-2804; US Patent Application Number: 20030013976 Date filed: June 25, 2002 Abstract: The invention is directed to a wrist blood pressure monitoring device comprising a pressure sensor for detecting a pressure signal, an applicator unit for applying the pressure sensor against the wrist area of a subject's lower arm, an evaluating unit for evaluating the pressure signal, and an inclination detecting device for detecting the inclination of the blood pressure monitoring device and for delivering an electrical inclination signal corresponding to the inclination. According to the invention, the inclination detecting device comprises at least one movable, in particular pendulum-type positioning element and an inclination sensing device cooperating with the positioning element and including at least one sensing element movable with the positioning element and formed in particular by an optically reflecting, wedge-shaped arc section of the positioning element, and at least one further sensing element having in particular a reflected light barrier. The sensing elements are configured such that the electrical inclination signal is derivable from the relative position of the relatively movable sensing elements.
Patents 433
Excerpt(s): This invention relates to a blood pressure monitoring device according to the prior-art portion of claim 1. Blood pressure monitoring devices of this type include integrated in a housing a display device for indicating the blood pressure measurement values, a control device for controlling the individual components of the blood pressure monitoring device, a power source, a pumping device, and a valve for controlled air inflation and deflation in the bladder of a cuff, a pressure sensor for detecting a pressure signal, an evaluating device for evaluating the pressure signal, and an inclination detecting device preferably arranged in the interior of a housing of the blood pressure monitoring device for detecting the inclination of the blood pressure monitoring device relative to the horizontal and for delivering an electrical inclination signal indicative of the inclination, and, disposed on the housing, an applicator unit for applying the pressure sensor against a subject's limb in the wrist area of his or her lower arm. Blood pressure monitoring at a subject's wrist or finger frequently suffer from lack of measurement accuracy and insufficient repeatability. For one part, this may be attributable to the high sensitivity of the measurements to variations in the measuring position, that is, the individual position of the wrist or finger relative to the position of the heart. In the event of a measuring position deviating from heart level, the measurement result is corrupted by about 0.8 mm Hg/mm due to the hydrostatic pressure differential between the heart and the measuring position. An improper position during a measurement cycle hence produces a systematic measurement error. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Blood-pressure measurement apparatus capable of heart function assessment Inventor(s): Ogura, Toshihiko; (Komaki-shi, JP) Correspondence: OLIFF & BERRIDGE, PLC; P.O. BOX 19928; ALEXANDRIA; VA; 22320; US Patent Application Number: 20020188209 Date filed: May 13, 2002 Abstract: An apparatus for blood pressure measurement capable of heart function assessment for readily putting on a living subject, comprising an inflatable cuff including a pressure-pulse-wave sensor, which is combined into one body with the cuff at an upper-stream side end of the cuff, when wrapped around an upper-arm portion, so as to detect, at the upper-stream side than a blood-flow stopped position, the pressure-pulse-wave, which is of the same waveform as an aorta waveform while bloodflow is stopped, and an ejection time calculating means (a heart function parameter calculating means), by which an ejection time ET can be calculated as a time difference from a rising-point to a dicrotic notch of the pressure-pulse waveform for heart function assessment. Since a blood pressure BP also can be measured with the cuff, all the putting on the living subject, that is needed to measure the blood pressure and heart-function is to put on the cuff, which is combined with the pressure-pulse wave sensor, and to wrap the cuff around the upper-arm portion, therefore, putting-on becomes more simple and easier for measuring a heart function parameter and a blood pressure. Excerpt(s): The present invention relates in general to a blood-pressure measurement apparatus capable of heart function assessment. In order to diagnose a state of circulating system, a blood pressure is conventionally measured. Although a heart is one of circulatory organs, it is difficult to assess a heart function, only by measuring the blood pressure. Sometimes it is needed to assess the heart function as well as the blood pressure. In order to assess a heart function of a living subject, such heart function
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parameters are calculated as an ejection time, which is an actual period of ejecting blood from the heart, a pre-ejection period, which is a period from a start of cardiac muscle activity to actual starting of blood ejection, and a cardiac mechanical efficiency. These parameters can also be calculated based on a waveform of an aorta pressure-pulse. For example, the ejection time can be calculated based on a period from a rising point of an aorta pressure-pulse-waveform to a dicrotic notch of the same. Also, the pre-ejection period can be calculated based on a period from a Q-wave appearing point of an electrocardiogram to the rising point of the aorta pressure-pulse-waveform. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Blood-pressure measuring apparatus Inventor(s): Nishibayashi, Hideo; (Komaki-shi, JP) Correspondence: OLIFF & BERRIDGE, PLC; P.O. BOX 19928; ALEXANDRIA; VA; 22320; US Patent Application Number: 20030069507 Date filed: March 4, 2002 Abstract: A blood-pressure measuring apparatus including a cuff worn on a body portion of a subject to apply a pressure to the body portion; a changing device which changes the cuff pressure between a pressure lower than a systolic blood pressure of the body portion and higher than a mean blood pressure of the body portion, and a pressure lower than a diastolic blood pressure of the body portion; a determining device which determines a diastolic and a mean blood pressure of the subject based on a heartbeat-synchronous signal detected from the subject while the changing device changes the cuff pressure; a detecting device which detects a cuff pulse wave as an oscillation of the cuff pressure; a pulse-wave-magnitude determining device for operating the changing device to maintain the cuff pressure at a pressure lower than the mean blood pressure of the body portion, and determining a minimal, a mean, and a maximal magnitude of the cuff pulse wave detected in a state in which the cuff pressure is maintained at that pressure; and a systolic-blood-pressure determining device for determining a systolic blood pressure of the subject, based on the determined diastolic and mean blood pressure and the determined minimal, mean, and maximal magnitudes of the cuff pulse wave, according to a fact that the minimal, mean, and maximal magnitudes of the cuff pulse wave correspond to the diastolic, mean, and systolic blood pressure of the subject, respectively. Excerpt(s): The present invention relates to a blood-pressure measuring apparatus that measures a blood pressure with an inflatable cuff. There is widely known a bloodpressure measuring apparatus that includes an inflatable cuff adapted to be worn on a body portion of a living subject and measures a blood pressure of the subject by slowly changing a pressing pressure of the cuff. The blood-pressure measuring apparatus is operated according to any of various known blood-pressure measuring methods including a microphone method, an oscillometric method, and an ultrasonic Doppler method. In many cases, the pressing pressure of the cuff is slowly decreased to measure a blood pressure but, in some cases, the pressing pressure is slowly increased. In a conventional blood-pressure measuring apparatus that measures a blood pressure of a living subject with an inflatable cuff, first, a pressing pressure of the cuff is increased up to a target pressure that is estimated to be sufficiently higher than a systolic blood pressure of the subject, so that an artery located under the cuff can be completely occluded. If not, the systolic blood pressure of the subject cannot be measured. Thus, a
Patents 435
blood-pressure measurement causes a living subject to feel some pain. In particular, in the case where a blood pressure is measured using an inflatable cuff adapted to be worn on an ankle of a living subject, the subject feels more pain because of having a higher systolic blood pressure at the ankle. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Blood-pressure measuring apparatus and inferior-and-superior-limb blood-pressureindex measuring apparatus Inventor(s): Ogura, Toshihiko; (Komaki-shi, JP), Nunome, Tomohiro; (Komaki-shi, JP) Correspondence: OLIFF & BERRIDGE, PLC; P.O. BOX 19928; ALEXANDRIA; VA; 22320; US Patent Application Number: 20030163053 Date filed: October 7, 2002 Abstract: An apparatus for measuring a blood pressure of a living subject, including an inflatable cuff which has an inside surface adapted to contact a body surface of the subject and an outside surface exposed to an ambient air, and which is adapted to be wound around a portion of the subject to press the portion of the subject, a temperature sensor which is provided in the inside surface of the cuff and detects, in a state in which the cuff is wound around the portion of the subject, a temperature of the portion of the subject, and a display device which displays the temperature of the portion of the subject detected by the first temperature sensor. Excerpt(s): The present invention relates to a blood-pressure measuring apparatus which measures a blood pressure of a living subject, and an inferior-and-superior-limb blood-pressure-index measuring apparatus which measures an inferior-and-superiorlimb blood-pressure index of a living subject. A blood pressure of a living subject can be measured using an inflatable cuff which is wound around a portion of the subject, such as an upper or an ankle. For example, there are known a Korotkoff-sound bloodpressure measuring apparatus which determines, as a systolic and a diastolic blood pressure of a living subject, respective pressures of a cuff at respective times when the first and last Korotkoff sounds occur during decreasing of the cuff pressure, and an oscillometric blood-pressure measuring apparatus which determines a systolic and a diastolic blood pressure of a living subject, based on change of respective amplitudes of respective pulses of a pulse wave detected during changing of pressure of a cuff. Meanwhile, a body temperature of a peripheral portion of a living subject is lower than that of a central portion of the same. Therefore, an artery of the peripheral portion of the subject more contracts than that of the central portion of the same, under influence of the lower body temperature. Thus, when a blood pressure of the subject is measured using a cuff that is wound around the peripheral portion, the accuracy of measurement of the blood pressure is not so high. In particular, when an inferior-and-superior-limb blood-pressure index, i.e., the ratio of a superior-limb blood pressure to an inferior-limb blood pressure or the ratio of an inferior-limb blood pressure to a superior-limb blood pressure is measured to diagnose arteriostenosis, a cuff is wound around, e.g. an ankle to measure a blood pressure of the ankle. Thus, the accuracy of measurement of the ankle blood pressure or the inferior-and-superior-limb blood-pressure index obtained therefrom may be lowered by the influence of temperature of the ankle or the leg. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Blood-pressure measuring apparatus for patient under blood-dialysis treatment Inventor(s): Inukai, Hidekatsu; (Komaki-shi, JP), Oka, Tohru; (Komaki-shi, JP) Correspondence: Oliff & Berridge PLC; P.O. Box 19928; Alexandria; VA; 22320; US Patent Application Number: 20010012917 Date filed: December 28, 2000 Abstract: An apparatus for iteratively measuring a blood pressure of a living subject who is undergoing a blood-dialysis treatment, including an inflatable cuff which applies a pressing force to a body portion of the subject, a blood-pressure measuring device which measures a blood pressure of the subject by changing the pressing force of the cuff, a starting device for starting the blood-pressure measuring device at a predetermined period in the dialysis duration, so that the blood-pressure measuring device iteratively measures a blood pressure of the subject at the predetermined period, a period memory device which stores, for a plurality of living subjects including the subject, a plurality of sets of predetermined periods each set of which includes respective predetermined periods for a plurality of partial durations of the dialysis duration, an identifying device for identifying the subject, and a selecting device for selecting, from the sets of predetermined periods stored in the period memory device, the set of predetermined periods for the subject, so that the starting device starts, in each of the partial durations of the dialysis duration, the blood-pressure measuring device at a corresponding one of the predetermined periods of the selected set, and the bloodpressure measuring device iteratively measures a blood pressure of the subject in the each of the partial durations of the dialysis duration at the corresponding one of the predetermined periods of the selected set. Excerpt(s): The present invention relates to an apparatus for iteratively measuring a blood pressure of a living subject who is undergoing a blood-dialysis treatment. When a patient is undergoing a blood-dialysis treatment, the dynamic condition of his or her circulatory system may largely change and accordingly his or her blood pressure may largely change. The measurement of blood pressure of the patient under the dialysis treatment is usually carried out by not an invasive method in which blood pressure (BP) values can be continuously measured but a so-called Korotkoff-sound-type or oscillometric-type automatic BP measuring apparatus in which a BP value or values are determined based on the change of Korotkoff sounds, or the change of respective amplitudes of heartbeat-synchronous pulses of pulse wave, detected during the change of pressing pressure of a pressing belt (e.g., a cuff) applied to a body portion of the patient. However, each of the conventional automatic BP measuring apparatuses can obtain a BP value or values, only at a predetermined BP-measurement period. Therefore, if the BP values of the patient under the dialysis treatment significantly largely change immediately after the measuring apparatus measures a BP value or values in one BP measuring operation, the apparatus cannot detect any significant changes (e.g., decreases) of the BP values of the patient, until the measuring apparatus performs the following BP measuring operation after the predetermined BPmeasurement period, which may be considerably long. On the other hand, if the BP measuring apparatus measures, in the entire duration of the dialysis treatment, a BP value or values at a BP-measurement period which is so short as to be able to detect any abrupt change of the BP values of the patient, the frequency at which the pressing belt presses the body portion of the patient is increased as such, which leads to increasing the burden exerted to the patient and even producing congestion in the body portion, which, in turn, introduces errors into the BP values measured. Meanwhile, a doctor or a nurse can estimate, from his or her experiences, a specific partial duration, in the entire
Patents 437
duration of dialysis treatment, in which the BP values of the patient may largely decrease, i.e., the BP measuring operations should be performed at a short period. Therefore, it has been generally practiced that the doctor or nurse modifies the BPmeasurement-start period to a shorter period at a time around the start of the specific partial duration, and returns the shorter period to the initial, longer period at the end of the specific partial duration. In addition, there is known an apparatus which can employ respective BP-measurement-start periods for a plurality of partial durations in the entire duration of dialysis treatment, such that one of the periods that corresponds to a specific partial duration in which BP values of a patient may largely decrease is shorter than the period or periods for the other partial duration or durations. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Blood-pressure monitoring apparatus for use in dialysis, and dialyzing apparatus Inventor(s): Sato, Atsushi; (Komaki-shi, JP) Correspondence: OLIFF & BERRIDGE, PLC; P.O. BOX 19928; ALEXANDRIA; VA; 22320; US Patent Application Number: 20020193691 Date filed: February 12, 2002 Abstract: A blood-pressure monitoring apparatus for use with a dialyzing device, including a blood-pressure-related-information obtaining device which iteratively obtains, from a patient who is undergoing a dialysis operation of the dialyzing device, a piece of blood-pressure-related information that can change in relation with a blood pressure of the patient, a change-value determining device for determining a change value representing a change of each piece of blood-pressure-related information iteratively obtained by the blood-pressure-related-information obtaining device, a memory device which stores, for the patient, a plurality of prescribed threshold values corresponding to a plurality of prescribed periods of an entire duration of the dialysis operation, at least one of the threshold values that corresponds to at least one of the prescribed periods being smaller than the other threshold values, the blood pressure of the patient being more likely to lower during the one period of the entire duration, than during the other periods of the entire duration, and a judging device for judging that the blood pressure of the patient is abnormal, when the change value determined by the change-value determining device is greater than one of the threshold values that corresponds to one of the prescribed periods that includes a dialysis time, measured from a commencement of the dialysis operation, when the each piece of blood-pressurerelated information is obtained by the blood-pressure-related-information obtaining device. Excerpt(s): The present invention relates to a blood-pressure monitoring apparatus for use in dialysis that continuously monitors change of blood pressure of a patient during a dialysis treatment, and to a dialyzing apparatus including the blood-pressure monitoring apparatus. Since blood pressure of a patient who is undergoing a dialysis treatment may largely lower, there is a need to monitor the blood pressure. A bloodpressure measuring method using a cuff is preferable with respect to reliability. However, when the cuff is used to measure the blood pressure, it is needed to increase a pressure in the cuff up to a value higher than a systolic blood pressure of the patient. Thus, the patient feels discomfort, and accordingly blood-pressure measuring operations each using the cuff cannot be carried out so frequently. Hence, there has been proposed a blood-pressure monitoring apparatus which successively obtains a piece of
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blood-pressure-related information that is related to blood pressure of a patient, successively determines an estimated blood pressure of the patient based each piece of blood-pressure-related information, and monitors, based on change of each estimated blood pressure, blood pressure of the patient who is undergoing a dialysis treatment. This blood-pressure monitoring apparatus is disclosed in, e.g., Japanese patent document No. 10-043147 or its corresponding U.S. Pat. No. 5,752,920. The monitoring apparatus iteratively determines an estimated blood pressure based on a pulse-wave propagation velocity at which a pulse wave propagates in patient's body. If change of the estimated blood pressure is greater than a prescribed threshold value, indicating that patient's blood pressure may be abnormal, then the monitoring apparatus carries out a blood-pressure measuring operation using a cuff to obtain a more reliable bloodpressure value of the patient. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Blood-pressure-waveform monitoring apparatus Inventor(s): Oka, Tohru; (Ichinomiya-shi, JP) Correspondence: OLIFF & BERRIDGE, PLC; P.O. BOX 19928; ALEXANDRIA; VA; 22320; US Patent Application Number: 20020161305 Date filed: December 28, 2001 Abstract: An apparatus for monitoring a blood-pressure waveform representing a blood pressure of a living subject, including a cuff which is around a portion of the subject, a blood-pressure determining device which determines a blood pressure of the subject based on a signal obtained while a pressure in the cuff is changed, a blood-pressurewaveform detecting device which continuously detects the blood-pressure waveform, a display device which displays the blood-pressure waveform, a cuff-using-bloodpressure-measure- ment starting device for operating, when a prescribed bloodpressure-measurement-starting condition is satisfied, the blood-pressure determining device to determine the blood pressure of the subject, a pulse-wave detecting device which is adapted to be worn on a portion of the subject that is not located on a downstream side of the portion around which the cuff is wound, an estimated-bloodpressure-wavef- orm determining device for continuously determining, based on the pulse wave detected by the pulse-wave detecting device, a estimated blood-pressure waveform representing an estimated blood pressure of the subject, according to a predetermined relationship between blood-pressure waveform and pulse wave, and a waveform-displaying control device for operating, when the blood-pressure waveform is not abnormal, the display device to display the blood-pressure waveform, and operating, when the blood-pressure waveform is abnormal, the display device to display the estimated blood-pressure waveform. Excerpt(s): The present invention relates to a blood-pressure-waveform monitoring apparatus which continuously displays a waveform representing blood pressure of a living subject. During a surgical operation, or in an intensive care unit, a blood-pressurewaveform monitoring apparatus may be used to continuously monitor blood pressure of a patient. The blood-pressure-waveform monitoring apparatus includes a bloodpressure-waveform detecting device which continuously detects a blood-pressure waveform from the patient, and a display device which displays the blood-pressure waveform detected by the blood-pressure-waveform detecting device. The bloodpressure-waveform detecting device may be one which employs a tonometry in which a
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pressure-pulse-wave sensor is used to detect a blood-pressure waveform, or one which employs a catheter method in which a catheter is used to detect a blood-pressure waveform. In the tonometry, the pressure-pulse-wave sensor is fixed above an artery, such as a radial artery, that is considerably near to skin, and is pressed with an appropriate force against the artery via the skin to detect a pressure pulse wave that is produced by pulsation of the artery in synchronism with heartbeat of the patient. The thus detected pressure pulse wave represents relative change of blood pressure in the artery, and therefore represents a blood-pressure waveform. Meanwhile, the cathetertype pressure-waveform detecting device requires a person to invasively insert the catheter into an artery of the patient so that a pressure-converting element in the catheter can directly detect blood pressure in the artery. Thus, the tonometry-type pressure-waveform detecting device can accurately measure relative change of the intraarterial blood pressure, but cannot accurately measure absolute blood pressure because of visco-elasticity of the skin or subcutaneous tissue located above the artery. Hence, it is needed to wind a cuff around an upper arm of the patient, measure a blood pressure of the upper arm of the patient using the cuff, and calibrate the relative change of intraarterial blood pressure based on the thus measured upper-arm blood pressure. This calibration is periodically performed since the pressure-pulse wave sensor may be moved out of position. In addition, when the blood pressure detected by the pressurepulse-wave sensor is judged as being abnormal, a blood-pressure measurement using the cuff may be started to obtain a more reliable blood-pressure value. Meanwhile, the catheter-type pressure-waveform detecting device usually requires a person to insert the catheter into a considerably distal portion of a peripheral artery of a patient and, in an emergency, a cuff may be needed to be wound around an upper arm of the patient so as to obtain a central-side blood-pressure value of the patient. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Central blood pressure waveform estimation device and peripheral blood pressure waveform detection device Inventor(s): Amano, Kazuhiko; (Yokohama-shi, JP) Correspondence: OLIFF & BERRIDGE, PLC; P.O. BOX 19928; ALEXANDRIA; VA; 22320; US Patent Application Number: 20020177781 Date filed: April 17, 2002 Abstract: A central blood pressure waveform estimation device has a pulse wave detection section, a transfer function storage section, and a central blood pressure waveform calculation section. The pulse wave detection section non-invasively detects a peripheral pulse wave. The transfer function storage section stores a transfer function calculated in advance based on a peripheral pulse waveform detected by the pulse wave detection section and a central blood pressure waveform invasively measured. The central blood pressure waveform calculation section calculates a central blood pressure waveform based on a peripheral pulse waveform newly detected by the pulse wave detection section and the transfer function stored in the transfer function storage section. Excerpt(s): Japanese Patent Application No. 2001-121583 filed on Apr. 19, 2001, is hereby incorporated by reference in its entirety. The present invention relates to a central blood pressure waveform estimation device and a peripheral blood pressure waveform detection device. A central blood pressure, specifically, a blood pressure and a blood pressure waveform in the origin of the aorta can be important information for treatment
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policy planning, post-operative or post-treatment management, intensity management in ergotherapy, and the like for patients suffering from a heart disease. However, it is difficult to non-invasively measure the central blood pressure. In particular, it is very difficult to measure the central blood pressure when the patient takes exercise or the like. Because of this, the central blood pressure and the blood pressure waveform are not generally utilized in clinical applications. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Circulation dynamics measuring apparatus, circulation dynamics measuring method, blood pressure measuring method and circulation dynamics sensor Inventor(s): Nakamura, Takashi; (Chiba-shi, JP), Yamamoto, Minao; (Chiba-shi, JP), Nakamura, Takahiko; (Chiba-shi, JP), Shinogi, Masataka; (Chiba-shi, JP), Muramatsu, Hiroyuki; (Chiba-shi, JP) Correspondence: ADAMS & WILKS; 50 Broadway; 31st Floor; New York; NY; 10004; US Patent Application Number: 20030191399 Date filed: April 2, 2003 Abstract: When a wave is noninvasively inputted through a surface of a living body to be reflected by a body fluid flowing through the living body, and the state of blood and the like is analyzed on the basis of the motion and the position to obtain circulation information in order to evaluate the health state, the circulation information can be accurately measured irrespective of the degree of strain of a blood vessel of a part to be measured in the living body. In a circulation dynamics measuring apparatus having a circulation sensor portion for transmitting/receiving a wave to/from the inside of the living body through a surface of the living body, and a processing portion for calculating a circulation dynamics from the received wave, the circulation sensor portion has a portion for measuring a blood pressure and a portion for measuring a blood flow rate, and information concerned with viscosity of blood is calculated by the processing portion. Excerpt(s): The present invention relates in general to an apparatus for measuring a body fluid circulating a living body, and a tissue constituting a circulatory organ, and the sensor technology. In particular, the invention relates to a technology for grasping a state of blood in a distal end part to carry out an evaluation of health, a diagnosis of a disease, an evaluation of medicines, and the like. Heretofore, for the purpose of carrying out the evaluation of health of a living body, the diagnosis of a disease, the grasping of an influence of medicines exerted on a living body, and the like, there have been made various methods of utilizing an information of the blood. In terms of a medical treatment for example, there is a method in which the blood is collected from a living body, and the blood concerned is applied to a component analyzer to obtain a circulation information from a rate of the various blood components contained in the blood to thereby evaluate the health state, and the like. Here, a circulation dynamics means a state in which the blood and a lymph fluid which are moved through the inside of the circulatory organ to supply tissues and cells of a living body with oxygen and nutrition to carry carbon dioxide gas and wastes away vary continuously with time. For example, a blood flow rate, a change in blood flow, a flow property, a pulse wave and the like correspond to the circulation dynamics. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Patents 441
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Compositions and methods for alleviating hypertension or preventing a rise in blood pressure Inventor(s): Ochiai, Ryuji; (Chuo-ku, JP), Suzuki, Atsushi; (Chuo-ku, JP), Tokimitsu, Ichiro; (Chuo-ku, JP) Correspondence: OBLON SPIVAK MCCLELLAND MAIER & NEUSTADT PC; FOURTH FLOOR; 1755 JEFFERSON DAVIS HIGHWAY; ARLINGTON; VA; 22202; US Patent Application Number: 20020051810 Date filed: August 7, 2001 Abstract: Products and compositions for preventing or reducing the severity of hypertension. These products contain (a) ferulic acid or a ferulate ester, and (b) caffeic acid and/or a chlorogenic acid. The preventive or remedy can suppress a rise in blood pressure and alleviate hypertension, and is usable as a food. Excerpt(s): The present invention relates to products and compositions that prevent, remedy or reduce the severity of hypertension and that are capable of suppressing a rise in blood pressure. Hypertension in Japan ranks first among reasons why patients attend hospitals. According to the National Life Fundamental Survey of Ministry of Health and Welfare (fiscal 1998), in Japan, 64 patients per 1000 were admitted to hospitals for hypertension. Heart diseases such as angina pectoris, myocardial infarction and heart failure and cerebrovascular diseases such as cerebral infarction, cerebral hemorrhage and subarachnoid hemorrhage are closely related to hypertension and rank second and third, respectively, among the causes of death of the Japanese. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Continuous blood-pressure monitoring apparatus Inventor(s): Oka, Tohru; (Ichinomiya-shi, JP) Correspondence: OLIFF & BERRIDGE, PLC; P.O. BOX 19928; ALEXANDRIA; VA; 22320; US Patent Application Number: 20020147401 Date filed: December 28, 2001 Abstract: An apparatus for continuously monitoring a blood pressure of a subject, comprising a cuff; a device for determining a blood pressure of the subject based on a signal obtained while the cuff pressure is changed; a device for determining a relationship between blood pressure and pressure pulse wave, based on a determined blood pressure and a detected magnitude of a first-artery pressure pulse wave; a device for iteratively determining, according to the relationship, a monitor blood pressure based on a magnitude of each pulse of the first-artery pressure pulse wave; a sensor which detects a second-artery pressure pulse wave from a second artery and produces a pressure-pulse-wave signal representing the second-artery pressure pulse wave; a device for extracting, from the pressure-pulse-wave signal, a heart-sound component representing heart sounds; a device for iteratively obtaining a piece of pulse-wavepropagation-velocity-related information, based on a time of occurrence of a periodic point of a pulse of the heart-sound component and a time of occurrence of a periodic point of a corresponding pulse of the second-artery pressure pulse wave; a device for periodically determining a change value of the pieces of information; a device for periodically determining a change value of the monitor blood-pressure values; and a
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device for comparing the change value of the pieces of information and the change value of the monitor blood-pressure values, with each other, and thereby judging whether the relationship is appropriate. Excerpt(s): The present invention relates to a continuous blood-pressure monitoring apparatus which includes a pressure-pulse-wave sensor adapted to be pressed against an artery of a living subject via the skin and continuously monitors blood pressure of the subject based on a pressure pulse wave detected by the sensor. There is known a continuous blood-pressure monitoring apparatus which includes an inflatable cuff adapted to be worn on a portion of a living subject; a blood-pressure determining means for determining a blood pressure of the subject based on a signal obtained while a pressure in the cuff is slowly changed; a relationship determining means for determining, in advance, a relationship between blood pressure and magnitude of pressure pulse wave, based on the blood pressure determined by the blood-pressure determining means and a magnitude of a pressure pulse wave detected from an artery of the subject; and a blood-pressure monitoring means for successively determining, according to the thus determined relationship, a blood-pressure value of the subject based on each of respective magnitudes of the pressure pulse wave detected from the artery. Since the blood-pressure values successively determined by the continuous blood-pressure monitoring apparatus are very highly reliable, the apparatus can be used in those cases in which strict blood-pressure monitoring is needed. This apparatus is disclosed in, e.g., Japanese Utility Model Document No. 2-82309 or its corresponding U.S. Pat. No. 5,139,026. In the conventional continuous blood-pressure monitoring apparatus, disclosed in the above-indicated document, a pressure-pulse-wave detecting device for detecting the pressure pulse wave employs a pressure-pulse-wave sensor which is worn on a wrist of a living subject and is pressed against a radial artery of the wrist. In this case, a condition under which the pressure-pulse-wave sensor is pressed against the artery may be changed by, e.g., a change of a state in which the sensor is worn, caused by a physical motion of the subject. Hence, in order to increase the reliability of blood-pressure values determined by the blood-pressure monitoring means, a calibration is periodically carried out to update the relationship between blood pressure and magnitude of pressure pulse wave. In each calibration, the blood-pressure determining means determines a new blood pressure of the subject in a process in which the pressure of the cuff is changed in a prescribed manner, and the relationship determining means determines a new relationship between blood pressure and magnitude of pressure pulse wave, based on the new blood pressure determined by the blood-pressure determining means and a magnitude of the pressure pulse wave detected by the pressure-pulse-wave sensor during the above-indicated process. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Continuous non-invasive blood pressure monitoring method and apparatus Inventor(s): Chen, Yunquan; (Delta, CA), Li, Luya; (Coquitlam, CA), Dill, Ryan Peter; (Vancouver, CA), Hershler, Cecil; (Vancouver, CA) Correspondence: CROMPTON, SEAGER & TUFTE, LLC; Suite 895; 331 Second Avenue South; Minneapolis; MN; 55401-2246; US Patent Application Number: 20020058876 Date filed: July 27, 2001 Abstract: A non-invasive apparatus and method for monitoring the blood pressure of a subject detects a pulse signal at both a first and second location on the subject's body.
Patents 443
The elapsed time between the arrival of corresponding points of the pulse signal at the first and second locations is determined. Blood pressure is related to the elapsed time by relationships such as:P=a+b 1n (2)where a and b are constants dependent upon the nature of the subject and the signal detecting devices. The system can be calibrated by measuring a single pair of reference blood pressure and corresponding elapsed time. Excerpt(s): This application claims the benefit of the filing dates of U.S. provisional patent application No. 60/178,027 filed on Jan. 26, 2000 and of PCT international application No. PCT/CA00/0152 filed on Dec. 22, 2000 and entitled CONTINUOUS BLOOD PRESSURE MONITORING METHOD AND APPARATUS. Various approaches have been tried for monitoring the blood pressure of living subjects. One approach is to insert a pressure sensor directly into a suitable artery in the subject. The sensor can be connected to a suitable monitoring device by a lead which passes through the subject's skin. This approach provides accurate and instantaneous blood pressure measurements. A disadvantage of this approach is that it is invasive. A surgical procedure is required to introduce the pressure sensor. The fistula through which the lead exits the subject's body can provide a pathway for infection. Another approach to measuring blood pressure uses a sphygmomanometer. A typical sphygmomanometer has an occluding cuff capable of being wrapped around a subject's arm; a pump for inflating the cuff; either an aneroid or mercury gravity sphygmomanometer to measure pressure in the cuff; and a stethoscope or other system for detecting Korotkoff sounds. Such devices are widely used in hospitals and doctors' offices for making routine blood pressure measurements but are not well adapted to providing continuous blood pressure monitoring. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
CONTINUOUS, NON-INVASIVE TECHNIQUE FOR MEASURING BLOOD PRESSURE USING IMPEDANCE PLETHYSMOGRAPHY Inventor(s): Kolluri, Sai; (Tampa, FL), Friedman, Bruce A. (Tampa, FL), Medero, Richard; (Tampa, FL), Hersh, Lawrence T. (Tampa, FL) Correspondence: QUARLES & BRADY LLP; 411 E. WISCONSIN AVENUE; SUITE 2040; MILWAUKEE; WI; 53202-4497; US Patent Application Number: 20030167012 Date filed: March 1, 2002 Abstract: Blood pressure is measured using the pulse transit time required for the blood volume pulse to propagate between two locations in an animal. Impedance plethysmography is employed to detect when the blood volume pulse occurs at one location. The plethysmograph may detect thoracic impedance to determine when the aortic heart valve opens or it may detect impedance at one location on a limb of the animal. Occurrence of the blood volume pulse at another location can be determined by impedance plethysmography or another technique, such as pulse oximetry. The calculation of cardiac stroke volume can be employed to compensate the derivation of the blood pressure for effects due to blood vessel compliance. A nonblood pressure monitor may periodically provide a reference blood pressure measurement that is used calibrate derivation of the blood pressure based on the pulse transit time. Excerpt(s): The invention generally relates to apparatus and methods for measuring blood pressure in animals, and more particularly continuous nonblood pressure measurement apparatus and methods. In the case of a hospitalized patient, it is
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frequently desired to be able to measure the blood pressure on a continuous basis. A very reliable technique for continuously measuring blood pressure is to insert a saline filled catheter through the patient's vascular system to the point at which it is desired to perform the measurements. The catheter is connected to a pressure sensor, which measures the pressure in the vessel. An alternative method uses a catheter with a pressure sensor at the tip that directly senses the blood pressure. However these techniques involve making an incision through the patient's skin and inserting the catheter into a blood vessel. As a consequence, this invasive procedure entails some risk of complications for the patient. An indirect, non-invasive process for continuously measuring blood pressure is based on the pulse transit time (PTT) which is the time required for a blood pressure pulse from the heart beat to propagate between two points in the vascular system. One apparatus for this technique includes an electrocardiograph which senses electrical signals in the heart to provide an indication when a blood pulse enters the aorta. A pulse oximeter is placed on an index finger of the patient to detect when the blood pressure pulse reaches that location. The pulse transit time between the heart and the index finger is measured and calibrated to the existing blood pressure that is measured by another means, such as by the automated oscillometric method. Thereafter changes in the pulse transit time correspond to changes in the blood pressure. Generally the faster the transit time the higher the blood pressure. Thus changes in the pulse transit time can be equated to changes in the blood pressure. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Cuff for blood pressure monitor Inventor(s): Taniguchi, Minoru; (Kyoto-shi, JP), Sano, Yoshihiko; (Kyoto-shi, JP), Inagaki, Takashi; (Kyoto-shi, JP) Correspondence: Barry E. Bretschneider; Morrison & Foerster LLP; Suite 300; 1650 Tysons Boulevard; McLean; VA; 22102; US Patent Application Number: 20030171683 Date filed: February 3, 2003 Abstract: The invention provides a variety of cuff design for blood pressure monitor, which assures an easy and firm fitting to an arm of a patient. Specifically, the curled elastic member of the cuff is overlapped at both end portions for easy fitting. The rigidity and thickness of the curled elastic member are designed to follow the shape of the upper arm of the patient, which significantly varies in size depending on the location of the arm. Excerpt(s): This application is a continuation-in-part of Ser. No. 10/047,994, filed Jan. 17, 2002. The present invention relates to a cuff for a blood pressure monitor and, more particularly, to a cuff characterized by a curled elastic member disposed on the outside of a bladder to hold a ring form of the cuff. 1. Operation of uncurling the curled elastic member 92 to be attached on an arm is not easy. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Cuff of wrist-mount blood pressure monitor Inventor(s): Kato, Hiroyuki; (Kyoto-shi, JP), Tanaka, Takahide; (Kyoto-shi, JP), Oku, Shojiro; (Kyoto-shi, JP), Yamakoshi, Ken-Ichi; (Kanazawa-shi, JP), Sano, Yoshihiko; (Kyoto-shi, JP) Correspondence: Barry E. Bretschneider; Morrison & Foerster LLP; Suite 5500; 2000 Pennsylvania Avenue, N.W. Washington; DC; 20006-1888; US Patent Application Number: 20020170359 Date filed: May 1, 2002 Abstract: A cuff of a wrist-mount blood pressure monitor capable of oppressing an artery of the wrist securely without having effects of muscle, tendon or bone existing in the wrist area is presented. This cuff 10 of a wrist-mount blood pressure monitor comprises a first air bag 14A as a first inflatable portion, and a second air bag 16A as a second inflatable region disposed between the first inflatable portion 14A and the wrist, being made of a material of a higher stretchability than the material for the first air bag 14A. Excerpt(s): The present invention relates to a cuff of a blood pressure monitor for measuring the blood pressure as being mounted on the body of a subject, and more particularly relates to a structure of the cuff of a wrist-mount blood pressure monitor used in a wrist-mount blood pressure monitor for measuring the blood pressure on the wrist. A display 103 and a start switch 104 are provided on the outer surface of the main body 101, and a pressure sensor 105, a pressurizing pump 106, an exhaust valve 107, and a CPU 108 for controlling these devices are provided in its inside. The cuff 102 of wristmount blood pressure monitor comprises an air bag 109 for collecting the air sent out from the pressurizing pump 106 and oppressing an artery of the wrist, a band 110 having the air bag 109 disposed at its inner side for mounting on the wrist, and a fastener 111 for winding and fixing the band 110 on the wrist. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Dipeptidyl peptidase IV inhibitors and their uses for lowering blood pressure levels Inventor(s): Pederson, Ray A. (Vancouver, CA), Hoffmann, Matthias; (Weingelsdorf, DE), McIntosh, Christopher H. S. (Vancouver, CA), Glund, Konrad; (Halle, DE), Demuth, Hans-Ulrich; (Halle, DE), Pospisilik, Andrew J. (Vancouver, CA) Correspondence: BROWN, RUDNICK, BERLACK & ISRAELS, LLP. BOX IP, 18TH FLOOR; ONE FINANCIAL CENTER; BOSTON; MA; 02111; US Patent Application Number: 20030176357 Date filed: July 23, 2002 Abstract: The present invention provides new uses of DPIV-inhibitors of the present invention, and their corresponding pharmaceutically acceptable acid addition salt forms, for lowering blood pressure levels. Excerpt(s): This application is a continuation in part of U.S. application Ser. No. 09/932,546 filed Aug. 17, 2001 which claims the benefit from U.S. application Ser. No. 09/155,833, which is incorporated by reference in its entirety. The present invention relates to inhibitors of dipeptidyl peptidase IV and dipeptidyl peptidase IV-like enzyme activity and, more particularly, pharmaceutical compositions containing said compounds, and the use of said compounds for lowering blood pressure levels in
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mammals and related disorders. Dipeptidyl peptidase IV (DPIV) is a serine protease which cleaves N-terminal dipeptides from a peptide chain containing, preferably, a proline residue in the penultimate position. Although the biological role of DPIV in mammalian systems has not been completely established, it is believed to play an important role in neuropeptide metabolism, T-cell activation and the entry of HIV into lymphoid cells. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
DISPOSABLE NON-INVASIVE BLOOD PRESSURE SENSOR Inventor(s): Evans, Kevin R. (New Richmond, WI), Thede, Roger C. (Afton, MN) Correspondence: KINNEY & LANGE, P.A. THE KINNEY & LANGE BUILDING; 312 SOUTH THIRD STREET; MINNEAPOLIS; MN; 55415-1002; US Patent Application Number: 20030158487 Date filed: February 21, 2002 Abstract: A non-invasive blood pressure measurement device is used for determining blood pressure of an artery. The device comprises a housing unit, a base unit and a sensing unit. The base unit is pivotally connected to the housing unit and comprises electrical circuitry, a flexible ring, and a receptacle. The sensing unit comprises a pressure transducer for sensing pulses of the underlying artery, the transducer having a sensing surface, a flexible diaphragm having an active portion for transmitting blood pressure pulses of the underlying artery, interface means coupled between the sensing surface of the transducer and the flexible diaphragm for transmitting the blood pressure pulses within the underlying artery from the flexible diaphragm to the sensing surface of the transducer, a compressible ring, and connection means for detachably connecting the sensing unit to the receptacle of the base unit. Excerpt(s): None. The present invention relates to systems and devices for measuring arterial blood pressure. In particular, the invention relates to a two-piece sensor interface assembly for a non-invasive blood pressure measurement device, including a disposable sensing unit. There has been a continuing need for devices which will measure blood pressure non-invasively and have accuracy comparable to invasive methods. Medwave, Inc. the assignee of the present invention, has developed non-invasive blood pressure measurement devices which are described in the following United States patents: U.S. Pat. No. 5,450,852 entitled CONTINUOUS NON-INVASIVE PRESSURE MONITORING SYSTEM; U.S. Pat. No. 5,640,964 entitled WRIST MOUNTED BLOOD PRESSURE SENSOR; U.S. Pat. No. 5,642,733 entitled BLOOD PRESSURE SENSOR LOCATOR; U.S. Pat. No. 5,649,542 entitled CONTINUOUS NON-INVASIVE BLOOD PRESSURE MONITORING SYSTEM; U.S. Pat. No. 5,720,292 entitled BEAT ONSET DETECTOR; U.S. Pat. No. 5,722,414 entitled CONTINUOUS NON-INVASIVE BLOOD PRESSURE MONITORING SYSTEM; U.S. Pat. No. 5,738,103 entitled SEGMENTED ESTIMATION METHOD; U.S. Pat. No. 5,797,850 entitled METHOD AND APPARATUS FOR CALCULATING BLOOD PRESSURE OF AN ARTERY; U.S. Pat. No. 5,941,828 entitled HAND-HELD NON-INVASIVE BLOOD PRESSURE MEASUREMENT DEVICE; U.S. Pat. No. 6,159,157 entitled BLOOD PRESSURE MEASUREMENT DEVICE WITH SENSOR LOCATOR; and U.S. Pat. No. 6,241,679 entitled NON-INVASIVE BLOOD PRESSURE SENSING DEVICE AND METHOD USING TRANSDUCER WITH ASSOCIATE MEMORY. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Drinking carbonated water for the use of reducing high blood pressure and edema Inventor(s): Bida, Sam; (Ely, NV) Correspondence: Sam Bida; 2160 Crawford Street; Ely; NV; 89301; US Patent Application Number: 20020098263 Date filed: January 25, 2001 Abstract: By taking carbonated water orally each day it aids in the reduction of high blood pressure and edema. To use this invention a person would orally drink 5 oz. of the carbonated water in the morning and another 5 oz. in the evening for the reduction of high blood pressure and edema. Excerpt(s): This invention pertains to home health remedy. Many prescription drugs are sold each year for the control of high blood pressure and edema. The drugs which are prescribed for these aliments have many unhealthy side effects. My invention entails a person who is plagued by either or both high blood pressure and edema to take along with any medication that they may be on in order to help with the reduction of both high blood pressure and edema. By orally drinking the carbonated water daily, high blood pressure and edema is reduced. The advantage of this invention is that it may be taken along with any and all prescription and non-prescription medications while aiding in the reduction of high blood pressure and edema without the side effects caused by some prescription and non-prescription drugs. Not Applicable. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Electronic blood pressure monitor Inventor(s): Shirasaki, Osamu; (Kyoto-shi, JP) Correspondence: MORRISON & FOERSTER LLP; 1650 TYSONS BOULEVARD; SUITE 300; MCLEAN; VA; 22102; US Patent Application Number: 20030181816 Date filed: February 10, 2003 Abstract: Provided is an electronic blood pressure monitor capable of realizing functions of blood pressure measurement in a shorter time and blood pressure measurement with more of correctness in the same and one construction thereof. The electronic blood pressure monitor includes: an oscillometric measuring section capable of calculating a blood pressure with a high precision using much of biogenic information though a time is required since a blood pressure is calculated during a period in which the cuff pressure is gradually changed; and an SPD measuring section completing measurement in a short time though a fluctuation in precision of measurement arises according to an individual difference with less of biogenic information since a blood pressure is calculated using only one or several pulse waves. Since the oscillometric measuring portion performs a calibration processing for the SPD measuring section simultaneously during measurement thereof, a complicated calibrating operation can be practically excluded. Since the same electronic blood pressure monitor has integrally the two kinds of blood pressure measuring functions, different in operation and feature from each other, economy and convenience can be enjoyed without a necessity for separate purchases of two electronic blood pressure monitors with the respective different two kinds of blood pressure measuring functions.
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Excerpt(s): The present invention relates to an electronic blood pressure monitor, and more particularly to an electronic blood pressure monitor using a pressurizing section (hereinafter referred to as a "cuff") for pressurizing a portion in one of four limbs and others of a mammal by injecting a fluid such as air thereinto. Among methods measuring a blood pressure using a cuff, there has been available a method in which various kinds of arterial signals (hereinafter referred to as "pulse waves") originated from changes in inner volume of an artery around which a pressure is applied with the cuff are captured in the course during which a pressure in the cuff (hereinafter referred to as a "cuff pressure") is gradually changed to calculate and determine a blood pressure based on the captured pulse waves. This method is called an oscillometric method. The CPU 1A of the microprocessor 1 controls other sections. The pressurizing section 5 has a pressure pump, by which the cuff 2 is pressurized to a predetermined cuff pressure. The gradual pressure reduction section 3 has a valve for reducing a cuff pressure. While the valve is closed during pressurization of the cuff 2, it works so as to gradually reduce a cuff pressure when being opened. The rapid discharging section 4 has a valve for reducing a cuff pressure. While the valve is closed during pressurization of the cuff 2, it works so as to rapidly reduce a cuff pressure when being opened. The cuff pressure detecting section 6 has a pressure sensor to detect a cuff pressure. The pulse wave detecting section 7 detects a pulse wave. The amplifying circuit-AD converters 8 and 9 amplify signals outputted from the cuff pressure detecting section 6 and the pulse wave detecting section 7, respectively, to convert the signals to digital values and to give the digital values to the microprocessor 1. The microprocessor 1 processes given data to calculate a blood pressure value and to output a result of the calculation through the output interface 11. The input interface 10 is constituted of switches, buttons and others and installed so as to enable to be externally operable by a user. The output interface 11 is constituted of a display section for displaying information; a printer for printing the information; a speech output section for outputting the information in speech; and others. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Electronic blood pressure monitor and blood pressure data processing system Inventor(s): Sakai, Kiyoshi; (Kyoto-shi, JP), Nakazawa, Fumio; (Kyoto-shi, JP), Takizawa, Koichi; (Kyoto-shi, JP) Correspondence: Barry E. Bretschneider; Morrison & Foerster LLP; Suite 300; 1650 Tysons Blvd. McLean; VA; 22102; US Patent Application Number: 20030060721 Date filed: August 27, 2002 Abstract: In a blood pressure monitor, time habit data representing daily time habits of a patient and a plurality of timings for blood pressure measurement determined by a medical doctor are inputted. The predetermined timings are variably adjusted based on the daily time habit data, and results of blood pressure measurements at the specified timings are stored in a memory. A personal computer for the doctor of a medical facility receives and outputs information read out from the memory of the blood pressure monitor. Accordingly, blood pressure measurements can be performed in timings adjusted in accordance with the daily habit pattern of the patient, so that more accurate measurement can be achieved. Because information including such measurement data is presented to the doctor with diagnostic authority via the personal computer, the doctor
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can acquire useful information for assisting diagnosis and treatment of hypertension symptoms of the patient. Excerpt(s): This invention relates to an electronic blood pressure monitor and a blood pressure data processing system for processing results of measurement which are obtained by electronically measuring blood pressures, and in particular, to an electronic blood pressure monitor and a blood pressure data processing system capable of assisting diagnosis and treatment of hypertension in a subject. Conventionally, when a person with the authority to diagnose a patient diagnoses and treats an outpatient on the basis of blood pressure values of the patient, the blood pressure values are not necessarily considered to be reliable values since they are results of a measurement performed when the patient is at a medical facility. That is, blood pressure values are variable even within a day, as well as influenced by additional body activity due to the visit to the hospital. Also, the phenomenon of "white-coat hypertension" is known, socalled because it is induced by the patient's seeing a doctor wearing a white laboratory coat, so that diagnosing and treating hypertension based on blood pressure values taken when a patient is at a medical facility has been viewed with suspicion. Hence there has been a demand for a blood pressure measurement system which is useful for properly measuring blood pressures which are representative of blood pressures of the patient and for diagnosing and treating hypertension. Conventionally, there have been a few examples of measuring blood pressures in a daily life outside a hospital, in which a patient herself/himself regularly measures blood pressures and records the result of the measurement every day and at predetermined times under the instruction of a person with the authority. In the manner as described above, however, the patient may forget the measurements to be performed at the predetermined times, or may be in a condition in which measurement is impossible, or the measurement data may not be recorded properly, and additionally, measurement of blood pressure cannot be performed when the patient is asleep. Accordingly, it has been impossible to properly measure blood pressure values throughout the daily life of the patient. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Hand-Held blood pressure measuring apparatus Inventor(s): Dromms, Raymond P. (Liverpool, NY), Sims, John W. (Weedsport, NY), Vivenzio, Robert L. (Auburn, NY), Osiecki, Scott W. (Skaneateles, NY), Mininger, Staci A. (Dallas, TX), Grant, Thomas J. (Skaneateles, NY) Correspondence: WALL MARJAMA & BILINSKI; 101 SOUTH SALINA STREET; SUITE 400; SYRACUSE; NY; 13202; US Patent Application Number: 20030135123 Date filed: January 16, 2002 Abstract: A blood pressure measuring apparatus includes an inflatable cuff which can be wrapped about the limb of a patient. The sleeve includes a sealed interior capable of inflation, and an integrated inflation/measuring device. The integrated device is an elastomeric enclosure which retains a gage and a pneumatic bulb therein and hosing for fluidly interconnecting the pneumatic bulb, the inflatable cuff, and the gage. Excerpt(s): This invention relates to the field of medical diagnostic instruments, and more particularly to a hand-held blood pressure measuring device. A gage 26 is also separately tethered through a hose 27 to an adjacent port of the inflatable sleeve 14 and is in fluid communication with the interior of the sleeve, the housing including a dial
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face 30 which includes measuring indicia 32. A movement mechanism (not shown) provided within the interior of the gage 26 is responsive to changes in pressure of the sleeve interior and causes an attached indicating member to move relative to the measuring indicia 32 on the dial face 30 as the sleeve 14 is inflated and deflated using the pneumatic assembly 18. A stethoscope (not shown) is used to monitor the heartbeats of the brachial artery (when the sleeve 14 is wrapped onto a patient's arm) and to determine systolic and diastolic pressure of the patient using the gage 26 as the sleeve is inflated to an appropriate inflation pressure and then deflated using a bleed valve 36. It is a primary object of the present invention to overcome the above-noted deficiencies of the prior art. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Inferior-and-superior-limb blood-pressure index measuring apparatus Inventor(s): Nomura, Takashi; (Komaki-shi, JP) Correspondence: OLIFF & BERRIDGE, PLC; P.O. BOX 19928; ALEXANDRIA; VA; 22320; US Patent Application Number: 20030153838 Date filed: September 9, 2002 Abstract: An apparatus for measuring an inferior-and-superior-limb blood-pressure index of a living subject, including an inferior-limb blood-pressure measuring device which measures an inferior-limb blood pressure of an inferior limb of the subject, a superior-limb blood-pressure measuring device which measures a superior-limb blood pressure of a superior limb of the subject, an inferior-and-superior-limb blood-pressure index determining device for determining the inferior-and-superior-limb blood-pressure index based on the inferior-limb blood pressure measured by the inferior-limb bloodpressure measuring device and the superior-limb blood pressure measured by the superior-limb blood-pressure measuring device, a heartbeat-synchronous-signal detecting device which detects a heartbeat-synchronous signal that is produced from the subject, a pulse-period-related-information obtaining device for obtaining, based on the heartbeat-synchronous signal detected by the heartbeat-synchronous-signal detecting device, pulse-period-related information that is related to a pulse period of the subject, and a neuropathy-related-information obtaining device for obtaining, based on the pulse-period-related information obtained by the pulse-period-related-information obtaining device, neuropathy-related information that is related to diabetic neuropathy. Excerpt(s): The present invention relates to an inferior-and-superior-limb blood-pressure index measuring apparatus which measures an inferior-and-superior-limb bloodpressure index of a living subject, and particularly to such an inferior-and-superior-limb blood-pressure index measuring apparatus which assures that angiopathy of a living subject can be diagnosed with high reliability. There has been proposed an inferior-andsuperior-limb blood-pressure index measuring apparatus which measures an inferiorand-superior-limb blood-pressure index of a living subject, that is, measures respective blood-pressure values of inferior and superior limbs of the subject and calculates, as the index, a ratio of one of the two blood-pressure values to the other. An example of this apparatus is disclosed in Japanese Patent No. 3,027,750 or its corresponding U.S. Pat. No. 6,379,309. The inferior-and-superior-limb blood-pressure index is used to evaluate a degree of arteriostenosis of an inferior limb that is caused by atheromatosis of a considerably large artery (i.e., atherosclerosis). Since a patient who feels numbness in his inferior limb is suspected to have arteriostenosis in the inferior limb, an inferior-and-
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superior-limb blood-pressure index is measured to make a diagnosis about the stenosis. However, a diabetic patient may feel numbness that is caused by diabetic neuropathy derived from diabetic microangiopathy. Therefore, it has been difficult to make a reliable diagnosis on the cause of the numbness felt by the patient, based on the inferiorand-superior-limb blood-pressure index only. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Inferior-and-superior-limb blood-pressure-index measuring apparatus Inventor(s): Nunome, Tomohiro; (Komaki-shi, JP), Narimatsu, Kiyoyuki; (Komaki-shi, JP), Ogura, Toshihiko; (Komaki-shi, JP) Correspondence: OLIFF & BERRIDGE, PLC; P.O. BOX 19928; ALEXANDRIA; VA; 22320; US Patent Application Number: 20030109789 Date filed: November 21, 2002 Abstract: An apparatus for measuring an inferior-and-superior-limb blood-pressure index of a patient, including an inferior-limb blood-pressure measuring device, a superior-limb blood-pressure measuring device, an index determining device for determining the inferior-and-superior-limb blood-pressure index, based on a blood pressure of an inferior limb measured by the inferior-limb blood-pressure measuring device and a blood pressure of a superior limb measured by the superior-limb bloodpressure measuring device, an inferior-limb-pulse-wave-propagation-velocity-relate- dinformation obtaining device which obtains inferior-limb-pulse-wave-prop- agationvelocity-related information, an upper-half-body-pulse-wave-propag- ation-velocityrelated-information obtaining device which obtains upper-half-body-pulse-wavepropagation-velocity-related information, and an evaluation-information obtaining device for obtaining, based on the inferior-limb-pulse-wave-propagation-velocityrelated information and the upper-half-body-pulse-wave-propagation-velocity-related information, evaluation information that is related to evaluation of reliability of the inferior-and-superior-limb blood-pressure index. Excerpt(s): The present invention relates to an inferior-and-superior-limb bloodpressure-index measuring apparatus which measures an inferior-and-superior-limb blood-pressure index of a living subject. An inferior-and-superior-limb blood-pressure index is generally known as a ratio of a blood pressure of a superior limb of a living subject to a blood pressure of an inferior limb of the subject, or a ratio of the blood pressure of the inferior limb to that of the superior limb. Respective systolic blood pressures of the inferior and superior limbs are generally used as the respective blood pressures of those limbs. In addition, generally, an ankle is selected as the inferior limb and an upper arm is selected as the superior limb, so that an ankle-and-upper-arm blood-pressure index is determined as the inferior-and-superior-limb blood-pressure index. The inferior-and-superior-limb blood-pressure index represented by the ankleand-upper-arm blood-pressure index is useful in making a diagnosis about stenosis or obliteration caused by atheromatous arteriosclerosis (atherosclerosis). If a living subject has stenosis in a portion of an artery, subject's blood pressure lowers on a downstream side of the stenotic portion, which leads to showing an abnormal inferior-and-superiorlimb blood-pressure index. Thus, stenonis of artery can be diagnosed based on inferiorand-superior-limb blood-pressure index. In many cases, stenosis of artery occurs to inferior limbs of a human person. Since inferior-and-superior-limb blood-pressure index is a simple ratio, i.e., a ratio of one of inferior-limb blood pressure and superior-limb
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blood pressure to the other, reliable measurement of inferior-and-superior-limb bloodpressure index requires that inferior-limb blood pressure and superior-limb blood pressure be measured with accuracy. There is known a different sort of arteriosclerosis than atherosclerosis, that is, "calcification". If calcification of an artery advances, blood pressure in the artery increases because of hardening of the wall of artery. If the calcification of the artery further advances, the artery cannot be completely closed and the blood pressure further increases. Thus, even if an artery of an inferior limb has stenosis, a normal inferior-and-superior-limb blood-pressure index value may be obtained if the artery suffers advanced calcification. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Inflatable cuff used for blood pressure measurement Inventor(s): Nakagawa, Tsuneo; (Komaki-shi, JP), Kurosaki, Takeshi; (Komaki-shi, JP) Correspondence: OLIFF & BERRIDGE, PLC; P.O. BOX 19928; ALEXANDRIA; VA; 22320; US Patent Application Number: 20020099297 Date filed: January 25, 2001 Abstract: An inflatable cuff for being wound and inflated around a body portion pressing a body portion of a living subject to press the body portion in measuring a blood pressure of the subject, the cuff comprising: an inflatable bag which is located in a portion of the cuff in a lengthwise direction thereof and a connector which is attached to a portion of the inflatable bag that is distant, by a predetermined distance, from a distal end of the cuff in a widthwise direction thereof, and which is adapted to connect the inflatable bag to a gas-supply pipe to supply a pressurized gas from the pipe to the inflatable bag. Excerpt(s): This application is based on Japanese Patent Application No. 10-220158 filed Aug. 4, 1998, the contents of which are incorporated hereinto by reference. The present invention relates in general to an inflatable cuff which is cylindrically wound around a body portion of a living subject so as to press the body portion in measuring a blood pressure of the subject. There is known an inflatable cuff which is cylindrically wound around a body portion of a living subject so as to press the body portion in measuring a blood pressure of the subject. The inflatable cuff includes a belt-like elongate bag which is formed of a nylon resin cloth, and a rubber-made inflatable bag accommodated in the belt-like elongate bag. Alternatively, the inflatable cuff includes a belt-like elongate bag which is formed by folding a vinyl resin sheet, and a portion of the elongate bag is highfrequency welded so as to define an air-tight inner space functioning as an inflatable bag. With the cuff being wound around a body portion of the living subject, e.g., an upper arm of the subject, a pressurized air is supplied to the inflatable bag of the cuff through an air pipe connected thereto, so that the inflatable bag is inflated to press the body portion. The air pipe is formed of a material which can be elastically deformable, and is connected to the inflatable bag at a distal end of the cuff, which distal end is more distant from the heart of the subject than an opposite proximal end of the cuff, such that the air pipe extends in a direction parallel to the widthwise direction of the cuff. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Patents 453
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INSTRUMENT FOR MEASURING BLOOD PRESSURE AND TEMPERATURE Inventor(s): Yang, Paul; (Taipei Hsien, TW) Correspondence: FINNEGAN, HENDERSON, FARABOW, GARRETT &; DUNNER LLP; 1300 I STREET, NW; WASHINGTON; DC; 20005; US Patent Application Number: 20020123691 Date filed: March 2, 2001 Abstract: An instrument for measuring blood pressure and temperature includes a digital sphygmomanometer, a digital thermometer, and a transmission device. The digital sphygmomanometer includes a housing formed with a thermometer-receiving groove, and a control unit mounted in the housing. The control unit is operable so as to activate an air pump unit and obtain pressure information corresponding to air pressure inside a pneumatic wristlet and so as to activate a display unit to show the blood pressure information thereon. The digital thermometer is fitted removably in the thermometer-receiving groove, and includes a processor that is operable so as to obtain temperature information from a temperature probe and so as to activate a display panel to show the temperature thereon. The transmission device is provided on the digital sphygmomanometer and the digital thermometer for establishing a communications link between the control unit and the processor. The control unit is operable so as to receive the temperature information from the processor via the transmission device and to enable the display unit to show the temperature information thereon. Excerpt(s): The invention relates to an instrument for measuring blood pressure and temperature, more particularly to an instrument for measuring blood pressure and temperature that can show temperature information from a digital thermometer on a digital sphygmomanometer. In co-pending U.S. patent application Ser. No. 09/392492, the applicant disclosed a touch-control digital sphygmomanometer which includes a pneumatic wristlet, a housing, an air pump unit, a pressure sensing unit, a control unit, a display panel, and a touch-control panel. The disclosure of the aforesaid co-pending U.S. patent application is incorporated herein by reference. A conventional digital thermometer includes processor mounted in a casing, a display unit mounted on the casing, and a sensing unit provided with a temperature probe. The processor is operable so as to enable the display unit to show temperature information from the temperature probe thereon. Since the casing is elongated, the size of the display unit is limited to that of the casing, thereby resulting in inconvenience when reading the temperature information. Furthermore, due to the small size of the conventional digital thermometer, misplacement of the same can easily occur. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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METHOD AND A DEVICE FOR NON-INVASIVE MEASUREMENT OF THE BLOOD PRESSURE AND FOR DETECTION OF ARRHYTHMIA Inventor(s): FORSTNER, KLAUS; (ASPERG/WURTTEMBERG, DE) Correspondence: CHARLES W FALLOW; SHOEMAKER & MATTARE LTD; 2001 JEFFERSON DAVIS HIGHWAY; SUITE 1203; ARLINGTON; VA; 222020286 Patent Application Number: 20010049476 Date filed: May 24, 1999
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Abstract: In a device or in a method for oscillometric measurement of the blood pressure, the pulse time differences are determined associated with the measurement of the blood pressure. Subsequent pulse time differences are stored in a storing unit (15). A distribution of pulse time differences is calculated in a calculating unit (16) and compared in a comparing unit (17) with predetermined reference values. If the distribution or the values of pulse time differences exceed a predetermined amount, an indication means (19) is activated which indicates existence of arrhythmic activities. Excerpt(s): The invention relates to a method and a device for the non-invasive measurement of the blood pressure and for simultaneous detection of arrhythmia. The clinical standard of measuring the arterial blood pressure is the auscultation of audible sounds during the release of an inflated cuff in the cubital region of the brachial artery. The method is called the Riva/Rocci method by analysis of the so-called Korotkoff pulse sounds. First, non-invasive blood pressure measuring devices automatically recorded the Korotkoff sounds by the integration of a microphone into the cuff design. Although these devices proved to be very accurate, the critical microphone positioning and the occurrence of artefact sounds limited the clinical use of this method. Detection of arrhythmia proves to be an important parameter for prevention of cardiac diseases. It is known in the art to determine arrhythmic activities by means of an electrocardiographic method. Since both arrhythmia and chronic hypertension is associated with a severe risk in establishing cardiovascular diseases such as arteriosclerosis and cerebral ischaemia, it is known to simultaneously measure the blood pressure of the patient and to detect arrhythmic activities by the use of an electrocardiogram. From U.S. Pat. No. 4,262,674 it is known, to simultaneously measure the blood pressure based on Korotkoff sounds and to determine time differences between two consecutive pulses. The method according to this US patent is difficult To carry out because of the mentioned critical microphone positioning and the occurrence of artefact sounds. Further, the method according to the US patent is based on a strict consecutive treatment of measured pulses. The procedure does not analyse the total pulse pattern during the measuring time. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method and apparatus for measuring blood pressure by the oscillometric technique Inventor(s): Zorn, Anton Bogdan; (Vancouver, CA), Strange, Kevin Daryl; (Port Moody, CA), Chen, Yunquan; (Delta, CA) Correspondence: Oyen Wiggs Green & Mutala; The Station, Suite 480; 601 West Cordova Street; Vancouver; BC; V6B 1G1; CA Patent Application Number: 20030045801 Date filed: June 15, 2001 Abstract: A method and apparatus for measuring blood pressure by the oscillometric technique. The method incorporates variable PIP's. The method comprises the steps of obtaining a value for the peak amplitude A.sub.max of an oscillometric envelope; determining a cuff pressure, CP, which corresponds in time with A.sub.max, this pressure representing the MAP of the subject; computing a variable value PIP.sub.SBP as a function of MAP; performing the calculation A.sub.sbp=A.sub.max*PIP.sub.SBP to determine a systolic amplitude value A.sub.sbp along the oscillometric envelope; and determining the cuff pressure C which corresponds in time to A.sub.sbp, this value representing the systolic blood pressure (SBP) of the subject. PIP can be calculated using a piece-wise linear, polynomial, exponential or other function.
Patents 455
Excerpt(s): The present invention relates to non-invasive methods for determining the blood pressure of a subject. More particularly, the invention relates to an improved method and apparatus for making oscillometric measurements of systolic blood pressure. Physicians and others monitor various physiological parameters in their patients and in other subjects. Such monitoring is an important tool in evaluating patients' health. The monitoring of cardiovascular function is particularly valuable and is performed on a very widespread basis. Accurate measurement of blood pressure ("BP") and other physiological parameters allows for more precise diagnosis of medical problems. For example, accurate measurement of BP is important in the correct diagnosis of hypertension. There are various ways to measure BP. For example, BP may be measured directly in the aorta or in other arterial blood vessels. This may be done, for example, by inserting into an arterial blood vessel a probe, such as a needle or catheter which bears, or is attached to, a pressure transducer. The transducer measures the actual pressure of the blood within the blood vessel. Although it is ideal to have directlymeasured BP values for diagnostic purposes, procedures for directly measuring BP are invasive and are normally restricted to critical care environments such as operating rooms. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method and apparatus for monitoring biological abnormality and blood pressure Inventor(s): Hayano, Junichiro; (Nagoya-city, JP), Nishii, Katsuyoshi; (Okazaki-city, JP), Kimura, Teiyuu; (Nagoya-city, JP), Takeuchi, Satoshi; (Nagoya-city, JP), Nanba, Shinji; (Kariya-city, JP) Correspondence: LAW OFFICES OF DAVID G. POSZ; 2000 L STREET, N.W. SUITE 200; WASHINGTON; DC; 20036; US Patent Application Number: 20020183627 Date filed: May 21, 2002 Abstract: In a clinical and physiological abnormality monitoring apparatus, and blood pressure monitoring apparatus detects a blood pressure abnormality and the like of a body by employing a pulse wave signal. A frequency analysis is carried out with respect to a pulse wave signal, while this pulse wave signal corresponds to time sequential data of pulse waves. As a result, both a C-frequency component indicative of a fluctuation component of a base line of the pulse wave signal, and also an A-frequency component representative of the respective pulse waves are acquired. A ratio C/A of power of a peak contained in the C-frequency component with respect to power of a peak contained in the A-frequency component is calculated to determine abnormality of the blood pressure. Excerpt(s): This application is based on and incorporates herein by reference Japanese Patent Applications No. 2001-165297 filed May 31, 2001 and No. 2002-24056 filed Jan. 31, 2002. The present invention is related to a clinical and physiological abnormality (biological abnormality) monitoring apparatus and method capable of predicting and sensing abnormal (unusual) clinical and physiological conditions based upon, for example, fluctuation of a blood flow rate or tissue blood volume. The present invention is also related to a blood pressure monitoring apparatus and method for predicting critical blood pressure changes. Conventionally, in order to prevent cardiovascular attacks such as syncope caused by rapid lowering of blood pressure in medical emergency fields and/or medical hemodialysis fields, blood pressure of patients is
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measured either in a continuous manner or in a certain constant interval. When the blood pressure is lowered, necessary medical treatments are carried out. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method and device for measuring systolic and diastolic blood pressure and heart rate in an environment with extreme levels of noise and vibrations Inventor(s): Pinto, Lisa; (Pickering, CA), Stergiopoulos, Stergios; (Toronto, CA), Wong, Man Yee Winnie; (Markham, CA), Dhanantwari, Amar; (Vaughan, CA), Zachariah, Ronald; (Richmond Hill, CA) Correspondence: FREEDMAN & ASSOCIATES; 117 CENTREPOINTE DRIVE; SUITE 350; NEPEAN, ONTARIO; K2G 5X3; CA Patent Application Number: 20030139674 Date filed: January 15, 2003 Abstract: A method and a device for measuring blood pressure and heart rate in an environment comprising extreme levels of noise and vibrations is disclosed. Blood pressure signals corresponding to the Korotkoff sounds are detected using an array of primary acoustic sensors, placed on the patient's skin over the brachial artery. A secondary acoustic transducer is placed on the outside of a pressure cuff the patient away for detecting noise and vibrations. Pressure is applied to the artery using the pressure cuff forcing the artery to close. The pressure is then reduced and while reducing the pressure the acoustic signals detected by the first and second acoustic sensor as well as a signal indicative of the pressure applied to the artery are provided to a processor. The signals provided by the primary acoustic sensors are then processed using a combination of focused beamforming and planar wave beamforming. The final beam time series is then processed using an adaptive interferer canceller algorithm with the signal provided by the secondary acoustic sensor as interferer. Use of an array of acoustic sensors in combination with beamforming substantially enhances signal detection as well as accurate isolation of the signal source which is highly beneficial for blood pressure measurements measurements performed under extreme levels of noise and vibrations. Excerpt(s): This is a continuation-in-part of U.S. patent application Ser. No. 10/133,575 filed Apr. 29, 2002 which is a continuation-in-part of U.S. patent application Ser. No. 09/718,515 filed Nov. 24, 2000 in the name of Stergiopoulos et al. This invention relates generally to the field of blood pressure monitoring methods and devices and more particularly to auscultatory blood pressure monitoring methods and devices employing means for removing noise and vibration effects from audible blood flow sounds. The blood pressure in the brachial artery is not constant, but varies with time in relation to the beating of the heart. Following a contraction of the heart to pump blood through the circulatory system, the blood pressure increases to a maximum level known as the systolic blood pressure. The minimum blood pressure between heartbeats is known as the diastolic blood pressure. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Patents 457
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Method and device for monitoring blood pressure Inventor(s): Chua, Ngak Hwee; (Singapore, SG), Ting, Choon Meng; (Singapore, SG) Correspondence: LADAS & PARRY; 26 WEST 61ST STREET; NEW YORK; NY; 10023; US Patent Application Number: 20030004421 Date filed: July 9, 2002 Abstract: A device for continuously monitoring a user's arterial blood pressure has a sensor adapted to continuously detect the blood pressure and to generate signals representative thereof by contact with an external surface of the user's body at a location adjacent an artery. The sensor is securely held in operable contact with the user's body at the location. A microprocessor interprets the signals generated by the sensor to determine the actual arterial blood pressure. The sensor includes a projecting portion for detecting and transmitting changes in blood pressure, wherein the projecting portion is adapted to effect at least partial occlusion of the artery at the location. Excerpt(s): The present invention relates to a method and device for monitoring blood pressure. In particular, such method and device is non-invasive to the human body and the device is preferably portable. 4. more and younger patients requiring renal dialysis. Such facts are not unique to Singapore. Many developed countries have comparable, if not higher, statistics. In other words, hypertension is a global problem of epidemic proportions. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Method and system for evaluating cardiac ischemia with RR-interval data sets and pulse or blood pressure monitoring Inventor(s): Chernyak, Yuri B. (Lexington, MA), Starobin, Joseph M. (Greensboro, NC) Correspondence: MYERS BIGEL SIBLEY & SAJOVEC; PO BOX 37428; RALEIGH; NC; 27627; US Patent Application Number: 20020165460 Date filed: December 26, 2001 Abstract: A method of assessing cardiac ischemia in a subject to provide a measure of cardiac or cardiovascular health in that subject is described herein. The method comprises the steps of: (a) collecting a first RR-interval data set from the subject during a stage of gradually increasing heart rate (e.g., a stage of gradually increasing exercise load); (b) collecting a second RR-interval data set from the subject during a stage of gradually decreasing heart rate (e.g., a stage of gradually decreasing exercise load); (c) comparing the first RR-interval data set to the second RR-interval data set to determine the difference between the data sets; and (d) generating from the comparison of step (c) a measure of cardiac ischemia during exercise in the subject. A greater difference between the first and second data sets indicates greater cardiac ischemia and lesser cardiac or cardiovascular health in the subject. The data sets may be collected by any suitable method or device, including pulse monitoring and blood pressure monitoring. Excerpt(s): This application is a continuation-in-part of copending application Ser. No. 09/891,910, filed Jun. 26, 2001, which in turn is a continuation-in-part of copending application Ser. No. 09/603,286, filed Jun. 26, 2000, the disclosures of both of which are incorporated by reference herein in their entirety. The present invention relates to non-
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invasive high-resolution diagnostics of cardiac ischemia based on processing of data such as body-surface electrocardiogram (ECG) data, or other pulse or blood pressure data. The invention's quantitative method of assessment of cardiac ischemia may simultaneously indicate both cardiac health itself and cardiovascular system health in general. Heart attacks and other ischemic events of the heart are among the leading causes of death and disability in the United States. In general, the susceptibility of a particular patient to heart attack or the like can be assessed by examining the heart for evidence of ischemia (insufficient blood flow to the heart tissue itself resulting in an insufficient oxygen supply) during periods of elevated heart activity. Of course, it is highly desirable that the measuring technique be sufficiently benign to be carried out without undue stress to the heart (the condition of which might not yet be known) and without undue discomfort to the patient. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method for diastolic blood pressure measurement Inventor(s): Rosenfeld, Chaim; (Jerusalem, IL), Nitzan, Meir; (Belt El, IL) Correspondence: DR. MARK FRIEDMAN LTD. C/O BILL POLKINGHORN; DISCOVERY DISPATCH; 9003 FLORIN WAY; UPPER MARLBORO; MD; 20772; US Patent Application Number: 20020147402 Date filed: April 9, 2002 Abstract: A method for measuring arterial diastolic blood pressure in a subject includes deriving values of a delay between pulses in two signals indicative of cardiac induced pulsatile variations of a cardiovascular parameter in a first region and a second region of the subject's body. A variable pressure applied to a region of the subject's body causes variation of the delay. A difference curve is calculated by subtracting from the delay values a monotonic mathematical function adjusted as a best-fit to the data. A value of the variable pressure for which the difference curve exhibits a stationary point is then identified as the diastolic blood pressure. Excerpt(s): This invention relates to a refinement of a method and corresponding device for measurement of blood pressure, and particularly diastolic blood pressure (DBP), which is described in U.S. Pat. No. 6,120,459 and the related PCT Patent Publication No. WO0074563, both of which are hereby incorporated by reference in their entirety as if fully laid out herein. According to a preferred embodiment of the aforementioned U.S. patent, DBP is derived from the measurement of the time-delay (TD) of a PPG pulse in the finger distal to a pressure cuff wrapped around the arm, relative to the PPG pulse in a contralateral finger. TD is measured as a function of the cuff pressure P.sub.C, and the cuff pressure for which TD has a predefined value is taken to be the DBP. The preferred value for this predefined value of TD was suggested to lie in the range between 15 and 25 ms. Without limiting the present invention to any specific physiological model, it is believed that the time delay measured between PPG signals in the contralateral fingers is a sum of the effects of at least two different phenomena, one of which falls to zero at cuff pressures less than DBP and another of which continues to produce a time delay even below the DBP. For this reason, it has been observed that the variation of TD with cuff pressure P.sub.C exhibits a change of (the generally negative) gradient from more moderate to (negative) steeper when P.sub.C is in the vicinity of the DBP. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Patents 459
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Method of blood pressure moderation Inventor(s): Gruzdowich, Gregory J. (Carlsbad, CA), Grey, Thomas L. (Carlsbad, CA), Swenson, David D. (Carlsbad, CA) Correspondence: CROCKETT & CROCKETT; 24012 CALLE DE LA PLATA; SUITE 400; LAGUNA HILLS; CA; 92653; US Patent Application Number: 20020133210 Date filed: May 16, 2002 Abstract: A method of controlling the blood pressure in a patient with high blood pressure or low blood pressure utilizing a non-invasive nerve stimulation device applied to the wrist. Excerpt(s): This application is a continuation of U.S. application Ser. No. 09/767,062 filed Jan. 22, 2001, now U.S. Pat. No. 6,393,324, which is a continuation of U.S. application Ser. No. 09/307,272 filed May 7, 1999, now U.S. Pat. No. 6,178,352. This invention relates to moderation of blood pressure. High blood pressure and low blood pressure are usually treated with drugs. Several proposals have been made to treat blood pressure with electrical stimulus applied to the body. For example, Terry, et al, Treating Refractory Hypertension By Nerve Stimulation, U.S. Pat. No. 5,707,400 (Jan. 13, 1998) proposes implantation of an electrical coil around the vagus nerve, which runs superficially through the neck, and stimulation of the vagus nerve to lower high blood pressure. Zhu, Blood Pressure Depressor, U.S. Pat. No. 5,891,181 (Apr. 6, 1999) proposes electrical stimulation of nerves in the ear lobe to lower blood pressure. Pomeranz, et al, Electrotherapy Acupuncture Apparatus and Method, U.S. Pat. No. 4,566,064 (Dec. 3 1985) mentions blood pressure as an indication for electro-acupuncture, but does not mention any point of application. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Method of periodically or constantly watching a person's blood pressure and system thereof Inventor(s): Cheng, Hui-Wen; (Taipei, TW) Correspondence: BACON & THOMAS, PLLC; 625 Slaters Lane - 4th Floor; Alexandria; VA; 22314; US Patent Application Number: 20020077557 Date filed: February 14, 2001 Abstract: A system of watching a person's blood pressure includes a database server; a network server; and a communication devices; wherein the database server is built-in with a database of blood pressure and with a software, so that a) the database server determines time for a person to measure his/her blood pressure according to medical criteria on his/her blood pressure history recorded in the database; b) the network server and the communication device notify the person to measure his/her blood pressure in advance the determined time and report his/her measured blood pressure to the network server according to the determined time; and c) the network server and the communication device remind the person of the blood pressure measurement if the network server should fail to receive his/her measured blood pressure after the determined time.
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Excerpt(s): The present invention relates to a method and a system of periodically or constantly watching a person's blood pressure. After receiving a treatment from a doctor, a hypertensive patient should continue his/her treatment according to the appointment with the doctor. However, due to lack of an adequate reminding system, the hospital is unable to remind a patient of the appointment in advance or after the patient misses the appointment. Therefore, a hypertensive patient suffers a higher risk of seizure or death from cardiovascular disease. The present invention provides a method and a system of periodically or constantly recording and watching a patient's blood pressure to solve the above-mentioned problems long existed in the medical field. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method of selling a continuous mode blood pressure monitor Inventor(s): Kiani, Massi E. (Laguna Niguel, CA) Correspondence: KNOBBE MARTENS OLSON & BEAR LLP; 2040 MAIN STREET; FOURTEENTH FLOOR; IRVINE; CA; 92614; US Patent Application Number: 20030013975 Date filed: July 12, 2001 Abstract: A blood pressure monitor has a noninvasive continuous blood pressure measurement mode and a non-continuous blood pressure measurement mode. At the time of a first sale, the noninvasive continuous blood pressure measurement mode is disabled. Thus, the blood pressure monitor operates only in the non-continuous measurement mode. At a later time, a sensor is sold to generate a sensor signal for noninvasive continuous blood pressure measurements, thereby enabling the continuous measurement mode of the blood pressure monitor. Excerpt(s): The present invention relates to a method for selling a blood pressure monitor that has a continuous mode and a non-continuous mode for measuring a patient's blood pressure. In the field of medicine, constant monitoring of a patient's blood pressure is needed because blood pressure is affected by the body's reaction during and after surgery. Continuous measurement of blood pressure has been linked to reduced risk of heart attack and stroke. As opposed to non-continuous measurement of blood pressure where measurements are taken at intervals, continuous measurements generally are beat-to-beat measurements and thereby provide more accurate and reliable indications of a patient's well being. Two general methods have been developed for measuring blood pressure. The two methods are categorized as invasive and noninvasive. The invasive method places a catheter within the patient's body to receive continuous measurements. The invasive method has disadvantages such as the risk of embolization, infection, bleeding, and vessel wall damage. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Patents 461
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Methods and pharmaceutical preparations for normalizing blood pressure with (-)hydroxycitric acid Inventor(s): Clouatre, Dallas L. (Menlo Park, CA), Dunn, James M. (Littleton, CO) Correspondence: Dallas L. Clouatre; #357; 555 BRYANT ST. Palo Alto; CA; 94301; US Patent Application Number: 20010044469 Date filed: February 13, 2001 Abstract: A method whereby the blood pressure metabolism in an individual showing evidence of dysregulation is improved when that person receives an appropriate oral administration of (-)-hydroxycitric acid. The potassium salt of (-)-hydroxycitric acid is a preferred form of the compound, followed by the sodium salt, then by the amide and other derivatives of the acid. The regulation of blood pressure levels over any given period of time may be improved with a controlled release form of (-)-hydroxycitric acid. Controlled release can be used to provide a sustained and modulated amount of the active to the body as desired and therefore regulate the use of the compound as a hypotensive agent. Excerpt(s): The invention is directed toward the use of (-)-hydroxycitric acid, especially as potassium (-)-hydroxycitrate, a preferred salt of (-)-hydroxycitric acid, to reduce ("normalize") elevated blood pressure in individuals in need thereof. Hypertension is defined as an average or sustained systolic blood pressure over 140 mm Hg and/or a diastolic blood pressure over 90 mm Hg. Hypertension has an overall incidence of 20%, with onset usually occurring after age 20. The prevalence rises with age to over 50% past age 65. Ninety-five to 99% of hypertensive individuals have essential hypertension. Persons with hypertension are three to four times more likely to experience a major cardiovascular event (e.g., myocardial infarction, cerebrovascular accident, congestive heart failure) than those without. Essential, or primary, hypertension is often said to have no identifiable cause. However, this belies the fact that risk factors long have been identified. Hypertension is more common in African Americans at all ages and in persons from lower socioeconomic groups. Individual risk factors include family history, excessive alcohol consumption, high sodium intake, stress, sedentary lifestyle, obesity and a high intake of sugars (sucrose, fructose, glucose, etc.) Hypertension is one of the disorders which are linked to insulin resistance and elevated insulin levels. Hypertension is also linked to the excessive production of "stress hormones," such as cortisol and corticosterone. Long-term stress is known to elevate aldosterone levels and thereby to increase sodium retention, a source of hypertension. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Noninvasive blood pressure measuring method and apparatus Inventor(s): Kan, Jie; (Ningxia, CN) Correspondence: Joseph W. Bain; Akerman, Senterfitt & Eidson, P.A. 222 Lakeview Avenue, 4th Floor; P.O. Box 3188; West Palm Beach; FL; 33402-3188; US Patent Application Number: 20020026121 Date filed: October 16, 2001 Abstract: A method and a device for non-invasive blood pressure measurement wherein the angle between the hand and the wrist, and the turning angle of the wrist relative to the middle part of the forearm, are kept to the most suitable degree for measuring the
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blood pressure of the radial artery. At least one pressure bladder and one arterial pulse transducer array are placed on the skin over the radial artery of the wrist to apply the external pressure to the artery and to detect the change of the arterial pulse signals. This method and device can correctly measure the intermittent or blood pressure of the radial artery or the ulnar artery based on the principles of volume oscillation method and volume compensation method, and effectively eliminate the influence on the measurement due to body movement and the influence on blood circulation and neural function of the hand caused by long-term blood pressure measurement. Excerpt(s): This application is a continuation-in-part of international application number PCT/CN00/00097, filed Apr. 21, 2000. This invention relates to a method and apparatus for non-invasive measurement of blood pressure, and, in particular, relates to a so-called oscillometric method and the corresponding apparatus for intermittent measurement of arterial blood pressure, as well as a so-called vascular unloading method and the corresponding apparatus for continuous measurement of arterial blood pressure. The oscillometric method is based on the principle that the blood vessel will be the most flexible (This state is called the "unloading state") and will be flattened separately when the external pressure of the artery is equal to the mean blood pressure and higher than the internal systolic blood pressure. Since the internal blood pressure of the artery is changing periodically along with the heart beat at all time (during a heartbeat cycle, the highest pressure is called systolic blood pressure, the lowest pressure is called diastolic blood pressure, and the average of the all pressure value over the heartbeat cycle is called the mean blood pressure), and the diameter (or volume) is changing periodically with the blood pressure so as to form the arterial pulse. The amplitude of the pulse will be maximum when the external pressure of the vessel is equal to the mean blood pressure so that the vascular wall is the most flexible, and the amplitude of the pulse will disappear when the external pressure of the vessel is higher than the systolic blood pressure so that the blood vessel is flattened. When measuring the blood pressure by using oscillometric method, at first, an air bladder (or liquid bladder) to apply the external pressure to the artery is fixed on the skin over the artery. Then the pressure of the bladder is changed. At the same time, the change in pulse amplitude is measured by a pulse transducer during the entire course. If the bladder pressure can be transmitted accurately to the outside of the blood vessel through the soft tissues under the center of the bladder and the pulse transducer can detect the arterial pulse from these soft tissues, the pressure will be equal to the mean blood pressure and the systolic blood pressure separately when the pulse amplitudes are at their maximum and close to disappearance. Therefore, the mean blood pressure and the systolic blood pressure can be measured by measuring the bladder pressure at the two moments using a pressure transducer. Furthermore, the diastolic blood pressure can be obtained by using some estimation algorithm. This method can only measure blood pressure intermittently because each process of pressure change for one cycle of measurement of the blood pressure needs a considerable amount of time. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Patents 463
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Noninvasive continuous blood pressure measuring apparatus and a method of noninvasively measuring continuous blood pressure Inventor(s): Hagiwara, Hisashi; (Yokohama, JP), Hasegawa, Kinya; (Sagamihara-shi, JP), Nishimura, Yushi; (Yokohama, JP) Correspondence: CONNOLLY BOVE LODGE & HUTZ LLP; SUITE 800; 1990 M STREET NW; WASHINGTON; DC; 20036-3425; US Patent Application Number: 20020169380 Date filed: January 29, 2002 Abstract: One of pairs of an exciter and a sensor is selected in accordance with the detection signal which is derived from an exciter waveform induced in an artery transmitted therethrough. The pairs of exciters and sensors are arranged on a substrate in various formations. A/D converters are provided to respective detection signals. A frequency of the oscillation signal supplied to the exciter is controlled by various oscillation signal generation circuits. Bandpass filtering for extracting the exciter waveform, low-pass-filtering for extracting a natural blood pressure waveform, phase difference detection processes are provided by a microprocessor, wherein the bandpass filtering and low-pass-filtering processes may be replaced with a bandpass filter and a low pass filter, and their outputs are selected by a switching circuit and supplied to the microprocessor through one a/d converter. The frequency of the oscillation signal is controlled to an optimum frequency by detecting the detection signal and estimating the attenuation, dispersion, phase shift with respect to different frequency and by determining one of the different frequency in accordance with the estimation result. The waveform of the oscillation signal is controlled to an optimum waveform similarly. Excerpt(s): This invention relates to a noninvasive continuous blood pressure measuring apparatus for noninvasively, continuously measuring blood pressure and a method of noninvasively measuring continuous blood pressure. A noninvasive continuous blood pressure measuring apparatus for noninvasively, continuously measuring blood pressure is known. An apparatus and a method for measuring an induced perturbation to determine a blood pressure is disclosed in U.S. Pat. No. 5,590,649. In this prior art apparatus, a monitor for continuously determining a patient's physiological parameter includes a means for obtaining a periodic calibration measurement of the patient's physiological parameter. An exciter, positioned over an artery of the patient induces an exciter waveform into the patient's arterial blood. A noninvasive sensor, positioned over the artery, senses a hemoparameter and provides a noninvasive sensor signal output representative of the hemoparameter. A processor receives the calibration measurement and noninvasive sensor signal output. The processor determines a SC offset based on the calibration measurement and processes the noninvasive sensor signal to continuously determine the patient's physiological parameter. The aim of the present invention is to provide a superior noninvasive continuous blood pressure measuring apparatus and a superior method of noninvasively measuring continuous blood pressure. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Oscillometric automatic blood-pressure measuring apparatus Inventor(s): Yokozeki, Akihiro; (Komaki-shi, JP), Oka, Tohru; (Komaki-shi, JP) Correspondence: OLIFF & BERRIDGE, PLC; P.O. BOX 19928; ALEXANDRIA; VA; 22320; US Patent Application Number: 20030097074 Date filed: November 4, 2002 Abstract: An oscillometric automatic blood-pressure measuring apparatus, including an inflatable cuff which is adapted to be wound around a portion of a living subject, so as to detect respective amplitudes of a plurality of heartbeat-synchronous pulses of a cuff pulse wave as an oscillatory component that is produced in the cuff in synchronism with heartbeats of the subject in a cuff-pressure change process in which a cuff pressure as a pressure in the cuff is changed, a cuff-pulse-wave-amplitude correcting device for correcting the respective amplitudes of the respective pulses of the cuff pulse wave, according to a predetermined non-linear relationship between difference between cuff pressure and subject's mean blood pressure, and amplitude of cuff pulse wave, and a blood-pressure determining device for determining a blood pressure of the subject based on a change of the corrected amplitudes of the cuff pulse wave. Excerpt(s): The present invention relates to an automatic blood-pressure measuring apparatus for automatically measuring a blood pressure of a living subject according to so-called oscillometric method. It is therefore an object of the present invention to provide an automatic blood-pressure measuring apparatus which can measure blood pressure with high accuracy even in the case where arrhythmia occurs. The above object has been achieved by a first aspect of the present invention according to which there is provided an oscillometric automatic blood-pressure measuring apparatus, comprising an inflatable cuff which is adapted to be wound around a first portion of a living subject, so as to detect respective amplitudes of a plurality of heartbeat-synchronous pulses of a cuff pulse wave as an oscillatory component that is produced in the cuff in synchronism with heartbeats of the subject in a cuff-pressure change process in which a cuff pressure as a pressure in the cuff is changed; a cuff-pulse-wave-amplitude correcting means for correcting the respective amplitudes of the respective pulses of the cuff pulse wave, according to a predetermined non-linear relationship between difference between cuff pressure and subject's mean blood pressure, and amplitude of cuff pulse wave; and a blood-pressure determining means for determining a blood pressure of the subject based on a change of the corrected amplitudes of the cuff pulse wave. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Passive/non-invasive systemic and pulmonary blood pressure measurement Inventor(s): Mohler, Sailor; (Columbia, MD) Correspondence: ROBERTS ABOKHAIR & MARDULA; SUITE 1000; 11800 SUNRISE VALLEY DRIVE; RESTON; VA; 20191; US Patent Application Number: 20010039383 Date filed: December 18, 2000 Abstract: An apparatus, operation and method for measurement of systemic and/or pulmonic blood pressure. The present invention offers a passive non-invasive method and system that can be used where measurement of systemic pressure with a traditional
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blood pressure cuff is contraindicated. The present invention also affords a means for early diagnosis and opportunity for intervention in patients with no symptoms or signs of elevated pulmonary blood pressure that can be performed as part of a routine physical exam. The present invention accomplishes this non-invasive measurement through detection, identification and characterization of the second heart sound acoustic signature associated with heart valve closure. An apparatus for measuring systemic and/or pulmonic blood pressure in accordance with the present invention includes a sensor assembly comprising a housing, an electronic module, a shock dampener, a mounting means, a transducer, an acoustic coupling and a back cover. The sensor assembly is connected to a data acquisition module which in turn is connected to a signal processing means, a remote connection means and a monitor. An improved acoustic coupling is disclosed that provides low-loss acoustic transmission coupling between the skin of the patient and the detector. Excerpt(s): This invention relates generally to an apparatus, operation and method for measurement of blood pressure. In particular, this invention relates to an apparatus, operation and method for the detection, identification and characterization of sounds relating to either systemic or pulmonary blood pressure through the use of sonospectrography. Blood pressure is the force exerted by the blood against the inner walls of blood vessels. Blood pressure determination is an important diagnostic tool. The blood vessels that comprise the vascular system can be grouped into two main divisions, a systemic circuit and a pulmonary circuit. In the systemic circuit, high blood pressure may indicate the presence of arteriosclerosis or other vascular disease, while low blood pressure may indicate shock or blood loss. Detection and measurement of elevated pulmonary blood pressure is a key diagnostic indicator for a number of pulmonary diseases, such as: cystic fibrosis, pleuresy, lung pulmonary diseases, and pulmonary impedance. Early diagnosis of these diseases greatly assists in symptom mitigation and improved patient quality of life. The systemic circuit includes the aorta and its branches that deliver oxygenated blood to all body tissues, as well as the companion system of veins returning blood to the right atrium. Freshly oxygenated blood received by the left atrium is forced into the systemic circuit by the contraction of the left ventricle. When the left ventricle contracts, the mitral valve closes, and the only exit is through the aortic valve into the aorta. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Physiological-signal-analysis device for measuring a blood pressure and method Inventor(s): Medero, Richard; (Tampa, FL), Kolluri, Sai; (Tampa, FL), Hersh, Lawrence T. (Tampa, FL) Correspondence: MICHAEL BEST & FRIEDRICH, LLP; 100 E WISCONSIN AVENUE; MILWAUKEE; WI; 53202; US Patent Application Number: 20020082507 Date filed: March 1, 2002 Abstract: A physiological-signal-analysis device for determining a blood pressure value of a patient and a method of operating the device. The device includes a cuff attachable to an extremity of the patient, a pneumatic system connected to the cuff that supplies a fluid to the cuff, a pressure transducer that measures the pressure signal having pressure oscillations, and a control unit connected to the pneumatic system and the pressure transducer. The control unit is operable to acquire a first oscillation having a first fiducial point, acquire a second oscillation having a second fiducial point, calculate
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a time interval representing a time from the first fiducial point to the second fiducial point, decide against selecting the second oscillation when the time interval is not a substantial integral multiple of a nominal oscillation period, and calculate a blood pressure value based on selected oscillations. Excerpt(s): This application is a continuation of prior filed, co-pending U.S. patent application No. 09/678,650, entitled OSCILLOMETRIC BLOOD PRESSURE MONITOR WITH IMPROVED PERFORMANCE IN THE PRESENCE OF ARRHYTHMIAS, filed on Oct. 4, 2000, the entire contents of which are incorporated herein by reference. The invention relates to a physiological-signal-analysis device for measuring a blood pressure, and particularly to a device that applies a pressure to a patient and determines whether a detected pressure oscillation satisfies one or more criteria. There are many known devices for measuring a patient''s blood pressure. One type of device uses a technique referred to as an oscillometric technique. For this technique, typically, a blood pressure cuff is connected to an arm of the patient and is pneumatically controlled to apply a high pressure to the patient. The pressure is then reduced in steps to a low pressure. For each pressure step (also referred herein as pressure level), a pressure transducer connected with the cuff senses a cuff pressure. The sensed cuff pressure includes the applied pressure and pressure oscillations (also referred to herein as blood pressure oscillations, pressure pulses and blood pressure pulses). The sensed cuff pressure is applied to a control unit that isolates the pressure oscillations and stores two consecutive, matching oscillations at each pressure step. Requiring two consecutive, matching oscillations prevents intermittent artifact from causing the device to seriously err when performing the measurement. Example blood pressure monitors that require two consecutive, matching oscillations are described in RAMSEY M., Blood Pressure Monitoring: Automated Oscillometric Devices, Journal of Clinical Monitoring, 1991, 7 (1), 56-67, which is incorporated herein by reference. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
RAPID NON-INVASIVE BLOOD PRESSURE MEASURING DEVICE Inventor(s): SHER, MARK HENRY; (SAN FRANCISCO, CA), FLAHERTY, BRYAN PATRICK; (HALF MOON BAY, CA), CARO, RICHARD G. (SAN FRANCISCO, CA) Correspondence: KNOBBE MARTENS OLSON & BEAR LLP; 620 NEWPORT CENTER DRIVE; SIXTEENTH FLOOR; NEWPORT BEACH; CA; 92660; US Patent Application Number: 20020099296 Date filed: October 5, 1999 Abstract: A blood pressure can be obtained by supplying an external pressure to a portion of an artery. The external pressure is preferably between the systolic and diastolic pressure. An event which occurs at least once a cycle can then be identified. This event can be, for example, a peak in the arterial compliance that occurs at a transmural pressure approximately equal to zero. A pair of signals, one that is an arterial volume-indicating signal, and one that is an arterial pressure-indicating signal can be used to identify this event. Alternately, a small signal, high-frequency exciter component can be placed upon the pressure or volume of the artery and detected to determine the time that the transmural pressure is equal to zero. Excerpt(s): The present invention relates to methods and apparatus for the non-invasive determination of blood pressure. Direct measurement of blood pressure with a pressure measuring device such as a tonometer is difficult in a clinical setting. A problem with
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tonometer readings is that although the times of the systolic and diastolic pressures are correct, the pressure readings may have an incorrect scaling or have an offset in the recorded pressure. Tonometer measurements can depend on the position of the tonometer, artery and bone structure behind the artery. Another prior art system used to determine arterial pressures is an automated oscillometric device called a "Dinamap" (device for indirect non-invasive mean arterial pressure). This device is described in a paper entitled "Arterial Pressure Monitoring: Automated Oscillometric Devices"; M. Ramsey III; Journal of Clinical Monitoring; Volume 7, No. 1; January 1991; pp. 56-67. This system uses a cuff to supply an external pressure to an artery. The cuff pressure is stepped in increments from a pressure believed to be above the systolic pressure to a pressure believed to be below the diastolic pressure. An arterial volumetric indication is monitored by the system. For example, a pressure transducer attached to the cuff will give some indication of the volume of the artery, since the pressure in the cuff will be greater when the artery volume is high. When the mean value of the arterial blood pressure is about the same as the external cuff pressure, the amplitude of the variations of the volumetric indication will be the greatest. In this way, an indication of the mean arterial pressure can be obtained. A disadvantage of this prior art system is the considerable time it takes to obtain the arterial pressure information. Many cardiac cycles are needed to obtain the data required to determine a blood pressure. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Respiration monitoring system based on sensed blood pressure variations Inventor(s): Brockway, Brian P. (Arden Hills, MN), Fundakowski, Richard A. (St. Paul, MN), Brockway, Robert V. (Maple Grove, MN) Correspondence: SCHWEGMAN, LUNDBERG, WOESSNER & KLUTH, P.A. P.O. BOX 2938; MINNEAPOLIS; MN; 55402; US Patent Application Number: 20020082506 Date filed: August 10, 2001 Abstract: A system and method obtains physiologic parameter information of an animal or human, such as respiratory rate, from a blood pressure signal from an implanted blood pressure sensor in the animal or human. Specifically, the blood pressure signal is externally signal processed to develop an amplitude versus time waveform. A sequence of selected blood pressure features derived from individual cardiac cycles of the amplitude versus time waveform over a selected time interval are extracted from the developed amplitude versus time waveform. A mathematical model is fitted to the extracted sequence of selected blood pressure features to yield a fitted mathematical model. The physiologic parameter information is computed from the fitted mathematical model. Excerpt(s): The present invention relates generally to obtaining physiological parameters from animals or humans, and more particularly to a system for deriving respiratory related information from a blood pressure signal obtained from either humans or animals. In animals or humans, it is often desirable to be able to monitor a variety of physiological parameters for purposes of research, therapeutics, and diagnosis. One such parameter that is of value is respiration. Simple measurement of the animal's or human's respiration rate have included the use of plethysmographs, strain gauges, chest impedance measurements, diaphragmatic EMG measurements, and other known measurement devices. For example in animal research, the plethysmograph approach requires the use of a non-compliant closed box in which the animal is placed with a
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means for measuring either the air flow in and out of the box or pressure changes inside the box or air flow at the animal's mouth when breathing air from outside or inside the closed container. While plethysmographs work reasonably well with human subjects who can cooperate with test personnel, it is unreliable when dealing with laboratory animals, such as rats, dogs, monkeys, and etc. The use of strain gauges and apparatus for measuring chest impedance changes generally require the animal to be tethered to the test equipment via electrical leads and the like. This does not lend itself to chronic testing and, moreover, strain gauges are quite sensitive to movement artifacts that can mask the desired signal output. Diaphragmatic EMG measurements can be used to determine respiratory rate, but electrode placement requires a higher skilled surgeon, and electrical noise from ECG and other sources can make accurate detection of respiration difficult. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Simulative electronic blood pressure meter Inventor(s): Hung, George; (Shen-Keng Hsiang, TW) Correspondence: DOUGHERTY & TROXELL; SUITE 1404; 5205 LEESBURG PIKE; FALLS CHURCH; VA; 22041; US Patent Application Number: 20020183630 Date filed: May 31, 2001 Abstract: Simulative electronic blood pressure meter in which by means of internal program, a central processor/controller converts and outputs the sensed blood pressure signal to a liquid crystal display to show a column-type indication simulating the mercury column of a traditional blood pressure meter. A digital counting circuit is combined, whereby when simulating the mercury column, an auxiliary display of digital change is provided for the user to easily know the value. The central processor/controller cooperates with a sound emitting unit which synchronously emits a sound simulating the sensed pulse from the start to the end. The volume of the emitted sound is varied with the strength of the pulse. The electronic blood pressure meter is used in a state like the mercury column-type blood pressure meter for a user to more accurately and lively judge the measured value. Excerpt(s): The present invention is related to a simulative electronic blood pressure meter which displays a column-type indication on a liquid crystal display to simulate the going up and down of the mercury column of a traditional blood pressure meter. A sound emitting unit is combined to synchronously emit a sound simulating the sensed pulse for a user to more accurately and lively judge the measured value. Various kinds of electronic blood pressure meters have been developed. However, the conventional mercury column-type blood pressure meters are still widely used by doctors and nurses. This is because that the data measured by the electronic blood pressure meters often have errors due to various kinds of factors. Moreover, the electronic blood pressure meters can only show the measured value at the end of the measurement and fail to lively and accurately continuously indicate the value of the measured blood pressure during the entire measurement. Therefore, a user can hardly truly judge the measured value. It is therefore a primary object of the present invention to provide a simulative electronic blood pressure meter which is able to display a column-type indication simulating the mercury column of a traditional blood pressure meter. A digital counting circuit is combined, whereby when simulating the mercury column, the digital change is also shown. The central processor/controller cooperates with a sound emitting unit
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which synchronously emits a sound simulating the sensed pulse. The volume of the emitted sound is varied with the strength of the pulse. The electronic blood pressure meter is used in a state like the mercury column-type blood pressure meter for a user to more accurately and lively judge the value of the blood pressure. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Superior-and -inferior-limb blood-pressure index measuring apparatus Inventor(s): Ogura, Toshihiko; (Komaki-shi, JP) Correspondence: OLIFF & BERRIDGE, PLC; P.O. BOX 19928; ALEXANDRIA; VA; 22320; US Patent Application Number: 20020133082 Date filed: October 16, 2001 Abstract: An apparatus for measuring a superior-and-inferior-limb blood-pressure index of a living subject, including an inferior-limb-blood-pressure measuring device which includes an inferior-limb cuff adapted to be wound around an inferior limb of the subject and which measures an inferior-limb blood pressure of the inferior limb, a superior-limb-blood-pressure measuring device which includes a superior-limb cuff adapted to be wound around a superior limb of the subject and which measures a superior-limb blood pressure of the superior limb, a blood-pressure-index determining device for determining the superior-and-inferior-limb blood-pressure index, based on the inferior-limb blood pressure measured by the inferior-limb-blood-pressure measuring device and the superior-limb blood pressure measured by the superior-limbblood-pressure measuring device, an inferior-limb-pulse-wav- e detecting device which is adapted to be worn on an inferior limb of the subject and which detects an inferiorlimb pulse wave from the inferior limb, and a stenosis-relating-pulse-wave-information obtaining device which obtains, based on the inferior-limb pulse wave detected by the inferior-limb-pulse-wave detecting device, stenosis-relating pulse-wave information which changes in relation with a degree of stenosis of an artery of the inferior limb. Excerpt(s): The present invention relates to an apparatus for measuring a superior-andinferior-limb blood-pressure index of a living subject. A blood pressure of an inferior limb (hereinafter, referred to as "inferior-limb blood pressure") of a normal person is higher than a blood pressure of a superior limb (hereinafter, referred to as "superiorlimb blood pressure") of the person. However, if arteries of the inferior limb of the person suffer stenosis, the inferior-limb blood pressure may be lower than the superiorlimb blood pressure. This can be utilized to diagnose the stenosis of arteries of inferior limb. For example, European Patent Document No. 1053714 A2 discloses a superiorand-inferior-limb blood-pressure index measuring apparatus which determines a superior-and-inferior-limb blood-pressure index as a ratio of an inferior-limb blood pressure to a superior-limb blood pressure or a ratio of a superior-limb blood pressure to an inferior-limb blood pressure. The determination of superior-and-inferior-limb blood-pressure index needs measurements of inferior-limb blood pressure and superiorlimb blood pressure. To this end, generally, those blood-pressure measuring devices are used which include respective inflatable cuffs adapted to be wound around an inferior limb and a superior limb of a living subject and each of which determines a blood pressure based on a signal occurring to a corresponding one of the cuffs when a pressure in the cuff is slowly changed. The blood-pressure measuring devices utilizing the cuffs provide highly reliable blood-pressure values. Since a superior-and-inferiorlimb blood-pressure index determined based on inferior-limb and superior-limb blood-
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pressure values measured using cuffs is highly reliable, the diagnosis of stenosis of arteries of inferior limb can be made with accuracy. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Superior-and-inferior-limb blood-pressure index measuring apparatus and inferiorlimb blood-pressure measuring apparatus Inventor(s): Nunome, Tomohiro; (Komaki-shi, JP), Ogura, Toshihiko; (Inuyama-shi, JP), Suzuki, Hidenori; (Nagoya-shi, JP) Correspondence: OLIFF & BERRIDGE, PLC; P.O. Box 19928; Alexandria; VA; 22320; US Patent Application Number: 20020026120 Date filed: October 4, 2001 Abstract: An apparatus for measuring a superior-and-inferior-limb blood-pressure index of a living subject, including a first blood-pressure measuring device which measures a first blood pressure of a right inferior limb of the subject, a second bloodpressure measuring device which measures a second blood pressure of a left inferior limb of the subject, a third blood-pressure measuring device which measures a third blood pressure of a superior limb of the subject, a first information obtaining device which obtains first information relating to a first velocity of propagation of a first pulse wave which propagates through a first route a portion of which runs in the right inferior limb, a second information obtaining device which obtains second information relating to a second velocity of propagation of a second pulse wave which propagates through a second route a portion of which runs in the left inferior limb, a selecting device for selecting one of the measured first and second blood pressures that corresponds to one of the first and second information that relates to a lower one of the first and second velocities, and an index determining device for determining the superior-and-inferiorlimb blood-pressure index, based on the selected one of the first and second blood pressures, and the measured third blood pressure. Excerpt(s): The present invention relates to an apparatus for measuring a superior-andinferior-limb blood-pressure index of a living subject (e.g., a ratio of an inferior-limb blood pressure to a superior-limb blood pressure, or a ratio of a superior-limb blood pressure to an inferior-limb blood pressure), and to an apparatus for measuring a blood pressure of an inferior limb of a living subject, the latter apparatus being advantageously employed by the former apparatus. For a person who suffers arterial obstruction or arteriostenosis, his or her inferior-limb blood pressure ("BP") value is lower than his or her corresponding superior-limb BP value (for example, a systolic superior-limb BP value corresponds to a systolic inferior-limb BP value). Meanwhile, if an inferior-limb BP value of a person is higher than his or her corresponding superiorlimb BP value by a prescribed value, he or she may suffer aortic incompetence or aortitis syndrome limited to aortic arch. It has been practiced to utilize this for diagnosing arterial disease based on the ratio of inferior-limb BP value to superior-limb BP value or the ratio of superior-limb BP value to inferior-limb BP value, that is, a superior-andinferior-limb BP index. Since the superior-and-inferior-limb BP index is simply obtained as the ratio of inferior-limb BP value to superior-limb BP value or the ratio of superiorlimb BP value to inferior-limb BP value, it is required to measure accurately the inferiorlimb BP value. However, if one or more blood vessels running in a portion of an inferior limb from which the inferior-limb BP value is measured suffer advanced calcification, that is, sclerosis of tunica media as the middle one of three layers of tunica vasculosa, the inferior-limb BP value is raised because of the hardness of the blood vessels. In
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addition, since an inferior limb is thicker than a superior limb and has a generally conical shape, it is hard to wind an inflatable cuff around it. Moreover, since arterial vessels running in an inferior limb are present deep in adipose tissues and muscles, it is naturally harder to measure an inferior-limb BP value than measure a superior-limb BP value. In the case where blood vessels running in a portion of an inferior limb from which an inferior-limb BP value is measured suffer highly advanced calcification, those blood vessels cannot be fully occluded by the pressing of an inflatable cuff and accordingly an excessively high inferior-limb BP value may be measured. Therefore, if a person who suffers arterial obstruction or arteriostenosis also suffers advanced calcification of his or her inferior-limb blood vessels, a normal superior-and-inferiorlimb BP index value may be measured from the person. In this case, arterial obstruction or arteriostenosis cannot be accurately diagnoses based on the superior-and-inferiorlimb BP index. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
System for measuring blood pressure Inventor(s): Glick, Baruch; (Haifa, IL), Urbach, Israel; (Haifa, IL), Wasserman, Yoram; (Haifa, IL), Palti, Yoram; (Haifa, IL) Correspondence: PHILIPS ELECTRONICS NORTH AMERICAN CORP; 580 WHITE PLAINS RD; TARRYTOWN; NY; 10591; US Patent Application Number: 20030114766 Date filed: January 23, 2003 Abstract: A system (1) for measuring blood pressure during a limited number of blood pressure cycles at an area (2) overlying an artery (3) of a living subject, comprising means (4) for applying a pressure (P) to the artery for occluding said artery in response to a pressure signal (Uprise), and for subsequently releasing said pressure to re-open said artery in response to a pressure release signal (Uprelease), and means (11) for computing, by comparing a first time duration (.DELTA.T1) with a second time duration (.DELTA.T2), a delay time (Tdelay1) from a reference point in time after which a next pressure release signal is to be supplied to said means (4) for applying a pressure, and for computing a pressure (P2) to be applied to said artery in a next measuring cycle, and for supplying subsequently a pressure signal (Uprise) and a pressure release signal (Uprelease) corresponding to said computed pressure (P2) and delay time (Tdelay1) to said means (4) for applying a pressure. Excerpt(s): The invention relates to a system for measuring blood pressure during a limited number of blood pressure cycles at an area overlying an artery of a living subject. A system of the type defined in the opening paragraph is known from U.S. Pat. No. 4,660,566. The known system comprises a measuring unit comprising a sensor provided on an inflatable cushion, and a processing unit. The cushion is provided on a carrier comprising a bracelet of flexible material worn by a user around his or her wrist. In this known system, pressure pulses are applied by means of the cushion to a local, discrete external point overlying the radial artery of the subject, to effect a blocking and successively an unblocking condition of the artery, or to effect an unblocking and successively a blocking condition of the artery. When the sensor detects said respective unblocking or blocking condition, the instantaneous value of the pressure in the cushion is measured for the purpose of providing through the processing unit a value of said subject's blood pressure. A disadvantage of the known system is that the measurement results of the systolic and diastolic blood pressure given by the system are not accurate
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due to the fact that the measurements along the subjects pressure line cannot be exactly located, and it is not known whether there is at least one measurement at the systolic peak and one at the diastolic minimum of the blood pressure cycle. Because of this, long measurement times are needed in order to have a high statistical probability that the measurements have taken place at those points in time at which the systolic and the diastolic pressure occurred. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Use of dipeptidyl peptidase IV effectors for lowering blood pressure in mammals Inventor(s): Pospisilik, Andrew J. (Vancouver, CA), Glund, Konrad; (Halle, DE), Mcintosh, Christopher H.S. (Vancouver, CA), Hoffmann, Matthias; (Wengelsdorf, DE), Pederson, Ray A. (Vancouver, CA), Demuth, Hans-Ulrich; (Halle, DE) Correspondence: BROWN RUDNICK FREED AND GESMER P C; BOX IP; 18TH FLOOR ONE FINANCIAL CENTER; BOSTON; MA; 02111; US Patent Application Number: 20020006899 Date filed: August 17, 2001 Abstract: The invention comprises the use of activity-reducing effectors of dipeptidyl peptidase (DP IV) and DP IV-analogous enzyme activity in the blood of a mammal to lower the blood sugar level and the blood pressure in mammalian organisms. Excerpt(s): This is a continuation in part of co-pending U.S. Ser. No. 09/155,833. The present invention relates to a novel method for the reduction in the concentration of circulating blood glucose and blood pressure by applying activity lowering effectors (substrates, pseudosubstrates, inhibitors, binding proteins, antibodies and the like) of enzymes with similar or identical activity to the enzymatic activity of the enzyme Dipeptidyl Peptidase IV. Besides proteases involved in non-specific proteolysis, proteases resulting in the specific degradation of proteins are known which are involved in the functional regulation (activation, deactivation or modulation) of endogenous peptides. [KIRSCHKE, H., LANGNER, J., RIEMANN, S., WIEDERANDERS, B., ANSORGE, S. and BOHLEY, P., Lysosomal cysteine proteases. Excerpta Medica (Ciba Foundation Symposium 75), 15 (1980); KRUSSLICH, H.-G. and WIMMER, E., Viral Proteinases. Ann. Rev. Biochem. 57, 701 (1987)]. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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User releasable and adjustable blood pressure cuff and method Inventor(s): Sadritabrizi, Alireza; (Issaquah, WA), Sadritabrizi, Alireza; (Issaquah, WA), Sadritabrizi, Alireza; (Issaquah, WA), Sadritabrizi, Alireza; (Issaquah, WA) Correspondence: Steven H. Arterberry, Esq. DORSEY & WHITNEY LLP; Suite 3400; 1420 Fifth Avenue; Seattle; WA; 98101; US, Steven H. Arterberry, Esq. DORSEY & WHITNEY LLP; Suite 3400; 1420 Fifth Avenue; Seattle; WA; 98101; US, Steven H. Arterberry, Esq. DORSEY & WHITNEY LLP; Suite 3400; 1420 Fifth Avenue; Seattle; WA; 98101; US, Steven H. Arterberry, Esq. DORSEY & WHITNEY LLP; Suite 3400; 1420 Fifth Avenue; Seattle; WA; 98101; US Patent Application Number: 20030078507 Date filed: July 11, 2002
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Abstract: The present invention is directed to a method and apparatus for obtaining blood pressure measurements employing a user releasable and adjustable blood pressure cuff. In one aspect of the invention, the blood pressure cuff apparatus consists of a first cuff member connected to a mounting surface and rotatable about a first axis of rotation substantially perpendicular to the mounting surface. The first cuff member is connected to a second cuff member that is rotatable about a second axis of rotation that is substantially perpendicular to the first. A blood pressure cuff comprised of a loop adapted to receive the arm of a test subject is connected to the second cuff member. In another aspect of the invention, the elongated flexible band has a first end and a second end. The first end is connected to the second member of the cuff housing, and the second end is connected to a cuff retainer. The cuff retainer is releasibly latchable from the second member so that the elongated flexible band forms a loop to snugly fit the arm of the test subject with a first circumferential length when the cuff retainer is latched. When the cuff retainer is unlatched, the elongated flexible band forms a loop with a second circumferential length, which allows the arm of the test subject to be easily withdrawn. Excerpt(s): This invention relates to blood pressure measurements, and more particularly to a blood pressure cuff that may be easily installed around the arm and released. This invention relates to blood pressure measurements, and more particularly to a blood pressure cuff that may be easily installed around the arm and released. This invention relates to blood pressure measurements, and more particularly to a blood pressure cuff that may be easily installed around the arm and released. This invention relates to blood pressure measurements, and more particularly to a blood pressure cuff that may be easily installed around the arm and released. Hypertension in adults is regarded as a significant health risk since the symptoms of the disease are not apparent to the individual. The presence of the disease in the individual may therefore remain hidden until a catastrophic health event, such as a heart attack, or a stroke occurs. Fortunately, initial diagnosis of the condition is easily accomplished by a simple blood pressure measurement. Consequently, automatic blood pressure monitoring stations have become widely available to the general public that allow blood pressure measurements to be self-administered. An example of one such system is the VITASTAT.TM. blood pressure monitoring station manufactured by Spacelabs Medical, Inc. of Redmond, Wash., which is shown in U.S. Pat. No. D-371,844 to Sadritabrizi, et al. Briefly, the VITA-STAT.TM. station consists of a kiosk, in which a test subject can be accommodated in a sitting position. The test subject then places an upper arm into a blood pressure cuff apparatus that constricts the flow of blood in an artery to obtain blood pressure measurements at systole and diastole. A processor accepts and processes blood pressure signals obtained from the cuff apparatus during the examination, and subsequently displays the processed information to the test subject on a monitoring device. Hypertension in adults is regarded as a significant health risk since the symptoms of the disease are not apparent to the individual. The presence of the disease in the individual may therefore remain hidden until a catastrophic health event, such as a heart attack, or a stroke occurs. Fortunately, initial diagnosis of the condition is easily accomplished by a simple blood pressure measurement. Consequently, automatic blood pressure monitoring stations have become widely available to the general public that allow blood pressure measurements to be self-administered. An example of one such system is the VITA-STAT.TM. blood pressure monitoring station manufactured by Spacelabs Medical, Inc. of Redmond, Wash., which is shown in U.S. Pat. No. D-371,844 to Sadritabrizi, et al. Briefly, the VITA-STAT.TM. station consists of a kiosk, in which a test subject can be accommodated in a sitting position. The test subject then places an upper arm into a blood pressure cuff apparatus that constricts the flow of blood in an
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artery to obtain blood pressure measurements at systole and diastole. A processor accepts and processes blood pressure signals obtained from the cuff apparatus during the examination, and subsequently displays the processed information to the test subject on a monitoring device. Hypertension in adults is regarded as a significant health risk since the symptoms of the disease are not apparent to the individual. The presence of the disease in the individual may therefore remain hidden until a catastrophic health event, such as a heart attack, or a stroke occurs. Fortunately, initial diagnosis of the condition is easily accomplished by a simple blood pressure measurement. Consequently, automatic blood pressure monitoring stations have become widely available to the general public that allow blood pressure measurements to be selfadministered. An example of one such system is the VITA-STAT.TM. blood pressure monitoring station manufactured by Spacelabs Medical, Inc. of Redmond, Wash., which is shown in U.S. Pat. No. D-371,844 to Sadritabrizi, et al. Briefly, the VITA-STAT.TM. station consists of a kiosk, in which a test subject can be accommodated in a sitting position. The test subject then places an upper arm into a blood pressure cuff apparatus that constricts the flow of blood in an artery to obtain blood pressure measurements at systole and diastole. A processor accepts and processes blood pressure signals obtained from the cuff apparatus during the examination, and subsequently displays the processed information to the test subject on a monitoring device. Hypertension in adults is regarded as a significant health risk since the symptoms of the disease are not apparent to the individual. The presence of the disease in the individual may therefore remain hidden until a catastrophic health event, such as a heart attack, or a stroke occurs. Fortunately, initial diagnosis of the condition is easily accomplished by a simple blood pressure measurement. Consequently, automatic blood pressure monitoring stations have become widely available to the general public that allow blood pressure measurements to be self-administered. An example of one such system is the VITASTAT.TM. blood pressure monitoring station manufactured by Spacelabs Medical, Inc. of Redmond, Wash., which is shown in U.S. Pat. No. D-371,844 to Sadritabrizi, et al. Briefly, the VITA-STAT.TM. station consists of a kiosk, in which a test subject can be accommodated in a sitting position. The test subject then places an upper arm into a blood pressure cuff apparatus that constricts the flow of blood in an artery to obtain blood pressure measurements at systole and diastole. A processor accepts and processes blood pressure signals obtained from the cuff apparatus during the examination, and subsequently displays the processed information to the test subject on a monitoring device. A significant difficulty encountered in self-administered blood pressure measurements is the application of the blood pressure cuff to the test subject. The flat, flexible cuff commonly associated with the sphygmomanometer is particularly unsuited for use in automatic blood pressure monitoring stations, since the application of the flexible cuff around the arm of the test subject is difficult to accomplish without assistance. Moreover, once properly positioned, it must be secured into place by hooks, elastic bands, or specialized fasteners such as VELCRO.TM. As a consequence, a number of automatic cuff devices have been developed for use with automatic blood pressure monitoring stations. An example of a self-installing cuff apparatus is described in U.S. Pat. No. 4,109,646 to Keller, which uses a motor-driven rotating drum to continuously wrap a blood pressure band onto a limb of a test subject that is placed within the drum. Removal of the blood pressure band from the test subject is accomplished by reversing the motor. A similar technique is described in U.S. Pat. No. 4,206,765 to Huber, which uses a motor driven tensioning drum to tension the blood pressure band around the limb of a test subject. A slip clutch is provided to prevent over tensioning of the blood pressure band during the application of the band to the test subject. U.S. Pat. No. 3,935,984 to Lichowsky, et al., uses a mechanical cable wrapped around the blood pressure band to snug the band tightly about the arm of the test subject. Release of the
Patents 475
test subject's arm is similarly accomplished by reversing the direction of the motor. A significant difficulty encountered in self-administered blood pressure measurements is the application of the blood pressure cuff to the test subject. The flat, flexible cuff commonly associated with the sphygmomanometer is particularly unsuited for use in automatic blood pressure monitoring stations, since the application of the flexible cuff around the arm of the test subject is difficult to accomplish without assistance. Moreover, once properly positioned, it must be secured into place by hooks, elastic bands, or specialized fasteners such as VELCRO.TM. As a consequence, a number of automatic cuff devices have been developed for use with automatic blood pressure monitoring stations. An example of a self-installing cuff apparatus is described in U.S. Pat. No. 4,109,646 to Keller, which uses a motor-driven rotating drum to continuously wrap a blood pressure band onto a limb of a test subject that is placed within the drum. Removal of the blood pressure band from the test subject is accomplished by reversing the motor. A similar technique is described in U.S. Pat. No. 4,206,765 to Huber, which uses a motor driven tensioning drum to tension the blood pressure band around the limb of a test subject. A slip clutch is provided to prevent over tensioning of the blood pressure band during the application of the band to the test subject. U.S. Pat. No. 3,935,984 to Lichowsky, et al., uses a mechanical cable wrapped around the blood pressure band to snug the band tightly about the arm of the test subject. Release of the test subject's arm is similarly accomplished by reversing the direction of the motor. A significant difficulty encountered in self-administered blood pressure measurements is the application of the blood pressure cuff to the test subject. The flat, flexible cuff commonly associated with the sphygmomanometer is particularly unsuited for use in automatic blood pressure monitoring stations, since the application of the flexible cuff around the arm of the test subject is difficult to accomplish without assistance. Moreover, once properly positioned, it must be secured into place by hooks, elastic bands, or specialized fasteners such as VELCRO.TM. As a consequence, a number of automatic cuff devices have been developed for use with automatic blood pressure monitoring stations. An example of a self-installing cuff apparatus is described in U.S. Pat. No. 4,109,646 to Keller, which uses a motor-driven rotating drum to continuously wrap a blood pressure band onto a limb of a test subject that is placed within the drum. Removal of the blood pressure band from the test subject is accomplished by reversing the motor. A similar technique is described in U.S. Pat. No. 4,206,765 to Huber, which uses a motor driven tensioning drum to tension the blood pressure band around the limb of a test subject. A slip clutch is provided to prevent over tensioning of the blood pressure band during the application of the band to the test subject. U.S. Pat. No. 3,935,984 to Lichowsky, et al., uses a mechanical cable wrapped around the blood pressure band to snug the band tightly about the arm of the test subject. Release of the test subject's arm is similarly accomplished by reversing the direction of the motor. A significant difficulty encountered in self-administered blood pressure measurements is the application of the blood pressure cuff to the test subject. The flat, flexible cuff commonly associated with the sphygmomanometer is particularly unsuited for use in automatic blood pressure monitoring stations, since the application of the flexible cuff around the arm of the test subject is difficult to accomplish without assistance. Moreover, once properly positioned, it must be secured into place by hooks, elastic bands, or specialized fasteners such as VELCRO.TM. As a consequence, a number of automatic cuff devices have been developed for use with automatic blood pressure monitoring stations. An example of a self-installing cuff apparatus is described in U.S. Pat. No. 4,109,646 to Keller, which uses a motor-driven rotating drum to continuously wrap a blood pressure band onto a limb of a test subject that is placed within the drum. Removal of the blood pressure band from the test subject is accomplished by reversing the motor. A similar technique is described in U.S. Pat. No. 4,206,765 to Huber, which
476 Blood Pressure
uses a motor driven tensioning drum to tension the blood pressure band around the limb of a test subject. A slip clutch is provided to prevent over tensioning of the blood pressure band during the application of the band to the test subject. U.S. Pat. No. 3,935,984 to Lichowsky, et al., uses a mechanical cable wrapped around the blood pressure band to snug the band tightly about the arm of the test subject. Release of the test subject's arm is similarly accomplished by reversing the direction of the motor. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
User releasable and adjustable blood pressure cuff and method Inventor(s): Sadritabrizi, Alireza; (Issaquah, WA), Sadritabrizi, Alireza; (Issaquah, WA), Sadritabrizi, Alireza; (Issaquah, WA), Sadritabrizi, Alireza; (Issaquah, WA) Correspondence: Steven H. Arterberry, Esq. DORSEY & WHITNEY LLP; Suite 3400; 1420 Fifth Avenue; Seattle; WA; 98101; US, Steven H. Arterberry, Esq. DORSEY & WHITNEY LLP; Suite 3400; 1420 Fifth Avenue; Seattle; WA; 98101; US, Steven H. Arterberry, Esq. DORSEY & WHITNEY LLP; Suite 3400; 1420 Fifth Avenue; Seattle; WA; 98101; US, Steven H. Arterberry, Esq. DORSEY & WHITNEY LLP; Suite 3400; 1420 Fifth Avenue; Seattle; WA; 98101; US Patent Application Number: 20030078507 Date filed: July 11, 2002 Abstract: The present invention is directed to a method and apparatus for obtaining blood pressure measurements employing a user releasable and adjustable blood pressure cuff. In one aspect of the invention, the blood pressure cuff apparatus consists of a first cuff member connected to a mounting surface and rotatable about a first axis of rotation substantially perpendicular to the mounting surface. The first cuff member is connected to a second cuff member that is rotatable about a second axis of rotation that is substantially perpendicular to the first. A blood pressure cuff comprised of a loop adapted to receive the arm of a test subject is connected to the second cuff member. In another aspect of the invention, the elongated flexible band has a first end and a second end. The first end is connected to the second member of the cuff housing, and the second end is connected to a cuff retainer. The cuff retainer is releasibly latchable from the second member so that the elongated flexible band forms a loop to snugly fit the arm of the test subject with a first circumferential length when the cuff retainer is latched. When the cuff retainer is unlatched, the elongated flexible band forms a loop with a second circumferential length, which allows the arm of the test subject to be easily withdrawn. Excerpt(s): This invention relates to blood pressure measurements, and more particularly to a blood pressure cuff that may be easily installed around the arm and released. This invention relates to blood pressure measurements, and more particularly to a blood pressure cuff that may be easily installed around the arm and released. This invention relates to blood pressure measurements, and more particularly to a blood pressure cuff that may be easily installed around the arm and released. This invention relates to blood pressure measurements, and more particularly to a blood pressure cuff that may be easily installed around the arm and released. Hypertension in adults is regarded as a significant health risk since the symptoms of the disease are not apparent to the individual. The presence of the disease in the individual may therefore remain hidden until a catastrophic health event, such as a heart attack, or a stroke occurs. Fortunately, initial diagnosis of the condition is easily accomplished by a simple blood pressure measurement. Consequently, automatic blood pressure monitoring stations
Patents 477
have become widely available to the general public that allow blood pressure measurements to be self-administered. An example of one such system is the VITASTAT.TM. blood pressure monitoring station manufactured by Spacelabs Medical, Inc. of Redmond, Wash., which is shown in U.S. Pat. No. D-371,844 to Sadritabrizi, et al. Briefly, the VITA-STAT.TM. station consists of a kiosk, in which a test subject can be accommodated in a sitting position. The test subject then places an upper arm into a blood pressure cuff apparatus that constricts the flow of blood in an artery to obtain blood pressure measurements at systole and diastole. A processor accepts and processes blood pressure signals obtained from the cuff apparatus during the examination, and subsequently displays the processed information to the test subject on a monitoring device. Hypertension in adults is regarded as a significant health risk since the symptoms of the disease are not apparent to the individual. The presence of the disease in the individual may therefore remain hidden until a catastrophic health event, such as a heart attack, or a stroke occurs. Fortunately, initial diagnosis of the condition is easily accomplished by a simple blood pressure measurement. Consequently, automatic blood pressure monitoring stations have become widely available to the general public that allow blood pressure measurements to be self-administered. An example of one such system is the VITA-STAT.TM. blood pressure monitoring station manufactured by Spacelabs Medical, Inc. of Redmond, Wash., which is shown in U.S. Pat. No. D-371,844 to Sadritabrizi, et al. Briefly, the VITA-STAT.TM. station consists of a kiosk, in which a test subject can be accommodated in a sitting position. The test subject then places an upper arm into a blood pressure cuff apparatus that constricts the flow of blood in an artery to obtain blood pressure measurements at systole and diastole. A processor accepts and processes blood pressure signals obtained from the cuff apparatus during the examination, and subsequently displays the processed information to the test subject on a monitoring device. Hypertension in adults is regarded as a significant health risk since the symptoms of the disease are not apparent to the individual. The presence of the disease in the individual may therefore remain hidden until a catastrophic health event, such as a heart attack, or a stroke occurs. Fortunately, initial diagnosis of the condition is easily accomplished by a simple blood pressure measurement. Consequently, automatic blood pressure monitoring stations have become widely available to the general public that allow blood pressure measurements to be selfadministered. An example of one such system is the VITA-STAT.TM. blood pressure monitoring station manufactured by Spacelabs Medical, Inc. of Redmond, Wash., which is shown in U.S. Pat. No. D-371,844 to Sadritabrizi, et al. Briefly, the VITA-STAT.TM. station consists of a kiosk, in which a test subject can be accommodated in a sitting position. The test subject then places an upper arm into a blood pressure cuff apparatus that constricts the flow of blood in an artery to obtain blood pressure measurements at systole and diastole. A processor accepts and processes blood pressure signals obtained from the cuff apparatus during the examination, and subsequently displays the processed information to the test subject on a monitoring device. Hypertension in adults is regarded as a significant health risk since the symptoms of the disease are not apparent to the individual. The presence of the disease in the individual may therefore remain hidden until a catastrophic health event, such as a heart attack, or a stroke occurs. Fortunately, initial diagnosis of the condition is easily accomplished by a simple blood pressure measurement. Consequently, automatic blood pressure monitoring stations have become widely available to the general public that allow blood pressure measurements to be self-administered. An example of one such system is the VITASTAT.TM. blood pressure monitoring station manufactured by Spacelabs Medical, Inc. of Redmond, Wash., which is shown in U.S. Pat. No. D-371,844 to Sadritabrizi, et al. Briefly, the VITA-STAT.TM. station consists of a kiosk, in which a test subject can be accommodated in a sitting position. The test subject then places an upper arm into a
478 Blood Pressure
blood pressure cuff apparatus that constricts the flow of blood in an artery to obtain blood pressure measurements at systole and diastole. A processor accepts and processes blood pressure signals obtained from the cuff apparatus during the examination, and subsequently displays the processed information to the test subject on a monitoring device. A significant difficulty encountered in self-administered blood pressure measurements is the application of the blood pressure cuff to the test subject. The flat, flexible cuff commonly associated with the sphygmomanometer is particularly unsuited for use in automatic blood pressure monitoring stations, since the application of the flexible cuff around the arm of the test subject is difficult to accomplish without assistance. Moreover, once properly positioned, it must be secured into place by hooks, elastic bands, or specialized fasteners such as VELCRO.TM. As a consequence, a number of automatic cuff devices have been developed for use with automatic blood pressure monitoring stations. An example of a self-installing cuff apparatus is described in U.S. Pat. No. 4,109,646 to Keller, which uses a motor-driven rotating drum to continuously wrap a blood pressure band onto a limb of a test subject that is placed within the drum. Removal of the blood pressure band from the test subject is accomplished by reversing the motor. A similar technique is described in U.S. Pat. No. 4,206,765 to Huber, which uses a motor driven tensioning drum to tension the blood pressure band around the limb of a test subject. A slip clutch is provided to prevent over tensioning of the blood pressure band during the application of the band to the test subject. U.S. Pat. No. 3,935,984 to Lichowsky, et al., uses a mechanical cable wrapped around the blood pressure band to snug the band tightly about the arm of the test subject. Release of the test subject's arm is similarly accomplished by reversing the direction of the motor. A significant difficulty encountered in self-administered blood pressure measurements is the application of the blood pressure cuff to the test subject. The flat, flexible cuff commonly associated with the sphygmomanometer is particularly unsuited for use in automatic blood pressure monitoring stations, since the application of the flexible cuff around the arm of the test subject is difficult to accomplish without assistance. Moreover, once properly positioned, it must be secured into place by hooks, elastic bands, or specialized fasteners such as VELCRO.TM. As a consequence, a number of automatic cuff devices have been developed for use with automatic blood pressure monitoring stations. An example of a self-installing cuff apparatus is described in U.S. Pat. No. 4,109,646 to Keller, which uses a motor-driven rotating drum to continuously wrap a blood pressure band onto a limb of a test subject that is placed within the drum. Removal of the blood pressure band from the test subject is accomplished by reversing the motor. A similar technique is described in U.S. Pat. No. 4,206,765 to Huber, which uses a motor driven tensioning drum to tension the blood pressure band around the limb of a test subject. A slip clutch is provided to prevent over tensioning of the blood pressure band during the application of the band to the test subject. U.S. Pat. No. 3,935,984 to Lichowsky, et al., uses a mechanical cable wrapped around the blood pressure band to snug the band tightly about the arm of the test subject. Release of the test subject's arm is similarly accomplished by reversing the direction of the motor. A significant difficulty encountered in self-administered blood pressure measurements is the application of the blood pressure cuff to the test subject. The flat, flexible cuff commonly associated with the sphygmomanometer is particularly unsuited for use in automatic blood pressure monitoring stations, since the application of the flexible cuff around the arm of the test subject is difficult to accomplish without assistance. Moreover, once properly positioned, it must be secured into place by hooks, elastic bands, or specialized fasteners such as VELCRO.TM. As a consequence, a number of automatic cuff devices have been developed for use with automatic blood pressure monitoring stations. An example of a self-installing cuff apparatus is described in U.S. Pat. No. 4,109,646 to Keller, which uses a motor-driven rotating drum to continuously
Patents 479
wrap a blood pressure band onto a limb of a test subject that is placed within the drum. Removal of the blood pressure band from the test subject is accomplished by reversing the motor. A similar technique is described in U.S. Pat. No. 4,206,765 to Huber, which uses a motor driven tensioning drum to tension the blood pressure band around the limb of a test subject. A slip clutch is provided to prevent over tensioning of the blood pressure band during the application of the band to the test subject. U.S. Pat. No. 3,935,984 to Lichowsky, et al., uses a mechanical cable wrapped around the blood pressure band to snug the band tightly about the arm of the test subject. Release of the test subject's arm is similarly accomplished by reversing the direction of the motor. A significant difficulty encountered in self-administered blood pressure measurements is the application of the blood pressure cuff to the test subject. The flat, flexible cuff commonly associated with the sphygmomanometer is particularly unsuited for use in automatic blood pressure monitoring stations, since the application of the flexible cuff around the arm of the test subject is difficult to accomplish without assistance. Moreover, once properly positioned, it must be secured into place by hooks, elastic bands, or specialized fasteners such as VELCRO.TM. As a consequence, a number of automatic cuff devices have been developed for use with automatic blood pressure monitoring stations. An example of a self-installing cuff apparatus is described in U.S. Pat. No. 4,109,646 to Keller, which uses a motor-driven rotating drum to continuously wrap a blood pressure band onto a limb of a test subject that is placed within the drum. Removal of the blood pressure band from the test subject is accomplished by reversing the motor. A similar technique is described in U.S. Pat. No. 4,206,765 to Huber, which uses a motor driven tensioning drum to tension the blood pressure band around the limb of a test subject. A slip clutch is provided to prevent over tensioning of the blood pressure band during the application of the band to the test subject. U.S. Pat. No. 3,935,984 to Lichowsky, et al., uses a mechanical cable wrapped around the blood pressure band to snug the band tightly about the arm of the test subject. Release of the test subject's arm is similarly accomplished by reversing the direction of the motor. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
User releasable and adjustable blood pressure cuff and method Inventor(s): Sadritabrizi, Alireza; (Issaquah, WA), Sadritabrizi, Alireza; (Issaquah, WA), Sadritabrizi, Alireza; (Issaquah, WA), Sadritabrizi, Alireza; (Issaquah, WA) Correspondence: Steven H. Arterberry, Esq. DORSEY & WHITNEY LLP; Suite 3400; 1420 Fifth Avenue; Seattle; WA; 98101; US, Steven H. Arterberry, Esq. DORSEY & WHITNEY LLP; Suite 3400; 1420 Fifth Avenue; Seattle; WA; 98101; US, Steven H. Arterberry, Esq. DORSEY & WHITNEY LLP; Suite 3400; 1420 Fifth Avenue; Seattle; WA; 98101; US, Steven H. Arterberry, Esq. DORSEY & WHITNEY LLP; Suite 3400; 1420 Fifth Avenue; Seattle; WA; 98101; US Patent Application Number: 20030078507 Date filed: July 11, 2002 Abstract: The present invention is directed to a method and apparatus for obtaining blood pressure measurements employing a user releasable and adjustable blood pressure cuff. In one aspect of the invention, the blood pressure cuff apparatus consists of a first cuff member connected to a mounting surface and rotatable about a first axis of rotation substantially perpendicular to the mounting surface. The first cuff member is connected to a second cuff member that is rotatable about a second axis of rotation that is substantially perpendicular to the first. A blood pressure cuff comprised of a loop
480 Blood Pressure
adapted to receive the arm of a test subject is connected to the second cuff member. In another aspect of the invention, the elongated flexible band has a first end and a second end. The first end is connected to the second member of the cuff housing, and the second end is connected to a cuff retainer. The cuff retainer is releasibly latchable from the second member so that the elongated flexible band forms a loop to snugly fit the arm of the test subject with a first circumferential length when the cuff retainer is latched. When the cuff retainer is unlatched, the elongated flexible band forms a loop with a second circumferential length, which allows the arm of the test subject to be easily withdrawn. Excerpt(s): This invention relates to blood pressure measurements, and more particularly to a blood pressure cuff that may be easily installed around the arm and released. This invention relates to blood pressure measurements, and more particularly to a blood pressure cuff that may be easily installed around the arm and released. This invention relates to blood pressure measurements, and more particularly to a blood pressure cuff that may be easily installed around the arm and released. This invention relates to blood pressure measurements, and more particularly to a blood pressure cuff that may be easily installed around the arm and released. Hypertension in adults is regarded as a significant health risk since the symptoms of the disease are not apparent to the individual. The presence of the disease in the individual may therefore remain hidden until a catastrophic health event, such as a heart attack, or a stroke occurs. Fortunately, initial diagnosis of the condition is easily accomplished by a simple blood pressure measurement. Consequently, automatic blood pressure monitoring stations have become widely available to the general public that allow blood pressure measurements to be self-administered. An example of one such system is the VITASTAT.TM. blood pressure monitoring station manufactured by Spacelabs Medical, Inc. of Redmond, Wash., which is shown in U.S. Pat. No. D-371,844 to Sadritabrizi, et al. Briefly, the VITA-STAT.TM. station consists of a kiosk, in which a test subject can be accommodated in a sitting position. The test subject then places an upper arm into a blood pressure cuff apparatus that constricts the flow of blood in an artery to obtain blood pressure measurements at systole and diastole. A processor accepts and processes blood pressure signals obtained from the cuff apparatus during the examination, and subsequently displays the processed information to the test subject on a monitoring device. Hypertension in adults is regarded as a significant health risk since the symptoms of the disease are not apparent to the individual. The presence of the disease in the individual may therefore remain hidden until a catastrophic health event, such as a heart attack, or a stroke occurs. Fortunately, initial diagnosis of the condition is easily accomplished by a simple blood pressure measurement. Consequently, automatic blood pressure monitoring stations have become widely available to the general public that allow blood pressure measurements to be self-administered. An example of one such system is the VITA-STAT.TM. blood pressure monitoring station manufactured by Spacelabs Medical, Inc. of Redmond, Wash., which is shown in U.S. Pat. No. D-371,844 to Sadritabrizi, et al. Briefly, the VITA-STAT.TM. station consists of a kiosk, in which a test subject can be accommodated in a sitting position. The test subject then places an upper arm into a blood pressure cuff apparatus that constricts the flow of blood in an artery to obtain blood pressure measurements at systole and diastole. A processor accepts and processes blood pressure signals obtained from the cuff apparatus during the examination, and subsequently displays the processed information to the test subject on a monitoring device. Hypertension in adults is regarded as a significant health risk since the symptoms of the disease are not apparent to the individual. The presence of the disease in the individual may therefore remain hidden until a catastrophic health event, such as a heart attack, or a stroke occurs. Fortunately, initial diagnosis of the
Patents 481
condition is easily accomplished by a simple blood pressure measurement. Consequently, automatic blood pressure monitoring stations have become widely available to the general public that allow blood pressure measurements to be selfadministered. An example of one such system is the VITA-STAT.TM. blood pressure monitoring station manufactured by Spacelabs Medical, Inc. of Redmond, Wash., which is shown in U.S. Pat. No. D-371,844 to Sadritabrizi, et al. Briefly, the VITA-STAT.TM. station consists of a kiosk, in which a test subject can be accommodated in a sitting position. The test subject then places an upper arm into a blood pressure cuff apparatus that constricts the flow of blood in an artery to obtain blood pressure measurements at systole and diastole. A processor accepts and processes blood pressure signals obtained from the cuff apparatus during the examination, and subsequently displays the processed information to the test subject on a monitoring device. Hypertension in adults is regarded as a significant health risk since the symptoms of the disease are not apparent to the individual. The presence of the disease in the individual may therefore remain hidden until a catastrophic health event, such as a heart attack, or a stroke occurs. Fortunately, initial diagnosis of the condition is easily accomplished by a simple blood pressure measurement. Consequently, automatic blood pressure monitoring stations have become widely available to the general public that allow blood pressure measurements to be self-administered. An example of one such system is the VITASTAT.TM. blood pressure monitoring station manufactured by Spacelabs Medical, Inc. of Redmond, Wash., which is shown in U.S. Pat. No. D-371,844 to Sadritabrizi, et al. Briefly, the VITA-STAT.TM. station consists of a kiosk, in which a test subject can be accommodated in a sitting position. The test subject then places an upper arm into a blood pressure cuff apparatus that constricts the flow of blood in an artery to obtain blood pressure measurements at systole and diastole. A processor accepts and processes blood pressure signals obtained from the cuff apparatus during the examination, and subsequently displays the processed information to the test subject on a monitoring device. A significant difficulty encountered in self-administered blood pressure measurements is the application of the blood pressure cuff to the test subject. The flat, flexible cuff commonly associated with the sphygmomanometer is particularly unsuited for use in automatic blood pressure monitoring stations, since the application of the flexible cuff around the arm of the test subject is difficult to accomplish without assistance. Moreover, once properly positioned, it must be secured into place by hooks, elastic bands, or specialized fasteners such as VELCRO.TM. As a consequence, a number of automatic cuff devices have been developed for use with automatic blood pressure monitoring stations. An example of a self-installing cuff apparatus is described in U.S. Pat. No. 4,109,646 to Keller, which uses a motor-driven rotating drum to continuously wrap a blood pressure band onto a limb of a test subject that is placed within the drum. Removal of the blood pressure band from the test subject is accomplished by reversing the motor. A similar technique is described in U.S. Pat. No. 4,206,765 to Huber, which uses a motor driven tensioning drum to tension the blood pressure band around the limb of a test subject. A slip clutch is provided to prevent over tensioning of the blood pressure band during the application of the band to the test subject. U.S. Pat. No. 3,935,984 to Lichowsky, et al., uses a mechanical cable wrapped around the blood pressure band to snug the band tightly about the arm of the test subject. Release of the test subject's arm is similarly accomplished by reversing the direction of the motor. A significant difficulty encountered in self-administered blood pressure measurements is the application of the blood pressure cuff to the test subject. The flat, flexible cuff commonly associated with the sphygmomanometer is particularly unsuited for use in automatic blood pressure monitoring stations, since the application of the flexible cuff around the arm of the test subject is difficult to accomplish without assistance. Moreover, once properly positioned, it must be secured into place by hooks, elastic
482 Blood Pressure
bands, or specialized fasteners such as VELCRO.TM. As a consequence, a number of automatic cuff devices have been developed for use with automatic blood pressure monitoring stations. An example of a self-installing cuff apparatus is described in U.S. Pat. No. 4,109,646 to Keller, which uses a motor-driven rotating drum to continuously wrap a blood pressure band onto a limb of a test subject that is placed within the drum. Removal of the blood pressure band from the test subject is accomplished by reversing the motor. A similar technique is described in U.S. Pat. No. 4,206,765 to Huber, which uses a motor driven tensioning drum to tension the blood pressure band around the limb of a test subject. A slip clutch is provided to prevent over tensioning of the blood pressure band during the application of the band to the test subject. U.S. Pat. No. 3,935,984 to Lichowsky, et al., uses a mechanical cable wrapped around the blood pressure band to snug the band tightly about the arm of the test subject. Release of the test subject's arm is similarly accomplished by reversing the direction of the motor. A significant difficulty encountered in self-administered blood pressure measurements is the application of the blood pressure cuff to the test subject. The flat, flexible cuff commonly associated with the sphygmomanometer is particularly unsuited for use in automatic blood pressure monitoring stations, since the application of the flexible cuff around the arm of the test subject is difficult to accomplish without assistance. Moreover, once properly positioned, it must be secured into place by hooks, elastic bands, or specialized fasteners such as VELCRO.TM. As a consequence, a number of automatic cuff devices have been developed for use with automatic blood pressure monitoring stations. An example of a self-installing cuff apparatus is described in U.S. Pat. No. 4,109,646 to Keller, which uses a motor-driven rotating drum to continuously wrap a blood pressure band onto a limb of a test subject that is placed within the drum. Removal of the blood pressure band from the test subject is accomplished by reversing the motor. A similar technique is described in U.S. Pat. No. 4,206,765 to Huber, which uses a motor driven tensioning drum to tension the blood pressure band around the limb of a test subject. A slip clutch is provided to prevent over tensioning of the blood pressure band during the application of the band to the test subject. U.S. Pat. No. 3,935,984 to Lichowsky, et al., uses a mechanical cable wrapped around the blood pressure band to snug the band tightly about the arm of the test subject. Release of the test subject's arm is similarly accomplished by reversing the direction of the motor. A significant difficulty encountered in self-administered blood pressure measurements is the application of the blood pressure cuff to the test subject. The flat, flexible cuff commonly associated with the sphygmomanometer is particularly unsuited for use in automatic blood pressure monitoring stations, since the application of the flexible cuff around the arm of the test subject is difficult to accomplish without assistance. Moreover, once properly positioned, it must be secured into place by hooks, elastic bands, or specialized fasteners such as VELCRO.TM. As a consequence, a number of automatic cuff devices have been developed for use with automatic blood pressure monitoring stations. An example of a self-installing cuff apparatus is described in U.S. Pat. No. 4,109,646 to Keller, which uses a motor-driven rotating drum to continuously wrap a blood pressure band onto a limb of a test subject that is placed within the drum. Removal of the blood pressure band from the test subject is accomplished by reversing the motor. A similar technique is described in U.S. Pat. No. 4,206,765 to Huber, which uses a motor driven tensioning drum to tension the blood pressure band around the limb of a test subject. A slip clutch is provided to prevent over tensioning of the blood pressure band during the application of the band to the test subject. U.S. Pat. No. 3,935,984 to Lichowsky, et al., uses a mechanical cable wrapped around the blood pressure band to snug the band tightly about the arm of the test subject. Release of the test subject's arm is similarly accomplished by reversing the direction of the motor.
Patents 483
Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
User releasable and adjustable blood pressure cuff and method Inventor(s): Sadritabrizi, Alireza; (Issaquah, WA), Sadritabrizi, Alireza; (Issaquah, WA), Sadritabrizi, Alireza; (Issaquah, WA), Sadritabrizi, Alireza; (Issaquah, WA) Correspondence: Steven H. Arterberry, Esq. DORSEY & WHITNEY LLP; Suite 3400; 1420 Fifth Avenue; Seattle; WA; 98101; US, Steven H. Arterberry, Esq. DORSEY & WHITNEY LLP; Suite 3400; 1420 Fifth Avenue; Seattle; WA; 98101; US, Steven H. Arterberry, Esq. DORSEY & WHITNEY LLP; Suite 3400; 1420 Fifth Avenue; Seattle; WA; 98101; US, Steven H. Arterberry, Esq. DORSEY & WHITNEY LLP; Suite 3400; 1420 Fifth Avenue; Seattle; WA; 98101; US Patent Application Number: 20030078507 Date filed: July 11, 2002 Abstract: The present invention is directed to a method and apparatus for obtaining blood pressure measurements employing a user releasable and adjustable blood pressure cuff. In one aspect of the invention, the blood pressure cuff apparatus consists of a first cuff member connected to a mounting surface and rotatable about a first axis of rotation substantially perpendicular to the mounting surface. The first cuff member is connected to a second cuff member that is rotatable about a second axis of rotation that is substantially perpendicular to the first. A blood pressure cuff comprised of a loop adapted to receive the arm of a test subject is connected to the second cuff member. In another aspect of the invention, the elongated flexible band has a first end and a second end. The first end is connected to the second member of the cuff housing, and the second end is connected to a cuff retainer. The cuff retainer is releasibly latchable from the second member so that the elongated flexible band forms a loop to snugly fit the arm of the test subject with a first circumferential length when the cuff retainer is latched. When the cuff retainer is unlatched, the elongated flexible band forms a loop with a second circumferential length, which allows the arm of the test subject to be easily withdrawn. Excerpt(s): This invention relates to blood pressure measurements, and more particularly to a blood pressure cuff that may be easily installed around the arm and released. This invention relates to blood pressure measurements, and more particularly to a blood pressure cuff that may be easily installed around the arm and released. This invention relates to blood pressure measurements, and more particularly to a blood pressure cuff that may be easily installed around the arm and released. This invention relates to blood pressure measurements, and more particularly to a blood pressure cuff that may be easily installed around the arm and released. Hypertension in adults is regarded as a significant health risk since the symptoms of the disease are not apparent to the individual. The presence of the disease in the individual may therefore remain hidden until a catastrophic health event, such as a heart attack, or a stroke occurs. Fortunately, initial diagnosis of the condition is easily accomplished by a simple blood pressure measurement. Consequently, automatic blood pressure monitoring stations have become widely available to the general public that allow blood pressure measurements to be self-administered. An example of one such system is the VITASTAT.TM. blood pressure monitoring station manufactured by Spacelabs Medical, Inc. of Redmond, Wash., which is shown in U.S. Pat. No. D-371,844 to Sadritabrizi, et al. Briefly, the VITA-STAT.TM. station consists of a kiosk, in which a test subject can be accommodated in a sitting position. The test subject then places an upper arm into a
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blood pressure cuff apparatus that constricts the flow of blood in an artery to obtain blood pressure measurements at systole and diastole. A processor accepts and processes blood pressure signals obtained from the cuff apparatus during the examination, and subsequently displays the processed information to the test subject on a monitoring device. Hypertension in adults is regarded as a significant health risk since the symptoms of the disease are not apparent to the individual. The presence of the disease in the individual may therefore remain hidden until a catastrophic health event, such as a heart attack, or a stroke occurs. Fortunately, initial diagnosis of the condition is easily accomplished by a simple blood pressure measurement. Consequently, automatic blood pressure monitoring stations have become widely available to the general public that allow blood pressure measurements to be self-administered. An example of one such system is the VITA-STAT.TM. blood pressure monitoring station manufactured by Spacelabs Medical, Inc. of Redmond, Wash., which is shown in U.S. Pat. No. D-371,844 to Sadritabrizi, et al. Briefly, the VITA-STAT.TM. station consists of a kiosk, in which a test subject can be accommodated in a sitting position. The test subject then places an upper arm into a blood pressure cuff apparatus that constricts the flow of blood in an artery to obtain blood pressure measurements at systole and diastole. A processor accepts and processes blood pressure signals obtained from the cuff apparatus during the examination, and subsequently displays the processed information to the test subject on a monitoring device. Hypertension in adults is regarded as a significant health risk since the symptoms of the disease are not apparent to the individual. The presence of the disease in the individual may therefore remain hidden until a catastrophic health event, such as a heart attack, or a stroke occurs. Fortunately, initial diagnosis of the condition is easily accomplished by a simple blood pressure measurement. Consequently, automatic blood pressure monitoring stations have become widely available to the general public that allow blood pressure measurements to be selfadministered. An example of one such system is the VITA-STAT.TM. blood pressure monitoring station manufactured by Spacelabs Medical, Inc. of Redmond, Wash., which is shown in U.S. Pat. No. D-371,844 to Sadritabrizi, et al. Briefly, the VITA-STAT.TM. station consists of a kiosk, in which a test subject can be accommodated in a sitting position. The test subject then places an upper arm into a blood pressure cuff apparatus that constricts the flow of blood in an artery to obtain blood pressure measurements at systole and diastole. A processor accepts and processes blood pressure signals obtained from the cuff apparatus during the examination, and subsequently displays the processed information to the test subject on a monitoring device. Hypertension in adults is regarded as a significant health risk since the symptoms of the disease are not apparent to the individual. The presence of the disease in the individual may therefore remain hidden until a catastrophic health event, such as a heart attack, or a stroke occurs. Fortunately, initial diagnosis of the condition is easily accomplished by a simple blood pressure measurement. Consequently, automatic blood pressure monitoring stations have become widely available to the general public that allow blood pressure measurements to be self-administered. An example of one such system is the VITASTAT.TM. blood pressure monitoring station manufactured by Spacelabs Medical, Inc. of Redmond, Wash., which is shown in U.S. Pat. No. D-371,844 to Sadritabrizi, et al. Briefly, the VITA-STAT.TM. station consists of a kiosk, in which a test subject can be accommodated in a sitting position. The test subject then places an upper arm into a blood pressure cuff apparatus that constricts the flow of blood in an artery to obtain blood pressure measurements at systole and diastole. A processor accepts and processes blood pressure signals obtained from the cuff apparatus during the examination, and subsequently displays the processed information to the test subject on a monitoring device. A significant difficulty encountered in self-administered blood pressure measurements is the application of the blood pressure cuff to the test subject. The flat,
Patents 485
flexible cuff commonly associated with the sphygmomanometer is particularly unsuited for use in automatic blood pressure monitoring stations, since the application of the flexible cuff around the arm of the test subject is difficult to accomplish without assistance. Moreover, once properly positioned, it must be secured into place by hooks, elastic bands, or specialized fasteners such as VELCRO.TM. As a consequence, a number of automatic cuff devices have been developed for use with automatic blood pressure monitoring stations. An example of a self-installing cuff apparatus is described in U.S. Pat. No. 4,109,646 to Keller, which uses a motor-driven rotating drum to continuously wrap a blood pressure band onto a limb of a test subject that is placed within the drum. Removal of the blood pressure band from the test subject is accomplished by reversing the motor. A similar technique is described in U.S. Pat. No. 4,206,765 to Huber, which uses a motor driven tensioning drum to tension the blood pressure band around the limb of a test subject. A slip clutch is provided to prevent over tensioning of the blood pressure band during the application of the band to the test subject. U.S. Pat. No. 3,935,984 to Lichowsky, et al., uses a mechanical cable wrapped around the blood pressure band to snug the band tightly about the arm of the test subject. Release of the test subject's arm is similarly accomplished by reversing the direction of the motor. A significant difficulty encountered in self-administered blood pressure measurements is the application of the blood pressure cuff to the test subject. The flat, flexible cuff commonly associated with the sphygmomanometer is particularly unsuited for use in automatic blood pressure monitoring stations, since the application of the flexible cuff around the arm of the test subject is difficult to accomplish without assistance. Moreover, once properly positioned, it must be secured into place by hooks, elastic bands, or specialized fasteners such as VELCRO.TM. As a consequence, a number of automatic cuff devices have been developed for use with automatic blood pressure monitoring stations. An example of a self-installing cuff apparatus is described in U.S. Pat. No. 4,109,646 to Keller, which uses a motor-driven rotating drum to continuously wrap a blood pressure band onto a limb of a test subject that is placed within the drum. Removal of the blood pressure band from the test subject is accomplished by reversing the motor. A similar technique is described in U.S. Pat. No. 4,206,765 to Huber, which uses a motor driven tensioning drum to tension the blood pressure band around the limb of a test subject. A slip clutch is provided to prevent over tensioning of the blood pressure band during the application of the band to the test subject. U.S. Pat. No. 3,935,984 to Lichowsky, et al., uses a mechanical cable wrapped around the blood pressure band to snug the band tightly about the arm of the test subject. Release of the test subject's arm is similarly accomplished by reversing the direction of the motor. A significant difficulty encountered in self-administered blood pressure measurements is the application of the blood pressure cuff to the test subject. The flat, flexible cuff commonly associated with the sphygmomanometer is particularly unsuited for use in automatic blood pressure monitoring stations, since the application of the flexible cuff around the arm of the test subject is difficult to accomplish without assistance. Moreover, once properly positioned, it must be secured into place by hooks, elastic bands, or specialized fasteners such as VELCRO.TM. As a consequence, a number of automatic cuff devices have been developed for use with automatic blood pressure monitoring stations. An example of a self-installing cuff apparatus is described in U.S. Pat. No. 4,109,646 to Keller, which uses a motor-driven rotating drum to continuously wrap a blood pressure band onto a limb of a test subject that is placed within the drum. Removal of the blood pressure band from the test subject is accomplished by reversing the motor. A similar technique is described in U.S. Pat. No. 4,206,765 to Huber, which uses a motor driven tensioning drum to tension the blood pressure band around the limb of a test subject. A slip clutch is provided to prevent over tensioning of the blood pressure band during the application of the band to the test subject. U.S. Pat. No.
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3,935,984 to Lichowsky, et al., uses a mechanical cable wrapped around the blood pressure band to snug the band tightly about the arm of the test subject. Release of the test subject's arm is similarly accomplished by reversing the direction of the motor. A significant difficulty encountered in self-administered blood pressure measurements is the application of the blood pressure cuff to the test subject. The flat, flexible cuff commonly associated with the sphygmomanometer is particularly unsuited for use in automatic blood pressure monitoring stations, since the application of the flexible cuff around the arm of the test subject is difficult to accomplish without assistance. Moreover, once properly positioned, it must be secured into place by hooks, elastic bands, or specialized fasteners such as VELCRO.TM. As a consequence, a number of automatic cuff devices have been developed for use with automatic blood pressure monitoring stations. An example of a self-installing cuff apparatus is described in U.S. Pat. No. 4,109,646 to Keller, which uses a motor-driven rotating drum to continuously wrap a blood pressure band onto a limb of a test subject that is placed within the drum. Removal of the blood pressure band from the test subject is accomplished by reversing the motor. A similar technique is described in U.S. Pat. No. 4,206,765 to Huber, which uses a motor driven tensioning drum to tension the blood pressure band around the limb of a test subject. A slip clutch is provided to prevent over tensioning of the blood pressure band during the application of the band to the test subject. U.S. Pat. No. 3,935,984 to Lichowsky, et al., uses a mechanical cable wrapped around the blood pressure band to snug the band tightly about the arm of the test subject. Release of the test subject's arm is similarly accomplished by reversing the direction of the motor. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Keeping Current In order to stay informed about patents and patent applications dealing with blood pressure, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “blood pressure” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on blood pressure. You can also use this procedure to view pending patent applications concerning blood pressure. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
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CHAPTER 7. BOOKS ON BLOOD PRESSURE Overview This chapter provides bibliographic book references relating to blood pressure. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on blood pressure include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “blood pressure” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on blood pressure: •
Mayo Clinic on High Blood Pressure Source: New York, NY: Kensington Publishing. 1999. 180 p. Contact: Available from Mayo Clinic. 200 First Street, S.W., Rochester, MN 55905. (800) 291-1128 or (507) 284-2511. Fax (507) 284-0161. Website: www.mayo.edu. PRICE: $14.95 plus shipping and handling. ISBN: 1893005011. Summary: This book focuses on what people who have high blood pressure can do to better manage their blood pressure and keep it at a safe level. The book begins with a chapter that explains the basics of blood pressure, how high blood pressure develops, and why it can be harmful. This is followed by a chapter that identifies unmodifiable and modifiable risk factors for high blood pressure. Unmodifiable risk factors include race, age, family history, and gender. Modifiable risk factors include obesity, inactivity, tobacco use, sodium sensitivity, low potassium, excessive alcohol consumption, stress,
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chronic illness, high cholesterol, diabetes, sleep apnea, and heart failure. Other topics addressed in this chapter include secondary high blood pressure and ways of preventing high blood pressure. The third chapter focuses on the diagnosis and treatment of high blood pressure. Topics include measuring blood pressure, receiving a diagnosis, getting a medical evaluation, and deciding on treatment with either medication or lifestyle changes. Subsequent chapters discuss determining a healthy weight, losing weight, becoming more physically active, and eating well using the Dietary Approaches to Stop Hypertension (DASH) plan. The following chapters detail the effects of sodium, tobacco, alcohol, caffeine, and stress on blood pressure. Another chapter focuses on the mode of action and side effects of various medications used in controlling high blood pressure, including diuretics, beta blockers, angiotensinconverting enzyme inhibitors, angiotensin II receptor blockers, calcium antagonists, alpha blockers, central acting agents, and direct vasodilators. Remaining chapters examine factors unique to women, management of high blood pressure among specific populations and groups, treatment of difficult-to-control high blood pressure, management of a hypertensive emergency, and home monitoring of blood pressure. The book also includes a week of menus based on the recommendations of the DASH eating plan. 17 figures. 2 tables. •
You Can Control Diabetes and High Blood Pressure: Self Care Handbook Source: South Deerfield, MA: Channing L. Bete Co., Inc. 2000. 31 p. Contact: Available from Channing L. Bete, Co., Inc. 200 State Road, South Deerfield, MA 01373-0200. (800) 628-7733. Fax (800) 499-6464. PRICE: $2.73 each; plus shipping and handling; quantity discounts available. Summary: This handbook provides people who have diabetes with self care advice for managing high blood pressure. The handbook begins with an explanation of diabetes and high blood pressure and the complications they can cause. Having both conditions puts a person at greater risk of stroke, coronary artery disease, heart failure, kidney disease, blindness, reduced circulation to the feet and legs, and nerve damage. The handbook then provides guidelines for monitoring blood glucose and blood pressure, setting weight and exercise goals, making other lifestyle changes to improve health, eating balanced meals and snacks, and managing their medications. The handbook includes charts and worksheets that help readers with managing their diabetes and high blood pressure. The handbook also stresses the importance of undergoing regular screenings, caring for one's emotional health, and seeking outside assistance when needed. The handbook includes a list of organizations that can answer questions about diabetes and high blood pressure.
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “blood pressure” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “blood pressure” (or a synonym) in their titles. The following is indicative of the results you might find when searching for
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“blood pressure” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
24-hour Control of Blood Pressure by Henry L. Elliott; ISBN: 1870026837; http://www.amazon.com/exec/obidos/ASIN/1870026837/icongroupinterna
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25 Nautural Ways To Lower Blood Pressure [DOWNLOAD: ADOBE READER] by James Scala (2001); ISBN: B00008KJ5J; http://www.amazon.com/exec/obidos/ASIN/B00008KJ5J/icongroupinterna
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A Guide to controlling high blood pressure in black communities; ISBN: 086536074X; http://www.amazon.com/exec/obidos/ASIN/086536074X/icongroupinterna
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About your high blood pressure medicines; ISBN: 0913595411; http://www.amazon.com/exec/obidos/ASIN/0913595411/icongroupinterna
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About Your High Blood Pressure Medicines (1993); ISBN: 0913595586; http://www.amazon.com/exec/obidos/ASIN/0913595586/icongroupinterna
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About Your High Blood Pressure Medicines by U S Pharmacopeia; ISBN: 0913595756; http://www.amazon.com/exec/obidos/ASIN/0913595756/icongroupinterna
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ACE Inhibition and 24-hour Control of Blood Pressure by P.A. Meredith MD, H.L. Elliott MD; ISBN: 1858731720; http://www.amazon.com/exec/obidos/ASIN/1858731720/icongroupinterna
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ACE Inhibition in the Management of High Blood Pressure - pocketbook by Robert J. MacFayden, Robert J. Macfadyen (1999); ISBN: 185317730X; http://www.amazon.com/exec/obidos/ASIN/185317730X/icongroupinterna
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Adrenergic Blood Pressure Regulation: Proceedings (Current Clinical Practice Series, Vol 14) by W.H. Birkenhager, et al; ISBN: 0444904085; http://www.amazon.com/exec/obidos/ASIN/0444904085/icongroupinterna
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Alternative Medicine Guide: Heart Disease, Stroke & High Blood Pressure/With Alternative Medicine Digest by Burton Goldberg, The Editors of Alternative Medicine; ISBN: 1887299270; http://www.amazon.com/exec/obidos/ASIN/1887299270/icongroupinterna
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Ambulatory Blood Pressure Monitoring by M.A. Weber (Editor) (1984); ISBN: 0387912495; http://www.amazon.com/exec/obidos/ASIN/0387912495/icongroupinterna
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Ambulatory Blood Pressure Recording by Hans R. Brunner, Bernard Waeber (Editor); ISBN: 0881678899; http://www.amazon.com/exec/obidos/ASIN/0881678899/icongroupinterna
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Ambulatory Monitoring and Blood Pressure Variability by T.G. Pickering MD DPhil FRCP (Editor); ISBN: 1870026829; http://www.amazon.com/exec/obidos/ASIN/1870026829/icongroupinterna
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Angiotensin and Blood Pressure Regulation (Research Topics in Physiology, Vol 10) by Joseph W. Harding (Editor); ISBN: 012324790X; http://www.amazon.com/exec/obidos/ASIN/012324790X/icongroupinterna
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Better Blood Pressure by Milner, Rob Edwards; ISBN: 1863510303; http://www.amazon.com/exec/obidos/ASIN/1863510303/icongroupinterna
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Biochemical Regulation of Blood Pressure by Soffer; ISBN: 0471056006; http://www.amazon.com/exec/obidos/ASIN/0471056006/icongroupinterna
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•
Blood Pressure by Sandra M. Gilbert (1989); ISBN: 0393306240; http://www.amazon.com/exec/obidos/ASIN/0393306240/icongroupinterna
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Blood Pressure by Tape Love; ISBN: 9998273927; http://www.amazon.com/exec/obidos/ASIN/9998273927/icongroupinterna
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Blood Pressure - Diet Against It (Wellness); ISBN: 0572015747; http://www.amazon.com/exec/obidos/ASIN/0572015747/icongroupinterna
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Blood Pressure (Biophysical Measurement Ser.) by W. Gregory Downs, et al; ISBN: 0962744905; http://www.amazon.com/exec/obidos/ASIN/0962744905/icongroupinterna
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Blood Pressure and Drug Effects: Medical Analysis Index With Reference Bibliography by Dancilla Horaibe (1987); ISBN: 0881644099; http://www.amazon.com/exec/obidos/ASIN/0881644099/icongroupinterna
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Blood Pressure and Heart Rate Variability: Computer Analysis, Methodology and Clinical Applications (Studies in Health Technology and Informatics, V) by M. Di Rienzo (Editor), Dirienzo (1993); ISBN: 9051990774; http://www.amazon.com/exec/obidos/ASIN/9051990774/icongroupinterna
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Blood Pressure Control (1988); ISBN: 0939838133; http://www.amazon.com/exec/obidos/ASIN/0939838133/icongroupinterna
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Blood Pressure Control (Blood Pressure Control) by T.G. Coleman; ISBN: 085200382X; http://www.amazon.com/exec/obidos/ASIN/085200382X/icongroupinterna
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Blood Pressure Control at the Work Site by J. Erfurt, Andrea Toote (1979); ISBN: 087736334X; http://www.amazon.com/exec/obidos/ASIN/087736334X/icongroupinterna
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Blood Pressure Control: A Matter of Choices by Nancy R., B.A. Hull (1988); ISBN: 0939838249; http://www.amazon.com/exec/obidos/ASIN/0939838249/icongroupinterna
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Blood Pressure Levels in Persons 18-74 Years of Age in 1976-1980, and Trends in Blood Pressure from 1960 to 1980 in the United States; ISBN: 9997584015; http://www.amazon.com/exec/obidos/ASIN/9997584015/icongroupinterna
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Blood pressure levels in persons 18-74 years of age in 1976-80, and trends in blood pressure from 1960 to 1980 in the United States by Terence Drizd; ISBN: 0840603304; http://www.amazon.com/exec/obidos/ASIN/0840603304/icongroupinterna
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Blood pressure levels of persons 6-74 years, United States, 1971-1974 by Jean Roberts; ISBN: 0840600879; http://www.amazon.com/exec/obidos/ASIN/0840600879/icongroupinterna
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Blood Pressure Measurement by E.T. O'Brien, et al; ISBN: 0727902733; http://www.amazon.com/exec/obidos/ASIN/0727902733/icongroupinterna
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Blood Pressure Measurement: An Illustrated History by Nasim H. Naqvi, et al; ISBN: 1850700133; http://www.amazon.com/exec/obidos/ASIN/1850700133/icongroupinterna
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Blood Pressure Measurements: New Techniques in Automatic and 24-Hour Indirect Monitoring by W. Meyer-Sabellek, et al (1990); ISBN: 0387913327; http://www.amazon.com/exec/obidos/ASIN/0387913327/icongroupinterna
Books 491
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Blood Pressure Monitoring in Cardiovascular Medicine and Therapeutics by William B., Md. White (Editor) (2000); ISBN: 0896038408; http://www.amazon.com/exec/obidos/ASIN/0896038408/icongroupinterna
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Blood Pressure Monitoring: An International Journal Devoted to Research in Blood Pressure Monitoring and Variability by William B. White, Thomas G. Pickering (Editor) (2003); ISBN: 0013595237; http://www.amazon.com/exec/obidos/ASIN/0013595237/icongroupinterna
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Blood pressure of persons 18-74 years, United States, 1971-72; preliminary findings for systolic and diastolic blood pressures of adults by age, sex, and race from the first health and nutrition examination survey during 1971-72 by Jean Roberts; ISBN: 0840600313; http://www.amazon.com/exec/obidos/ASIN/0840600313/icongroupinterna
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Blood pressure of youths 12-17 years, United States by Jean Roberts; ISBN: 0840600747; http://www.amazon.com/exec/obidos/ASIN/0840600747/icongroupinterna
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Blood pressure studies in children : report of a WHO study group; ISBN: 9241207159; http://www.amazon.com/exec/obidos/ASIN/9241207159/icongroupinterna
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Blood Pressure Variability: Proceedings of the International Workshop on Blood Pressure Variability Held at the University Hospital, Gent, on June 15 by Ghent, International Workshop on Blood Pressure Variability; ISBN: 083911477X; http://www.amazon.com/exec/obidos/ASIN/083911477X/icongroupinterna
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Blood Pressure&pulse Chartx500; ISBN: 0412499606; http://www.amazon.com/exec/obidos/ASIN/0412499606/icongroupinterna
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Blood pressure, edema, and proteinuria in pregnancy; ISBN: 0845100076; http://www.amazon.com/exec/obidos/ASIN/0845100076/icongroupinterna
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Blood Pressure: All You Need to Know by Hugh Coni, Nick Coni; ISBN: 1853155365; http://www.amazon.com/exec/obidos/ASIN/1853155365/icongroupinterna
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Blood Pressure: Questions You Have Answers You Need; ISBN: 9995003325; http://www.amazon.com/exec/obidos/ASIN/9995003325/icongroupinterna
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Blood Pressure: Questions You Have.Answers You Need by Staff of the People's Medical Society (Editor), People's Medical Society (1996); ISBN: 1882606612; http://www.amazon.com/exec/obidos/ASIN/1882606612/icongroupinterna
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Brain and Blood Pressure Control: Proceedings of the Tokyo Symposium on Brain and Blood Pressure Control, Tokyo, 25-27 October 1985 (International co by Keiji Nakamura (Editor); ISBN: 0444808108; http://www.amazon.com/exec/obidos/ASIN/0444808108/icongroupinterna
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Central action of drugs in blood pressure regulation : proceedings of an International Symposium on Central Actions of Drugs in the Regulation of Blood Pressure; ISBN: 0839108001; http://www.amazon.com/exec/obidos/ASIN/0839108001/icongroupinterna
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Central action of drugs in blood pressure regulation : proceedings of an International Symposium on Central Actions of Drugs in the Regulation of Blood Pressure, under the auspices of the British Pharmacological Society; ISBN: 0272793485; http://www.amazon.com/exec/obidos/ASIN/0272793485/icongroupinterna
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Chelation Can Cure: How to Reverse Heart Disease, Diabetes, Stroke, High Blood Pressure and Poor Circulation Without Drugs or Surgery by E. W. McDonagh; ISBN:
492 Blood Pressure
0912815000; http://www.amazon.com/exec/obidos/ASIN/0912815000/icongroupinterna •
Churches As an Avenue to High Blood Pressure Control by Edward J. Roccella (Editor) (1992); ISBN: 0788186108; http://www.amazon.com/exec/obidos/ASIN/0788186108/icongroupinterna
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Circulating Catecholamines and Blood Pressure. Ed by W.H. Birkenhaeger. (1979, C1978). Based on Symp Held in Rotterdam in April 1978 Under the sponsor by Birkenhage; ISBN: 0839113854; http://www.amazon.com/exec/obidos/ASIN/0839113854/icongroupinterna
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Clinical Approaches to High Blood Pressure in the Young by Theodore A. Kotchen; ISBN: 0723670323; http://www.amazon.com/exec/obidos/ASIN/0723670323/icongroupinterna
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Clinician's Manual on Blood Pressure and Stroke Prevention by J. Chalmers (Editor) (2002); ISBN: 1858731054; http://www.amazon.com/exec/obidos/ASIN/1858731054/icongroupinterna
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Clinician's Manual on Self-monitoring of Blood Pressure by Thomas Pickering; ISBN: 1858732379; http://www.amazon.com/exec/obidos/ASIN/1858732379/icongroupinterna
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Congress of Nephrology 1998: Joint Scientific Meeting Gesellschaft Fur Nephrologie Deutsche Arbeitsgemeinschaft Fur Klinische Nephrologie, Erlangen September 1998 (Kidney & Blood Pressure Research, 2-4) by Sterzel R. Bernd (Editor), Walter Schulz (Editor) (1998); ISBN: 3805567634; http://www.amazon.com/exec/obidos/ASIN/3805567634/icongroupinterna
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Congress of Nephrology 1999: 30th Joint Scientific Meeting Gesellschaft Fur Nephrologie (Kidney and Blood Pressure Research) by R. Greger, K. Kuhn (1999); ISBN: 3805569653; http://www.amazon.com/exec/obidos/ASIN/3805569653/icongroupinterna
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Congress of Nephrology 2000: Joint Scientific Meeting: Gesellschaft Fur Nephrologie, Deutsche Arbeitsgemeinschaft Fur Klinische Nephrologie, Osterreichische Gesellschaft Fur (Kidney and Blood Pressure Research, 3-5) by W.H. Horl (Editor), et al (2000); ISBN: 3805571534; http://www.amazon.com/exec/obidos/ASIN/3805571534/icongroupinterna
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Congress of Nephrology 2001: Joint Scientific Meeting: Gesellschaft Fur Nephrologie, Deutsche Arbeitsgemeinschaft Fur Klinische Nephrologie, Munster, SeptemberOctober 2001 (Special Issue: Kidney and Blood Pressure Research 2001, 4-6) by K. H. Rahn (Editor), et al (2001); ISBN: 3805573146; http://www.amazon.com/exec/obidos/ASIN/3805573146/icongroupinterna
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Conquering High Blood Pressure: The Complete Guide to Managing Hypertension by Stephen Wood, et al; ISBN: 0306456311; http://www.amazon.com/exec/obidos/ASIN/0306456311/icongroupinterna
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Conquering Hypertension: An Illustrated Guide to Understanding Treatment and Control of High Blood Pressure by R. Brian Haynes MD, Frans H. H. Leenen (1994); ISBN: 0969778120; http://www.amazon.com/exec/obidos/ASIN/0969778120/icongroupinterna
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Control High Blood Pressure Without Drugs: A Complete Hypertension Handbook by Robert L., Md Rowan, Constance Schrader (Contributor); ISBN: 0684873281; http://www.amazon.com/exec/obidos/ASIN/0684873281/icongroupinterna
Books 493
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Control Your High Blood Pressure Cookbook by Cleaves M. Bennett, et al; ISBN: 0385199198; http://www.amazon.com/exec/obidos/ASIN/0385199198/icongroupinterna
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Control Your High Blood Pressure Without Drugs by Cleaves M., M.D. Bennett, Charles Cameron; ISBN: 0385235798; http://www.amazon.com/exec/obidos/ASIN/0385235798/icongroupinterna
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Controlling high blood pressure; ISBN: 0891190244; http://www.amazon.com/exec/obidos/ASIN/0891190244/icongroupinterna
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Controlling High Blood Pressure by Frans H. Leenen (Editor), R. Brian Haynes (Editor) (1991); ISBN: 0914629875; http://www.amazon.com/exec/obidos/ASIN/0914629875/icongroupinterna
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Controlling High Blood Pressure the Natural Way by David L. Carroll, Wahida Karmally (Contributor); ISBN: 0345431464; http://www.amazon.com/exec/obidos/ASIN/0345431464/icongroupinterna
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Coping With High Blood Pressure by Sandy Sorrentino, et al; ISBN: 0934878765; http://www.amazon.com/exec/obidos/ASIN/0934878765/icongroupinterna
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Cure of High Blood Pressure by Respiratory Exercises by Tirala (2003); ISBN: 1852289023; http://www.amazon.com/exec/obidos/ASIN/1852289023/icongroupinterna
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Diet for a Strong Heart: Michio Kushi's Macrobiotic Dietary Guidelines for the Prevention of High Blood Pressure, Heart Attack, and Stroke by Michio Kushi, Alex Jack; ISBN: 0312209983; http://www.amazon.com/exec/obidos/ASIN/0312209983/icongroupinterna
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Down With High Blood Pressure; ISBN: 0886901030; http://www.amazon.com/exec/obidos/ASIN/0886901030/icongroupinterna
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Down With High Blood Pressure by R. Brian Haynes, Frans H.H. Leenen (Editor); ISBN: 0919959512; http://www.amazon.com/exec/obidos/ASIN/0919959512/icongroupinterna
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Dr. Donsbach Tells You What You Always Wanted to Know About.: High Blood Pressure (Hypertension) by Kurt W. Donsbach (1993); ISBN: 1569595623; http://www.amazon.com/exec/obidos/ASIN/1569595623/icongroupinterna
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Drop Your Blood Pressure by Rosenvold (1980); ISBN: 0515057215; http://www.amazon.com/exec/obidos/ASIN/0515057215/icongroupinterna
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Drugs for High Blood Pressure 2002 (Treatment Trove Series) by Lindy van den Berghe; ISBN: 1904279007; http://www.amazon.com/exec/obidos/ASIN/1904279007/icongroupinterna
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Eat Right to Help Lower Your High Blood Pressure; ISBN: 0160381274; http://www.amazon.com/exec/obidos/ASIN/0160381274/icongroupinterna
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Eat to Beat - High Blood Pressure: Natural Self-help for Hypertension, Including 60 Recipes (Eat to Beat) by Sarah Brewer, Michelle Berridale-Johnson; ISBN: 0007141351; http://www.amazon.com/exec/obidos/ASIN/0007141351/icongroupinterna
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Epidemiology of arterial blood pressure; ISBN: 9024723868; http://www.amazon.com/exec/obidos/ASIN/9024723868/icongroupinterna
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Essentials of blood pressure measurement by Eoin O'Brien; ISBN: 0443023360; http://www.amazon.com/exec/obidos/ASIN/0443023360/icongroupinterna
494 Blood Pressure
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Exploring the Heart: Discoveries in Heart Disease and High Blood Pressure/08952 by Julius H. Comroe; ISBN: 0393017087; http://www.amazon.com/exec/obidos/ASIN/0393017087/icongroupinterna
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Fact Book on Hypertension High Blood Pressure and Your Diet by Carlson Wade; ISBN: 0879830956; http://www.amazon.com/exec/obidos/ASIN/0879830956/icongroupinterna
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From the Isle of Skye to the Isle of Maui: A Doctor's Personal Story Including Plantation Medicine and the Cause of High Blood Pressure by William Benton Patterson; ISBN: 0533124751; http://www.amazon.com/exec/obidos/ASIN/0533124751/icongroupinterna
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Frontiers of Blood Pressure and Heart Rate Analysis (Studies in Health Technology and Informatics, 35) by M. Di Rienzo (Editor), et al (1997); ISBN: 9051993129; http://www.amazon.com/exec/obidos/ASIN/9051993129/icongroupinterna
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Gesellschaft Fuer Nephrologie 27th Scientific Meeting, September, Berlin 1996 (Kidney and Blood Pressure Research, Vol. 19, No. 3-4, 1996) by A. Distler, M. Molzahn (1996); ISBN: 3805563779; http://www.amazon.com/exec/obidos/ASIN/3805563779/icongroupinterna
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Gesellschaft Fur Nephrologie: Deutsche Arbeitsgemeinschaft Fur Klinische Nephrologie, Nederlandse Vereniging Voor Nefrologie: Joint Scientific Meeting, Aachen, September 1997 (Kindey & Blood Pressure Research Ser. 3) by H. G. Sieberth (Editor), et al (1997); ISBN: 3805565682; http://www.amazon.com/exec/obidos/ASIN/3805565682/icongroupinterna
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Good News About High Blood Pressure: Everything You Need to Know to Take Control of Hypertension -And Your Life by Thomas, MD Pickering (1997); ISBN: 0684832119; http://www.amazon.com/exec/obidos/ASIN/0684832119/icongroupinterna
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Guide to Contented Hearts: Cardiac Risk Management: Cholesterol, High Blood Pressure Exercise, Stress, Weight, Diet by D. Charles Van Fulpen (1995); ISBN: 0963756206; http://www.amazon.com/exec/obidos/ASIN/0963756206/icongroupinterna
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Handbook of Blood Pressure Measurement by L.A. Geddes; ISBN: 0896031942; http://www.amazon.com/exec/obidos/ASIN/0896031942/icongroupinterna
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Handbook of Blood Pressure Monitoring by John M.R. Bruner; ISBN: 0884162281; http://www.amazon.com/exec/obidos/ASIN/0884162281/icongroupinterna
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Health Journeys for People With High/ Abr Blood Pressure or Heart. by Belleruth Naparstek (Author); ISBN: 1570420149; http://www.amazon.com/exec/obidos/ASIN/1570420149/icongroupinterna
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Healthy Heart Handbook: Control Your Cholestrol, Lower Your Blood Pressure and Clean Your Arteries - Naturally! by Editors of Fc&a, Fc&a (1999); ISBN: 1890957291; http://www.amazon.com/exec/obidos/ASIN/1890957291/icongroupinterna
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Heart Disease and High Blood Pressure by Hutchin Kc; ISBN: 0668011351; http://www.amazon.com/exec/obidos/ASIN/0668011351/icongroupinterna
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Heart Disease and High Blood Pressure: How You Can Benefit from Diet, Vitamins, Minerals, Herbs, Exercise, and Other Natural Methods (Getting Well Naturally) by Michael T. Murray (1997); ISBN: 0761506586; http://www.amazon.com/exec/obidos/ASIN/0761506586/icongroupinterna
Books 495
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Herbs for the Heart: Herbs to Lower Cholesterol and Blood Pressure, Increase Circulation, Prevent Clotting, and Enhance Heart Heath (Keats Good Herb Guide Series) by C. J. Puotinen; ISBN: 0879837969; http://www.amazon.com/exec/obidos/ASIN/0879837969/icongroupinterna
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High Blood Pressure by Thomas J. Cottle, Martin Bates; ISBN: 0133873730; http://www.amazon.com/exec/obidos/ASIN/0133873730/icongroupinterna
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High Blood Pressure by Peter J. Lewis; ISBN: 0443023018; http://www.amazon.com/exec/obidos/ASIN/0443023018/icongroupinterna
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High blood pressure by George White Pickering; ISBN: 0700013725; http://www.amazon.com/exec/obidos/ASIN/0700013725/icongroupinterna
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High Blood Pressure by Leon Chaitow; ISBN: 072251221X; http://www.amazon.com/exec/obidos/ASIN/072251221X/icongroupinterna
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High Blood Pressure by Sarah Brewer; ISBN: 072253390X; http://www.amazon.com/exec/obidos/ASIN/072253390X/icongroupinterna
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High Blood Pressure by Ada P. Kahn (Editor); ISBN: 0809255995; http://www.amazon.com/exec/obidos/ASIN/0809255995/icongroupinterna
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High Blood Pressure (1987); ISBN: 0874340748; http://www.amazon.com/exec/obidos/ASIN/0874340748/icongroupinterna
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High Blood Pressure by Leonard Mervyn; ISBN: 0909911967; http://www.amazon.com/exec/obidos/ASIN/0909911967/icongroupinterna
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High Blood Pressure by Richard Burns (1995); ISBN: 0949142409; http://www.amazon.com/exec/obidos/ASIN/0949142409/icongroupinterna
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High Blood Pressure (Doctors' Rx for Health Series) (1997); ISBN: 0899708218; http://www.amazon.com/exec/obidos/ASIN/0899708218/icongroupinterna
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High Blood Pressure (Perspectives on Disease and Illness) by Susan R. Gregson (2001); ISBN: 0736807500; http://www.amazon.com/exec/obidos/ASIN/0736807500/icongroupinterna
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High Blood Pressure (Sound Techniques for Healing) by Robert Friedman, Kelly Howell (1993); ISBN: 1881451216; http://www.amazon.com/exec/obidos/ASIN/1881451216/icongroupinterna
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High Blood Pressure (The BMA Family Doctor Guides) by Peter Semple; ISBN: 1853360538; http://www.amazon.com/exec/obidos/ASIN/1853360538/icongroupinterna
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High Blood Pressure (What You Really Need to Know About.) by Patsy Westcott; ISBN: 1840282487; http://www.amazon.com/exec/obidos/ASIN/1840282487/icongroupinterna
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High blood pressure : how to help your doctor control it! by M. Douglas Dorn; ISBN: 091763201X; http://www.amazon.com/exec/obidos/ASIN/091763201X/icongroupinterna
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High Blood Pressure [LARGE PRINT] by Caroline Shreeve; ISBN: 1856950530; http://www.amazon.com/exec/obidos/ASIN/1856950530/icongroupinterna
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High Blood Pressure at Your Fingertips (At Your Fingertips) by Julian Tudor Hart, et al (1998); ISBN: 1872362818; http://www.amazon.com/exec/obidos/ASIN/1872362818/icongroupinterna
496 Blood Pressure
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High Blood Pressure at Your Fingertips ('Gao xue ya 305 wen', in traditional Chinese, NOT in English) by Dr. Julian (Author); ISBN: 9574690822; http://www.amazon.com/exec/obidos/ASIN/9574690822/icongroupinterna
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High Blood Pressure for Dummies by Alan L. Rubin M.D. ISBN: 0764554247; http://www.amazon.com/exec/obidos/ASIN/0764554247/icongroupinterna
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High Blood Pressure in Teenagers by David J. Gerrick; ISBN: 0916750272; http://www.amazon.com/exec/obidos/ASIN/0916750272/icongroupinterna
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High blood pressure in the African by O. O. Akinkugbe; ISBN: 0443008566; http://www.amazon.com/exec/obidos/ASIN/0443008566/icongroupinterna
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High Blood Pressure Lowered Naturally by Linda M. Sciullo (Editor), et al; ISBN: 1890957410; http://www.amazon.com/exec/obidos/ASIN/1890957410/icongroupinterna
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High blood pressure lowered naturally : the natural way to help control your blood pressure, with your doctor's permission by Janice McCall Failes (Author), et al; ISBN: B00005W10T; http://www.amazon.com/exec/obidos/ASIN/B00005W10T/icongroupinterna
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High Blood Pressure Lowered Naturally: Your Arteries Can Clean Themselves by Fireside Books, FC&A Publishing (2000); ISBN: 1890957348; http://www.amazon.com/exec/obidos/ASIN/1890957348/icongroupinterna
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High Blood Pressure Special Diet Cookbook: Delicious Low-Salt Recipes That Are Calorie Controlled for Weight Reduction (Special Diet Cookbooks) by Maggie Pannell; ISBN: 0722522363; http://www.amazon.com/exec/obidos/ASIN/0722522363/icongroupinterna
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High Blood Pressure, Cholesterol, and You by Harold C. Steele; ISBN: 0873971019; http://www.amazon.com/exec/obidos/ASIN/0873971019/icongroupinterna
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High Blood Pressure/Large Print by Vernon Coleman; ISBN: 0745108717; http://www.amazon.com/exec/obidos/ASIN/0745108717/icongroupinterna
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High Blood Pressure/the Clear, Complete, Up-To-Date Guide To.Tests, Treatments, Dangers, Cures by Neil B. Shulman, et al (1993); ISBN: 0440203589; http://www.amazon.com/exec/obidos/ASIN/0440203589/icongroupinterna
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High Blood Pressure: A Handbook for Survival by Neil B. Shulman; ISBN: 5556005141; http://www.amazon.com/exec/obidos/ASIN/5556005141/icongroupinterna
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High Blood Pressure: Diet Against It by James Scala; ISBN: 0572026412; http://www.amazon.com/exec/obidos/ASIN/0572026412/icongroupinterna
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High Blood Pressure: Everything You Need to Know and More by Vernon Coleman; ISBN: 1898947791; http://www.amazon.com/exec/obidos/ASIN/1898947791/icongroupinterna
•
High Blood Pressure: How to Control It/Cassette by Blocom Communications; ISBN: 0553450034; http://www.amazon.com/exec/obidos/ASIN/0553450034/icongroupinterna
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High Blood Pressure: How to Lower Your Blood Pressure in 4 Easy Stages: Effective Treatment Without Drugs (Thorsons Health) by Caroline M. Shreeve; ISBN: 0722530412; http://www.amazon.com/exec/obidos/ASIN/0722530412/icongroupinterna
Books 497
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High Blood Pressure: Practical, Medical, and Spiritual Guidelines for Daily Living With Hypertension (Hazelden Pocket Health Guide) by Mark Jenkins; ISBN: 1568383517; http://www.amazon.com/exec/obidos/ASIN/1568383517/icongroupinterna
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High Blood Pressure: The Black Man and Woman's Guide to Living with Hypertension by Hilton M., Ii Hudson, et al (2002); ISBN: 0971606714; http://www.amazon.com/exec/obidos/ASIN/0971606714/icongroupinterna
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High Blood Pressure: Treat It for Life by National Heart (1995); ISBN: 0160451760; http://www.amazon.com/exec/obidos/ASIN/0160451760/icongroupinterna
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High Blood Pressure: Treat It for Life. (1994); ISBN: 0788121685; http://www.amazon.com/exec/obidos/ASIN/0788121685/icongroupinterna
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High Blood Pressure: What Causes It, How to Tell If You Have It, How to Control It for a Longer Life by Frank A., Finnerty; ISBN: 0679505121; http://www.amazon.com/exec/obidos/ASIN/0679505121/icongroupinterna
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High Blood Pressure: What It Means for You, and How to Control It by Kevin, Md. O'Malley; ISBN: 0668053232; http://www.amazon.com/exec/obidos/ASIN/0668053232/icongroupinterna
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High Blood Pressure: What You Need to Know (Johns Hopkins Health) by Mark Giuliucci, Johns Hopkins Health (1999); ISBN: 0737016108; http://www.amazon.com/exec/obidos/ASIN/0737016108/icongroupinterna
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High Blood Pressure-Hypertension (Healthtalk the Complete Self-Health Series); ISBN: 0936439076; http://www.amazon.com/exec/obidos/ASIN/0936439076/icongroupinterna
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How to Control High Blood Pressure Without Drugs by Robert L. Rowan; ISBN: 0684183366; http://www.amazon.com/exec/obidos/ASIN/0684183366/icongroupinterna
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How to Live With You High Blood Pressure by William Alexander, Brams; ISBN: 0668026952; http://www.amazon.com/exec/obidos/ASIN/0668026952/icongroupinterna
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How to Lower High Blood Pressure: The Natural Way to Reduce Hypertension by Caroline M. Shreeve (2001); ISBN: 000712094X; http://www.amazon.com/exec/obidos/ASIN/000712094X/icongroupinterna
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How to Lower Your Blood Pressure and Reverse Heart Disease Naturally by Eric R. Braverman (1995); ISBN: 0963886932; http://www.amazon.com/exec/obidos/ASIN/0963886932/icongroupinterna
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How to Survive in the Middle Management Cadre Without Blood Pressure, Heart Attack or Ulcers by P.V. Pathak (2002); ISBN: 8186982280; http://www.amazon.com/exec/obidos/ASIN/8186982280/icongroupinterna
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How to watch and control your blood pressure by Aaron E. Klein; ISBN: 0448143305; http://www.amazon.com/exec/obidos/ASIN/0448143305/icongroupinterna
•
Hypertension : The Guide to Keeping Blood Pressure Down by Ifeoma, MD Ezekwo (2001); ISBN: 1930927002; http://www.amazon.com/exec/obidos/ASIN/1930927002/icongroupinterna
498 Blood Pressure
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Hypertension 2003 Weekly Planner: High Blood Pressure by Bonnie Dickens, Thomas Masterson; ISBN: 1588082083; http://www.amazon.com/exec/obidos/ASIN/1588082083/icongroupinterna
•
Hypertension Digest : Learn Why High Blood Pressure Is Such a Danger [DOWNLOAD: PDF]; ISBN: B00009KF23; http://www.amazon.com/exec/obidos/ASIN/B00009KF23/icongroupinterna
•
Hypertension Primer: The Essentials of High Blood Pressure by Joseph L. Izzo (Editor), et al (1999); ISBN: 0683307061; http://www.amazon.com/exec/obidos/ASIN/0683307061/icongroupinterna
•
Hypertension: A Self-Management Approach for High Blood Pressure; ISBN: 0815195974; http://www.amazon.com/exec/obidos/ASIN/0815195974/icongroupinterna
•
Hypertension: Community Control of High Blood Pressure by Julian Tudor Hart; ISBN: 0443031525; http://www.amazon.com/exec/obidos/ASIN/0443031525/icongroupinterna
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Imidazolines and Blood Pressure Control by B.N.C. Prichard, Franz H. Messerli (Editor); ISBN: 0792328965; http://www.amazon.com/exec/obidos/ASIN/0792328965/icongroupinterna
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JNC 7 Express: The Seventh Report of the Joint National Committe on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (2003); ISBN: 1588080013; http://www.amazon.com/exec/obidos/ASIN/1588080013/icongroupinterna
•
Keeping the Pressure Down: A Wellness Approach to Blood Pressure Control by National Council On The Aging; ISBN: 0910883645; http://www.amazon.com/exec/obidos/ASIN/0910883645/icongroupinterna
•
Kidney & Blood Pressure Research: Mechanisms of Progression in Renal Disease by Jurgen Floege (Editor) (1999); ISBN: 3805568762; http://www.amazon.com/exec/obidos/ASIN/3805568762/icongroupinterna
•
Kroger How to Control High Blood Pressure Without Drugs by Robert L. Rowan (1996); ISBN: 0804115737; http://www.amazon.com/exec/obidos/ASIN/0804115737/icongroupinterna
•
Libro de la presion sanguinea: Como bajarla y mantenerla (The Blood Pressure Book, Spanish-Language Edition) by Stephen P., Md. Fortmann, Prudence E. Breitrose (2003); ISBN: 0923521763; http://www.amazon.com/exec/obidos/ASIN/0923521763/icongroupinterna
•
Live Longer: Control Your Blood Pressure by Feinman; ISBN: 0515057223; http://www.amazon.com/exec/obidos/ASIN/0515057223/icongroupinterna
•
Living with High Blood Pressure by Tom Smith, Dr. Tom Smith; ISBN: 0859698610; http://www.amazon.com/exec/obidos/ASIN/0859698610/icongroupinterna
•
Living With High Blood Pressure Large Pr by Tom Smith (Author); ISBN: 1850891605; http://www.amazon.com/exec/obidos/ASIN/1850891605/icongroupinterna
•
Living With High Blood Pressure: The Hypertension Diet Cookbook by Joyce D. and Hunt, James C. Margie; ISBN: 0801968550; http://www.amazon.com/exec/obidos/ASIN/0801968550/icongroupinterna
Books 499
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Living With Your High Blood Pressure by William A. Brams; ISBN: 0668042869; http://www.amazon.com/exec/obidos/ASIN/0668042869/icongroupinterna
•
Lower Blood Pressure (1985); ISBN: 9995200287; http://www.amazon.com/exec/obidos/ASIN/9995200287/icongroupinterna
•
Lower Blood Pressure [ABRIDGED] by Barrie Konicov; ISBN: 0870829750; http://www.amazon.com/exec/obidos/ASIN/0870829750/icongroupinterna
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Lower Blood Pressure: A Subliminal Persuasion Self Hypnosis Tape; ISBN: 0870823450; http://www.amazon.com/exec/obidos/ASIN/0870823450/icongroupinterna
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Lower Blood Pressure: Subliminal Persuasion (Master Series) by Barry Konicov (1990); ISBN: 1560016094; http://www.amazon.com/exec/obidos/ASIN/1560016094/icongroupinterna
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Lower Your Blood Pressure & Live Longer by Moser M. D. ISBN: 0517067501; http://www.amazon.com/exec/obidos/ASIN/0517067501/icongroupinterna
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Lower Your Blood Pressure (Prod No:0177350); ISBN: 0878578978; http://www.amazon.com/exec/obidos/ASIN/0878578978/icongroupinterna
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Lower Your Blood Pressure and Live Longer by Marvin, M.D. Moser; ISBN: 0394568761; http://www.amazon.com/exec/obidos/ASIN/0394568761/icongroupinterna
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Lower Your Blood Pressure in 4 Easy Stages: Natural, Safe Ways to Reduce It by Caroline M., Dr. Shreeve; ISBN: 0722516355; http://www.amazon.com/exec/obidos/ASIN/0722516355/icongroupinterna
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Lower Your Blood Pressure in Eight Weeks: A Revolutionary New Program for a Longer, Healthier Life by Stephen T. Sinatra, et al (2003); ISBN: 0345448073; http://www.amazon.com/exec/obidos/ASIN/0345448073/icongroupinterna
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Lower Your Blood Pressure/Audio Cassette (Llewellyn Psy-Tech Subliminal Series); ISBN: 0875426263; http://www.amazon.com/exec/obidos/ASIN/0875426263/icongroupinterna
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Lower Your Blood Pressure: Controlling Your Blood Pressure Without Drugs (No Nonsense Health Guide) by Prevention Magazine Editors, Prevention Magazine; ISBN: 0681410221; http://www.amazon.com/exec/obidos/ASIN/0681410221/icongroupinterna
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Lowered Blood Pressure by Eldon Taylor (2001); ISBN: 1590043847; http://www.amazon.com/exec/obidos/ASIN/1590043847/icongroupinterna
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Lowering Your Blood Pressure Naturally (Stay Healthy Audio Series/Audio Cassette/241) by Earl Mindell; ISBN: 1561700126; http://www.amazon.com/exec/obidos/ASIN/1561700126/icongroupinterna
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Main findings report of the Canadian blood pressure survey; ISBN: 0662167988; http://www.amazon.com/exec/obidos/ASIN/0662167988/icongroupinterna
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Managing Your Blood Pressure: Food or Medicine? Seven Easy Steps to Know for Sure by Roth L. Riley; ISBN: 0974497819; http://www.amazon.com/exec/obidos/ASIN/0974497819/icongroupinterna
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Manual for High Blood Pressure Control at the Worksite by Darlyn Weikel; ISBN: 9996559475; http://www.amazon.com/exec/obidos/ASIN/9996559475/icongroupinterna
500 Blood Pressure
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Maternal Assessment: Blood Pressure (Prenatal Care, Series 2, Module 2B) by Linda A. Wheeler, et al (1988); ISBN: 0865250340; http://www.amazon.com/exec/obidos/ASIN/0865250340/icongroupinterna
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Mayo Clinic on High Blood Pressure by Sheldon G., Md. Sheps (Editor), Mayo Clinic (2003); ISBN: 1893005267; http://www.amazon.com/exec/obidos/ASIN/1893005267/icongroupinterna
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Mechanisms of Blood Pressure Waves by C. Polosa (Editor), et al; ISBN: 0387131647; http://www.amazon.com/exec/obidos/ASIN/0387131647/icongroupinterna
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Methodology and Clinical Applications of Blood Pressure and Heart Rate Analysis by M. Di Rienzo (Editor), et al; ISBN: 9051994362; http://www.amazon.com/exec/obidos/ASIN/9051994362/icongroupinterna
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Modern Approaches to Blood Pressure Measurement by T.G. Pickering MD DPhil FRCP (Editor); ISBN: 1870026888; http://www.amazon.com/exec/obidos/ASIN/1870026888/icongroupinterna
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Natural Care Library Garlic: Safe and Effective Self-Care for Arthritis, High Blood Pressure and Flu by Stephanie Pedersen; ISBN: 0789451921; http://www.amazon.com/exec/obidos/ASIN/0789451921/icongroupinterna
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Natural Guide to Treating High Blood Pressure by S. Streicher-Lankin (1998); ISBN: 0761515542; http://www.amazon.com/exec/obidos/ASIN/0761515542/icongroupinterna
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Natural Medicine for Heart Disease: The Best Alternative Methods for Prevention and Treatment: High Cholesterol, High Blood Pressure, Stroke, Chest Pain, Other Circulatory Problems by Glenn S., Md Rothfeld, et al; ISBN: 0875962890; http://www.amazon.com/exec/obidos/ASIN/0875962890/icongroupinterna
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New Ways to Lower Your Blood Pressure: Easy, Safe, Fast Method That Work (Pathway) by Claire Safran; ISBN: 0552128228; http://www.amazon.com/exec/obidos/ASIN/0552128228/icongroupinterna
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New Ways to Lower Your Blood Pressure: Easy, Safe, Fast Methods That Work by Claire Safran (Introduction); ISBN: 0671503804; http://www.amazon.com/exec/obidos/ASIN/0671503804/icongroupinterna
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NIH blood pressure regulation and aging : proceedings from a symposium; ISBN: 0935404783; http://www.amazon.com/exec/obidos/ASIN/0935404783/icongroupinterna
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No Drug Approach to Lowering Your Blood Pressure by George Berkley (1984); ISBN: 0915962322; http://www.amazon.com/exec/obidos/ASIN/0915962322/icongroupinterna
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Non-Invasive Continuous Blood Pressure Measurement: Methods, Evaluations and Applications of the Vascular Unloading Technique (Penaz-Method) by Heinz Ruddel (Editor), Immo Curio (Editor) (1991); ISBN: 3631432828; http://www.amazon.com/exec/obidos/ASIN/3631432828/icongroupinterna
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Nursing Assistant Techniques: Measuring Impulse, Respiration, Blood Pressure for Saunders Fundamentals for Nursing Assistants by Polaski, Warner (1993); ISBN: 0721697348; http://www.amazon.com/exec/obidos/ASIN/0721697348/icongroupinterna
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Nutrition and Blood Pressure by Peter Bursztyn (Editor) (1987); ISBN: 0861960939; http://www.amazon.com/exec/obidos/ASIN/0861960939/icongroupinterna
Books 501
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Opioid Peptides and Blood Pressure Control by K.O. Stumpe, et al (1988); ISBN: 0387189351; http://www.amazon.com/exec/obidos/ASIN/0387189351/icongroupinterna
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Opioid Peptides and Blood Pressure Control: 11th Scientific Meeting of the International Society of Hypertension Satellite Symposium, Bonn, September 6-7, 1986 by K. Stumper (Editor), Et Al (Editor); ISBN: 3540189351; http://www.amazon.com/exec/obidos/ASIN/3540189351/icongroupinterna
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Outsmart High Blood Pressure by The Editors of Prevention Health Books (Author); ISBN: 0312988125; http://www.amazon.com/exec/obidos/ASIN/0312988125/icongroupinterna
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PAL Video: Measuring Blood Pressure by Merritt; ISBN: 0815171676; http://www.amazon.com/exec/obidos/ASIN/0815171676/icongroupinterna
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Patient's Health Maintenance Workbook for High Blood Pressure: A Guide to SelfCare and Healing by Brian C. Leutholtz (1999); ISBN: 0849307376; http://www.amazon.com/exec/obidos/ASIN/0849307376/icongroupinterna
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Perfect Blood Pressure by David Lovell-Smith (2003); ISBN: 0140298878; http://www.amazon.com/exec/obidos/ASIN/0140298878/icongroupinterna
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Personality, Elevated Blood Pressure, and Essential Hypertension (Series in Health Psychology and Behavioral Medicine) by Ernest H. Johnson, et al (1992); ISBN: 1560321423; http://www.amazon.com/exec/obidos/ASIN/1560321423/icongroupinterna
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PHYSIOFILM ARTERIAL BLOOD PRESSURE REGULATION by PHYSIOFILM; ISBN: 0471685127; http://www.amazon.com/exec/obidos/ASIN/0471685127/icongroupinterna
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Plus 15 : fifteen days to lower blood pressure & cholesterol by Samuel L. DeShay; ISBN: 0945460163; http://www.amazon.com/exec/obidos/ASIN/0945460163/icongroupinterna
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Plus Fifteen: 15 Days to Lower Cholesterol and Blood Pressure by Samuel L. Deshay, Bernice Deshay (Editor); ISBN: 0898402980; http://www.amazon.com/exec/obidos/ASIN/0898402980/icongroupinterna
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Prevention & Cure Without Medicine: For High Blood Pressure, Diabetes, Flu-Cold, and 20 Other Diseases by Sahid Sulistija Hardja, Hardja. Sahid; ISBN: 1887750436; http://www.amazon.com/exec/obidos/ASIN/1887750436/icongroupinterna
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Progress in Hypertension: Neurotransmitters As Modulators of Blood Pressure (Vol 1) by H. Saito (Editor) (1987); ISBN: 9067641006; http://www.amazon.com/exec/obidos/ASIN/9067641006/icongroupinterna
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Protect Your Lifeline: Fight High Blood Pressure (1981); ISBN: 9997490673; http://www.amazon.com/exec/obidos/ASIN/9997490673/icongroupinterna
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Randalls/Tom Thumb How to Control High Blood Pressure Without Drugs by Robert L. Rowan (1996); ISBN: 0804115745; http://www.amazon.com/exec/obidos/ASIN/0804115745/icongroupinterna
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Recipes for Health: High Blood Pressure by Maggie Pannell; ISBN: 0722531443; http://www.amazon.com/exec/obidos/ASIN/0722531443/icongroupinterna
502 Blood Pressure
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Recommendations on Blood Pressure Measurement by J. C. Petrie, et al; ISBN: 0727911538; http://www.amazon.com/exec/obidos/ASIN/0727911538/icongroupinterna
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Regulation of blood pressure by the central nervous system; ISBN: 0808909363; http://www.amazon.com/exec/obidos/ASIN/0808909363/icongroupinterna
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Reversing Hypertension: Vital New Prog to Prevent, Treat & Reduce High Blood Pressure by Julian M.D. Whitaker (Author), Julian Whitaker M.D. (2000); ISBN: 0446522864; http://www.amazon.com/exec/obidos/ASIN/0446522864/icongroupinterna
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Salt, Diet and Health: Neptune's Poisoned Chalice: the Origins of High Blood Pressure by G. A. MacGregor (Author), H. E. de Wardener (Author); ISBN: 0521635454; http://www.amazon.com/exec/obidos/ASIN/0521635454/icongroupinterna
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Sex After Blood Pressure Medication.Really by Jessica Flemming, Bill Tyson; ISBN: 1883445019; http://www.amazon.com/exec/obidos/ASIN/1883445019/icongroupinterna
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Soothing Sound Therapy: Relieve Daily Stress, Lower Blood Pressure, Leave Worries Behind, Attain Inner Peace/Cassette (Prevention's Mind Body Healin) by Spirit Press Good; ISBN: 087857879X; http://www.amazon.com/exec/obidos/ASIN/087857879X/icongroupinterna
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Spain Anesthetic, Blood Pressure, Dyalisis and Transfusion 2001 [DOWNLOAD: PDF] by Snapshots International Ltd (Author); ISBN: B00006FCF4; http://www.amazon.com/exec/obidos/ASIN/B00006FCF4/icongroupinterna
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Speaking of High Blood Pressure: A Comprehensive Guide for Hypertensives and Their Partners by Hanns Peter Wolff (1979); ISBN: 0832622354; http://www.amazon.com/exec/obidos/ASIN/0832622354/icongroupinterna
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Sports and Blood Pressure: Medical Subject Index With Bibliography by Jerry B. Holtz (1987); ISBN: 0881646644; http://www.amazon.com/exec/obidos/ASIN/0881646644/icongroupinterna
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Stress and Relaxation: Self-Help Ways to Cope With Stress and Relieve Nervous Tension, Ulcers, Insomnia, Migraine, and High Blood Pressure by Jane. Madders; ISBN: 0668046805; http://www.amazon.com/exec/obidos/ASIN/0668046805/icongroupinterna
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Stress, Crowding, and Blood Pressure in Prison (Environment and Health) by Adrian M. Ostfeld (Editor) (1987); ISBN: 0898595746; http://www.amazon.com/exec/obidos/ASIN/0898595746/icongroupinterna
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Strokes and Their Prevention: How to Avoid High Blood Pressure and Hardening of the Arteries. by Arthur, Ancowitz; ISBN: 0442203306; http://www.amazon.com/exec/obidos/ASIN/0442203306/icongroupinterna
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Super Strength Healing Yourself With Your Mind/Relaxation and Blood Pressure by Super Strength Series, Robert E. Griswold; ISBN: 1558483144; http://www.amazon.com/exec/obidos/ASIN/1558483144/icongroupinterna
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Supercharge Your Heart in Seconds: The Rochlitz Discovery for Anti-Aging, Heart Health, Blood Pressure, and Maximum Athletic Performance by Steven Rochlitz; ISBN: 0945262493; http://www.amazon.com/exec/obidos/ASIN/0945262493/icongroupinterna
Books 503
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Taking Charge of High Blood Pressure: Start-Today Strategies for Combatting the Silent Killer by Susan Perry (2003); ISBN: 0762103515; http://www.amazon.com/exec/obidos/ASIN/0762103515/icongroupinterna
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Taking Control of Your Blood Pressure: Steps to a Heal Their Life Style by Lorna Milkovich, et al (1991); ISBN: 096942874X; http://www.amazon.com/exec/obidos/ASIN/096942874X/icongroupinterna
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Taking Control¹High Blood Pressure (Humanatomy, 19) by Tim Peters (1997); ISBN: 1879874016; http://www.amazon.com/exec/obidos/ASIN/1879874016/icongroupinterna
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Teenage of Insanity: Raising Your Teenager Without Raising Your Blood Pressure by Sherrie Weaver, Patrick Caton (Editor) (1996); ISBN: 1562452282; http://www.amazon.com/exec/obidos/ASIN/1562452282/icongroupinterna
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The 2002 Official Patient's Sourcebook on High Blood Pressure by James N. Parker (Editor), Philip M. Parker (Editor) (2002); ISBN: 0597831998; http://www.amazon.com/exec/obidos/ASIN/0597831998/icongroupinterna
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The Bible Cure for High Blood Pressure by Don, Md. Colbert, Don Colbert; ISBN: 0884197476; http://www.amazon.com/exec/obidos/ASIN/0884197476/icongroupinterna
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The Blood Pressure Book: How to Get It Down and Keep It Down by Stephen P., M.D. Fortmann, Prudence E. Breitrose; ISBN: 0923521607; http://www.amazon.com/exec/obidos/ASIN/0923521607/icongroupinterna
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The BMA Family Doctor Guides: Blood Pressure (BMA Family Doctor) by Tony Smith; ISBN: 0751308153; http://www.amazon.com/exec/obidos/ASIN/0751308153/icongroupinterna
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The complete family guide to living with high blood pressure by Michael K. Rees; ISBN: 0131604325; http://www.amazon.com/exec/obidos/ASIN/0131604325/icongroupinterna
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The Complete Guide to Living With High Blood Pressure by Michael K. Rees; ISBN: 0131593102; http://www.amazon.com/exec/obidos/ASIN/0131593102/icongroupinterna
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The Complete Guide to Living With High Blood Pressure (1988); ISBN: 0890431744; http://www.amazon.com/exec/obidos/ASIN/0890431744/icongroupinterna
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The Dash Diet for Hypertension: Lower Your Blood Pressure in 14 Days--Without Drugs by Thomas J. Moore M.D. (Editor), et al; ISBN: 0743202953; http://www.amazon.com/exec/obidos/ASIN/0743202953/icongroupinterna
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The direct and indirect measurement of blood pressure by L. A. Geddes; ISBN: 0815134002; http://www.amazon.com/exec/obidos/ASIN/0815134002/icongroupinterna
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The Doctor Is Out! Exposing the High Blood Pressure, Low Thyroid and Diabetes Scams by Sydney Ross Singer, Soma Grismaijer; ISBN: 1930858043; http://www.amazon.com/exec/obidos/ASIN/1930858043/icongroupinterna
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The H I G H Blood Pressure Relief Diet by James, Dr. Scala; ISBN: 0452264308; http://www.amazon.com/exec/obidos/ASIN/0452264308/icongroupinterna
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The H I G H Blood Pressure Relief Diet (1990); ISBN: 9993020249; http://www.amazon.com/exec/obidos/ASIN/9993020249/icongroupinterna
504 Blood Pressure
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The Hart Program: Lower Your Blood Pressure Without Drugs by D. Ariel, Dr. Kerman, et al; ISBN: 0060924039; http://www.amazon.com/exec/obidos/ASIN/0060924039/icongroupinterna
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The Healing Power of Exercise : Your Guide to Preventing and Treating Diabetes, Depression, Heart Disease, High Blood Pressure, Arthritis, and More by Linn Goldberg (Author), Diane L. Elliot (Author); ISBN: 0471348007; http://www.amazon.com/exec/obidos/ASIN/0471348007/icongroupinterna
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The High Blood Pressure Book: A Guide for Patients and Their Families by Edward D. Freis; ISBN: 0525124721; http://www.amazon.com/exec/obidos/ASIN/0525124721/icongroupinterna
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The High Blood Pressure Relief Diet by James, Dr. Scala; ISBN: 0453006302; http://www.amazon.com/exec/obidos/ASIN/0453006302/icongroupinterna
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The High Blood Pressure Relief Diet; ISBN: 9992711078; http://www.amazon.com/exec/obidos/ASIN/9992711078/icongroupinterna
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The High Blood Pressure Solution: A Scientifically Proven Program for Preventing Strokes and Heart Disease by Richard D. Moore M.D. Ph.D., Ph.D., Richard, D. Moore M.D. ISBN: 0892819758; http://www.amazon.com/exec/obidos/ASIN/0892819758/icongroupinterna
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The High Blood Pressure Solution: Natural Prevention and Cure With the K Factor by Richard D. Moore; ISBN: 0892814462; http://www.amazon.com/exec/obidos/ASIN/0892814462/icongroupinterna
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The Hypertension Report: Say Goodbye to High Blood Pressure by William Campbell Douglass (2003); ISBN: 9962636604; http://www.amazon.com/exec/obidos/ASIN/9962636604/icongroupinterna
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The K Factor: Reversing and Preventing High Blood Pressure Without Drugs by Richard, M.D. Ph.D. Moore, George, Ph.D. Webb; ISBN: 0025861905; http://www.amazon.com/exec/obidos/ASIN/0025861905/icongroupinterna
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The Pill Book of High Blood Pressure by Bood and Drug Book Company; ISBN: 0553244892; http://www.amazon.com/exec/obidos/ASIN/0553244892/icongroupinterna
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The Salt-Free Diet Book: An Appetizing Way to Help Reduce High Blood Pressure by Graham MacGregor; ISBN: 0668059664; http://www.amazon.com/exec/obidos/ASIN/0668059664/icongroupinterna
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The Salt-Free Diet Book: To Help Avoid High Blood Pressure and Other Common Conditions by Graham MacGregor; ISBN: 0668059729; http://www.amazon.com/exec/obidos/ASIN/0668059729/icongroupinterna
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The Secrets of Blood Pressure and High Blood Pressure by Afif N. Karkabi, Afif Karbaki (1998); ISBN: 0805940731; http://www.amazon.com/exec/obidos/ASIN/0805940731/icongroupinterna
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The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure by Claude Lenfant, et al (1997); ISBN: 1883205425; http://www.amazon.com/exec/obidos/ASIN/1883205425/icongroupinterna
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The Sodium Counter: Including Calories: Your Long Life Guide to Help Avoid High Blood Pressure and Heart Problems (Long Life Guide Series) by Jacqueline Nagel
Books 505
(Editor); ISBN: 155785100X; http://www.amazon.com/exec/obidos/ASIN/155785100X/icongroupinterna •
Time-Dependent Structure and Control of Arterial Blood Pressure (Annals of the New York Academy of Sciences, V. 783) by Francesco Portaluppi (Editor), et al (1996); ISBN: 1573310093; http://www.amazon.com/exec/obidos/ASIN/1573310093/icongroupinterna
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Twenty-Four-Hour Ambulatory Blood Pressure Monitoring in Clinical Practice by Bernard Waeber; ISBN: 0781702429; http://www.amazon.com/exec/obidos/ASIN/0781702429/icongroupinterna
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Understanding Blood Pressure by Alan Silman; ISBN: 1898205051; http://www.amazon.com/exec/obidos/ASIN/1898205051/icongroupinterna
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Understanding Blood Pressure by D.G. Beevers; ISBN: 1898205663; http://www.amazon.com/exec/obidos/ASIN/1898205663/icongroupinterna
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Understanding High Blood Pressure and Its Treatment by Richard A. Schacht; ISBN: 0941827003; http://www.amazon.com/exec/obidos/ASIN/0941827003/icongroupinterna
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Variability of Blood Pressure and Heart Rate in Borderline and Mild Hypertension: With Special Reference to Spectral Analysis (Comprehensive Summaries of Uppsala Dissertations, 854) by Reijo Takalo (1999); ISBN: 915544508X; http://www.amazon.com/exec/obidos/ASIN/915544508X/icongroupinterna
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Ventral Brainstem Mechanisms and Control of Respiration and Blood Pressure (Lung Biology in Health and Disease, Vol 82) by C. Ovid Trouth (1995); ISBN: 0824795148; http://www.amazon.com/exec/obidos/ASIN/0824795148/icongroupinterna
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What About Blood Pressure by Daniel E. James (1981); ISBN: 0892780258; http://www.amazon.com/exec/obidos/ASIN/0892780258/icongroupinterna
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What You Can Do About High Blood Pressure by Madias; ISBN: 0895690098; http://www.amazon.com/exec/obidos/ASIN/0895690098/icongroupinterna
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What You Really Need To Know About High Blood Pressure by Robert Buckman, et al; ISBN: 0867307951; http://www.amazon.com/exec/obidos/ASIN/0867307951/icongroupinterna
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Working Group Report on Primary Prevention of Hypertension: National High Blood Pressure Education Program by Edward J. Roccella (1993); ISBN: 0788142267; http://www.amazon.com/exec/obidos/ASIN/0788142267/icongroupinterna
The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “blood pressure” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:11 11
In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic
506 Blood Pressure
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Alameda County blood pressure study. Author: California. Dept. of Public Health.; Year: 1964; Berkeley, 1968
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Blood pressure - age relationships of Australian ex-servicemen classified in 87 disease categories, by R. V. Southcott, L. G. Veitch [and] R. B. Cunningham. Author: Southcott, R. V. (Ronald Vernon); Year: 1965; [Melbourne, Repatriation Dept., 1972]
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Blood pressure and subarctic climate in the Soviet Union; survey of the Russian literature and investigations on delayed repatriates. Author: Hoffmann, Bruno.; Year: 1962; [Berlin, 1959]
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Blood pressure as it relates to physique, blood glucose, and serum cholesterol, United States, 1960-1962; a tabular presentation of the data and a multiple regression analysis of blood pressure on five somatic measurements and their derivatives,and on blood glucose and serum cholesterol by age, sex, and race [by Charles du V. Florey and Roy M. Acheson]. Author: Florey, Charles du V.; Year: 1966; Washington, Health Services and Mental Health Administration; [for sale by the Supt. of Docs., U. S. Govt. Print. Off.] 1969
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Blood pressure changes in deception, by Matthew N. Chappell. Author: Chappell, Matthew Napoleon,; Year: 1948; New York, 1929
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Blood pressure levels of children 6-11 years: relationship to age, sex, race, and socioeconomic status, United States [by Noel S. Weiss, Peter V. V. Hamill, and Terence Drizd]. Author: Weiss, Noel S.,; Year: 1964; Rockville, Md., National Center for Health Statistics; [for sale by the Supt. of Docs., U. S. Govt. Print. Off., Washington] 1973
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Blood pressure measurement; a programmed notebook for nurses, prepared by Jane Wilcox. Author: National Institutes of Health (U.S.). Clinical Center.; Year: 1899; Bethesda, Md., 1964
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Blood pressure study, 1939. Compiled and published by the Actuarial Society of America and the Association of Life Insurance Medical Directors. Author: Joint Committee of the Actuarial Society of America and the Association of Life Insurance Medical Directors.; Year: 1959; New York, 1940
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Blood pressure. Report. Author: Joint Committee of the Actuarial Society of America and the Association of Life Insurance Medical Directors.; Year: 1967; New York, 1925
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On the relation between blood pressure and blood flow in the canine brain with particular regard to the mechanism responsible for cerebral blood flow autoregulation. Author: Ekström-Jodal, Barbro.; Year: 1929; Göteborg, 1970
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Proceedings of Symposium on Objective Recording of Blood Pressure held at Northwestern University, Chicago, Illinois, January 30-31, 1966. Sponsored by American Heart Association, Council on Epidemiology [et al.] Editorial committee: Joseph T. Doyle [et al. Author: Doyle, Joseph T.; Year: 1957; New York, American Heart Assn., 1967?]
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The blood pressure in a population; blood pressure readings and height and weight determinations in the adult population of the city of Bergen, by Johs. Bøe [and others]. Author: Bøe, Johannes,; Year: 1958; Bergen, Grieg [1957]
database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.
Books 507
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The direct and indirect measurement of blood pressure. Author: Geddes, L. A. (Leslie Alexander),; Year: 1963; Chicago, Year Book Medical Publishers [c1970]; ISBN: 815134002
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The measurement of blood pressure in the human body, by C. R. Smith and W. H. Bickley. Author: Williams (Clyde) and Company, Columbus, Ohio.; Year: 1963; Washington, National Aeronautics and Space Administration, 1964
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The Systemic systolic blood pressure of newborns with low weight; a multiple regression analysis, by Giovanni Bucci [et al.]. Author: Bucci, Giovanni.; Year: 1962; Uppsala, 1972
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Variations in blood pressure following lumbar puncture. Author: Messick, Joseph Marion,; Year: 1970; [Minneapolis] 1936
Chapters on Blood Pressure In order to find chapters that specifically relate to blood pressure, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and blood pressure using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “blood pressure” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on blood pressure: •
High Blood Pressure Source: in Gilroy, D.K., ed. Guide to a Man's Life. Emmaus, PA: Rodale Press. 1995. p. 11-13. Contact: Available from Rodale Press. 14 East Minor Street, Emmaus, PA 18098. (610) 967-8620. PRICE: Single copy free. Summary: This chapter on high blood pressure is from a booklet that presents the latest medical breakthroughs on common health risks that target men. The chapter presents a brief discussion of the problems caused by hypertension and then considers two recent advances in the treatment of hypertension: the use of beta blockers and the addition of high-potassium foods to the diet. The chapter then lists recommendations for lifestyle changes that can have a positive impact on the problem of hypertension. Suggestions cover topics including weight loss; sodium restrictions; alcohol consumptions; the role of calcium; avoiding isometrics; aerobic exercise; dietary changes, including the role of vegetarianism; monitoring blood pressure at home; psychological factors; and communication. The booklet is written in an informal, friendly style, with medical terms defined for the layperson.
Directories In addition to the references and resources discussed earlier in this chapter, a number of directories relating to blood pressure have been published that consolidate information
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across various sources. The Combined Health Information Database lists the following, which you may wish to consult in your local medical library:12 •
Asian Language: Sources of Health Materials Source: Washington, DC: Office of Minority Health Resource Center. 199x. [11 p.]. Contact: Available from Office of Minority Health Resource Center. P.O. Box 37337, Washington, DC 20013-7337. (800) 444-6472. Website: www.omhrc.gov. PRICE: Single copy free. Summary: This directory lists sources identified by the Office of Minority Health Resource Center (OMH RC) that produce or distribute health promotion materials in various Asian languages. Materials concentrate on minority health priority areas and associated risk factors: cancer, cardiovascular diseases and stroke, chemical dependency, diabetes, infant mortality, homicide, suicide, and unintentional injury. Sources of AIDS information and educational materials are also included. Topics related to kidney and urologic diseases include AIDS, cultural awareness, high blood pressure (hypertension), lupus, men's health, nutrition, sexually transmitted diseases, and women's health. Sources are arranged alphabetically. Organization entries include organization name, address, telephone number, source title, and annotation. The primary languages in which the organization provides materials are noted. Organizations should be contacted directly to determine the cost and availability of bulk quantities or for permission to photocopy.
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Finding resources for Healthy Heart programs at work Source: Bethesda, MD: National Heart, Lung, and Blood Institute, U.S. Department of Health and Human Services. 1992. 92 pp. Contact: Available from Information Center, National Heart, Lung, and Blood Institute, National Institutes of Health, P.O. Box 30105, Bethesda, MD 20824-0105. Telephone: (301) 951-3260. (NIH Publication No. 92-737). Summary: This resource directory is designed to assist in developing worksite Healthy Heart programs for employees. Healthy Heart programs emphasize cardiovascular health which includes high blood pressure, high cholesterol, smoking, nutrition, weight control, and physical fitness. There are three sections. The first section suggests organizations, associations, and government agencies which can provide information and resources on developing workplace health promotion activities. Included in this section is a list of National Heart, Lung, and Blood Institute Cardiovascular Disease Liaisons for each state health department. The second section lists brochures, guides, manuals, booklets, video recordings, programs, services, and other resources available through organizations. The third section is an alphabetical listing of the organizations with their addresses and phone numbers.
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You will need to limit your search to “Directory” and “blood pressure” using the "Detailed Search" option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find directories, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Select your preferred language and the format option “Directory.” Type “blood pressure” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months.
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CHAPTER 8. MULTIMEDIA ON BLOOD PRESSURE Overview In this chapter, we show you how to keep current on multimedia sources of information on blood pressure. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.
Video Recordings An excellent source of multimedia information on blood pressure is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “blood pressure” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “blood pressure” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on blood pressure: •
Preventing Long Term Complications of Diabetes Source: Timonium, MD: Milner-Fenwick, Inc. 1994. Contact: Available from Milner-Fenwick, Inc. 2125 Greenspring Drive, Timonium, MD 21093. (800) 432-8433. Fax (410) 252-6316. PRICE: $175 (as of 1995); discounts available for AADE members. Order Number DB-28. Summary: In this patient education videotape, viewers learn how the relationship between high blood glucose and the associated damage to blood vessels and nerves can lead to possible heart attack, stroke, loss of vision, kidney disease, and amputation. The program focuses on the results found in the Diabetes Control and Complications Trial (DCCT), i.e., that improving blood glucose levels can greatly reduce the risk of developing complications over time. The program also stresses the importance of lowering blood pressure and cholesterol, and encourages early detection through appropriate testing. The program is available in English or Spanish, and with closed captioning. (AA-M).
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Best of Living With Diabetes Television Video Series, Volume 1 Source: Vista, CA: CNBC. Lifetime. 1995. Contact: Available from Living with Diabetes. P.O. Box 2514, Vista, CA 92085-2514. (800) 433-2469. PRICE: $19.95 (as of 1995). Summary: In this videotape program, television medical correspondent Pat Gallagher narrates a compilation of the best of 100 episodes of the newsmagazine television show called Living With Diabetes. Produced by CNBC and Lifetime, the program explains the difference between insulin-dependent and noninsulin-dependent diabetes, and covers weight loss, exercise, cholesterol, high blood pressure, neuropathy, foot care, eye disease, kidney disease, and proper disposal of syringes. In addition, Terri Miller, a nurse and diabetes educator who has diabetes, shares practical tips on living with diabetes. (AA-M).
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Strategies for the Prevention and Treatment of Macrovascular Complications of Type 2 Diabetes Source: Kansas City, MO: American Academy of Family Physicians. 1998. (videocassette). Contact: Available from American Academy of Family Physicians. 8880 Ward Parkway, Kansas City, MO 64114-2797. (800) 274-2237. PRICE: $17.95 for members; $25.00 for nonmembers, plus shipping and handling. Summary: The macrovascular (large blood vessel) complications of diabetes account for the majority of the morbidity (related illness) and mortality (death) associated with the disease. In particular, people with type 2 diabetes are at increased risk for cardiovascular disease, since they exhibit many independent risk factors for heart disease, including obesity, hypertension (high blood pressure), and dyslipidemia (disordered levels of fats in the blood). This continuing education program features a videocassette and study guide that discuss why people with diabetes are at increased risk for macrovascular complications and how to reduce the patient's risk of cardiovascular disease. Topics include hyperglycemia (high blood glucose levels) and cardiovascular disease, insulin resistance and cardiovascular disease, the benefits of improved glycemic control, recommended target glycemic goals, nonpharmacologic therapies for diabetes (diet, exercise, patient education), pharmacologic (drug) therapies for diabetes (insulin secretagogues, insulin sensitizers, alpha-glucosidase inhibitors, and insulin), determining the optimal drug treatment regimen for individual patients, and treating cardiovascular risk factors. The program recommends that patients should be seen quarterly or more often, depending upon the severity of their disease, and target goals for HbA1c (glycosylated hemoglobin, a measurement of blood glucose levels over time) and fasting blood glucose should be established at the initial visit and discussed directly with the patient. Patients should be reminded at every office visit that weight loss and regular exercise are the most important aspects of controlling their diabetes and reducing the risk of macrovascular disease. A sample patient education hand out is included in the study guide. Through this program, users can qualify for one credit hour of Continuing Medical Education (CME) in category 1; the appropriate posttest is provided. 5 figures. 14 tables. 15 references.
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Barbershop Talk: Benny's Advice on Healthy Eating: A Nutrition Video for the Black Community Source: Southampton, PA: Dairy Council, Inc. 199x. (videocassette with leader's guide, participant cards, and education materials). Contact: Available from Dairy Council, Inc. 1225 Industrial Highway, Southampton, PA 18966-4010. (215) 322-0450. PRICE: $15 for video and all instructional materials. Video alone available for $12. Additional Leader's Guides and participant cards also available separately. Summary: This nutrition videotape on health targets black males. The videotape shows a group of African American men in an everyday setting talking about nutrition and health. Topics include high blood pressure, controlling dietary fats, lactose intolerance, the basic four food groups, soul food, and weight control. The packet includes the videotape, a leader's guide, 25 participant's cards, and Dairy Council education materials. The materials focus on the prevention of common health problems in this population, notably hypertension and diabetes.
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Kidneys Source: San Antonio, TX: The University of Texas Health Science Center. 199x. (videocassette and slide/tape). Contact: University of Texas Health Science Center at San Antonio. Television Production Services, 7703 Floyd Curl Drive, San Antonio, TX 78284. (512) 567-2220. PRICE: $150 (videocassette), $35 (preview fee), $150 (slide/tape), $0.25 (booklet). Summary: This patient education program is part of the series, 'An Ounce of Prevention,' which focuses on complications of diabetes. Set in a hospital, this program dramatizes the serious nature of renal complications. While waiting for a family member's test results, the characters discuss with the nurse the importance of lowering blood pressure and blood glucose levels in maintaining kidney function. An accompanying Leader's Guide suggests uses for the videotapes and slide/cassette tapes. Picture books that require no reading skills are available for people viewing the program. (AA-M).
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Caring for People with Renal Impairment Source: Princeton, NJ: Films for the Humanities and Sciences. 1996. (videocassette). Contact: Available from Films for the Humanities and Sciences. P.O. Box 2053, Princeton, NJ 08543-2053. (800) 257-5126 or (609) 275-1400. Fax (609) 275-3767. E-mail:
[email protected]. Website: www.films.com. PRICE: $129.00 to purchase; $75.00 for rental; plus shipping and handling. Order number BVL10421. Summary: This program offers nurses an overview of end stage renal (kidney) disease (ESRD) and the patient care that it entails. Using diagrams, expert commentary, and patient interviews, the program discusses ESRD and its management, including symptoms and causes; treatment options including hemodialysis, continuous ambulatory peritoneal dialysis (CAPD), and automated peritoneal dialysis (APD); and dietary restrictions that may help slow the progression of the disease. The program also considers the psychosocial impact of having kidney disease and the role of kidney transplantation. The program includes a review of the filtration, hormonal, and metabolic functions of healthy kidneys. Kidney functions covered include removal of metabolic waste, regulation of acid base balance, regulation of body fluids, blood
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pressure control, regulation of electrolytes, excretion of drugs and poisons, erythropoiesis, and production of renin. The program features graphics depicting the functions and physiology of the kidney. Various patients are interviewed throughout the program and followed through their normal care program on dialysis, both in center and home dialysis, or after transplantation. The program is produced by the Royal College of Nursing in England, and the health care delivery is from the British perspective. •
Partners in Care: You and Your Dialysis Machine Source: Waltham, MA: National Medical Care, Inc., Dialysis Services Division. 1991. Contact: Available from Patient Videotapes, NMC Dialysis Services Division. 1601 Trapelo Road, Waltham, MA 02154. (617) 466-9850. PRICE: $24.95 (as of 1995). Summary: This program takes an entertaining approach to teaching patients the mechanics of dialysis. A 'talking' dialysis machine captures the attention of a patient and explains its monitors, gauges, and alarm systems as well as how a dialyzer works. The information conveyed can be applied to any brand of dialysis machine. The video also discusses patient monitoring, including the routines of weighing in, blood pressure checks, and temperature checks. (AA-M).
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Diabetes and Heart Disease Source: Dallas, TX: American Heart Association. 1996. (videorecording). Contact: Available from Channing L. Bete Company/American Heart Association. Fulfillment Center, 200 State Road, South Deerfield, MA 01373-0200. (800) 611-6083. Fax (800) 499-6464. E-mail:
[email protected]. PRICE: $39.00 plus shipping and handling. Summary: This video, which was developed by the American Heart Association, is intended to help people with diabetes become better informed about heart disease. The video points out that people who have diabetes have a increased risk of developing problems that involve the cardiovascular system. These problems include atherosclerosis (the build up of fatty acids in arteries) and hypertension (high blood pressure). High levels of glucose can damage arteries and increase the likelihood of hypertension and atherosclerosis. In some cases, hypertension may be controlled with changes in lifestyle, such as losing weight, reducing salt intake, and exercising. When lifestyle changes are insufficient to control hypertension, medication is used. The video notes that people must not treat hypertension with over the counter medicines or prescriptions from a friend because they may worsen diabetes or its related conditions. Many of the things that help to manage diabetes can also be effective in reducing the risk of heart disease. Self monitoring of blood glucose, eating healthfully, exercising, taking medication as needed, and educating oneself are each important. The video concludes that people with diabetes can successfully control blood glucose levels and significantly lower the risk of heart disease by making appropriate lifestyle changes and working with health care professionals. An accompanying brochure focuses on topics addressed in the video. The video is available in English or Spanish. (AA-M).
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What You Should Know About Xerostomia (Dry Mouth) Source: Fairburn, GA: National Oral Cancer Awareness (NOCAP). 199x. (videocassette). Contact: Available from American Dental Hygienists' Association (ADHA). 444 North Michigan Avenue, Suite 3400, Chicago, IL 60611. (800) 243-2342 (press 2) or (312) 440-
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8900. Fax (312) 467-1806. Website: www.adha.org. PRICE: $18.00. Item Number 3917 COM. Summary: This videocassette program describes the problem of xerostomia (dry mouth). The introduction stresses that the health impact of saliva goes far beyond the mouth and includes eating, talking, tooth maintenance, and tasting. The program then features a person with xerostomia describing how it feels to have problems with dry mouth. A brief description of the chemical makeup of salivary and the anatomy of the salivary glands follow. The next section discusses the potential causes of xerostomia, including radiation therapy, especially for cancer of the head and neck; drug effects, particularly from antihistamines, tranquilizers, and some blood pressure medications; anxiety or depression, even without drug therapy; dehydration; and systemic diseases, including Sjogren's syndrome, lupus, cystic fibrosis, rheumatoid arthritis, and scleroderma. The narrator stresses that aging itself is not necessarily the cause of xerostomia. Complications of xerostomia include dry lips, burning mouth or tongue, constant thirst, difficulty talking or swallowing, impaired taste, dental caries (cavities), candidiasis (a fungal infection), and problems related to dehydration. Viewers are encouraged to work closely with health care providers to obtain an accurate diagnosis and employ strategies to cope with xerostomia. Treatment encompasses three options: eliminating the cause of the xerostomia, if possible; stimulating the salivary glands with sugar-free chewing gum, oral moisturizers, or the prescription drug pilocarpine; and using other measures to get relief, including saliva substitutes, frequent sips of water, room humidifiers (especially during winter), and lip balm. The program concludes with a reminder that xerostomia results in the need for increased attention to dental hygiene, including increased dental visits, limiting sugar intake, the use of fluoride, and the prevention of candidiasis. The program encourages viewers to learn about xerostomia, seek help, and improve the quality of their lives. •
Dr. Silvia Panitch y Su Salud. [Dr. Silvia Panitch and Your Health.] Contact: Lejon Productions, PO Box 59909, Chicago, IL, 60659-0990. Summary: This videorecording tells Hispanics about the threats they face from three sources: Cholesterol, high-blood pressure, and Acquired immunodeficiency syndrome (AIDS). Dr. Silvia Panitch, from Mount Sinai Hospital in Chicago, explains how the immune system functions, and how the Human immunodeficiency virus (HIV) invades the T-cells. After displaying a chart that shows the majority of AIDS cases are homosexual, Dr. Panitch discusses sexual transmission and other ways of getting AIDS. She explains that the American Red Cross now examines the blood supply for safety, practically eliminating the risk of contracting HIV through a transfusion. Another chart breaks down AIDS cases by race and by ethnic group. Dr. Panitch then explains which groups are at high risk for contracting HIV, and tells who should take the HIV-antibody test. She discusses the symptoms of HIV infection, such as nausea, diarrhea, swollen lymph glands, and opportunistic diseases. Treatments for AIDS are outlined, and means of HIV prevention are explained. Dr. Panitch tells viewers they shouldn't worry about contracting HIV through casual contact. Persons with AIDS (PWA's) are advised to follow nutritious diets and to exercise as means of maintaining better health.
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Obesity and Type II Diabetes Source: Los Angeles, CA: National Health Video, Inc. 2000. (videocassette).
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Contact: Available from National Health Video, Inc. 12021 Wilshire Boulevard, Suite 550, Los Angeles, CA 90025. (800) 543-6803. Fax (310) 477-8198. E-mail:
[email protected]. PRICE: $89.00 plus shipping and handling. Summary: This videotape discusses the relationship between type 2 diabetes and obesity. Obesity presents special problems for people who have diabetes because excess body fat decreases the body's ability to use insulin, strains the pancreas, and makes the body less able to use the insulin it produces. Although the causes of obesity are not well understood, factors such as age, heredity, and gender have been associated with weight gain. A weight loss of just 10 to 20 pounds can improve blood glucose levels, blood pressure, and cholesterol. Methods of losing weight include eating a variety of foods in moderation, incorporating moderate activity into a daily schedule, undergoing stomach restrictive and intestinal bypass procedures (recommended only for people who are severely obese), using diet medications, and enrolling in a weight loss program. Other topics include the role of obesity in diseases other than diabetes and the growing problem of childhood obesity. The videotape is accompanied by a teaching resource guide and a transcript of the tape. •
Kidney Disease and Diabetes Source: Los Angeles, CA: National Health Video, Inc. 2001. (videocassette). Contact: Available from National Health Video, Inc. 12021 Wilshire Boulevard, Suite 550, Los Angeles, CA 90025. (800) 543-6803. Fax (310) 477-8198. E-mail:
[email protected]. PRICE: $89.00 plus shipping and handling. Summary: This videotape focuses on diabetic kidney disease. Diabetes accounts for 40 percent of all new cases of kidney failure. The stages of diabetic kidney disease are hyperfiltration, microalbuminuria, nephrotic syndrome, renal insufficiency, and end stage renal disease (ESRD). The earliest sign of kidney disease is finding small amounts of protein in the urine, so urine checks are performed regularly. If there are signs of kidney damage, more careful control of blood glucose levels and blood pressure may help. For more advanced kidney disease, a low protein diet may be recommended. Treatment options for kidney failure are dialysis and kidney transplantation. The types of dialysis are hemodialysis and peritoneal dialysis. Transplantation is usually more effective than dialysis. The videotape is accompanied by an evaluation form and a transcript of the tape.
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Pediatric Hypertension Source: New Hyde Park, NY: Schneider Children's Hospital. 2000. (Videorecording). Contact: Available from Schneider Children's Hospital. 269-01 76th Avenue, Room 365, New Hyde Park, New York 11040-1432. (718) 470-3491. Fax: (718) 470-0887. Website: www.schneiderchildrenshospital.org. Summary: This videotape program educates parents and families of children who are diagnosed with hypertension (high blood pressure). The program is narrated by three health care providers: Dr. Julie Ingelfinger, Dr. Howard Trachtman, and Rachel Frank, a nephrology nurse. The program explains why it is vital to diagnose and manage pediatric hypertension, noting the role of long term hypertension in adult problems of heart attack, stroke, and congestive heart failure. The program reviews hypertension and its causes, treatment options, how to understand blood pressure readings (systolic and diastolic), classification of the different levels of hypertension, risk factors, diagnostic considerations and tests, and management options, including nutrition, drug
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therapy, weight control, exercise, relaxation methods, and refraining from smoking. The program features many interviews with children and parents and their health care providers. •
Choices: Options for Living with Kidney Failure Source: McGaw Park, IL: Baxter Healthcare Corporation. 1997 (videocassette). Contact: Available from community service section of Blockbuster video stores. PRICE: Free rental. Also available to health professionals from Baxter Healthcare Corporation. (888) 736-2543. 1620 Waukegan Road, McGaw Park, IL 60085. Summary: This videotape program helps viewers newly diagnosed with kidney failure to understand their treatment options and to make more informed choices for their own health care. The narrator reminds viewers that many members make up the health care team, but stresses that patients are the most important member of that team. The program reviews the functions of the kidneys, including clean the blood, make red blood cells, help maintain healthy bones and other bodily functions, balance body fluids and chemical levels, and retain valuable substances. Graphics demonstrate each of these functions. The narrator reviews the symptoms of kidney failure, and then real patients tell their own experiences of their movement into chronic kidney failure. The program outlines the common causes of chronic kidney failure, including diabetes, glomerulonephritis, hypertension (high blood pressure), polycystic kidney disease, and infections. The remainder of the program outlines each of the treatment options: hemodialysis, peritoneal dialysis, automated peritoneal dialysis (APD), and kidney transplantation. For each type, the program offers live footage of real patients using that treatment, drawings and graphics that demonstrate how the treatment works, and interviews with patients talking about how that treatment affects their lives. The program summarizes the reasons why each treatment option may be appropriate or inappropriate for a specific patient. The program concludes with a list of general guidelines that can help to reduce treatment side effects and with a list of associations to contact for more information.
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Kidney Failure: Are You At Risk? Source: Madison, WI: University of Wisconsin Hospitals and Clinics, Department of Outreach Education. 1998. (videocassette). Contact: Available from University of Wisconsin Hospital and Clinics. Picture of Health, 702 North Blackhawk Avenue, Suite 215, Madison, WI 53705-3357. (800) 757-4354 or (608) 263-6510. Fax (608) 262-7172. PRICE: $19.95 plus shipping and handling; bulk copies available. Order number 051498B. Summary: This videotape program, moderated by Mary Lee, discusses end stage renal disease and the prevention or delay of kidney failure. The program features Dr. Bryan Becker, a nephrologist (kidney specialist). Dr. Becker explores the epidemiology of the recent trend of increasing levels of kidney failure, discussing the aging population, better diagnostics, and better rates of survival. Dr. Becker then reviews the physiology of the kidneys, noting that kidneys control fluids and electrolytes (sodium, potassium, chloride) in the body, regulate the acid base balance, help metabolize proteins and carbohydrates, and remove creatinine (a muscle breakdown product). Different kidney diseases have a varying impact on kidney function. More than 50 percent of kidney failure is caused by two diseases: diabetes mellitus and hypertension; other causes include heredity, illnesses, inflammation, toxicity, kidney cancer, and trauma to the kidney (e.g., automobile accidents). The symptoms of kidney disease (which can be
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largely silent) can include protein in the urine, hypertension, elevated creatinine levels, decrease in urine output, swelling in the feet (edema, or fluid accumulation), and an increase in nocturia (urinating at night). End stage renal disease (ESRD) is defined as loss of 90 percent or more of kidney function. Dr. Becker discusses screening and identifying patients who may be at risk of kidney disease, then debunks various myths about kidney disease, on the topics of one kidney versus two kidneys, dialysis, and transplantation. Dr. Becker emphasizes that kidney disease, while treatable, has a great impact on lifestyle, diet, caretaking, finances, family and support systems, and heart disease. Prevention strategies include identifying high risk patients, avoiding nephrotoxic medications (including ibuprofen), monitoring the diet, controlling blood pressure, controlling blood glucose levels (for people with diabetes), and educating oneself about kidney disease. The program concludes by referring viewers to the National Kidney and Urologic Diseases Information Clearinghouse (www.niddk.nih.gov). •
Diagnosing Alpha 1 Antitrypsin Deficiency Source: Minneapolis, MN: Alpha 1 Association. 199x. (videocassette). Contact: Available from Alpha 1 Association. 8120 Penn Avenue, South, Suite 549, Minneapolis, MN 55431-1326. (800) 521-3025 or (612) 703-9979. Fax (612) 703-9977. Email:
[email protected]. Website: www.alpha1.org. PRICE: $3.00 plus shipping and handling. Summary: This videotape program, narrated by Sandra Brandley, the Executive Director of the Alpha 1 National Association, reminds physicians of the symptoms and differential diagnosis of alpha 1 antitrypsin deficiency (A1AD or Alpha 1). The program features Dr. James Stoller, who describes the typical underdiagnosis of A1AD which is typical: the mean time until diagnosis is 7 years (from onset of symptoms) and the mean number of doctors consulted before diagnosis is 3.5. Alpha 1 is a relatively common genetic disorder that affects infants, children, and adults. It is the most common metabolic disorder that causes liver disease in infants and children; the disorder also causes cirrhosis and cancer of the liver in adults. Symptoms of A1AD deficiency in children include prolonged obstructive jaundice, low birth weight, mildly elevated liver enzymes, cholestasis, enlarged liver, abnormal bleeding, feeding difficulties, poor growth (or failure to thrive), and ascites (abnormal accumulation of fluids). In adults, the spectrum of liver disease associated with A1AD deficiency varies from mild to severe. Symptoms include chronic active hepatitis, cryptogenic cirrhosis (liver scarring of unknown cause), portal hypertension (high blood pressure in the portal vein of the liver), and hepatocellular carcinoma (liver cancer). A rare but telling symptom is panniculitis, a chronic inflammation of subcutaneous fat featuring ulcerated skin lesions on the torso. Dr. Stoller reminds viewers of the indications for A1AD screening: premature onset of moderate to severe chronic obstructive pulmonary disease (COPD) before age 50; predominant basilar emphysema; chronic bronchitis with airflow obstruction in a nonsmoker; bronchiectasis (irreversible dilation and destruction of the bronchial walls) without clear risk factors; development of unremitting asthma; family history of A1AD; cirrhosis without apparent risk factors; and family history of panniculitis. The program includes a chart of laboratory values and the risk of development of A1AD, and a series of interviews with patients about the interplay of early diagnosis and good quality of life. The program concludes with the contact information for the Alpha 1 National Association (800-521-3025).
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Diabetes Home Video Guide: Skills for Self-Care Source: Timonium, MD: Milner-Fenwick. 2000. (videocassette). Contact: Available from Milner-Fenwick, Inc. 2125 Greenspring Drive, Timonium, MD 21093-3100. (800) 432-8433. Fax (410) 252-6316. PRICE: $350.00; bulk orders available; plus shipping and handling. Order number: HV-14. Summary: This videotape provides people who have diabetes with information on the basic skills needed to keep blood glucose in the target range and offers tips for incorporating these skills into daily life. Part one focuses on diabetes and related health concerns. One chapter in this segment of the tape explains how diabetes affects the body, what the long term complications are, and how to determine an appropriate blood glucose range. Another chapter examines related health concerns such as smoking, high blood cholesterol, high blood pressure, and excess body weight. Part two deals with blood glucose management, focusing on education, diet, exercise, monitoring, and medications. The chapter on education discusses the importance of education, the diabetes care team, and other resources. The chapter on nutrition provides nutrition guidelines and discusses other aspects of healthy eating. The chapter on exercise explains how to create an exercise plan. Other topics include doing aerobic and weight bearing exercises, keeping exercise fun and safe, and maintaining physical activity. The chapter on blood glucose monitoring focuses on laboratory testing, blood glucose self testing, and self testing techniques. Other topics include blood glucose records, medical emergencies, and equipment and supplies. The chapter on medications focuses on oral medications and insulin. Topics include insulin care, injection, and supplies; hypoglycemia; and medication tracking systems. Part three addresses the challenges of self management and offers strategies to help the viewer balance diabetes management with living. One chapter in this segment focuses on understanding the importance of pattern management, recognizing patterns, and adjusting a treatment plan. Another chapter deals with solving problems associated with sick days, dining out, unusual schedules, travel, special occasions, and holidays. A third chapter discusses lifestyle changes and emotions, focusing on incorporating change into daily life, managing emotions, handling sexual dysfunction and stress, dealing with close relationships, and finding support. The final chapter of the segment offers suggestions on maintaining good health, focusing on foot, skin, eye, and dental care; immunizations; and medical appointment and test scheduling. The video is accompanied by a foldout guide that provides an overview of diabetes self care skills.
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Get Up and Move! Source: Philadelphia, PA: Health Promotion Council of Southeastern Pennsylvania. 199x. Contact: Available from Health Promotion Council of Southeastern Pennsylvania. 260 S. Broad Street, Philadelphia, PA 19102. (215) 731-6150. Website: www.hpcpa.org. PRICE: $25.00. Summary: This videotape, designed for use with African American patients or consumers, focuses on the benefits of exercise and good eating habits. Topics include how weight control can help control blood pressure, blood glucose, and blood cholesterol; how exercise can combat stress; hints for establishing a good exercise program; and practical suggestions for improving eating habits. The creators of the videotape have attempted to produce a realistic message that patients can relate to easily. Suggestions for activities and discussion points to reinforce the messages in the videotape are included for health educators.
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Living with Diabetes: Making the Diagnosis Source: Madison, WI: University of Wisconsin Hospitals and Clinics, Department of Outreach Education. 1999. (videocassette). Contact: Available from University of Wisconsin Hospital and Clinics. Picture of Health, 702 North Blackhawk Avenue, Suite 215, Madison, WI 53705-3357. (800) 757-4354 or (608) 263-6510. Fax (608) 262-7172. PRICE: $19.95 plus shipping and handling; bulk copies available. Order number 071899A. Summary: This videotape, part of a series on living with diabetes, focuses on the diagnosis of diabetes. A moderator discusses the new criteria for the diagnosis and classification of diabetes, the rise in the incidence of diabetes, the symptoms of diabetes, and the prevention of diabetes with an endocrinologist. The videotape begins with a discussion of what diabetes is, how insulin works, the types of diabetes, and risk factors for diabetes. Type 1 diabetes, which was formerly known as insulin dependent diabetes, usually develops quickly, whereas type 2 diabetes, which was formerly known as noninsulin dependent diabetes, usually has a gradual onset. The symptoms of diabetes, which are generally the same regardless of the type, are related to high blood sugar. They include excessive urination and thirst, fatigue, hunger, weight loss, and blurred vision. Risk factors for type 1 diabetes include a genetic predisposition for developing the disease. Risk factors for type 2 diabetes include being overweight, sedentary, and over 45 years old; having a history of stillbirth or gestational diabetes; having high blood pressure and high cholesterol; being African American, Hispanic, or Native American; and having previously been identified with impaired glucose tolerance. The acute complications of diabetes include ketoacidosis, nonketotic hyperosmolar syndrome, and hypoglycemia. The chronic complications are divided into microvascular and macrovascular complications. Microvascular complications include retinopathy, neuropathy, and nephropathy. Macrovascular complications include heart attack, stroke, and peripheral vascular disease. Early diagnosis is important in preventing complications. Diagnosis is based on blood sugar levels obtained from a blood glucose test, a fasting plasma glucose test, or an oral glucose tolerance test. The risk of developing type 2 diabetes may be reduced by eating properly, maintaining an ideal weight, and exercising. The videotape includes a self test that viewers can take to assess their risk of developing type 2 diabetes.
Bibliography: Multimedia on Blood Pressure The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in blood pressure (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on blood pressure (for more information, follow the hyperlink indicated): •
Arterial blood pressure regulation [motion picture] Source: R. N. Hardy, P. W. Nathanielsz; Year: 1970; Format: Motion picture; New York: John Wiley and Sons, c1970
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Blood pressure measurement by the auscultatory method [motion picture] Source: Filmakers, Inc; Year: 1977; Format: Motion picture; Minneapolis: Filmakers, c1977
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Blood pressure readings [motion picture] Source: Heart Disease and Stroke Control Program, National Center for Chronic Disease Control; produced by National Medical Audiovisual Center; Year: 1968; Format: Motion picture; [Washington]: The Center: [for sale by National Audiovisual Center; Atlanta: for loan by National Medical Audiovisual Center, 1968]
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Doppler blood pressure measurement [videorecording] Source: University of California at Davis, School of Veterinary Medicine; Year: 1977; Format: Videorecording; [Berkeley]: Regents of the University of California; [Davis: for loan and sale by Univ. of California, Davis, Health Sciences Television], c1977
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Effects of renin and aldosterone on blood pressure [slide] Source: School of Nursing, State University of New York at Buffalo; Year: 1976; Format: Slide; Buffalo: Communications in Learning, 1976
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How to measure your patient's blood pressure [filmstrip] Source: Techniques Learning Council; Year: 1975; Format: Filmstrip; Pasadena, Calif.: The Council, c1975
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Pressure transducers and direct blood pressure measurement [slide] Source: William F. Betts and Bruce R. Herrick; produced by Medical Audiovisual Services, University of Arizona Health Sciences Center; Year: 1977; Format: Slide; Tucson: The Center: [for sale by its Biomedical Communications], c1977
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Taking a blood pressure [motion picture] Source: produced under the supervision of the Bureau of Aeronautics for the Bureau of Medicine and Surgery by Chicago Film Laboratory, Inc; Year: 1943; Format: Motion picture; United States: Navy Dept., [1943]
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Taking blood pressure [videorecording] Source: Medfact; Year: 1975; Format: Videorecording; [Massillon, Ohio]: Medfact, 1975
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The Measurement of blood pressure [motion picture] Source: Francis Payne Bolton School of Nursing, Case Western Reserve University; Year: 1971; Format: Motion picture; [Cleveland, Ohio]: The University, c1971
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CHAPTER 9. PERIODICALS AND NEWS ON BLOOD PRESSURE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover blood pressure.
News Services and Press Releases One of the simplest ways of tracking press releases on blood pressure is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “blood pressure” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to blood pressure. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “blood pressure” (or synonyms). The following was recently listed in this archive for blood pressure: •
Hostility, impatience raise future blood pressure Source: Reuters Health eLine Date: October 21, 2003
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Serum uric acid level predicts weight and blood pressure increases
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Source: Reuters Medical News Date: October 17, 2003 •
Racism, anger up blood pressure in blacks Source: Reuters Health eLine Date: October 14, 2003
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Adult blood pressure tied to birthweight Source: Reuters Health eLine Date: October 10, 2003
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Birthweight and childhood social class predict adult blood pressure Source: Reuters Medical News Date: October 09, 2003
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Candesartan superior to lisinopril in controlling morning blood pressure surge Source: Reuters Industry Breifing Date: October 01, 2003
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Blood pressure control may be improved with genotyping Source: Reuters Industry Breifing Date: September 26, 2003
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Blood pressure drugs may prevent broken hips Source: Reuters Health eLine Date: September 15, 2003
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Exercise plus weight loss reduces blood pressure in syndrome X patients Source: Reuters Medical News Date: September 10, 2003
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'Water pill' recommended first for blood pressure Source: Reuters Health eLine Date: September 10, 2003
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Positional change in blood pressure related to subsequent hypertension Source: Reuters Medical News Date: August 29, 2003
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Slow-release drug lowers diabetics' blood pressure Source: Reuters Health eLine Date: August 28, 2003
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Blood pressure drops as weight comes off Source: Reuters Health eLine Date: August 27, 2003
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Olmesartan better than candesartan at reducing blood pressure Source: Reuters Industry Breifing Date: August 21, 2003
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Heart rate, blood pressure responses have different implications after bypass Source: Reuters Medical News Date: August 18, 2003
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Nebivolol reduces blood pressure while preserving cardiac output Source: Reuters Medical News Date: August 15, 2003
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Modest exercise reduces blood pressure
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Source: Reuters Health eLine Date: August 13, 2003 •
Modest exercise reduces blood pressure in sedentary hypertensives Source: Reuters Medical News Date: August 13, 2003
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Joe Montana in Novartis blood pressure campaign Source: Reuters Industry Breifing Date: August 13, 2003
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US prevention group recommends blood pressure screening for all adults Source: Reuters Medical News Date: August 08, 2003
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Agency recommends blood pressure test for adults Source: Reuters Health eLine Date: August 08, 2003
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Nurse-led clinics help diabetics achieve blood pressure and lipid goals Source: Reuters Medical News Date: July 30, 2003
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High blood pressure in teens predicts heart disease Source: Reuters Health eLine Date: July 29, 2003
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Adolescent blood pressure predicts atherosclerosis in adulthood Source: Reuters Medical News Date: July 29, 2003
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Systolic BP predicts diabetic nephropathy progression Source: Reuters Medical News Date: July 23, 2003
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Significant drop in blood pressure observed in older adults soon after a meal Source: Reuters Medical News Date: July 03, 2003
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"White coat effect" minimized by measuring blood pressure outside office Source: Reuters Medical News Date: June 30, 2003
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Serious spousal spats spike blood pressure Source: Reuters Health eLine Date: June 27, 2003
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Blood pressure drops after meals, may deceive doc Source: Reuters Health eLine Date: June 27, 2003
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Unfair boss? Time to check your blood pressure Source: Reuters Health eLine Date: June 24, 2003 The NIH
Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the
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public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “blood pressure” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “blood pressure” (or synonyms). If you know the name of a company that is relevant to blood pressure, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “blood pressure” (or synonyms).
Newsletters on Blood Pressure Find newsletters on blood pressure using the Combined Health Information Database (CHID). You will need to use the “Detailed Search” option. To access CHID, go to the following hyperlink: http://chid.nih.gov/detail/detail.html. Limit your search to “Newsletter” and “blood pressure.” Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option,
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select “Newsletter.” Type “blood pressure” (or synonyms) into the “For these words:” box. The following list was generated using the options described above: •
Kidney Failure in Sarcoidosis Source: Sarcoidosis Networking. 8(3): 3. 2000. Contact: Available from Sarcoid Network Association. Sarcoidosis Networking, 13925 80th Street East, Puyallup, WA 98372-3614. Email:
[email protected]. Summary: Sarcoidosis is a chronic, progressive systemic granulomatous (causing lesions) disease of unknown cause (etiology), involving almost any organ or tissue, including the skin, lungs, lymph nodes, liver, spleen, eyes, and small bones of the hands or feet. This brief article, from a newsletter for patients with sarcoidosis, reviews the complications of kidney failure in sarcoidosis. Granulomatous infiltration of the kidney may be present in as many as 40 percent of patients with sarcoidosis, but it is rarely extensive enough to cause renal (kidney) dysfunction. The lesions are usually responsive to steroid therapy. Kidney failure has also been diagnosed in patients with sarcoidosis without the presence of lesions, possibly due to hypercalcemia (too much calcium in the blood), involvement of the glomerular filter system, and renal arteritis (inflammation of the arteries of the kidney), which may be associated with severe high blood pressure. It is recommended that all people with active sarcoidosis be screened for hypercalciuria (high levels of calcium in the urine). This may precede development of hypercalcemia, which should be treated. Glucocorticoids are the main choice of therapy and do seem to reduce levels of urinary calcium to normal within a few days. People with sarcoidosis may also have severe pain; the frequent use of pain medication can be another cause of kidney failure. People who take pain medication should ask their physicians to evaluate their kidneys on a regular basis. 9 references.
Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “blood pressure” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on blood pressure: •
Hypertension Drugs: They Can Treat More Than High Blood Pressure Source: Mayo Clinic Health Letter. 17(11): 5. November 1999. Contact: Available from Mayo Clinic Health Letter. Subscription Services, P.O. Box 53889, Boulder, CO 80322-3889. (800) 333-9037 or (303) 604-1465. Summary: This health newsletter article reviews the drugs used to treat hypertension (high blood pressure). The author focuses on the additional benefits of these drugs. Not only do hypertension drugs help control elevated blood pressure, but some actually offer additional health benefits. These can include treating heart failure, diabetes, or symptoms resulting from an enlarged prostate. There are several types of hypertension drugs, and each type helps control elevated blood pressure in a different way. These
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include diuretics, beta blockers, angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, calcium channel blockers, alpha blockers, and central acting agents (central adrenergic inhibitors). In choosing drug therapy to treat a specific patient's hypertension, the physician will consider age, overall health, other medications already being taken, and cost considerations. One table outlines the possible additional health benefits these drugs have beyond treating elevated blood pressure. 1 table.
Academic Periodicals covering Blood Pressure Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to blood pressure. In addition to these sources, you can search for articles covering blood pressure that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
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CHAPTER 10. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.
U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for blood pressure. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI® Advice for the Patient® can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with blood pressure. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The
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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to blood pressure: Amlodipine •
Systemic - U.S. Brands: Norvasc http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202670.html
Amlodipine and Benazepril •
Systemic - U.S. Brands: Lotrel http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203634.html
Angiotensin-Converting Enzyme (Ace) Inhibitors •
Systemic - U.S. Brands: Accupril; Aceon; Altace; Capoten; Lotensin; Mavik; Monopril; Prinivil; Univasc; Vasotec 4; Zestril http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202044.html
Angiotensin-Converting Enzyme (Ace) Inhibitors and Hydrochlorothiazide •
Systemic - U.S. Brands: Accuretic; Capozide; Lotensin HCT; Prinzide; Uniretic; Vaseretic; Zestoretic http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202045.html
Antihistamines and Decongestants •
Systemic - U.S. Brands: A.R.M. Maximum Strength Caplets; Actagen; Actifed; Actifed Allergy Nighttime Caplets 20; Alcomed; Alcomed 2-60; Allent; Allercon; Allerest Maximum Strength; Allerfrim; Allerphed; Amilon; Anamine; Anamine T.D. Andec; Andec-TR; Aprodrine; Atrofed; Atrohi http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202061.html
Antihistamines, Decongestants, and Analgesics •
Systemic - U.S. Brands: Aclophen; Actifed Cold & Sinus; Actifed Cold & Sinus Caplets; Actifed Sinus Nighttime; Actifed Sinus Nighttime Caplets; Alka-Seltzer Plus Allergy Medicine Liqui-Gels; Alka-Seltzer Plus Cold Medicine; Alka-Seltzer Plus Cold Medicine Liqui-Gels; Allerest http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202062.html
Antihistamines, Decongestants, and Anticholinergics •
Systemic - U.S. Brands: Note: http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202653.html
Beta-Adrenergic Blocking Agents •
Systemic - U.S. Brands: Betapace; Blocadren; Cartrol; Corgard; Inderal; Inderal LA; Kerlone; Levatol; Lopressor; Normodyne; Sectral; Tenormin; Toprol-XL; Trandate; Visken; Zebeta http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202087.html
Beta-Adrenergic Blocking Agents and Thiazide Diuretics •
Systemic - U.S. Brands: Corzide 40/5; Corzide 80/5; Inderide; Inderide LA; Lopressor HCT; Tenoretic 100; Tenoretic 50; Timolide 10-25; Ziac http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202088.html
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Calcium Channel Blocking Agents •
Systemic - U.S. Brands: Adalat; Adalat CC; Calan; Calan SR; Cardene; Cardizem; Cardizem CD; Cardizem SR; Dilacor-XR; DynaCirc; Isoptin; Isoptin SR; Nimotop; Plendil; Procardia; Procardia XL; Vascor; Verelan http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202107.html
Candesartan •
Systemic - U.S. Brands: Atacand http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203598.html
Carvedilol •
Systemic - U.S. Brands: Coreg http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203636.html
Clonidine •
Systemic - U.S. Brands: Catapres; Catapres-TTS http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202152.html
Clonidine and Chlorthalidone •
Systemic - U.S. Brands: Combipres http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202153.html
Cyclosporine •
Systemic - U.S. Brands: Neoral; Sandimmune; SangCya http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202176.html
Decongestants and Analgesics •
Systemic - U.S. Brands: Actifed Sinus Daytime; Actifed Sinus Daytime Caplets; Advil Cold and Sinus; Advil Cold and Sinus Caplets; Alka-Seltzer Plus Sinus Medicine; Allerest No-Drowsiness Caplets; Aspirin-Free Bayer Select Sinus Pain Relief Caplets; BC Cold Powder Non-Drowsy Fo http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202184.html
Diuretics, Loop •
Systemic - U.S. Brands: Bumex; Edecrin; Lasix; Myrosemide http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202205.html
Diuretics, Potassium-Sparing •
Systemic - U.S. Brands: Aldactone; Dyrenium; Midamor http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202206.html
Diuretics, Potassium-Sparing, and Hydrochlorothiazide •
Systemic - U.S. Brands: Aldactazide; Dyazide; Maxzide; Moduretic; Spirozide http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202207.html
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Diuretics, Thiazide •
Systemic - U.S. Brands: Aquatensen; Diucardin; Diulo; Diuril; Enduron; Esidrix; Hydro-chlor; Hydro-D; HydroDIURIL; Hydromox; Hygroton; Metahydrin; Microzide; Mykrox; Naqua; Naturetin; Oretic; Renese; Saluron; Thalitone; Trichlorex 10; Zaroxolyn http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202208.html
Doxazosin •
Systemic - U.S. Brands: Cardura http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202629.html
Enalapril and Felodipine •
Systemic - U.S. Brands: Lexxel http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203638.html
Epoprostenol •
Systemic - U.S. Brands: Flolan http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203429.html
Eprosartan •
Systemic - U.S. Brands: Teveten http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500044.html
Fludrocortisone •
Systemic - U.S. Brands: Florinef http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202244.html
Guanabenz •
Systemic - U.S. Brands: Wytensin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202271.html
Guanadrel •
Systemic - U.S. Brands: Hylorel http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202272.html
Guanethidine •
Systemic - U.S. Brands: Ismelin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202273.html
Guanfacine •
Systemic - U.S. Brands: Tenex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202275.html
Headache Medicines, Ergot Derivative-Containing •
Systemic - U.S. Brands: Cafergot; Cafertine; Cafetrate; D.H.E. 45; Ercaf; ErgoCaff; Ergomar; Ergostat; Gotamine; Migergot; Wigraine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202216.html
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Hydralazine and Hydrochlorothiazide •
Systemic - U.S. Brands: Apresazide http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202286.html
Indapamide •
Systemic - U.S. Brands: Lozol http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202296.html
Irbesartan •
Systemic - U.S. Brands: Avapro http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203379.html
Isoxsuprine •
Systemic - U.S. Brands: Vasodilan http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202310.html
Laxatives •
Oral - U.S. Brands: Afko-Lube; Afko-Lube Lax 40; Agoral Marshmallow; Agoral Raspberry; Alaxin; Alophen; Alphamul; Alramucil Orange; Alramucil Regular; Bilagog; Bilax; Bisac-Evac; Black-Draught; Black-Draught Lax-Senna; Carter's Little Pills; Cholac; Chronulac; Cillium; Cit http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202319.html
Losartan •
Systemic - U.S. Brands: Cozaar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202767.html
Losartan and Hydrochlorothiazide •
Systemic - U.S. Brands: Hyzaar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203639.html
Mecamylamine •
Systemic - U.S. Brands: Inversine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202340.html
Methyldopa •
Systemic - U.S. Brands: Aldomet http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202359.html
Methyldopa and Thiazide Diuretics •
Systemic - U.S. Brands: Aldoclor; Aldoril http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202360.html
Metyrosine •
Systemic - U.S. Brands: Demser http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202368.html
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Midodrine •
Systemic - U.S. Brands: ProAmatine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203640.html
Minoxidil •
Systemic - U.S. Brands: Loniten http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202373.html
Nisoldipine •
Systemic - U.S. Brands: Sular http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203431.html
Phenoxybenzamine •
Systemic - U.S. Brands: Dibenzyline http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202458.html
Phenylephrine •
Ophthalmic - U.S. Brands: Ak-Dilate; Ak-Nefrin; Dilatair; I-Phrine; Mydfrin; Neofrin; Neo-Synephrine; Ocugestrin; Phenoptic http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202461.html
Phenylpropanolamine •
Systemic - U.S. Brands: Note:; Propagest; Thinz-Span http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202462.html
Potassium Supplements •
Systemic - U.S. Brands: Cena-K; Effer-K; Gen-K; Glu-K; K+ 10; K+ Care; K+ Care ET; K-8; Kaochlor 10%; Kaochlor S-F 10%; Kaon; Kaon-Cl; Kaon-Cl 20% Liquid; Kaon-Cl-10; Kato; Kay Ciel; Kaylixir; K-Dur; K-Electrolyte; K-G Elixir; K-Ide; KLease; K-Lor; Klor-Con 10; Klor-Con 8; Kl http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202473.html
Prazosin •
Systemic - U.S. Brands: Minipress http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202475.html
Prazosin and Polythiazide •
Systemic - U.S. Brands: Minizide http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202476.html
Rauwolfia Alkaloids •
Systemic - U.S. Brands: Harmonyl; Raudixin; Rauval; Rauverid; Serpalan; Wolfina http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202503.html
Researching Medications 533
Rauwolfia Alkaloids and Thiazide Diuretics •
Systemic - U.S. Brands: Demi-Regroton; Diupres; Diurigen with Reserpine; Diutensen-R; Enduronyl; Enduronyl Forte; Oreticyl; Oreticyl Forte; Rauzide; Regroton http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202504.html
Reserpine, Hydralazine, and Hydrochlorothiazide •
Systemic - U.S. Brands: Cam-Ap-Es; Cherapas; Ser-A-Gen; Seralazide; Ser-ApEs; Serpazide; Tri-Hydroserpine; Unipres http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202506.html
Sibutramine •
Systemic - U.S. Brands: Meridia http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203725.html
Telmisartan •
Systemic - U.S. Brands: Micardis http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203710.html
Terazosin •
Systemic - U.S. Brands: Hytrin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202546.html
Torsemide •
Systemic - U.S. Brands: Demadex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202740.html
Trandolapril and Verapamil •
Systemic - U.S. Brands: Tarka http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203641.html
Valsartan •
Systemic - U.S. Brands: Diovan http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203478.html
Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.
Mosby’s Drug Consult™ Mosby’s Drug Consult™ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.
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PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.
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APPENDICES
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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute13: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
13
These publications are typically written by one or more of the various NIH Institutes.
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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.14 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:15 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
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HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
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NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
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Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
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Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
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MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
14
Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 15 See http://www.nlm.nih.gov/databases/databases.html.
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Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
•
Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database
A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “blood pressure” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “blood pressure” (or synonyms) into the “For these words:” box. The following is a sample result: •
Blood Pressure Control in Individuals with Pre-Kidney Disease Source: in Exceptional Parent. End Stage Renal Disease: A Practical Guide for Physicians, Dietitians, Nurses, Patients, Families, and Caregivers. Englewood Cliffs, NJ: Exceptional Parent. 1999. p. 7-8. Contact: Available from Exceptional Parent. P.O. Box 1807, Englewood Cliffs, NJ 07632. (800) 535-1910. Fax (201) 947-9376. E-mail:
[email protected]. Website: www.eparent.com. PRICE: $5.95. Summary: This article is from a monograph written to soften the blow of receiving the diagnosis of kidney failure by providing patients, caregivers, and their families some practical, easy to read information. The articles are written to be practical enough for patients to use, yet informative enough that professionals can refer to them as well. This article considers the role of blood pressure control in individuals with kidney disease. The author first reviews blood pressure, how it is measured, and the complications associated with high blood pressure (hypertension). The author then explains how high blood pressure affects the kidneys; years of untreated or poorly controlled blood pressure lead to irreversible scarring of the kidney, ending in kidney failure, dialysis, and the need for a kidney transplant. Under normal circumstances, the kidney has a unique ability to automatically regulate its own pressure. However, if blood pressure stays high over long periods of time, this autoregulatory function of the kidney is slowly destroyed, and renal circulation begins to suffer. The author discusses the use of a continuum for measuring blood pressure, noting that optimal blood pressure is a systolic reading of less than 120 with a diastolic reading of less than 80. In general, blood pressure should be kept well below 140 over 90. Individuals with diabetes or symptoms of abnormal kidney function, however, must keep their blood pressure below 135 over 85 for maximal protection against further kidney injury. These patients need to be aware of this goal and should work with their physicians to try to achieve it, knowing that in more than half the cases at least two different antihypertensive medications will be needed. 1 figure. 1 table.
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•
National High Blood Pressure Education Program Working Group Report on Hypertension in Diabetes Source: Bethesda, MD: National Heart, Lung, and Blood Institute, National Institutes of Health. 1995. 26 p. Contact: Available from NHLBI Information Center. P.O. Box 30105, Bethesda, MD 20824-0105. (301) 251-1222. Fax (301) 251-1223. PRICE: $3.00; bulk discounts available. This publication is also available on the Internet at http://www.nhlbi.nih.gov/nhlbi/nhlbi.htm. Summary: This report is designed to increase awareness of the importance and implications of the problem of hypertension in persons with diabetes in community control programs; and to guide clinicians in their care of persons with the concomitant problems of hypertension and diabetes. Topics include definitions and diagnostic criteria; epidemiologic considerations; clinical trials; a guide to clinical evaluation; special considerations in patients with diabetes and hypertension, including kidney disease, secondary forms of hypertension, cardiovascular disease, cerebrovascular disease, diabetic retinopathy, hypertension with orthostatic hypotension, autonomic neuropathy, sexual dysfunction, lipid disorders, obesity, pregnancy, and children; treatment considerations, including lifestyle modifications, the pharmacologic treatment of hypertension, and drugs for managing hypertensive emergencies in patients with diabetes; and considerations in education, control, and maintenance. 3 figures. 116 references. (AA-M).
•
Working group report on high blood pressure in pregnancy (Rev. ed.) Source: Bethesda, MD: National Heart, Lung, and Blood Institute, U.S. Department of Health and Human Services. 2000. 39 pp. Summary: This report provides guidance to the practicing physician in 1) managing hypertensive patients who become pregnant and 2) managing pregnant patients who become hypertensive. This report updates the 1990 National High Blood Pressure Education Program Working Group Report on High Blood Pressure in Pregnancy. It expands on recommendations made in the 6th Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC v1). Sections of the report are devoted to classification of hypertensive disorders of pregnancy; pathology and pathophysiology; differential diagnoses; chronic hypertension in pregnancy; preeclampsia; postpartum counseling and followup; and recommendations for future research. The section on management of hypertension in pregnancy contains recommendations on diet, alcohol and tobacco use, and lactation.
The NLM Gateway16 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.17 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. 16 17
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH).
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Type “blood pressure” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 244123 2198 1691 242 55 248309
HSTAT18 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.19 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.20 Simply search by “blood pressure” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
Coffee Break: Tutorials for Biologists21 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.22 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.23 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for
18
Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html.
19
The HSTAT URL is http://hstat.nlm.nih.gov/.
20 Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations. 21 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 22
The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 23 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
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general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
•
Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on blood pressure can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.
Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to blood pressure. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to blood pressure. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “blood pressure”:
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Other guides Coronary Disease http://www.nlm.nih.gov/medlineplus/coronarydisease.html Diabetes http://www.nlm.nih.gov/medlineplus/diabetes.html Heart Failure http://www.nlm.nih.gov/medlineplus/heartfailure.html Preeclampsia http://www.nlm.nih.gov/medlineplus/preeclampsia.html Stroke http://www.nlm.nih.gov/medlineplus/stroke.html
Within the health topic page dedicated to blood pressure, the following was listed: •
General/Overviews Blood Pressure Source: American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=4473 Low Blood Pressure Source: American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=4643
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Diagnosis/Symptoms Tilt-Table Test Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00268
•
Specific Conditions/Aspects Autonomic Nervous System Source: American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=4463 Blood Pressure Drops When You Stand Up Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ01027 Orthostatic Hypotension http://www.ninds.nih.gov/health_and_medical/disorders/orthosta_doc.htm Shy-Drager Syndrome http://www.ninds.nih.gov/health_and_medical/disorders/shydrger_doc.htm
•
Organizations American Heart Association http://www.americanheart.org/presenter.jhtml?identifier=1200000
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National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/ National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/ You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on blood pressure. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •
1 Out of Every 3 People with Kidney Failure is African American: High Blood Pressure and Kidney Disease Source: Rockville, MD: American Kidney Fund. 199x. [6 p.]. Contact: Available from American Kidney Fund. 6110 Executive Blvd., Suite 1010, Rockville, MD 20852-9813. (800) 638-8299 or (301) 881-3052. Fax (301) 881-0898. PRICE: Single copy free. Summary: High blood pressure is the leading cause of kidney failure in African Americans. This brochure encourages African Americans to learn about high blood pressure (hypertension) and kidney disease. The brochure emphasizes that kidney failure from hypertension is preventable; high blood pressure cannot be cured, but it can be controlled. Written in question and answer format, the brochure describes how blood pressure is monitored and measured, the risk factors for high blood pressure (including being African American, overweight, older, or in a family with high blood pressure, lack of exercise, eating too much salt, and smoking cigarettes), treatment options for hypertension, the complications that can arise from high blood pressure, how hypertension affects the kidneys, the role of the kidneys, what happens to the body in kidney failure, the warning signs of kidney disease, the role of diabetes in kidney disease, and the activities of the American Kidney Fund (AKF), an organization that helps people of all races cope with the effects of kidney disease. The warning signs of kidney disease include swelling of parts of the body (especially around the eyes or ankles), pain in the lower back, burning or unusual sensation during urination, bloody or coffee colored urine, urinating more often (especially at night), listless or tired feeling, and high blood pressure. The brochure includes a tear off card for readers to return to the AKF to obtain more information, to volunteer, or to contribute money. The brochure is written in nontechnical language.
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•
Eat Your Way to Lower Blood Pressure Source: Patient Care. 32(4): 80. February 28, 1998. Contact: Available from Medical Economics. 5 Paragon Drive, Montvale, NJ 07645. (800) 432-4570. Fax (201) 573-4956. Summary: The problem of hypertension (high blood pressure) is a health risk that continues to make its presence known as a public health concern. However, it's become increasingly clear that hypertension is preventable. This patient education fact sheet provides guidelines for using diet and meal planning for helping to achieve lower blood pressure. The fact sheet accompanies an article that helps physicians provide specific guidelines for their patients who wish to prevent or manage hypertension. The National Heart, Lung, and Blood Institute now recommends what they call the DASH diet as a way to prevent high blood pressure. The fact sheet outlines the DASH diet in a chart format, listing food groups, the recommended daily servings, the amount contained in one serving, and examples. The DASH diet recommends 7 to 8 servings of grains and grain products; 4 to 5 servings of vegetables; 4 to 5 servings of fruits; 2 to 3 servings of low fat dairy foods; 2 or fewer servings of meats, poultry, and fish; and a half serving of nuts. The fact sheet reminds readers to continue taking their blood pressure medication unless and until their physician recommends a change. 2 figures.
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High Blood Pressure and Kidney Disease Source: Lexington, KY: Virgil Smirnow Associates. Health Quality, Inc. 1993. 18 p. Contact: Available from Health Information Library. P.O. Box 55109, Lexington, KY 40555. (606) 299-8475. PRICE: $1.95 each for 1-99 copies; plus shipping and handling. Summary: The purpose of this booklet is to provide general information to patients and to the public about the relationships between hypertension and kidney diseases. The booklet is not intended as a detailed description of hypertension and its management, but rather as an explanation of kidney impairment in which hypertension is a significant causative or resultant factor. Written in detailed, but layperson's language, the brochure provides a definition of hypertension and then discusses how blood pressure is measured; its causes; secondary hypertension; the prevalence of hypertension; the effects of hypertension; malignant hypertension; stepped care; how hypertension is controlled; the side effects of hypertension medications; the kidneys and hypertension; how hypertension affects the kidneys; diagnostic factors; the relationship between endstage renal disease and hypertension; children and young people with hypertension; and how to avoid kidney damage from hypertension. The booklet concludes with an order form for the kidney series of booklets available from the Health Information Library.
•
Protect Your Heart! Prevent High Blood Pressure Source: Washington, DC: National Heart, Lung, and Blood Institute. Office of Research on Minority Health. 8p. 1997. Contact: NHLBI Information Center. Attention: Web Site P.O. Box 30105 Bethesda, MD 20824-0105. Phone 301-592-8573. Fax: 301-592- 8563 E-mail:
[email protected]. Website: http://www:nhlbi.nih.gov. Summary: This article, aimed at African Americans, explains high blood pressure and how it affects health. Ways of preventing high blood pressure are suggested, such as becoming physically active, maintaining a healthy weight, eating less salt, increasing
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consumption of fruits and vegetables, and reducing alcohol intake. If readers take medication for their high blood pressure, they are urged to take it consistently and not skip any doses. •
High Blood Pressure: What You Can Do Source: Santa Cruz, CA: ETR Associates. 2000. 15 p. Contact: Available from ETR Associates. P.O. Box 1830, Santa Cruz, CA 95061-1830. (800) 321-4407. Fax (800) 435-8433. Website: www.etr.org. PRICE: $1.00 plus shipping and handling; bulk orders available. Summary: This booklet focuses on steps people who have high blood pressure can take to manage this problem. The booklet explains what high blood pressure is and how blood pressure is measured. This is followed by a checklist of reasons people may have for managing their blood pressure and a checklist of steps people are already taking to lower their blood pressure. The booklet then offers tips for making an action plan, eating healthy foods, being active, losing weight, relaxing, quitting smoking, and limiting alcohol. The brochure also lists sources of additional information. 7 figures.
•
About High Blood Pressure: Control, Risk, Lifestyle, Weight Source: Dallas, TX: American Heart Association. 1995. 17 p. Contact: Available from Channing L. Bete Company/American Heart Association Fulfillment Center. 200 State Road, South Deerfield, MA 01373-0200. (800) 611-6083. Fax (800) 499-6464. E-mail:
[email protected]. PRICE: $7.50 for 50 copies. Summary: This booklet provides basic information about hypertension (high blood pressure). The booklet notes that adults have hypertension if their blood pressure remains above the threshold of 140 over 90. Approximately 90 percent of the cases of high blood pressure have no known causes. However, researchers have determined that some controllable risk factors for high blood pressure include obesity, excessive salt intake, excessive alcohol consumption, lack of exercise, and stress. Uncontrollable risk factors include race, heredity, and age. The booklet points out that an inactive lifestyle makes it easier for people to become overweight and therefore increases the chance of high blood pressure. High blood pressure has no symptoms, so adults should have a health care professional check their blood pressure at least once a year. Although high blood pressure cannot be cured, it can usually be controlled. When compared with people who have controlled high blood pressure, people with uncontrolled high blood pressure are on average three times more likely to develop coronary heart disease, six times more likely to develop congestive heart failure, and seven times more likely to have a stroke. Most treatments for high blood pressure involve a combination of diet, exercise, and medication. The booklet concludes with a list of related brochures available from the American Heart Association.
•
Living With High Blood Pressure and Diabetes Source: New York, NY: National Kidney Foundation. 1994. 6 p. Contact: Available from National Kidney Foundation. 30 East 33rd Street, New York, NY 10016. (800) 622-9010. PRICE: Single copy free. Summary: This booklet provides general information for people with high blood pressure and diabetes. The booklet focuses on preventing the complications of these two diseases. Written in a question-and-answer format, it covers the following topics: a
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definition of high blood pressure and how it is measured; the causes of high blood pressure; how diabetes increases one's chances of developing high blood pressure; the interaction of blood pressure and diabetes; the symptoms of complications; risk factors and diagnostic screening tests for kidney disease; treatment options for high blood pressure; medications and their side effects; recommendations for self-care; and pregnancy in women with diabetes and high blood pressure. The booklet concludes with a list of the other materials in the Living With High Blood Pressure program. •
High Blood Pressure and Your Kidneys Source: Montreal, Quebec: Kidney Foundation of Canada. 199x. [4 p.]. Contact: Available from Kidney Foundation of Canada. 300-5165, rue Sherbrooke Ouest, Montreal, QC H4A 1T6. (514) 369-4806. Fax (514) 369-2472. Website: www.kidney.ca. PRICE: Single copy free. Summary: This brochure answers common questions about high blood pressure and the kidneys. High blood pressure (hypertension) occurs when blood vessels become narrower, forcing the heart to pump harder to push blood through the body. If high blood pressure is left uncontrolled, it can damage the kidneys (kidney failure), heart (heart attacks), and brain (stroke). High blood pressure is a silent disease; there are no clear signs or warning signals. The causes of high blood pressure are not fully understood, but there are risk factors for developing hypertension, including family history of the problem, age, high sodium (salt) diet, and race. The brochure reviews the interplay between hypertension, kidney disease, and diabetes; describes the physiological role of the kidneys and why they are so important; and explains how hypertension can hurt the kidneys and reduce their effectiveness. The brochure also provides suggestions for healthier living to treat or prevent hypertension. One section reviews the warning signs of kidney disease. The brochure concludes with a brief description of the Kidney Foundation of Canada, including patient services and public education programs. 1 figure.
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Your Kidneys and High Blood Pressure: African-American Health Education Program Source: Cincinnati, OH: Kidney Foundation of Greater Cincinnati. 1997. [1 p.]. Contact: Available from Kidney Foundation of Greater Cincinnati. 220 Victory Parkway, Suite 510, Cincinnati, OH 45206. (513) 961-8105. Fax (513) 961-8120. PRICE: Single copy free. Summary: This brochure discusses kidneys and high blood pressure. The brochure is from the African American Health Education Program of the Kidney Foundation of Greater Cincinnati. This program was specially designed for adults and children in the African American community at risk for kidney disease, particularly those who have, or who are at risk of having, high blood pressure or diabetes. The mission of the program is to prevent or slow down the onset of kidney disease within the African American community through ministry, education, and counseling. The brochure answers common questions about blood pressure, including why measuring blood pressure is important, the problems associated with high blood pressure, factors that contribute to high blood pressure (including heredity, age, race, obesity, and sensitivity to salt), how to lower the risks associated with high blood pressure, and how to tell if one's blood pressure is high. The brochure stresses that people with kidney disease due to diabetes who control their blood pressure are half as likely to lose kidney function. The brochure includes a check list of strategies to employ after finding out that high blood pressure is present. These strategies include the following: have blood pressure checked regularly,
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maintain appropriate weight levels, do not use excessive salt, do not smoke cigarettes, eat a low fat diet, take medications exactly as prescribed, see a health care provider regularly, and follow the physician's advice about exercise. •
High Blood Pressure and Your Kidneys. [Acerca de Presion Arterial Alta y las Enfermedades de Rinones] Source: New York: National Kidney Foundation. 2001. 11 p. Contact: Available from National Kidney Foundation, Inc. 30 East 33rd Street, New York, NY 10016. (800) 622-9010. PRICE: Single copy free; bulk copies available. Summary: This brochure discusses the interrelationship of high blood pressure and kidney disease. Written in a question and answer format and designed for the person who as been diagnosed with high blood pressure, the brochure discusses the causes, detection, and dangers of high blood pressure. In addition, the incidence of high blood pressure in the black population is considered briefly. The final sections present information about how high blood pressure is treated, including the various medications used and their potential side effects. The brochure is available in English or Spanish.
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High Blood Pressure and its Effects on the Kidneys Source: Rockville, MD: American Kidney Fund. 1995. 4 p. Contact: Available from American Kidney Fund. 6110 Executive Boulevard, Suite 1010 Rockville, MD 20852. (800) 638-8299. Fax (301) 881-0898. PRICE: Single copy free; additional copies $0.15 each plus shipping (as of 1995). Summary: This brochure explains the symptoms, causes, effects, and treatment of hypertension. The damage to the body caused by hypertension is explained, with particular emphasis on how hypertension affects the kidneys. A list of factors that can aggravate hypertension is also given.
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Thinking About Lowering Your Blood Pressure Source: Midland, MI: Health Enhancement Systems. 1999. 2 p. Contact: Available from Health Enhancement Systems. P.O. Box 1035, Midland, MI 48641-1035. (800) 326-2317. Fax (517) 839-0025. PRICE: $0.68 each for a pack of 10 to 50 brochures; bulk quantities available; plus shipping and handling. Item number HESBP1. Summary: This brochure introduces the concept of blood pressure and the reasons why it is important to monitor and treat high blood pressure (hypertension). Blood pressure is a measurement of the force of blood pushing against the artery walls. The top number, systolic pressure, is the force when the heart beats and sends blood into the arteries. The bottom number, diastolic pressure, is the force when the heart is resting between beats. Each heart beat produces a slightly different pressure, but both numbers tend to go up and down together. High blood pressure refers to increased tension or pressure in the arteries. Hypertension increases the risk of serious medical conditions such as heart attack, stroke, kidney failure, and congestive heart failure. The brochure notes that many people do not feel the urgency to treat hypertension because it does not create symptoms as some other health concerns do. The brochure encourages readers to think about hypertension and the importance of addressing this potentially deadly medical condition. The brochure asks readers to consider four questions that ask how
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the reader would respond if a close friend or family member had hypertension that needed treatment. The brochure provides blank space for readers to answer the questions, then lists resources through which readers can obtain more information. •
Benefits of Lowering Your Blood Pressure Source: Midland, MI: Health Enhancement Systems. 1999. 6 p. Contact: Available from Health Enhancement Systems. P.O. Box 1035, Midland, MI 48641-1035. (800) 326-2317. Fax (517) 839-0025. PRICE: $0.98 each for a pack of 10 to 50 brochures; bulk quantities available; plus shipping and handling. Item number HESBP2. Summary: This brochure is addressed to readers with high blood pressure (hypertension) who need encouragement to treat their condition. Hypertension increases the risk of serious medical conditions such as heart attack, stroke, kidney failure, and congestive heart failure. The brochure notes that many people do not feel the urgency to treat hypertension because it does not create symptoms as some other health concerns do. The brochure first outlines the risk factors that can be controlled, including weight, exercise, alcohol, salt intake, and smoking, then notes the additional risk factors including heredity, race, age, and gender. The brochure encourages readers to learn about the advantages of controlling high blood pressure and to think about the changes that may be required in order to control hypertension. Blank space is provided to answer directed questions about these changes. The brochure then offers a guided imagery exercise in which the reader pictures himself or herself undertaking and succeeding at the lifestyle changes that would be required. The brochure includes a section for readers to monitor and record their blood pressure readings at different times of day for a week; space is then provided to answer questions about the results of this blood pressure record. Two final sections offer strategies for learning more about hypertension and the things that a supportive friend or spouse can provide. The brochure serves as a type of self-contract for getting readers committed to their own health care plan. The brochure concludes with a list of three resource organizations that can provide additional information and assistance.
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5 Ways to Lower Blood Pressure Source: Santa Cruz, CA: ETR Associates. 2001. [4 p.]. Contact: Available from ETR Associates. P.O. Box 1830, Santa Cruz, CA 95061-1830. (800) 321-4407. Fax (800) 435-8433. Website: www.etr.org. PRICE: $1.00 plus shipping and handling; bulk orders available. Summary: This brochure presents ways people can lower their blood pressure. Healthy lifestyle choices can help lower high blood pressure. Lowering high blood pressure involves eating healthy foods and drinking water or caffeine free and sugar free drinks, being active, losing weight, taking prescription medication, quitting smoking, and limiting alcohol. The brochure also illustrates healthy serving sizes and presents a checklist of reasons for wanting to lower blood pressure. 3 figures.
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Exercise Your Way to Lower Blood Pressure Source: American College of Sports Medicine. 2 pages. Contact: P.O. Box 1440, Indianapolis, IN 46206-1440. (317) 637-9200. www.acsm.org.
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Summary: This fact sheet describes the benefits of exercise as an adjunct therapy to treating patients with high blood pressure. Three to six months of healthy lifestyle changes are currently recommended for the initial treatment of mild to moderate high blood pressure. These changes include decreased sodium intake, weight loss, and increased physical activity. Any amount of physical activity is considered better than none, and low-intensity activities such as walking, can help lower blood pressure. The fact sheet recommends consulting one's physician before making lifestyle changes. •
Blood Pressure and Tinnitus Source: London, England: Royal National Institute for Deaf People. 1999. 3 p. Contact: Available from RNID Helpline. P.O. Box 16464, London EC1Y 8TT, United Kingdom. 0870 60 50 123. Fax 0171 296 8199. E-mail:
[email protected]. Website: www.rnid.org.uk. PRICE: Single copy free. Summary: This fact sheet from the Royal National Institute for Deaf People (RNID, London, England) reviews the interplay of blood pressure and tinnitus (ringing or other noises in the ear). High blood pressure (hypertension) alters the supply of blood to the small vessels of the inner ear and is therefore known to be associated with tinnitus. Tinnitus is also thought to be associated with arteriosclerotic heart disease (hardening of the arteries). Pulsatile tinnitus (the tinnitus noise beats in time with the patient's pulse) can be treatable. The fact sheet briefly discusses blood pressure medications and how they work. The fact sheet concludes with information about the RNID tinnitus helpline, including the web site and email address of the organization. 1 reference.
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High Blood Pressure and Diabetes: A Dangerous Combination Source: Clinical Diabetes. 14(4): 95. July-August 1996. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Reproducible. Summary: This fact sheet provides information about high blood pressure and diabetes. Topics include determining if high blood pressure is present; steps to take to lower hypertension without medication; the use of antihypertensive medications, including diuretics, beta blockers, vasodilators, alpha blockers, ACE inhibitors, and calcium channel blockers; and the side effects of some hypertensive medications. One chart lists the ranges of blood pressure readings from high normal to very severe hypertension. The fact sheet includes the toll-free number of the American Diabetes Association (800342-2383).
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About High Blood Pressure Source: Dallas: The Association, 17 p., 1995. Contact: American Heart Association, National Center, 7272 Greenville Ave., Dallas, TX 75231-4596. Summary: This pamphlet explains what high blood pressure is, and how it is affected by various factors. The author distinguishes between controllable factors, such as obesity, salt intake, physical inactivity, and stress, and uncontrollable factors, such as race, heredity, and age. The brochure then goes on to offer suggestions on how to change the controllable factors by losing weight, changing the diet, and becoming more active.
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Your Podiatric Physician Talks About High Blood Pressure Source: Bethesda, MD: American Podiatric Medical Association. 1993. 4 p. Contact: Available from American Podiatric Medical Association. 9312 Old Georgetown Road, Bethesda, MD 20814-1698. (800) 366-8227 or (301) 581-9200. Fax (301) 530-2752. Website: www.apma.org. PRICE: Single copy free; bulk orders available at cost. Summary: This pamphlet provides people who have foot problems with information on high blood pressure. A podiatrist is concerned about hypertension and vascular disease, so he or she should know whether a patient has rheumatic heart disease, diabetes, ulceration, swollen feet, or burning feet. In addition, the pamphlet explains that a podiatrist assists in controlling high blood pressure by taking every patient's blood pressure on a routine basis; referring all patients who have high blood pressure to their physicians for evaluation, diagnosis, and treatment; and encouraging patients to adhere to treatment.
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Living With High Blood Pressure and Eating Healthy Source: New York, NY: National Kidney Foundation. 1994. 5 p. Contact: Available from National Kidney Foundation. 30 East 33rd Street, New York, NY 10016. (800) 622-9010. PRICE: Single copy free. Summary: This patient education booklet is one of a series on living with high blood pressure. Designed for patients newly diagnosed with hypertension, the booklet gives general information about the role diet plays in treating high blood pressure. Written in question-and-answer format, the booklet covers topics including blood pressure measurement; the causes of hypertension; the complications associated with hypertension; treatment options; how weight loss and exercise can help control high blood pressure; dietary changes recommended for people with hypertension; limiting sodium intake; the effects of potassium and calcium on blood pressure; the importance of following medication guidelines, even while utilizing diet therapy; patients with diabetes; and patients with kidney function. The brochure concludes with a list of the other resources in the Living With High Blood Pressure program. The brochure presents information in clear, easy-to-understand language.
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Living With High Blood Pressure: An Introduction Source: New York, NY: National Kidney Foundation. 1994. 5 p. Contact: Available from National Kidney Foundation. 30 East 33rd Street, New York, NY 10016. (800) 622-9010. PRICE: Single copy free. Summary: This patient education booklet is the first in a series on living with high blood pressure. Designed for patients newly diagnosed with hypertension, the booklet answers basic questions in the areas of blood pressure measurement; the causes of hypertension; the complications associated with hypertension; treatment options; side effects attributable to hypertension medications; and the role of diet therapy. The brochure concludes with a list of the other resources in the Living With High Blood Pressure program. The brochure presents information in clear, easy-to-understand language.
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The National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “blood pressure” (or synonyms). The following was recently posted: •
National High Blood Pressure Education Program: Working Group report on high blood pressure in pregnancy Source: National Heart, Lung, and Blood Institute (U.S.) - Federal Government Agency [U.S.]; 1990 (revised 2000 Jul); 39 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1478&nbr=704&am p;string=blood+AND+pressure
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Primary prevention of hypertension. Clinical and public health advisory from the National High Blood Pressure Education Program Source: National Heart, Lung, and Blood Institute (U.S.) - Federal Government Agency [U.S.]; 1993 (revised 2002 October 16); 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3482&nbr=2708&a mp;string=blood+AND+pressure
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Screening for high blood pressure: recommendations and rationale Source: United States Preventive Services Task Force - Independent Expert Panel; 1996 (revised 2003 July 14); 12 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3853&nbr=3068&a mp;string=blood+AND+pressure
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The evidence base for tight blood pressure control in the management of type 2 diabetes mellitus Source: American College of Physicians - Medical Specialty Society; 2003 April 1; 6 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3739&nbr=2965&a mp;string=blood+AND+pressure
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The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Source: National Heart, Lung, and Blood Institute (U.S.) - Federal Government Agency [U.S.]; 1997 (revised 2003 May 21); 22 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3744&nbr=2970&a mp;string=blood+AND+pressure
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Healthfinder™ Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •
Age Page - High Blood Pressure--A Common but Controllable Disorder Summary: This pamphlet provides basic facts about high blood pressure (hypertension)-what it is, how it is tested, what causes it, and how it can be treated, controled and prevented. Source: National Institute on Aging, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=36
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Be Smart About Your Heart: Control the ABCs of Diabetes Summary: This brochure from the National Diabetes Education Program focuses not only on glucose control but on the control of blood pressure and cholesterol as well. Source: National Diabetes Education Program, National Institute of Diabetes & Digestive & Kidney Diseases http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6365
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Blood Pressure Testing and Measurement Summary: Information about at-home high blood pressure monitoring. Source: American Heart Association http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3826
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Control the ABCs of Diabetes Summary: This page links to the National Diabetes Education Program campaign stressing the management of blood glucose, blood pressure, and cholesterol. Source: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6553
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Controlling High Blood Pressure: A Woman's Guide Summary: Three out of every four women with high blood pressure know they have it. Yet fewer than one in three are controlling it. This easy-to-read guide tells women how to control their high blood pressure. Source: National Heart, Lung, and Blood Institute, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=717
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Facts About Heart Disease and Women: Preventing and Controlling High Blood Pressure Summary: If you have high blood pressure, you can control it with proper treatment. If you don't have high blood pressure now, you can take steps to prevent it from developing. Source: National Heart, Lung, and Blood Institute, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=242
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Facts About Lowering Blood Pressure Summary: This page links to consumer health information booklets that contain advice about how to maintain a healthy lifestyle and avoid the damaging effects of high blood pressure. Source: National Heart, Lung, and Blood Institute, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2708
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healthfinder® just for you: Adults Summary: healthfinder®'s just for you: Adults section features topics such as heart disease, high blood pressure, and physical activity. Source: U.S. Department of Health and Human Services http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7017
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healthfinder® just for you: Blacks or African Americans Summary: healthfinder®'s just for you: Blacks or African Americans section features topics such as diabetes, high blood pressure, and obesity Source: U.S. Department of Health and Human Services http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7021
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High Blood Pressure Summary: The American Heart Association provides this site as a service to the general public. Users can get general information about high blood pressure risks, prevention and management. Source: American Heart Association http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3827
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High Blood Pressure and Kidney Disease Summary: High blood pressure is one of the leading causes of kidney failure. This patient education fact sheet provides basic information about high blood pressure and kidney disease. Source: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2693
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High Blood Pressure Guidelines (JNC VI) Summary: This is an update of the previous guideline (JNC V, 1992), and contains important new information for clinicians. Source: National Heart, Lung, and Blood Institute, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2610
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Men: Eat 9 A Day for Better Health Summary: Black men are at high risk for many serious and potentially fatal diseases including many cancers, high blood pressure, diabetes, and heart disease. Source: National Cancer Institute, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7470
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Questions To Ask Your Doctor If You Have High Blood Pressure Summary: Questions you should ask if your doctor prescribes a drug to treat your blood pressure. Source: National Heart, Lung, and Blood Institute, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5290
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Take Care of Your Heart. Manage Your Diabetes: Blood Glucose, Blood Pressure, and Cholesterol Source: National Diabetes Education Program, National Institute of Diabetes & Digestive & Kidney Diseases http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7350
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Take Steps--Prevent High Blood Pressure Source: National Heart, Lung, and Blood Institute, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3173
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Tips for Reducing Sodium in Your Diet Summary: Written specifically for persons with high blood pressure, following these tips will help you to reduce salt and sodium in your diet. Source: National Heart, Lung, and Blood Institute, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5291
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Tips On How To Make Healthier Meals Summary: These tips were written specifically for persons with high blood pressure but may be used by anyone who would like to improve their eating habits. Source: National Heart, Lung, and Blood Institute, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5289
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Tips To Help You Remember To Take Your High Blood Pressure Medicine Summary: This mini fact sheet presents advice for patients with high blood pressure. Source: National Heart, Lung, and Blood Institute, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5227
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Your Guide to Lowering High Blood Pressure Summary: Your Guide to Lowering Blood Pressure is intended for people who are interested in learning more about preventing and controlling high blood pressure. Source: National Heart, Lung, and Blood Institute, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6385 The NIH Search Utility
The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to blood pressure. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources
A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/specific.htm
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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
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Med Help International: http://www.medhelp.org/HealthTopics/A.html
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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
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WebMD®Health: http://my.webmd.com/health_topics
Associations and Blood Pressure The following is a list of associations that provide information on and resources relating to blood pressure: •
Addison and Cushing International Federation Telephone: 31-153699339 Fax: 31-153699339 Email:
[email protected] Web Site: www.nvacp.nl Background: The Addison and Cushing International Federation (ACIF), established in 1996, is a platform of organisations involved in the support of those affected with Addison's disease, Cushing's syndrome (or disease) and related adrenal or pituitaryrelated diseases (e.g., Acromegaly, CAH and other disorders). ACIF maintains a listing of organisations, support groups and individuals who want to start support groups in countries where none exist, that are involved in the field of adrenal and pituitary disorders. The ACIF web site remains a part of the web site of the Dutch Addison and Cushing Society (NVACP). Whenever possible, messages will be diverted to existing patient support groups already known to ACIF. Addison's disease is a rare disorder characterized by deficiency of certain hormones (i.e., hydrocortisone and aldosterone) produced by the outer region (cortex) of the adrenal glands. Acute episodes (Addisonian crises) may be characterized by excessive loss of sodium and water in the urine, dehydration, low blood pressure (hypotension), extreme muscle weakness, confusion, and coma. In most cases, however, the disease's onset is chronic and progressive where affected individuals may experience fatigue, weakness, weight loss, abdominal pain, and abnormal darkening of the skin in certain areas of the body. Cushing's syndrome is a hormonal disorder characterized by abnormally increased levels of certain hormones (i.e., corticosteroid hormones) produced by the adrenal glands. Associated symptoms and findings may include abnormal roundness and reddening of the face, weight gain, wasting of the limbs, excessive hair growth, loss of bone density and susceptibility to fractures (osteoporosis), increased blood pressure (hypertension), susceptibility to bruising, mental changes, and/or other abnormalities.
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Alveolar Capillary Dysplasia Association Telephone: (630) 416-6776 Fax: (630) 416-6776 Email:
[email protected] Web Site: http://www.acd-association.com
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Background: The Alveolar Capillary Dysplasia Association is a not-for-profit organization dedicated to providing information, support, and resources to parents of children born with alveolar capillary dysplasia (ACD). ACD is a condition characterized by abnormal development (dysplasia) of the tiny air sacs in the lungs (alveoli). In all reported cases, ACD has occurred in association with primary pulmonary hypertension of the newborn (PPHN), which is characterized by abnormally increased blood pressure in the arteries supplying the lungs. Affected infants also typically have misalignment of pulmonary veins, poor development of certain capillaries, and/or other findings. In most cases, during the first days of life, affected newborns develop a bluish discoloration of the skin and mucous membranes (cyanosis) due to abnormally low levels of circulating oxygen (hypoxia) and experience difficulty breathing. In many cases, life-threatening complications may result within approximately three to four weeks. The condition usually appears to occur randomly, for no apparent reason (sporadic). However, a few familial cases have been reported. The Alveolar Capillary Dysplasia Association was established in 1997 by the parents of a child born with ACD. The Association is committed to providing mutual support to affected families through networking services; offering information concerning current research; educating the medical community and the general public about alveolar capillary dysplasia; and working with affected families and the medical community to expand the current knowledge of ACD. The Association offers an in-depth bibliography of medical journal articles on ACD, provides a newsletter via e-mail, and has a web site on the Internet that offers understandable information on ACD, a guestbook area, and linkage to additional sources of information and support. •
Anaphylaxis Campaign Telephone: 01252 542029 Fax: 01252 377140 Email:
[email protected] Web Site: http://www.anaphylaxis.org.uk/ Background: The Anaphylaxis Campaign is a health organization in the United Kingdom dedicated to providing information, support, and guidance concerning anaphylaxis. Established in 1994 (current membership as of Jan 2003 is 6000), the Campaign is committed to raising awareness in the food industry as well as promoting professional education and awareness within the health care communities to ensure optimum provision of information to and treatment of affected individuals. Anaphylaxis is a severe allergic reaction upon exposure to certain 'sensitizing factors' (allergens), such as particular foods, drugs, chemicals, or insect stings. The condition occurs due to overreaction of the body's immune system in response to a previously encountered allergen (hypersensitivity reaction). Within seconds to minutes of exposure to such allergens, affected individuals may experience flushing of the skin; hives; swelling of the mouth and throat; difficulty speaking, swallowing, and/or breathing; nausea and vomiting; low blood pressure (hypotension); irregular heart beat (arrhythmia); and/or collapse and unconsciousness. If severe symptoms occur, an affected individual should immediately receive medical attention, and an injection of the naturally occurring hormone epinephrine (adrenaline) may be lifesaving. The Anaphylaxis Campaign promotes research, provides a variety of educational materials including informational brochures, publishes a regular newsletter, and has a web site on the Internet.
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Autonomic Dysfunction Center Telephone: (615) 343-0124 Fax: (615) 343-8649 Web Site: http://www.mc.vanderbilt.edu/gcrc/adc Background: The Autonomic Dysfunction Center, a not-for-profit clinical facility, provides treatment, conducts clinical research, and offers support resources and referrals to adults with conditions and disorders characterized by autonomic nervous system dysfunction. Such conditions and disorders include Orthostatic Hypotension, Bradbury Eggleston Syndrome, Shy Drager Syndrome, and Multiple System Atrophy. The autonomic nervous system controls a variety of vital involuntary body functions including regulation of heart rate, blood pressure, sweating, and bowel and bladder control. As a result, autonomic nervous system dysfunction may result in a variety of symptoms and findings such as unusually low blood pressure while standing upright (orthostatic hypotension), impairment or loss of bladder and bowel control, and/or deficiency or absence of sweating. Established in 1978, the Autonomic Dysfunction Center provides treatment to adults with autonomic nervous system dysfunction and conducts ongoing clinical research studies, regularly publishes research results within the peer-reviewed medical literature, and provides supportive services for affected individuals and family members.
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Canadian Addison Society Telephone: (519) 751-4472 Fax: (519) 751-4473 Email:
[email protected] Web Site: http://www.spin.nl/nvap0490.htm Background: The Canadian Addison Society (La Societe Canadienne d Addison) is a nonprofit voluntary agency dedicated to providing support and educational information to individuals affected by Addison s disease and their families. All Society staff members are volunteers. Addison s disease is a rare disorder characterized by chronic, usually progressive, insufficient functioning of the outer layer of the adrenal glands (adrenal cortex). Deficiencies of certain hormones manufactured by the adrenals (i.e., cortisol and aldosterone) result in abnormally low levels of sodium and chloride in the blood and body tissues as well as unusually high levels of potassium (electrolyte imbalance). Increased urinary output and abnormally low blood pressure (hypotension) can lead to extremely low levels of fluid in the body (dehydration). Other early symptoms of Addison s disease may include weakness, fatigue, loss of appetite (anorexia), and a darkened discoloration of scars, skin folds, and/or mucous membranes (hyperpigmentation). The Canadian Addison Society publishes a quarterly newsletter that includes information on national and international issues from support groups around the world; information on local support group activities is also included. In addition, the Society publishes an educational brochure on Addison s disease. The society has approximately 200 members and is itself a member of The Addison and Cushing International Federation.
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Canadian Reflex Sympathetic Dystrophy Network Telephone: (250) 338-5835 Fax: (250) 338-5835
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Email:
[email protected] Web Site: www.canadianrsd.com Background: The Canadian RSD (CRSD) Network is a nonprofit support organization dedicated to offering support and information to individuals affected by reflex sympathetic dystrophy syndrome (RSDS), also known as Complex Regional Pain Syndrome (CRPS) and those who care for them. Reflex sympathetic dystrophy syndrome is a rare disorder of the sympathetic nervous system characterized by chronic, severe pain. The sympathetic nervous system is that part of the autonomic nervous system that regulates involuntary, bodily functions such as heart rate, blood vessel constriction, and blood pressure changes. Excessive or abnormal responses of portions of the sympathetic nervous system are thought to be responsible for the pain associated with reflex sympathetic dystrophy syndrome. CRSD Network's mission is to provide information about RSDS and enhance public awareness of RSDS; offer support to individuals and families living with RSDS, including pain and stress management; engage in programs of public advocacy; and provide referrals to health care professionals who have expertise in treating RSDS. The Network answers inquiries from all over the world. Available information includes an extensive library of reprints of medical articles, brochures, and a newsletter. CRSD Network is also actively engaged in establishing support groups throughout Canada. •
Dysautonomia Foundation, Inc Telephone: (212) 949-6644 Fax: (212) 682-7625 Email:
[email protected] Web Site: http://www.familialdysautonomia.org Background: The Dysautonomia Foundation is a national nonprofit organization founded in 1951 by parents of children with familial dysautonomia, a rare genetic disorder characterized by dysfunction of the autonomic nervous system (ANS). Symptoms and findings may include absence of pain sensation, defective secretion and discharge of tears, unusual fluctuations of body temperature, unstable blood pressure, skin blotching, impaired coordination, abnormally decreased reflex responses, and/or other abnormalities. The foundation has chapters located throughout the United States, Canada, the United Kingdom, and Israel. It provides informational materials and supports ongoing medical research and the clinical care of children with this disorder by maintaining the Familial Dysautonomia Treatment and Evaluation Center at New York University Medical Center in New York City and the Israeli Familial Dysautonomia Center at Hadassah Hospital in Jerusalem. In addition, the foundation is dedicated to funding basic medical research studies, particularly studies related to identification of the familial dysautonomia gene.
•
Familial Dysautonomia Hope, Inc Telephone: (847) 913-9377 Fax: (847) 913-8589 Email:
[email protected] Web Site: http://www.fdhope.org Background: The mission of Familial Dysautonomia Hope, Inc., a voluntary, not-forprofit organization established in 2001, is to expand and accelerate scientific research to
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find a cure for familial dysautonomia while improving the lives of the children and adults who are challenged by the disease. Familial Dysautonomia is a rare genetic disorder of the autonomic nervous system that primarily affects people of Eastern European Jewish heritage. It is characterized by diminished sensitivity to pain, lack of overflow tearing in the eyes, and unusual fluctuations of body temperature and blood pressure. Familial Dysautonomia Hope provides publications, advocacy, and patient networking services. •
JDF The Diabetes Research Foundation Telephone: (905) 889-4171 Toll-free: (800) 287-2533 Fax: (905) 889-4209 Email:
[email protected] Web Site: http://www.jdfc.ca Background: JDF The Diabetes Research Foundation is an international not-for-profit organization in Canada dedicated to raising funds to support and promote diabetes research. Diabetes is a chronic metabolic disorder that affects the body s ability to properly manufacture or utilize insulin, a hormone necessary for the body to transport food glucose into cells for energy. There are several types of diabetes including InsulinDependent Diabetes Mellitus, IDDM (also known as Juvenile Diabetes); Non-Insulin Dependent (Type II, also known as Adult-Onset Diabetes); and Gestational Diabetes. Established in 1974 and consisting of 14 chapters, JDF supports research advances in therapies to reduce the risk of diabetes-caused blindness, decrease the number of amputations due to diabetes, and control high blood pressure associated with diabetes; disease management practices that help maintain tight control of glucose levels to prevent or delay complications of diabetes; and practices that afford women with diabetes the opportunity for safe pregnancies and healthy children.
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National Hypertension Association, Inc Telephone: (212) 889-3557 Toll-free: (800) 575-9355 TTY: Fax: (212) 447-7032 Background: The National Hypertension Association, Inc. (NHA) is a not-for-profit organization dedicated to combating the chronic health problem of high blood pressure (hypertension) by developing, directing, and implementing effective programs to promote research, educate the public, and ensure prompt detection and effective treatment of hypertension. The NHA is committed to researching the causes of essential hypertension and enhancing the understanding of certain secondary types of hypertension through basic laboratory research studies, thereby improving treatment of these conditions; educating and alerting the public to the severe, life-threatening dangers of hypertension and informing physicians as well as medical students of the most current advances in its causes, diagnosis, treatment, and prevention; and detecting hypertension wherever it exists in the most economical and effective way and urging treatment if indicated. Established in 1977 by a group of concerned scientists, doctors, and philanthropists, NHA offers charitable blood pressure screening, provides worksite detection programs, and has a well-defined program of basic and clinical research to gain better insight into the causes of hypertension. Materials include brochures, pamphlets, a regular newsletter, reports, and information packets.
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•
Pulmonary Hypertension Association Telephone: (301) 565-3004 Toll-free: (800) 748-7274 Fax: (301) 565-3994 Email:
[email protected] Web Site: http://www.phassociation.org Background: The Pulmonary Hypertension Association (PHA) is an international notfor-profit voluntary organization that provides educational information and fellowship to people with primary or secondary pulmonary hypertension. Pulmonary hypertension is a condition characterized by abnormally high blood pressure in the arteries that supply the lungs. Pulmonary hypertension may be an isolated condition that may occur for unknown reasons (primary pulmonary hypertension) or may occur due to or in association with other underlying disorders or conditions (secondary pulmonary hypertension). Established in 1992, the organization addresses issues pertinent to people with these disorders such as current research, early detection, orphan drug designations, organ donor awareness, and organ transplantation. It conducts international conferences; provides a networking service; offers referrals; and publishes a quarterly newsletter, 'Pathlight.'.
•
RSDHope Group Telephone: (207) 583-4589 Fax: (207) 583-4978 Email:
[email protected] Web Site: http://www.rsdhope.org Background: The American RSDHope Group is a national not-for-profit organization dedicated to increasing awareness of Reflex Sympathetic Dystrophy Syndrome (RSDS) among affected individuals, their family members, health professionals, and the general public. RSDS is a rare disorder of the sympathetic nervous system that is characterized by chronic, severe pain following a simple trauma, break or fracture, sharp force injury, or surgery. The sympathetic nervous system is that part of the autonomic nervous system which regulates involuntary, bodily functions such as increasing heart rate, constricting blood vessels, and increasing blood pressure. Excessive or abnormal responses of portions of the sympathetic nervous system are thought to be responsible for the pain associated with Reflex Sympathetic Dystrophy Syndrome. Established in 1995, the American RSDHope Group produces educational materials including newsletters, national seminars, videotapes, information packets, and one on one assistance when needed. It makes information available to patients, their families, and their healthcare professionals. RSDHope has established the Hope For Tomorrow Research Fund, which has no administrative costs.
•
Sturge Weber Foundation (UK) Telephone: 01392-464675 Toll-free: (800) 748-7274 Fax: 01392-464675 Email:
[email protected] Web Site: http://www.sturgeweber.org.uk Background: The Sturge Weber Foundation (UK) offers support to individuals affected by Sturge Weber Syndrome and to their families. It raises both public and professional
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awareness of this syndrome, which is usually indicated by a port wine stain around the area of the eye and forehead, with similar blood vessels on the brain (angioma). People affected by the syndrome may also have epilepsy, increased pressure in the eye (glaucoma), and some children may have learning difficulties. Some may have a weakness or stiffness affecting one side of the body, similar in appearance to that of a stroke (hemiplegia). The Foundation encourages and funds research at the Sturge Weber Clinic at Great Ormond Street Hospital in London. It hosts an annual family weekend conference.
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to blood pressure. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with blood pressure. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about blood pressure. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “blood pressure” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit
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your search to “Organizations” and “blood pressure”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “blood pressure” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “blood pressure” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.24
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
24
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)25: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
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Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
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Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
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California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
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California: Gateway Health Library (Sutter Gould Medical Foundation)
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California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
•
California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
•
Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
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Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
•
Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
25
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
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•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
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Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
•
Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
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Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
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Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
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Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
•
Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
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Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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•
Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
•
Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
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Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
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National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
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National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
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National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
Finding Medical Libraries 573
•
Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
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New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
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New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
•
Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
•
MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
•
On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
•
Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
•
Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on blood pressure: •
Basic Guidelines for Blood Pressure Blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003398.htm Blood pressure - high Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003082.htm Blood pressure - low Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003083.htm
•
Signs & Symptoms for Blood Pressure Agitation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003212.htm Anxiety Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm
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Aphasia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003204.htm Fainting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003092.htm High blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003082.htm Hypotension Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003083.htm Loss of consciousness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003202.htm Obesity Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003101.htm Stress Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Syncope Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003092.htm Weight loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003107.htm •
Diagnostics and Tests for Blood Pressure Blood differential Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003657.htm Blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003398.htm CBC Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003642.htm Chem-20 Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003468.htm Diastolic BP Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003398.htm ECG Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003868.htm Pulse Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003399.htm
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Urinalysis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003579.htm X-ray of the abdomen Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003815.htm X-ray of the chest Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003804.htm X-rays of the kidneys Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003815.htm •
Nutrition for Blood Pressure Sodium (salt) in diet Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002415.htm
•
Background Topics for Blood Pressure Adolescent test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002054.htm Alcohol toxicity Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001944.htm Alcohol use Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001944.htm Allergic reaction Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000005.htm Analgesics Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002123.htm Exercise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001941.htm Infant test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002055.htm Mercury Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002476.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm Preschooler test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002057.htm Renal Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002289.htm
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Schoolage test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002058.htm Shock Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000039.htm Smoking Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002032.htm Toddler test or procedure preparation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002056.htm Vital signs Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002341.htm
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
•
MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
•
Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
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BLOOD PRESSURE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal fat: Fat (adipose tissue) that is centrally distributed between the thorax and pelvis and that induces greater health risk. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Abducens: A striated, extrinsic muscle of the eyeball that originates from the annulus of Zinn. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Accommodation: Adjustment, especially that of the eye for various distances. [EU] Acculturation: Process of cultural change in which one group or members of a group assimilates various cultural patterns from another. [NIH] Acetaldehyde: A colorless, flammable liquid used in the manufacture of acetic acid, perfumes, and flavors. It is also an intermediate in the metabolism of alcohol. It has a general narcotic action and also causes irritation of mucous membranes. Large doses may cause death from respiratory paralysis. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acidosis: A pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, and characterized by an increase in hydrogen ion concentration. [EU] Acoustic: Having to do with sound or hearing. [NIH] Acrylonitrile: A highly poisonous compound used widely in the manufacture of plastics, adhesives and synthetic rubber. [NIH] Actin: Essential component of the cell skeleton. [NIH] Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH]
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Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenovirus: A group of viruses that cause respiratory tract and eye infections. Adenoviruses used in gene therapy are altered to carry a specific tumor-fighting gene. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adipose Tissue: Connective tissue composed of fat cells lodged in the meshes of areolar tissue. [NIH] Adjunctive Therapy: Another treatment used together with the primary treatment. Its purpose is to assist the primary treatment. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenalin: A hormone of the adrenal medulla. [NIH] Adrenaline: A hormone. Also called epinephrine. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adrenergic beta-Antagonists: Drugs that bind to but do not activate beta-adrenergic receptors thereby blocking the actions of beta-adrenergic agonists. Adrenergic betaantagonists are used for treatment of hypertension, cardiac arrythmias, angina pectoris, glaucoma, migraine headaches, and anxiety. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerobic Exercise: A type of physical activity that includes walking, jogging, running, and dancing. Aerobic training improves the efficiency of the aerobic energy-producing systems that can improve cardiorespiratory endurance. [NIH] Aeroembolism: Joint pains, respiratory distress, and central nervous system symptoms which may follow decompression after exposure to air or other gas mixture at a pressure greater than the normal atmospheric pressure. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element,
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organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Afterload: The tension produced by the heart muscle after contraction. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]
Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Ageing: A physiological or morphological change in the life of an organism or its parts, generally irreversible and typically associated with a decline in growth and reproductive vigor. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Air Sacs: Thin-walled sacs or spaces which function as a part of the respiratory system in birds, fishes, insects, and mammals. [NIH] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Albuminuria: More than normal amounts of a protein called albumin in the urine. Albuminuria may be a sign of kidney disease. [NIH] Alcohol Drinking: Behaviors associated with the ingesting of alcoholic beverages, including social drinking. [NIH] Aldosterone: (11 beta)-11,21-Dihydroxy-3,20-dioxopregn-4-en-18-al. A hormone secreted by the adrenal cortex that functions in the regulation of electrolyte and water balance by increasing the renal retention of sodium and the excretion of potassium. [NIH] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH]
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Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Allograft: An organ or tissue transplant between two humans. [NIH] Allylamine: Possesses an unusual and selective cytotoxicity for vascular smooth muscle cells in dogs and rats. Useful for experiments dealing with arterial injury, myocardial fibrosis or cardiac decompensation. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [NIH] Alternans: Ipsilateral abducens palsy and facial paralysis and contralateral hemiplegia of the limbs, due to a nuclear or infranuclear lesion in the pons. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Ameliorating: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino Acid Neurotransmitters: Amino acids released by neurons as intercellular messengers. Among the amino acid neurotransmitters are glutamate (glutamic acid) and GABA which are, respectively, the most common excitatory and inhibitory neurotransmitters in the central nervous system. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form
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proteins. [NIH] Amlodipine: 2-((2-Aminoethoxy)methyl)-4-(2-chlorophenyl)-1,4-dihydro-6-methyl-3,5pyridinedicarboxylic acid 3-ethyl 5-methyl ester. A long-acting dihydropyridine calcium channel blocker. It is effective in the treatment of angina pectoris and hypertension. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amniotic Fluid: Amniotic cavity fluid which is produced by the amnion and fetal lungs and kidneys. [NIH] Amphetamine: A powerful central nervous system stimulant and sympathomimetic. Amphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulation of release of monamines, and inhibiting monoamine oxidase. Amphetamine is also a drug of abuse and a psychotomimetic. The l- and the d,l-forms are included here. The l-form has less central nervous system activity but stronger cardiovascular effects. The d-form is dextroamphetamine. [NIH] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Amputation: Surgery to remove part or all of a limb or appendage. [NIH] Amyloid: A general term for a variety of different proteins that accumulate as extracellular fibrils of 7-10 nm and have common structural features, including a beta-pleated sheet conformation and the ability to bind such dyes as Congo red and thioflavine (Kandel, Schwartz, and Jessel, Principles of Neural Science, 3rd ed). [NIH] Anabolic: Relating to, characterized by, or promoting anabolism. [EU] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anaphylaxis: An acute hypersensitivity reaction due to exposure to a previously encountered antigen. The reaction may include rapidly progressing urticaria, respiratory distress, vascular collapse, systemic shock, and death. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of
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hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Anginal: Pertaining to or characteristic of angina. [EU] Angiography: Radiography of blood vessels after injection of a contrast medium. [NIH] Angioma: A tumor composed of lymphatic or blood vessels. [NIH] Angiopathy: Disease of the blood vessels (arteries, veins, and capillaries) that occurs when someone has diabetes for a long time. There are two types of angiopathy: macroangiopathy and microangiopathy. In macroangiopathy, fat and blood clots build up in the large blood vessels, stick to the vessel walls, and block the flow of blood. In microangiopathy, the walls of the smaller blood vessels become so thick and weak that they bleed, leak protein, and slow the flow of blood through the body. Then the cells, for example, the ones in the center of the eye, do not get enough blood and may be damaged. [NIH] Angiotensin converting enzyme inhibitor: A drug used to decrease pressure inside blood vessels. [NIH] Angiotensin I: The decapeptide precursor of angiotensin II, generated by the action of renin on angiotensinogen. It has limited pharmacologic activity. [NIH] Angiotensin II: The active form of angiotensin. An octapeptide found in blood, it is synthesized from angiotensin I and quickly destroyed. Angiotensin II causes profound vasoconstriction with a resulting increase in blood pressure. It differs among species by the amino acid in position 5. The human form has isoleucine in this position. The clinically and experimentally used bovine form has valine in position 5. [NIH] Angiotensin-Converting Enzyme Inhibitors: A class of drugs whose main indications are the treatment of hypertension and heart failure. They exert their hemodynamic effect mainly by inhibiting the renin-angiotensin system. They also modulate sympathetic nervous system activity and increase prostaglandin synthesis. They cause mainly vasodilation and mild natriuresis without affecting heart rate and contractility. [NIH] Angiotensinogen: An alpha-globulin of which a fragment of 14 amino acids is converted by renin to angiotensin I, the inactive precursor of angiotensin II. It is a member of the serpin superfamily. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or
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positive pole during electrolysis. [NIH] Ankle: That part of the lower limb directly above the foot. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anterior Cerebral Artery: Artery formed by the bifurcation of the internal carotid artery. Branches of the anterior cerebral artery supply the caudate nucleus, internal capsule, putamen, septal nuclei, gyrus cinguli, and surfaces of the frontal lobe and parietal lobe. [NIH] Anterior Hypothalamic Nucleus: Loose heterogeneous collection of cells in the anterior hypothalamus, continuous rostrally with the medial and lateral preoptic areas and caudally with the tuber cinereum. [NIH] Anthropometric measurements: Measurements of human body height, weight, and size of component parts, including skinfold measurement. Used to study and compare the relative proportions under normal and abnormal conditions. [NIH] Antiallergic: Counteracting allergy or allergic conditions. [EU] Anti-Anxiety Agents: Agents that alleviate anxiety, tension, and neurotic symptoms, promote sedation, and have a calming effect without affecting clarity of consciousness or neurologic conditions. Some are also effective as anticonvulsants, muscle relaxants, or anesthesia adjuvants. Adrenergic beta-antagonists are commonly used in the symptomatic treatment of anxiety but are not included here. [NIH] Antiarrhythmic: An agent that prevents or alleviates cardiac arrhythmia. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
Antibiotic Prophylaxis: Use of antibiotics before, during, or after a diagnostic, therapeutic, or surgical procedure to prevent infectious complications. [NIH] Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antidiuretic: Suppressing the rate of urine formation. [EU] Antidote: A remedy for counteracting a poison. [EU] Antiepileptic: An agent that combats epilepsy. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a
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specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antihypertensive: An agent that reduces high blood pressure. [EU] Antihypertensive Agents: Drugs used in the treatment of acute or chronic hypertension regardless of pharmacological mechanism. Among the antihypertensive agents are diuretics (especially diuretics, thiazide), adrenergic beta-antagonists, adrenergic alpha-antagonists, angiotensin-converting enzyme inhibitors, calcium channel blockers, ganglionic blockers, and vasodilator agents. [NIH] Anti-infective: An agent that so acts. [EU] Anti-Infective Agents: Substances that prevent infectious agents or organisms from spreading or kill infectious agents in order to prevent the spread of infection. [NIH] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Anuria: Inability to form or excrete urine. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Aorta: The main trunk of the systemic arteries. [NIH]
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Aortic Coarctation: Narrowing of the lumen of the aorta, caused by deformity of the aortic media. [NIH] Aortic Valve: The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. [NIH] Aortitis: Inflammation of the wall of the aorta. [NIH] Aperture: A natural hole of perforation, especially one in a bone. [NIH] Apnea: A transient absence of spontaneous respiration. [NIH] Apnoea: Cessation of breathing. [EU] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Aponeurosis: Tendinous expansion consisting of a fibrous or membranous sheath which serves as a fascia to enclose or bind a group of muscles. [NIH] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Aromatic: Having a spicy odour. [EU] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteriolar: Pertaining to or resembling arterioles. [EU] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriolosclerosis: Sclerosis and thickening of the walls of the smaller arteries (arterioles). Hyaline arteriolosclerosis, in which there is homogeneous pink hyaline thickening of the arteriolar walls, is associated with benign nephrosclerosis. Hyperplastic arteriolosclerosis, in which there is a concentric thickening with progressive narrowing of the lumina may be associated with malignant hypertension, nephrosclerosis, and scleroderma. [EU] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Arteriosus: Circle composed of anastomosing arteries derived from two long posterior ciliary and seven anterior ciliary arteries, located in the ciliary body about the root of the iris. [NIH]
Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Arteritis: Inflammation of an artery. [NIH] Articular: Of or pertaining to a joint. [EU] Artifacts: Any visible result of a procedure which is caused by the procedure itself and not
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by the entity being analyzed. Common examples include histological structures introduced by tissue processing, radiographic images of structures that are not naturally present in living tissue, and products of chemical reactions that occur during analysis. [NIH] Ascites: Accumulation or retention of free fluid within the peritoneal cavity. [NIH] Ascorbic Acid: A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C, functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is considered an antioxidant. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [NIH] Astringents: Agents, usually topical, that cause the contraction of tissues for the control of bleeding or secretions. [NIH] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atenolol: A cardioselective beta-adrenergic blocker possessing properties and potency similar to propranolol, but without a negative inotropic effect. [NIH] Atherectomy: Endovascular procedure in which atheromatous plaque is excised by a cutting or rotating catheter. It differs from balloon and laser angioplasty procedures which enlarge vessels by dilation but frequently do not remove much plaque. If the plaque is removed by surgical excision under general anesthesia rather than by an endovascular procedure through a catheter, it is called endarterectomy. [NIH] Atheromatosis: A diffuse atheromatous disease of the arteries. [EU] Atmospheric Pressure: The pressure at any point in an atmosphere due solely to the weight of the atmospheric gases above the point concerned. [NIH] Atopic: Pertaining to an atopen or to atopy; allergic. [EU] Atrial: Pertaining to an atrium. [EU] Atrial Natriuretic Factor: A potent natriuretic and vasodilatory peptide or mixture of different-sized low molecular weight peptides derived from a common precursor and secreted by the heart atria. All these peptides share a sequence of about 20 amino acids. [NIH] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrioventricular Node: A small nodular mass of specialized muscle fibers located in the
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interatrial septum near the opening of the coronary sinus. It gives rise to the atrioventricular bundle of the conduction system of the heart. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU] Aural: Pertaining to or perceived by the ear, as an aural stimulus. [EU] Auscultation: Act of listening for sounds within the body. [NIH] Autacoids: A chemically diverse group of substances produced by various tissues in the body that cause slow contraction of smooth muscle; they have other intense but varied pharmacologic activities. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Autonomic Neuropathy: A disease of the nerves affecting mostly the internal organs such as the bladder muscles, the cardiovascular system, the digestive tract, and the genital organs. These nerves are not under a person's conscious control and function automatically. Also called visceral neuropathy. [NIH] Autoradiography: A process in which radioactive material within an object produces an image when it is in close proximity to a radiation sensitive emulsion. [NIH] Axillary: Pertaining to the armpit area, including the lymph nodes that are located there. [NIH]
Axillary Artery: The continuation of the subclavian artery; it distributes over the upper limb, axilla, chest and shoulder. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [NIH] Backcross: A cross between a hybrid and either one of its parents. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH]
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Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Baroreflex: A negative feedback system which buffers short-term changes in blood pressure. Increased pressure stretches blood vessels which activates pressoreceptors (baroreceptors) in the vessel walls. The net response of the central nervous system is a reduction of central sympathetic outflow. This reduces blood pressure both by decreasing peripheral vascular resistance and by lowering cardiac output. Because the baroreceptors are tonically active, the baroreflex can compensate rapidly for both increases and decreases in blood pressure. [NIH]
Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Bed Rest: Confinement of an individual to bed for therapeutic or experimental reasons. [NIH] Bends: The form of aeroembolism that is marked by intense pain in muscles and joints due to formation of gas bubbles in the tissues. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Beta blocker: A drug used to slow the heart rate and reduce pressure inside blood vessels. It also can regulate heart rhythm. [NIH] Beta-Endorphin: A peptide consisting of amino acid sequence 61-91 of the endogenous pituitary hormone beta-lipotropin. The first four amino acids show a common tetrapeptide sequence with methionine- and leucine enkephalin. The compound shows opiate-like activity. Injection of beta-endorphin induces a profound analgesia of the whole body for several hours. This action is reversed after administration of naloxone. [NIH] Bewilderment: Impairment or loss of will power. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU]
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Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological Factors: Compounds made by living organisms that contribute to or influence a phenomenon or process. They have biological or physiological activities. [NIH] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Biometry: The use of statistical methods to analyze biological observations and phenomena. [NIH]
Biophysics: The science of physical phenomena and processes in living organisms. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Flow Velocity: A value equal to the total volume flow divided by the cross-sectional area of the vascular bed. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood Pressure Determination: Techniques for measuring blood pressure. [NIH] Blood Pressure Monitors: Devices for continuously measuring and displaying the arterial blood pressure. [NIH] Blood transfusion: The administration of blood or blood products into a blood vessel. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood Viscosity: The internal resistance of the blood to shear forces. The in vitro measure of whole blood viscosity is of limited clinical utility because it bears little relationship to the actual viscosity within the circulation, but an increase in the viscosity of circulating blood can contribute to morbidity in patients suffering from disorders such as sickle cell anemia and polycythemia. [NIH]
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Blood Volume: Volume of circulating blood. It is the sum of the plasma volume and erythrocyte volume. [NIH] Blot: To transfer DNA, RNA, or proteins to an immobilizing matrix such as nitrocellulose. [NIH]
Body Composition: The relative amounts of various components in the body, such as percent body fat. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bolus: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus infusion. [NIH] Bolus infusion: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus. [NIH] Bolus injection: The injection of a drug (or drugs) in a high quantity (called a bolus) at once, the opposite of gradual administration (as in intravenous infusion). [EU] Bone Density: The amount of mineral per square centimeter of bone. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is most frequently measured by photon absorptiometry or x-ray computed tomography. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachial Artery: The continuation of the axillary artery; it branches into the radial and ulnar arteries. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Bradycardia: Excessive slowness in the action of the heart, usually with a heart rate below 60 beats per minute. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures.
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[NIH]
Breakdown: A physical, metal, or nervous collapse. [NIH] Breast Self-Examination: The inspection of one's breasts, usually for signs of disease, especially neoplastic disease. [NIH] Breeding: The science or art of changing the constitution of a population of plants or animals through sexual reproduction. [NIH] Broadband: A wide frequency range. Sound whose energy is distributed over a broad range of frequency (generally, more than one octave). [NIH] Bromine: A halogen with the atomic symbol Br, atomic number 36, and atomic weight 79.904. It is a volatile reddish-brown liquid that gives off suffocating vapors, is corrosive to the skin, and may cause severe gastroenteritis if ingested. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchiectasis: Persistent abnormal dilatation of the bronchi. [NIH] Bronchioles: The tiny branches of air tubes in the lungs. [NIH] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Bronchodilator: A drug that relaxes the smooth muscles in the constricted airway. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Buffers: A chemical system that functions to control the levels of specific ions in solution. When the level of hydrogen ion in solution is controlled the system is called a pH buffer. [NIH]
Butyric Acid: A four carbon acid, CH3CH2CH2COOH, with an unpleasant odor that occurs in butter and animal fat as the glycerol ester. [NIH] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in
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many enzymatic processes. [NIH] Calcium blocker: A drug used to relax the blood vessel and heart muscle, causing pressure inside blood vessels to drop. It also can regulate heart rhythm. [NIH] Calcium channel blocker: A drug used to relax the blood vessel and heart muscle, causing pressure inside blood vessels to drop. It also can regulate heart rhythm. [NIH] Calcium Channel Blockers: A class of drugs that act by selective inhibition of calcium influx through cell membranes or on the release and binding of calcium in intracellular pools. Since they are inducers of vascular and other smooth muscle relaxation, they are used in the drug therapy of hypertension and cerebrovascular spasms, as myocardial protective agents, and in the relaxation of uterine spasms. [NIH] Calcium Channels: Voltage-dependent cell membrane glycoproteins selectively permeable to calcium ions. They are categorized as L-, T-, N-, P-, Q-, and R-types based on the activation and inactivation kinetics, ion specificity, and sensitivity to drugs and toxins. The L- and T-types are present throughout the cardiovascular and central nervous systems and the N-, P-, Q-, & R-types are located in neuronal tissue. [NIH] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Candidosis: An infection caused by an opportunistic yeasts that tends to proliferate and become pathologic when the environment is favorable and the host resistance is weakened. [NIH]
Cannula: A tube for insertion into a duct or cavity; during insertion its lumen is usually occupied by a trocar. [EU] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capillary Permeability: Property of blood capillary walls that allows for the selective exchange of substances. Small lipid-soluble molecules such as carbon dioxide and oxygen move freely by diffusion. Water and water-soluble molecules cannot pass through the endothelial walls and are dependent on microscopic pores. These pores show narrow areas (tight junctions) which may limit large molecule movement. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Captopril: A potent and specific inhibitor of peptidyl-dipeptidase A. It blocks the conversion of angiotensin I to angiotensin II, a vasoconstrictor and important regulator of arterial blood pressure. Captopril acts to suppress the renin-angiotensin system and inhibits pressure responses to exogenous angiotensin. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH]
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Carcinogen: Any substance that causes cancer. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]
Cardiac: Having to do with the heart. [NIH] Cardiac Output: The volume of blood passing through the heart per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with stroke volume (volume per beat). [NIH] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiopulmonary Bypass: Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs. [NIH] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] Cardioselective: Having greater activity on heart tissue than on other tissue. [EU] Cardiotonic: 1. Having a tonic effect on the heart. 2. An agent that has a tonic effect on the heart. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular Abnormalities: Congenital structural abnormalities of the cardiovascular system. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Cardiovascular Physiology: Functions and activities of the cardiovascular system as a whole or of any of its parts. [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Carotid Arteries: Either of the two principal arteries on both sides of the neck that supply blood to the head and neck; each divides into two branches, the internal carotid artery and the external carotid artery. [NIH] Carotid Body: A small cluster of chemoreceptive and supporting cells located near the bifurcation of the internal carotid artery. The carotid body, which is richly supplied with fenestrated capillaries, senses the pH, carbon dioxide, and oxygen concentrations in the blood and plays a crucial role in their homeostatic control. [NIH] Carotid Sinus: The dilated portion of the common carotid artery at its bifurcation into external and internal carotids. It contains baroreceptors which, when stimulated, cause slowing of the heart, vasodilatation, and a fall in blood pressure. [NIH] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH]
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Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Causal: Pertaining to a cause; directed against a cause. [EU] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Celecoxib: A drug that reduces pain. Celecoxib belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is being studied for cancer prevention. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cell Hypoxia: A condition of decreased oxygen content at the cellular level. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Centrifugation: A method of separating organelles or large molecules that relies upon differential sedimentation through a preformed density gradient under the influence of a gravitational field generated in a centrifuge. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Aqueduct: Narrow channel in the mesencephalon that connects the third and fourth ventricles. [NIH] Cerebral Arteries: The arteries supplying the cerebral cortex. [NIH] Cerebral hemispheres: The two halves of the cerebrum, the part of the brain that controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. The right hemisphere controls muscle movement on the left side of the body, and
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the left hemisphere controls muscle movement on the right side of the body. [NIH] Cerebral Hemorrhage: Bleeding into a cerebral hemisphere of the brain, including lobar, subcortical white matter, and basal ganglia hemorrhages. Commonly associated conditions include hypertension; intracranial arteriosclerosis; intracranial aneurysm; craniocerebral trauma; intracranial arteriovenous malformations; cerebral amyloid angiopathy; and cerebral infarction. [NIH] Cerebral Infarction: The formation of an area of necrosis in the cerebrum caused by an insufficiency of arterial or venous blood flow. Infarcts of the cerebrum are generally classified by hemisphere (i.e., left vs. right), lobe (e.g., frontal lobe infarction), arterial distribution (e.g., infarction, anterior cerebral artery), and etiology (e.g., embolic infarction). [NIH]
Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Chaos: Complex behavior that seems random but actually has some hidden order. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Checkup: A general physical examination. [NIH] Check-up: A general physical examination. [NIH] Chemoreceptor: A receptor adapted for excitation by chemical substances, e.g., olfactory and gustatory receptors, or a sense organ, as the carotid body or the aortic (supracardial) bodies, which is sensitive to chemical changes in the blood stream, especially reduced oxygen content, and reflexly increases both respiration and blood pressure. [EU] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Chlorine: A greenish-yellow, diatomic gas that is a member of the halogen family of elements. It has the atomic symbol Cl, atomic number 17, and atomic weight 70.906. It is a powerful irritant that can cause fatal pulmonary edema. Chlorine is used in manufacturing, as a reagent in synthetic chemistry, for water purification, and in the production of chlorinated lime, which is used in fabric bleaching. [NIH] Chlorogenic Acid: A naturally occuring phenolic acid which is a carcinogenic inhibitor. It has also been shown to prevent paraquat-induced oxidative stress in rats. (From J Chromatogr A 1996;741(2):223-31; Biosci Biotechnol Biochem 1996;60(5):765-68). [NIH] Cholestasis: Impairment of biliary flow at any level from the hepatocyte to Vater's ampulla.
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[NIH]
Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Cholinergic Agonists: Drugs that bind to and activate cholinergic receptors. [NIH] Chromaffin Cells: Cells that store epinephrine secretory vesicles. During times of stress, the nervous system signals the vesicles to secrete their hormonal content. Their name derives from their ability to stain a brownish color with chromic salts. Characteristically, they are located in the adrenal medulla and paraganglia (paraganglia, chromaffin) of the sympathetic nervous system. [NIH] Chromic: Catgut sterilized and impregnated with chromium trioxide. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic Obstructive Pulmonary Disease: Collective term for chronic bronchitis and emphysema. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chronotropic: Affecting the time or rate, as the rate of contraction of the heart. [EU] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Circadian: Repeated more or less daily, i. e. on a 23- to 25-hour cycle. [NIH] Circadian Rhythm: The regular recurrence, in cycles of about 24 hours, of biological processes or activities, such as sensitivity to drugs and stimuli, hormone secretion, sleeping, feeding, etc. This rhythm seems to be set by a 'biological clock' which seems to be set by recurring daylight and darkness. [NIH] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Citrus: Any tree or shrub of the Rue family or the fruit of these plants. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Claudication: Limping or lameness. [EU]
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Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]
Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clitoral: Pertaining to the clitoris. [EU] Clone: The term "clone" has acquired a new meaning. It is applied specifically to the bits of inserted foreign DNA in the hybrid molecules of the population. Each inserted segment originally resided in the DNA of a complex genome amid millions of other DNA segment. [NIH]
Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Clozapine: A tricylic dibenzodiazepine, classified as an atypical antipsychotic agent. It binds several types of central nervous system receptors, and displays a unique pharmacological profile. Clozapine is a serotonin antagonist, with strong binding to 5-HT 2A/2C receptor subtype. It also displays strong affinity to several dopaminergic receptors, but shows only weak antagonism at the dopamine D2 receptor, a receptor commonly thought to modulate neuroleptic activity. Agranulocytosis is a major adverse effect associated with administration of this agent. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cochlea: The part of the internal ear that is concerned with hearing. It forms the anterior part of the labyrinth, is conical, and is placed almost horizontally anterior to the vestibule. [NIH]
Cochlear: Of or pertaining to the cochlea. [EU] Cochlear Diseases: Diseases of the cochlea, the part of the inner ear that is concerned with hearing. [NIH] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH]
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Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Cognitive restructuring: A method of identifying and replacing fear-promoting, irrational beliefs with more realistic and functional ones. [NIH] Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collagen disease: A term previously used to describe chronic diseases of the connective tissue (e.g., rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis), but now is thought to be more appropriate for diseases associated with defects in collagen, which is a component of the connective tissue. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Collateral Circulation: Maintenance of blood flow to an organ despite obstruction of a principal vessel. Blood flow is maintained through small vessels. [NIH] Colloidal: Of the nature of a colloid. [EU] Colonoscopy: Endoscopic examination, therapy or surgery of the luminal surface of the colon. [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials
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including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementation: The production of a wild-type phenotype when two different mutations are combined in a diploid or a heterokaryon and tested in trans-configuration. [NIH] Compress: A plug used to occludate an orifice in the control of bleeding, or to mop up secretions; an absorbent pad. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computer Simulation: Computer-based representation of physical systems and phenomena such as chemical processes. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Concentric: Having a common center of curvature or symmetry. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] Concretion: Minute, hard, yellow masses found in the palpebral conjunctivae of elderly people or following chronic conjunctivitis, composed of the products of cellular degeneration retained in the depressions and tubular recesses in the conjunctiva. [NIH] Conditioned stimulus: A situation in which one signal, or stimulus, is given just before
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another signal. After this happens several times, the first signal alone can cause the response that would usually need the second signal. [NIH] Cone: One of the special retinal receptor elements which are presumed to be primarily concerned with perception of light and color stimuli when the eye is adapted to light. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Conscious Sedation: An alternative to general anesthesia in patients for whom general anesthesia is refused or considered inadvisable. It involves the administering of an antianxiety drug (minor tranquilizer) and an analgesic or local anesthetic. This renders the patient free of anxiety and pain while allowing the patient to remain in verbal contact with the physician or dentist. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constrict: Tighten; narrow. [NIH] Constriction: The act of constricting. [NIH] Constriction, Pathologic: The condition of an anatomical structure's being constricted beyond normal dimensions. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Continuous infusion: The administration of a fluid into a blood vessel, usually over a prolonged period of time. [NIH] Continuum: An area over which the vegetation or animal population is of constantly changing composition so that homogeneous, separate communities cannot be distinguished. [NIH]
Contraceptive: An agent that diminishes the likelihood of or prevents conception. [EU] Contractility: Capacity for becoming short in response to a suitable stimulus. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contralateral: Having to do with the opposite side of the body. [NIH] Contrast Media: Substances used in radiography that allow visualization of certain tissues. [NIH]
Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH]
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Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]
Conus: A large, circular, white patch around the optic disk due to the exposing of the sclera as a result of degenerative change or congenital abnormality in the choroid and retina. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Convulsive: Relating or referring to spasm; affected with spasm; characterized by a spasm or spasms. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Artery Bypass: Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion. [NIH] Coronary Circulation: The circulation of blood through the coronary vessels of the heart. [NIH]
Coronary Disease: Disorder of cardiac function due to an imbalance between myocardial function and the capacity of the coronary vessels to supply sufficient flow for normal function. It is a form of myocardial ischemia (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels. [NIH] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Coronary Vessels: The veins and arteries of the heart. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune
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response. Called also adrenocortical hormone and corticoid. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] C-Reactive Protein: A plasma protein that circulates in increased amounts during inflammation and after tissue damage. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Critical Care: Health care provided to a critically ill patient during a medical emergency or crisis. [NIH] Crossing-over: The exchange of corresponding segments between chromatids of homologous chromosomes during meiosia, forming a chiasma. [NIH] Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with longitudinal studies which are followed over a period of time. [NIH] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH] Curare: Plant extracts from several species, including Strychnos toxifera, S. castelnaei, S. crevauxii, and Chondodendron tomentosum, that produce paralysis of skeletal muscle and are used adjunctively with general anesthesia. These extracts are toxic and must be used with the administration of artificial respiration. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyanosis: A bluish or purplish discoloration of the skin and mucous membranes due to an increase in the amount of deoxygenated hemoglobin in the blood or a structural defect in the hemoglobin molecule. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclosporine: A drug used to help reduce the risk of rejection of organ and bone marrow transplants by the body. It is also used in clinical trials to make cancer cells more sensitive to anticancer drugs. [NIH] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cystine: A covalently linked dimeric nonessential amino acid formed by the oxidation of cysteine. Two molecules of cysteine are joined together by a disulfide bridge to form cystine. [NIH]
Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as
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cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] Dairy Products: Raw and processed or manufactured milk and milk-derived products. These are usually from cows (bovine) but are also from goats, sheep, reindeer, and water buffalo. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Deception: The act of deceiving or the fact or condition of being deceived. [NIH] Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. [NIH] Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Decongestant: An agent that reduces congestion or swelling. [EU] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydration: The condition that results from excessive loss of body water. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population. [NIH]
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Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]
Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Dermatitis: Any inflammation of the skin. [NIH] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Detergents: Purifying or cleansing agents, usually salts of long-chain aliphatic bases or acids, that exert cleansing (oil-dissolving) and antimicrobial effects through a surface action that depends on possessing both hydrophilic and hydrophobic properties. [NIH] Developed Countries: Countries that have reached a level of economic achievement through an increase of production, per capita income and consumption, and utilization of natural and human resources. [NIH] Dexamethasone: (11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or esterified form in treatment of conditions that respond generally to cortisone. [NIH] Dextroamphetamine: The d-form of amphetamine. It is a central nervous system stimulant and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic. [NIH] Diabetes Insipidus: A metabolic disorder due to disorders in the production or release of vasopressin. It is characterized by the chronic excretion of large amounts of low specific gravity urine and great thirst. [NIH]
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Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Retinopathy: Retinopathy associated with diabetes mellitus, which may be of the background type, progressively characterized by microaneurysms, interretinal punctuate macular edema, or of the proliferative type, characterized by neovascularization of the retina and optic disk, which may project into the vitreous, proliferation of fibrous tissue, vitreous hemorrhage, and retinal detachment. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialysate: A cleansing liquid used in the two major forms of dialysis--hemodialysis and peritoneal dialysis. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastole: Period of relaxation of the heart, especially the ventricles. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diastolic blood pressure: The minimum pressure that remains within the artery when the heart is at rest. [NIH] Diastolic pressure: The lowest pressure to which blood pressure falls between contractions of the ventricles. [NIH] Diclofenac: A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt, diclofenac sodium. [NIH] Diclofenac Sodium: The sodium form of diclofenac. It is used for its analgesic and antiinflammatory properties. [NIH] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Dietary Fats: Fats present in food, especially in animal products such as meat, meat products, butter, ghee. They are present in lower amounts in nuts, seeds, and avocados. [NIH]
Dietitian: An expert in nutrition who helps people plan what and how much food to eat. [NIH]
Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dihydrotestosterone: Anabolic agent. [NIH]
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Dilatation: The act of dilating. [NIH] Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions. [NIH] Dilate: Relax; expand. [NIH] Dilated cardiomyopathy: Heart muscle disease that leads to enlargement of the heart's chambers, robbing the heart of its pumping ability. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dilator: A device used to stretch or enlarge an opening. [NIH] Dilution: A diluted or attenuated medicine; in homeopathy, the diffusion of a given quantity of a medicinal agent in ten or one hundred times the same quantity of water. [NIH] Dipeptides: Peptides composed of two amino acid units. [NIH] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Disparity: Failure of the two retinal images of an object to fall on corresponding retinal points. [NIH] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Distention: The state of being distended or enlarged; the act of distending. [EU] Diuresis: Increased excretion of urine. [EU] Diuretic: A drug that increases the production of urine. [NIH] Diuretics, Thiazide: Diuretics characterized as analogs of 1,2,4-benzothiadiazine-1,1dioxide. All have a common mechanism of action and differ primarily in the dose required to produce a given effect. They act directly on the kidney to increase the excretion of sodium chloride and water and also increase excretion of potassium ions. [NIH] Diurnal: Occurring during the day. [EU] Diving: An activity in which the organism plunges into water. It includes scuba and bell diving. Diving as natural behavior of animals goes here, as well as diving in decompression experiments with humans or animals. [NIH]
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Docosahexaenoic Acids: C22-unsaturated fatty acids found predominantly in fish oils. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Dose-dependent: Refers to the effects of treatment with a drug. If the effects change when the dose of the drug is changed, the effects are said to be dose dependent. [NIH] Doxazosin: A selective alpha-1-adrenergic blocker that lowers serum cholesterol. It is also effective in the treatment of hypertension. [NIH] Drinking Behavior: Behaviors associated with the ingesting of water and other liquids; includes rhythmic patterns of drinking (time intervals - onset and duration), frequency and satiety. [NIH] Drip: The continuous slow introduction of a fluid containing nutrients or drugs. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Design: The molecular designing of drugs for specific purposes (such as DNAbinding, enzyme inhibition, anti-cancer efficacy, etc.) based on knowledge of molecular properties such as activity of functional groups, molecular geometry, and electronic structure, and also on information cataloged on analogous molecules. Drug design is generally computer-assisted molecular modeling and does not include pharmacokinetics, dosage analysis, or drug administration analysis. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Resistance: Diminished or failed response of an organism, disease or tissue to the intended effectiveness of a chemical or drug. It should be differentiated from drug tolerance which is the progressive diminution of the susceptibility of a human or animal to the effects of a drug, as a result of continued administration. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dysgenesis: Defective development. [EU]
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Dyslipidemia: Disorders in the lipoprotein metabolism; classified as hypercholesterolemia, hypertriglyceridemia, combined hyperlipidemia, and low levels of high-density lipoprotein (HDL) cholesterol. All of the dyslipidemias can be primary or secondary. Both elevated levels of low-density lipoprotein (LDL) cholesterol and low levels of HDL cholesterol predispose to premature atherosclerosis. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Echocardiography: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. [NIH] Eclampsia: Onset of convulsions or coma in a previously diagnosed pre-eclamptic patient. [NIH]
Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Edrophonium: A rapid-onset, short-acting cholinesterase inhibitor used in cardiac arrhythmias and in the diagnosis of myasthenia gravis. It has also been used as an antidote to curare principles. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Effector cell: A cell that performs a specific function in response to a stimulus; usually used to describe cells in the immune system. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Egg Yolk: Cytoplasm stored in an egg that contains nutritional reserves for the developing embryo. It is rich in polysaccharides, lipids, and proteins. [NIH] Eicosanoids: A class of oxygenated, endogenous, unsaturated fatty acids derived from arachidonic acid. They include prostaglandins, leukotrienes, thromboxanes, and hydroxyeicosatetraenoic acid compounds (HETE). They are hormone-like substances that act near the site of synthesis without altering functions throughout the body. [NIH] Ejection fraction: A measure of ventricular contractility, equal to normally 65 8 per cent; lower values indicate ventricular dysfunction. [EU] Elasticity: Resistance and recovery from distortion of shape. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electric Wiring: An arrangement of wires distributing electricity. [NIH] Electroacupuncture: A form of acupuncture using low frequency electrically stimulated needles to produce analgesia and anesthesia and to treat disease. [NIH] Electrocardiogram: Measurement of electrical activity during heartbeats. [NIH] Electrocardiograph: Apparatus which, by means of currents produced by contractions of the cardiac muscle, records heart movements as electro-cardiograms. [NIH] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electroconvulsive Therapy: Electrically induced convulsions primarily used in the
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treatment of severe affective disorders and schizophrenia. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Electroshock: Induction of a stress reaction in experimental subjects by means of an electrical shock; applies to either convulsive or non-convulsive states. [NIH] Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embolization: The blocking of an artery by a clot or foreign material. Embolization can be done as treatment to block the flow of blood to a tumor. [NIH] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emergency Treatment: First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured. [NIH] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Enalapril: An angiotensin-converting enzyme inhibitor that is used to treat hypertension. [NIH]
Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH] Endarterectomy: Surgical excision, performed under general anesthesia, of the atheromatous tunica intima of an artery. When reconstruction of an artery is performed as an endovascular procedure through a catheter, it is called atherectomy. [NIH]
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Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinologist: A doctor that specializes in diagnosing and treating hormone disorders. [NIH]
Endocrinology: A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the endocrine system. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endorphin: Opioid peptides derived from beta-lipotropin. Endorphin is the most potent naturally occurring analgesic agent. It is present in pituitary, brain, and peripheral tissues. [NIH]
Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxic: Of, relating to, or acting as an endotoxin (= a heat-stable toxin, associated with the outer membranes of certain gram-negative bacteria. Endotoxins are not secreted and are released only when the cells are disrupted). [EU] Endotoxin: Toxin from cell walls of bacteria. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH]
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Energy Intake: Total number of calories taken in daily whether ingested or by parenteral routes. [NIH] Enhancers: Transcriptional element in the virus genome. [NIH] Enkephalin: A natural opiate painkiller, in the hypothalamus. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Enzyme Inhibitors: Compounds or agents that combine with an enzyme in such a manner as to prevent the normal substrate-enzyme combination and the catalytic reaction. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Ephedrine: An alpha- and beta-adrenergic agonist that may also enhance release of norepinephrine. It has been used in the treatment of several disorders including asthma, heart failure, rhinitis, and urinary incontinence, and for its central nervous system stimulatory effects in the treatment of narcolepsy and depression. It has become less extensively used with the advent of more selective agonists. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiologic Studies: Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are case-control studies, cohort studies, and cross-sectional studies. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH]
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Epoxide Hydrolases: Enzymes that catalyze reversibly the formation of an epoxide or arene oxide from a glycol or aromatic diol, respectively. EC 3.3.2.3. [NIH] Equalization: The reduction of frequency and/or phase distortion, or modification of gain and or phase versus frequency characteristics of a transducer, by the use of attenuation circuits whose loss or delay is a function of frequency. [NIH] Equipment and Supplies: Expendable and nonexpendable equipment, supplies, apparatus, and instruments that are used in diagnostic, surgical, therapeutic, scientific, and experimental procedures. [NIH] Erythrocyte Volume: Volume of circulating erythrocytes. It is usually measured by radioisotope dilution technique. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythropoiesis: The production of erythrocytes. [EU] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophageal Varices: Stretched veins in the esophagus that occur when the liver is not working properly. If the veins burst, the bleeding can cause death. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estrogen: One of the two female sex hormones. [NIH] Estrogen receptor: ER. Protein found on some cancer cells to which estrogen will attach. [NIH]
Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Ethanolamine: A viscous, hygroscopic amino alcohol with an ammoniacal odor. It is widely distributed in biological tissue and is a component of lecithin. It is used as a surfactant, fluorimetric reagent, and to remove CO2 and H2S from natural gas and other gases. [NIH] Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Excipients: Usually inert substances added to a prescription in order to provide suitable consistency to the dosage form; a binder, matrix, base or diluent in pills, tablets, creams, salves, etc. [NIH] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH]
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Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Excrete: To get rid of waste from the body. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Exocytosis: Cellular release of material within membrane-limited vesicles by fusion of the vesicles with the cell membrane. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exon: The part of the DNA that encodes the information for the actual amino acid sequence of the protein. In many eucaryotic genes, the coding sequences consist of a series of exons alternating with intron sequences. [NIH] Expert Systems: Computer programs based on knowledge developed from consultation with experts on a problem, and the processing and/or formalizing of this knowledge using these programs in such a manner that the problems may be solved. [NIH] Expiration: The act of breathing out, or expelling air from the lungs. [EU] External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extracorporeal: Situated or occurring outside the body. [EU] Extraction: The process or act of pulling or drawing out. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extravasation: A discharge or escape, as of blood, from a vessel into the tissues. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Eye Infections: Infection, moderate to severe, caused by bacteria, fungi, or viruses, which occurs either on the external surface of the eye or intraocularly with probable inflammation, visual impairment, or blindness. [NIH] Facial: Of or pertaining to the face. [EU] Facial Paralysis: Severe or complete loss of facial muscle motor function. This condition may result from central or peripheral lesions. Damage to CNS motor pathways from the cerebral cortex to the facial nuclei in the pons leads to facial weakness that generally spares the forehead muscles. Facial nerve diseases generally results in generalized hemifacial weakness. Neuromuscular junction diseases and muscular diseases may also cause facial paralysis or paresis. [NIH] Failure to Thrive: A condition in which an infant or child's weight gain and growth are far below usual levels for age. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Family Practice: A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family. [NIH] Fat: Total lipids including phospholipids. [NIH]
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Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fatty Liver: The buildup of fat in liver cells. The most common cause is alcoholism. Other causes include obesity, diabetes, and pregnancy. Also called steatosis. [NIH] Felodipine: A dihydropyridine calcium antagonist with positive inotropic effects. It lowers blood pressure by reducing peripheral vascular resistance through a highly selective action on smooth muscle in arteriolar resistance vessels. [NIH] Femoral: Pertaining to the femur, or to the thigh. [EU] Femoral Artery: The main artery of the thigh, a continuation of the external iliac artery. [NIH] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Ferritin: An iron-containing protein complex that is formed by a combination of ferric iron with the protein apoferritin. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrinolytic: Pertaining to, characterized by, or causing the dissolution of fibrin by enzymatic action [EU] Fibrinolytic Agents: Fibrinolysin or agents that convert plasminogen to fibrinolysin (plasmin). [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Filtration: The passage of a liquid through a filter, accomplished by gravity, pressure, or vacuum (suction). [EU] Fish Oils: Oils high in unsaturated fats extracted from the bodies of fish or fish parts, especially the livers. Those from the liver are usually high in vitamin A. The oils are used as dietary supplements, in soaps and detergents, as protective coatings, and as a base for other food products such as vegetable shortenings. [NIH] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Flaccid: Weak, lax and soft. [EU] Flatus: Gas passed through the rectum. [NIH] Flavoring Agents: Substances added to foods and medicine to improve the quality of taste. [NIH]
Flexion: In gynaecology, a displacement of the uterus in which the organ is bent so far forward or backward that an acute angle forms between the fundus and the cervix. [EU] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH]
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Fluorescent Dyes: Dyes that emit light when exposed to light. The wave length of the emitted light is usually longer than that of the incident light. Fluorochromes are substances that cause fluorescence in other substances, i.e., dyes used to mark or label other compounds with fluorescent tags. They are used as markers in biochemistry and immunology. [NIH] Fluorine: A nonmetallic, diatomic gas that is a trace element and member of the halogen family. It is used in dentistry as flouride to prevent dental caries. [NIH] Flush: Transient, episodic redness of the face and neck caused by certain diseases, ingestion of certain drugs or other substances, heat, emotional factors, or physical exertion. [EU] Flushing: A transient reddening of the face that may be due to fever, certain drugs, exertion, stress, or a disease process. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Follicular Phase: The period of the menstrual cycle that begins with menstruation and ends with ovulation. [NIH] Food Additives: Substances which are of little or no nutritive value, but are used in the processing or storage of foods or animal feed, especially in the developed countries; includes antioxidants, food preservatives, food coloring agents, flavoring agents, anti-infective agents (both plain and local), vehicles, excipients and other similarly used substances. Many of the same substances are pharmaceutic aids when added to pharmaceuticals rather than to foods. [NIH]
Food Coloring Agents: Natural or synthetic dyes used as coloring agents in processed foods. [NIH] Food Preservatives: Substances capable of inhibiting, retarding or arresting the process of fermentation, acidification or other deterioration of foods. [NIH] Foot Care: Taking special steps to avoid foot problems such as sores, cuts, bunions, and calluses. Good care includes daily examination of the feet, toes, and toenails and choosing shoes and socks or stockings that fit well. People with diabetes have to take special care of their feet because nerve damage and reduced blood flow sometimes mean they will have less feeling in their feet than normal. They may not notice cuts and other problems as soon as they should. [NIH] Foramen: A natural hole of perforation, especially one in a bone. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fossa: A cavity, depression, or pit. [NIH] Fourth Ventricle: An irregularly shaped cavity in the rhombencephalon, between the medulla oblongata, the pons, and the isthmus in front, and the cerebellum behind. It is continuous with the central canal of the cord below and with the cerebral aqueduct above, and through its lateral and median apertures it communicates with the subarachnoid space. [NIH]
Fractals: Patterns (real or mathematical) which look similar at different scales, for example the network of airways in the lung which shows similar branching patterns at progressively higher magnifications. Natural fractals are self-similar across a finite range of scales while
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mathematical fractals are the same across an infinite range. Many natural, including biological, structures are fractal (or fractal-like). Fractals are related to "chaos" (see nonlinear dynamics) in that chaotic processes can produce fractal structures in nature, and appropriate representations of chaotic processes usually reveal self-similarity over time. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Frontal Lobe: The anterior part of the cerebral hemisphere. [NIH] Fructose: A type of sugar found in many fruits and vegetables and in honey. Fructose is used to sweeten some diet foods. It is considered a nutritive sweetener because it has calories. [NIH] Functional magnetic resonance imaging: A noninvasive tool used to observe functioning in the brain or other organs by detecting changes in chemical composition, blood flow, or both. [NIH]
Fundus: The larger part of a hollow organ that is farthest away from the organ's opening. The bladder, gallbladder, stomach, uterus, eye, and cavity of the middle ear all have a fundus. [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Furosemide: A sulfamyl saluretic and diuretic. It has a fast onset and short duration of action and is used in edema and chronic renal insufficiency. [NIH] Fuzzy Logic: Approximate, quantitative reasoning that is concerned with the linguistic ambiguity which exists in natural or synthetic language. At its core are variables such as good, bad, and young as well as modifiers such as more, less, and very. These ordinary terms represent fuzzy sets in a particular problem. Fuzzy logic plays a key role in many medical expert systems. [NIH] Gallate: Antioxidant present in tea. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] Ganglionic Blockers: Agents having as their major action the interruption of neural transmission at nicotinic receptors on postganglionic autonomic neurons. Because their
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actions are so broad, including blocking of sympathetic and parasympathetic systems, their therapeutic use has been largely supplanted by more specific drugs. They may still be used in the control of blood pressure in patients with acute dissecting aortic aneurysm and for the induction of hypotension in surgery. [NIH] Gap Junctions: Connections between cells which allow passage of small molecules and electric current. Gap junctions were first described anatomically as regions of close apposition between cells with a narrow (1-2 nm) gap between cell membranes. The variety in the properties of gap junctions is reflected in the number of connexins, the family of proteins which form the junctions. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Emptying: The evacuation of food from the stomach into the duodenum. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Gene Dosage: The number of copies of a given gene present in a cell or nucleus. An increase in gene dosage can result in the formation of higher levels of gene product, provided that the gene is not subject to autogenous regulation. [NIH] Gene Duplication: It encodes the major envelope protein and includes all the specifications for HBsAg. [NIH] Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Targeting: The integration of exogenous DNA into the genome of an organism at sites where its expression can be suitably controlled. This integration occurs as a result of homologous recombination. [NIH] Generator: Any system incorporating a fixed parent radionuclide from which is produced a daughter radionuclide which is to be removed by elution or by any other method and used in a radiopharmaceutical. [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH]
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Genetic Markers: A phenotypically recognizable genetic trait which can be used to identify a genetic locus, a linkage group, or a recombination event. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Geriatric: Pertaining to the treatment of the aged. [EU] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Gestational Age: Age of the conceptus. In humans, this may be assessed by medical history, physical examination, early immunologic pregnancy tests, radiography, ultrasonography, and amniotic fluid analysis. [NIH] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [NIH] Ginseng: An araliaceous genus of plants that contains a number of pharmacologically active agents used as stimulants, sedatives, and tonics, especially in traditional medicine. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]
Glomerular Filtration Rate: The volume of water filtered out of plasma through glomerular capillary walls into Bowman's capsules per unit of time. It is considered to be equivalent to inulin clearance. [NIH] Glomeruli: Plural of glomerulus. [NIH] Glomerulonephritis: Glomerular disease characterized by an inflammatory reaction, with leukocyte infiltration and cellular proliferation of the glomeruli, or that appears to be the result of immune glomerular injury. [NIH] Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH]
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Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]
Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]
Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycogen: A sugar stored in the liver and muscles. It releases glucose into the blood when cells need it for energy. Glycogen is the chief source of stored fuel in the body. [NIH] Glycogen Storage Disease: A group of inherited metabolic disorders involving the enzymes responsible for the synthesis and degradation of glycogen. In some patients, prominent liver involvement is presented. In others, more generalized storage of glycogen occurs, sometimes with prominent cardiac involvement. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycoside: Any compound that contains a carbohydrate molecule (sugar), particularly any such natural product in plants, convertible, by hydrolytic cleavage, into sugar and a nonsugar component (aglycone), and named specifically for the sugar contained, as glucoside (glucose), pentoside (pentose), fructoside (fructose) etc. [EU] Goats: Any of numerous agile, hollow-horned ruminants of the genus Capra, closely related to the sheep. [NIH] Gonadal: Pertaining to a gonad. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Government Agencies: Administrative units of government responsible for policy making and management of governmental activities in the U.S. and abroad. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH]
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Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Gravis: Eruption of watery blisters on the skin among those handling animals and animal products. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Haematoma: A localized collection of blood, usually clotted, in an organ, space, or tissue, due to a break in the wall of a blood vessel. [EU] Haemodialysis: The removal of certain elements from the blood by virtue of the difference in the rates of their diffusion through a semipermeable membrane, e.g., by means of a haemodialyzer. [EU] Haemorrhage: The escape of blood from the vessels; bleeding. Small haemorrhages are classified according to size as petechiae (very small), purpura (up to 1 cm), and ecchymoses (larger). The massive accumulation of blood within a tissue is called a haematoma. [EU] Hair Cells: Mechanoreceptors located in the organ of Corti that are sensitive to auditory stimuli and in the vestibular apparatus that are sensitive to movement of the head. In each case the accessory sensory structures are arranged so that appropriate stimuli cause movement of the hair-like projections (stereocilia and kinocilia) which relay the information centrally in the nervous system. [NIH] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Hate: An enduring attitude or sentiment toward persons or objects manifested by anger, aversion and desire for the misfortune of others. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Head-Down Tilt: Posture while lying with the head lower than the rest of the body. Extended time in this position is associated with temporary physiologic disturbances. [NIH] Health Behavior: Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural. [NIH] Health Care Costs: The actual costs of providing services related to the delivery of health
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care, including the costs of procedures, therapies, and medications. It is differentiated from health expenditures, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost. [NIH] Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (health care costs) and may or may not be shared among the patient, insurers, and/or employers. [NIH] Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heart Sounds: The sounds heard over the cardiac region produced by the functioning of the heart. There are four distinct sounds: the first occurs at the beginning of systole and is heard as a "lubb" sound; the second is produced by the closing of the aortic and pulmonary valves and is heard as a "dupp" sound; the third is produced by vibrations of the ventricular walls when suddenly distended by the rush of blood from the atria; and the fourth is produced by atrial contraction and ventricular filling but is rarely audible in the normal heart. The physiological concept of heart sounds is differentiated from the pathological heart murmurs. [NIH]
Heartbeat: One complete contraction of the heart. [NIH] Hemato: A selective mechanism opposing the passage of most large-molecular compounds from the blood to the cerebro-spinal fluid and brain tissue; offers some protection against intoxication. [NIH] Hematocrit: Measurement of the volume of packed red cells in a blood specimen by centrifugation. The procedure is performed using a tube with graduated markings or with automated blood cell counters. It is used as an indicator of erythrocyte status in disease. For example, anemia shows a low hematocrit, polycythemia, high values. [NIH] Hematoma: An extravasation of blood localized in an organ, space, or tissue. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemiparesis: The weakness or paralysis affecting one side of the body. [NIH] Hemiplegia: Severe or complete loss of motor function on one side of the body. This condition is usually caused by BRAIN DISEASES that are localized to the cerebral hemisphere opposite to the side of weakness. Less frequently, BRAIN STEM lesions; cervical spinal cord diseases; peripheral nervous system diseases; and other conditions may manifest as hemiplegia. The term hemiparesis (see paresis) refers to mild to moderate weakness involving one side of the body. [NIH] Hemodiafiltration: The combination of hemodialysis and hemofiltration either simultaneously or sequentially. Convective transport (hemofiltration) may be better for removal of larger molecular weight substances and diffusive transport (hemodialysis) for smaller molecular weight solutes. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid.
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The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemodilution: Reduction of blood viscosity usually by the addition of cell free solutions. Used clinically l) in states of impaired microcirculation, 2) for replacement of intraoperative blood loss without homologous blood transfusion, and 3) in cardiopulmonary bypass and hypothermia. [NIH] Hemodynamics: The movements of the blood and the forces involved in systemic or regional blood circulation. [NIH] Hemofiltration: Extracorporeal ultrafiltration technique without hemodialysis for treatment of fluid overload and electrolyte disturbances affecting renal, cardiac, or pulmonary function. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobin A: Normal adult human hemoglobin. The globin moiety consists of two alpha and two beta chains. [NIH] Hemoglobin C: A commonly occurring abnormal hemoglobin in which lysine replaces a glutamic acid residue at the sixth position of the beta chains. It results in reduced plasticity of erythrocytes. [NIH] Hemoglobin E: An abnormal hemoglobin that results from the substitution of lysine for glutamic acid at position 26 of the beta chain. It is most frequently observed in southeast Asian populations. [NIH] Hemoglobin M: A group of abnormal hemoglobins in which amino acid substitutions take place in either the alpha or beta chains but near the heme iron. This results in facilitated oxidation of the hemoglobin to yield excess methemoglobin which leads to cyanosis. [NIH] Hemolysis: The destruction of erythrocytes by many different causal agents such as antibodies, bacteria, chemicals, temperature, and changes in tonicity. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhagic stroke: A disorder involving bleeding within ischemic brain tissue. Hemorrhagic stroke occurs when blood vessels that are damaged or dead from lack of blood supply (infarcted), located within an area of infarcted brain tissue, rupture and transform an "ischemic" stroke into a hemorrhagic stroke. Ischemia is inadequate tissue oxygenation caused by reduced blood flow; infarction is tissue death resulting from ischemia. Bleeding irritates the brain tissues, causing swelling (cerebral edema). Blood collects into a mass (hematoma). Both swelling and hematoma will compress and displace brain tissue. [NIH] Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocellular: Pertaining to or affecting liver cells. [EU] Hepatocellular carcinoma: A type of adenocarcinoma, the most common type of liver tumor. [NIH]
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Hepatocyte: A liver cell. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]
High blood cholesterol: Cholesterol is the most abundant steroid in animal tissues, especially in bile and gallstones. The relationship between the intake of cholesterol and its manufacture by the body to its utilization, sequestration, or excretion from the body is called the cholesterol balance. When cholesterol accumulates, the balance is positive; when it declines, the balance is negative. In 1993, the NHLBI National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults issued an updated set of recommendations for monitoring and treatment of blood cholesterol levels. The NCEP guidelines recommended that total cholesterol levels and subfractions of high-density lipoprotein (HDL) cholesterol be measured beginning at age 20 in all adults, with subsequent periodic screenings as needed. Even in the group of patients at lowest risk for coronary heart disease (total cholesterol 200 mg/dL and HDL 35 mg/dL), the NCEP recommended that rescreening take place at least once every 5 years or upon physical examination. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Holidays: Days commemorating events. Holidays also include vacation periods. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homicide: The killing of one person by another. [NIH] Homogenate: A suspension of animal tissue that is ground in the all-glass "homogenizer" described by Potter and Elvehjem in 1936. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency. [NIH] Hormone therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called endocrine therapy. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain
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hormones). [EU] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydralazine: A direct-acting vasodilator that is used as an antihypertensive agent. [NIH] Hydration: Combining with water. [NIH] Hydrochlorothiazide: A thiazide diuretic often considered the prototypical member of this class. It reduces the reabsorption of electrolytes from the renal tubules. This results in increased excretion of water and electrolytes, including sodium, potassium, chloride, and magnesium. It has been used in the treatment of several disorders including edema, hypertension, diabetes insipidus, and hypoparathyroidism. [NIH] Hydrocortisone: The main glucocorticoid secreted by the adrenal cortex. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrolases: Any member of the class of enzymes that catalyze the cleavage of the substrate and the addition of water to the resulting molecules, e.g., esterases, glycosidases (glycoside hydrolases), lipases, nucleotidases, peptidases (peptide hydrolases), and phosphatases (phosphoric monoester hydrolases). EC 3. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxylation: Hydroxylate, to introduce hydroxyl into (a compound or radical) usually by replacement of hydrogen. [EU] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperalgesia: Excessive sensitiveness or sensibility to pain. [EU] Hyperbaric: Characterized by greater than normal pressure or weight; applied to gases under greater than atmospheric pressure, as hyperbaric oxygen, or to a solution of greater specific gravity than another taken as a standard of reference. [EU] Hyperbaric oxygen: Oxygen that is at an atmospheric pressure higher than the pressure at sea level. Breathing hyperbaric oxygen to enhance the effectiveness of radiation therapy is being studied. [NIH] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hypercalcemia: Abnormally high level of calcium in the blood. [NIH]
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Hypercalciuria: Abnormally large amounts of calcium in the urine. [NIH] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [NIH] Hyperglycemia: Abnormally high blood sugar. [NIH] Hyperlipidemia: An excess of lipids in the blood. [NIH] Hyperpigmentation: Excessive pigmentation of the skin, usually as a result of increased melanization of the epidermis rather than as a result of an increased number of melanocytes. Etiology is varied and the condition may arise from exposure to light, chemicals or other substances, or from a primary metabolic imbalance. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthermia: A type of treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] Hypertriglyceridemia: Condition of elevated triglyceride concentration in the blood; an inherited form occurs in familial hyperlipoproteinemia IIb and hyperlipoproteinemia type IV. It has been linked to higher risk of heart disease and arteriosclerosis. [NIH] Hypertrophic cardiomyopathy: Heart muscle disease that leads to thickening of the heart walls, interfering with the heart's ability to fill with and pump blood. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hyperventilation: A pulmonary ventilation rate faster than is metabolically necessary for the exchange of gases. It is the result of an increased frequency of breathing, an increased tidal volume, or a combination of both. It causes an excess intake of oxygen and the blowing off of carbon dioxide. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypoglycemia: Abnormally low blood sugar [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypotensive: Characterized by or causing diminished tension or pressure, as abnormally low blood pressure. [EU] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypothermia: Lower than normal body temperature, especially in warm-blooded animals; in man usually accidental or unintentional. [NIH] Hypovolemia: An abnormally low volume of blood circulating through the body. It may result in hypovolemic shock. [NIH] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU]
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Hysteroscopy: Endoscopic examination, therapy or surgery of the interior of the uterus. [NIH]
Ibotenic Acid: Neurotoxic isoxazole substance found in Amanita muscaria and A. pantherina. It causes motor depression, ataxia, and changes in mood, perceptions and feelings, and is a potent excitatory amino acid agonist. [NIH] Ibuprofen: A nonsteroidal anti-inflammatory agent with analgesic properties used in the therapy of rheumatism and arthritis. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Ileum: The lower end of the small intestine. [NIH] Imaging procedures: Methods of producing pictures of areas inside the body. [NIH] Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]
Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU]
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In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indapamide: A sulfamyl diuretic with about 16x the effect of furosemide. It has also been shown to be an effective antihypertensive agent in the clinic. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indigestion: Poor digestion. Symptoms include heartburn, nausea, bloating, and gas. Also called dyspepsia. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infant Mortality: Perinatal, neonatal, and infant deaths in a given population. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Inferior vena cava: A large vein that empties into the heart. It carries blood from the legs and feet, and from organs in the abdomen and pelvis. [NIH] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH]
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Inner ear: The labyrinth, comprising the vestibule, cochlea, and semicircular canals. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Inotropic: Affecting the force or energy of muscular contractions. [EU] Inpatients: Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment. [NIH] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility. [NIH]
Intensive Care Units: Hospital units providing continuous surveillance and care to acutely ill patients. [NIH] Interindividual: Occurring between two or more individuals. [EU] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interpersonal Relations: The reciprocal interaction of two or more persons. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intervention Studies: Epidemiologic investigations designed to test a hypothesized causeeffect relation by modifying the supposed causal factor(s) in the study population. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracranial Aneurysm: A saclike dilatation of the walls of a blood vessel, usually an artery. [NIH]
Intracranial Arteriosclerosis: Vascular diseases characterized by thickening, hardening, and remodeling of the walls of intracranial arteries. There are three subtypes: (1) atherosclerosis, marked by fatty depositions in the innermost layer of the arterial walls, (2) Monckeberg's sclerosis, which features calcium deposition in the media and (3) arteriolosclerosis, which refers to sclerosis of small caliber arteries. Clinically, this process may be associated with
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transient ischemic attack, brain infarction, intracranial embolism and thrombosis, or intracranial aneurysm. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [NIH] Intracranial Pressure: Pressure within the cranial cavity. It is influenced by brain mass, the circulatory system, CSF dynamics, and skull rigidity. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intraocular: Within the eye. [EU] Intraocular pressure: Pressure of the fluid inside the eye; normal IOP varies among individuals. [NIH] Intraperitoneal: IP. Within the peritoneal cavity (the area that contains the abdominal organs). [NIH] Intravascular: Within a vessel or vessels. [EU] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Intubation: Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from catheterization in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body. [NIH] Inulin: A starch found in the tubers and roots of many plants. Since it is hydrolyzable to fructose, it is classified as a fructosan. It has been used in physiologic investigation for determination of the rate of glomerular function. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
Investigative Techniques: Investigative techniques used in pre-clinical and clinical research, epidemiology, chemistry, immunology, genetics, etc. They do not include techniques specifically applied to diagnosis; therapeutics; anesthesia and analgesia, surgery, operative, and dentistry. [NIH] Involuntary: Reaction occurring without intention or volition. [NIH] Iodine: A nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ion Transport: The movement of ions across energy-transducing cell membranes. Transport can be active or passive. Passive ion transport (facilitated diffusion) derives its energy from the concentration gradient of the ion itself and allows the transport of a single solute in one direction (uniport). Active ion transport is usually coupled to an energy-yielding chemical or photochemical reaction such as ATP hydrolysis. This form of primary active transport is called an ion pump. Secondary active transport utilizes the voltage and ion gradients produced by the primary transport to drive the cotransport of other ions or molecules. These may be transported in the same (symport) or opposite (antiport) direction. [NIH]
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Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Ischemic stroke: A condition in which the blood supply to part of the brain is cut off. Also called "plug-type" strokes. Blocked arteries starve areas of the brain controlling sight, speech, sensation, and movement so that these functions are partially or completely lost. Ischemic stroke is the most common type of stroke, accounting for 80 percent of all strokes. Most ischemic strokes are caused by a blood clot called a thrombus, which blocks blood flow in the arteries feeding the brain, usually the carotid artery in the neck, the major vessel bringing blood to the brain. When it becomes blocked, the risk of stroke is very high. [NIH] Isoflavones: 3-Phenylchromones. Isomeric form of flavones in which the benzene group is attached to the 3 position of the benzopyran ring instead of the 2 position. [NIH] Isoleucine: An essential branched-chain amino acid found in many proteins. It is an isomer of LEUCINE. It is important in hemoglobin synthesis and regulation of blood sugar and energy levels. [NIH] Isoproterenol: Isopropyl analog of epinephrine; beta-sympathomimetic that acts on the heart, bronchi, skeletal muscle, alimentary tract, etc. It is used mainly as bronchodilator and heart stimulant. [NIH] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]
Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kallidin: A decapeptide bradykinin homolog produced by the action of tissue and glandular kallikreins on low-molecular-weight kininogen. It is a smooth-muscle stimulant and hypotensive agent that functions through vasodilatation. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratolytic: An agent that promotes keratolysis. [EU] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kidney Failure, Acute: A clinical syndrome characterized by a sudden decrease in glomerular filtration rate, often to values of less than 1 to 2 ml per minute. It is usually
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associated with oliguria (urine volumes of less than 400 ml per day) and is always associated with biochemical consequences of the reduction in glomerular filtration rate such as a rise in blood urea nitrogen (BUN) and serum creatinine concentrations. [NIH] Kidney Failure, Chronic: An irreversible and usually progressive reduction in renal function in which both kidneys have been damaged by a variety of diseases to the extent that they are unable to adequately remove the metabolic products from the blood and regulate the body's electrolyte composition and acid-base balance. Chronic kidney failure requires hemodialysis or surgery, usually kidney transplantation. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Kidney Transplantation: The transference of a kidney from one human or animal to another. [NIH] Kinetic: Pertaining to or producing motion. [EU] Labetalol: Blocker of both alpha- and beta-adrenergic receptors that is used as an antihypertensive. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH] Labyrinthine: A vestibular nystagmus resulting from stimulation, injury, or disease of the labyrinth. [NIH] Lactation: The period of the secretion of milk. [EU] Lactose Intolerance: The disease state resulting from the absence of lactase enzyme in the musocal cells of the gastrointestinal tract, and therefore an inability to break down the disaccharide lactose in milk for absorption from the gastrointestinal tract. It is manifested by indigestion of a mild nature to severe diarrhea. It may be due to inborn defect genetically conditioned or may be acquired. [NIH] Lag: The time elapsing between application of a stimulus and the resulting reaction. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Laryngoscopy: Examination, therapy, or surgery of the interior of the larynx performed with a specially designed endoscope. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Latency: The period of apparent inactivity between the time when a stimulus is presented and the moment a response occurs. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Least-Squares Analysis: A principle of estimation in which the estimates of a set of parameters in a statistical model are those quantities minimizing the sum of squared differences between the observed values of a dependent variable and the values predicted by the model. [NIH]
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Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethal: Deadly, fatal. [EU] Leucine: An essential branched-chain amino acid important for hemoglobin formation. [NIH] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]
Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leukotrienes: A family of biologically active compounds derived from arachidonic acid by oxidative metabolism through the 5-lipoxygenase pathway. They participate in host defense reactions and pathophysiological conditions such as immediate hypersensitivity and inflammation. They have potent actions on many essential organs and systems, including the cardiovascular, pulmonary, and central nervous system as well as the gastrointestinal tract and the immune system. [NIH] Levo: It is an experimental treatment for heroin addiction that was developed by German scientists around 1948 as an analgesic. Like methadone, it binds with opioid receptors, but it is longer acting. [NIH] Libido: The psychic drive or energy associated with sexual instinct in the broad sense (pleasure and love-object seeking). It may also connote the psychic energy associated with instincts in general that motivate behavior. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH] Likelihood Functions: Functions constructed from a statistical model and a set of observed data which give the probability of that data for various values of the unknown model parameters. Those parameter values that maximize the probability are the maximum likelihood estimates of the parameters. [NIH] Linear Models: Statistical models in which the value of a parameter for a given value of a factor is assumed to be equal to a + bx, where a and b are constants. The models predict a linear regression. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Linkage Disequilibrium: Nonrandom association of linked genes. This is the tendency of the alleles of two separate but already linked loci to be found together more frequently than would be expected by chance alone. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipase: An enzyme of the hydrolase class that catalyzes the reaction of triacylglycerol and water to yield diacylglycerol and a fatty acid anion. It is produced by glands on the tongue
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and by the pancreas and initiates the digestion of dietary fats. (From Dorland, 27th ed) EC 3.1.1.3. [NIH] Lipid: Fat. [NIH] Lipid A: Lipid A is the biologically active component of lipopolysaccharides. It shows strong endotoxic activity and exhibits immunogenic properties. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipophilic: Having an affinity for fat; pertaining to or characterized by lipophilia. [EU] Lipopolysaccharides: Substance consisting of polysaccaride and lipid. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Lipoprotein(a): A family of lipoprotein particles varying in density and size depending on the protein-lipid ratio and the protein composition. These particles consist of apolipoprotein B-100 covalently linked to apolipoprotein-a by one or two disulfide bonds. There is a correlation between high plasma levels of this lipoprotein and increased risk for atherosclerotic cardiovascular disease. [NIH] Lisinopril: An orally active angiotensin-converting enzyme inhibitor that has been used in the treatment of hypertension and congestive heart failure. [NIH] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH]
Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver cancer: A disease in which malignant (cancer) cells are found in the tissues of the liver. [NIH]
Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locus Coeruleus: Bluish region in the superior angle of the fourth ventricle floor, corresponding to melanin-like pigmented nerve cells which lie lateral to the pontomesencephalic central gray (griseum centrale). It is also known as nucleus pigmentosus pontis. [NIH] Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic
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method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Lovastatin: A fungal metabolite isolated from cultures of Aspergillus terreus. The compound is a potent anticholesteremic agent. It inhibits 3-hydroxy-3-methylglutaryl coenzyme A reductase (hydroxymethylglutaryl CoA reductases), which is the rate-limiting enzyme in cholesterol biosynthesis. It also stimulates the production of low-density lipoprotein receptors in the liver. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lubricants: Oily or slippery substances. [NIH] Lubrication: The application of a substance to diminish friction between two surfaces. It may refer to oils, greases, and similar substances for the lubrication of medical equipment but it can be used for the application of substances to tissue to reduce friction, such as lotions for skin and vaginal lubricants. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumbar puncture: A procedure in which a needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give anticancer drugs intrathecally. Also called a spinal tap. [NIH] Lumen: The cavity or channel within a tube or tubular organ. [EU] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Luteal Phase: The period of the menstrual cycle that begins with ovulation and ends with menstruation. [NIH] Lutein Cells: The cells of the corpus luteum which are derived from the granulosa cells and the theca cells of the Graafian follicle. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]
Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH]
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Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lysine: An essential amino acid. It is often added to animal feed. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Mammary: Pertaining to the mamma, or breast. [EU] Mammogram: An x-ray of the breast. [NIH] Manic: Affected with mania. [EU] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Man-made: Ionizing radiation emitted by artificial or concentrated natural, radioactive material or resulting from the operation of high voltage apparatus, such as X-ray apparatus or particle accelerators, of nuclear reactors, or from nuclear explosions. [NIH] Mass Screening: Organized periodic procedures performed on large groups of people for the purpose of detecting disease. [NIH] Mastication: The act and process of chewing and grinding food in the mouth. [NIH] Maternal Mortality: Maternal deaths resulting from complications of pregnancy and childbirth in a given population. [NIH] Maximum Tolerated Dose: The highest dose level eliciting signs of toxicity without having major effects on survival relative to the test in which it is used. [NIH] Mean blood pressure: The average blood pressure, taking account of the rise and fall that occurs with each heartbeat. It is often estimated by multiplying the diastolic pressure by two, adding the systolic pressure, and then dividing this sum by three. [NIH] Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]
Meat Products: Articles of food which are derived by a process of manufacture from any portion of carcasses of any animal used for food (e.g., head cheese, sausage, scrapple). [NIH] Meatus: A canal running from the internal auditory foramen through the petrous portion of the temporal bone. It gives passage to the facial and auditory nerves together with the auditory branch of the basilar artery and the internal auditory veins. [NIH] Mechanoreceptors: Cells specialized to transduce mechanical stimuli and relay that information centrally in the nervous system. Mechanoreceptors include hair cells, which mediate hearing and balance, and the various somatosensory receptors, often with nonneural accessory structures. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH]
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Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency. [NIH] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Megaloblastic: A large abnormal red blood cell appearing in the blood in pernicious anaemia. [EU] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Melanin: The substance that gives the skin its color. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Menarche: The establishment or beginning of the menstrual function. [EU] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mercury: A silver metallic element that exists as a liquid at room temperature. It has the atomic symbol Hg (from hydrargyrum, liquid silver), atomic number 80, and atomic weight 200.59. Mercury is used in many industrial applications and its salts have been employed therapeutically as purgatives, antisyphilitics, disinfectants, and astringents. It can be absorbed through the skin and mucous membranes which leads to mercury poisoning. Because of its toxicity, the clinical use of mercury and mercurials is diminishing. [NIH] Mesencephalic: Ipsilateral oculomotor paralysis and contralateral tremor, spasm. or choreic
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movements of the face and limbs. [NIH] Mesenteric: Pertaining to the mesentery : a membranous fold attaching various organs to the body wall. [EU] Mesentery: A layer of the peritoneum which attaches the abdominal viscera to the abdominal wall and conveys their blood vessels and nerves. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] Methylphenidate: A central nervous system stimulant used most commonly in the treatment of attention-deficit disorders in children and for narcolepsy. Its mechanisms appear to be similar to those of dextroamphetamine. [NIH] Methyltransferase: A drug-metabolizing enzyme. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microcalcifications: Tiny deposits of calcium in the breast that cannot be felt but can be detected on a mammogram. A cluster of these very small specks of calcium may indicate that cancer is present. [NIH] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] Microdialysis: A technique for measuring extracellular concentrations of substances in tissues, usually in vivo, by means of a small probe equipped with a semipermeable membrane. Substances may also be introduced into the extracellular space through the membrane. [NIH] Micronutrients: Essential dietary elements or organic compounds that are required in only small quantities for normal physiologic processes to occur. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Midaxillary line: An imaginary vertical line that passes midway between the anterior and posterior axillary (armpit) folds. [NIH]
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Midodrine: An ethanolamine derivative that is an adrenergic alpha agonist. It is used as a vasoconstrictor agent in the treatment of hypotension. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Milliliter: A measure of volume for a liquid. A milliliter is approximately 950-times smaller than a quart and 30-times smaller than a fluid ounce. A milliliter of liquid and a cubic centimeter (cc) of liquid are the same. [NIH] Millimeter: A measure of length. A millimeter is approximately 26-times smaller than an inch. [NIH] Mineralocorticoid: 1. Any of the group of C21 corticosteroids, principally aldosterone, predominantly involved in the regulation of electrolyte and water balance through their effect on ion transport in epithelial cells of the renal tubules, resulting in retention of sodium and loss of potassium; some also possess varying degrees of glucocorticoid activity. Their secretion is regulated principally by plasma volume, serum potassium concentration and angiotensin II, and to a lesser extent by anterior pituitary ACTH. 2. Of, pertaining to, having the properties of, or resembling a mineralocorticoid. [EU] Minority Groups: A subgroup having special characteristics within a larger group, often bound together by special ties which distinguish it from the larger group. [NIH] Miotic: 1. Pertaining to, characterized by, or producing miosis : contraction of the pupil. 2. An agent that causes the pupil to contract. 3. Meiotic: characterized by cell division. [EU] Mitochondria: Parts of a cell where aerobic production (also known as cell respiration) takes place. [NIH] Mitral Valve: The valve between the left atrium and left ventricle of the heart. [NIH] Mobilization: The process of making a fixed part or stored substance mobile, as by separating a part from surrounding structures to make it accessible for an operative procedure or by causing release into the circulation for body use of a substance stored in the body. [EU] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Modulator: A specific inductor that brings out characteristics peculiar to a definite region. [EU]
Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus
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surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Monophosphate: So called second messenger for neurotransmitters and hormones. [NIH] Monotherapy: A therapy which uses only one drug. [EU] Monounsaturated fat: An unsaturated fat that is found primarily in plant foods, including olive and canola oils. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor Activity: The physical activity of an organism as a behavioral phenomenon. [NIH] Mucinous: Containing or resembling mucin, the main compound in mucus. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Multiple Trauma: Physical insults or injuries occurring simultaneously in several parts of the body. [NIH] Muscle Contraction: A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments. [NIH] Muscle Relaxation: That phase of a muscle twitch during which a muscle returns to a resting position. [NIH] Muscle tension: A force in a material tending to produce extension; the state of being stretched. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Mutagenesis: Process of generating genetic mutations. It may occur spontaneously or be induced by mutagens. [NIH] Mutagens: Chemical agents that increase the rate of genetic mutation by interfering with the function of nucleic acids. A clastogen is a specific mutagen that causes breaks in chromosomes. [NIH] Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (coronary arteriosclerosis), to obstruction by a thrombus (coronary thrombosis), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (myocardial infarction). [NIH]
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Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Nadir: The lowest point; point of greatest adversity or despair. [EU] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH] Naltrexone: Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of naloxone. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Natriuresis: The excretion of abnormal amounts of sodium in the urine. [EU] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephrogenic: Constant thirst and frequent urination because the kidney tubules cannot respond to antidiuretic hormone. The result is an increase in urine formation and excessive urine flow. [NIH] Nephrologist: A doctor who treats patients with kidney problems or hypertension. [NIH] Nephrology: A subspecialty of internal medicine concerned with the anatomy, physiology, and pathology of the kidney. [NIH] Nephron: A tiny part of the kidneys. Each kidney is made up of about 1 million nephrons, which are the working units of the kidneys, removing wastes and extra fluids from the blood. [NIH] Nephropathy: Disease of the kidneys. [EU] Nephrosis: Descriptive histopathologic term for renal disease without an inflammatory component. [NIH]
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Nephrotic: Pertaining to, resembling, or caused by nephrosis. [EU] Nephrotic Syndrome: Clinical association of heavy proteinuria, hypoalbuminemia, and generalized edema. [NIH] Nephrotoxic: Toxic or destructive to kidney cells. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Fibers: Slender processes of neurons, especially the prolonged axons that conduct nerve impulses. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Nervousness: Excessive excitability and irritability, with mental and physical unrest. [EU] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuroeffector Junction: The synapse between a neuron (presynaptic) and an effector cell other than another neuron (postsynaptic). Neuroeffector junctions include synapses onto muscles and onto secretory cells. [NIH] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neurologist: A doctor who specializes in the diagnosis and treatment of disorders of the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neurophysiology: The scientific discipline concerned with the physiology of the nervous system. [NIH] Neurotoxin: A substance that is poisonous to nerve tissue. [NIH] Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only
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messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Neutrophils: Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nifedipine: A potent vasodilator agent with calcium antagonistic action. It is a useful antianginal agent that also lowers blood pressure. The use of nifedipine as a tocolytic is being investigated. [NIH] Nitrates: Inorganic or organic salts and esters of nitric acid. These compounds contain the NO3- radical. [NIH] Nitric acid: A toxic, corrosive, colorless liquid used to make fertilizers, dyes, explosives, and other chemicals. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]
Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nitroglycerin: A highly volatile organic nitrate that acts as a dilator of arterial and venous smooth muscle and is used in the treatment of angina. It provides relief through improvement of the balance between myocardial oxygen supply and demand. Although total coronary blood flow is not increased, there is redistribution of blood flow in the heart when partial occlusion of coronary circulation is effected. [NIH] Nitroprusside: (OC-6-22)-Pentakis(cyano-C)nitrosoferrate(2-). A powerful vasodilator used in emergencies to lower blood pressure or to improve cardiac function. It is also an indicator for free sulfhydryl groups in proteins. [NIH] Nocturia: Excessive urination at night. [EU] Nonlinear Dynamics: The study of systems which respond disproportionately (nonlinearly) to initial conditions or perturbing stimuli. Nonlinear systems may exhibit "chaos" which is classically characterized as sensitive dependence on initial conditions. Chaotic systems, while distinguished from more ordered periodic systems, are not random. When their behavior over time is appropriately displayed (in "phase space"), constraints are evident
Dictionary 645
which are described by "strange attractors". Phase space representations of chaotic systems, or strange attractors, usually reveal fractal (fractals) self-similarity across time scales. Natural, including biological, systems often display nonlinear dynamics and chaos. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Normotensive: 1. Characterized by normal tone, tension, or pressure, as by normal blood pressure. 2. A person with normal blood pressure. [EU] Nortriptyline: A metabolite of amitryptyline that is also used as an antidepressive agent. Nortriptyline is used in major depression, dysthymia, and atypical depressions. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleotidases: A class of enzymes that catalyze the conversion of a nucleotide and water to a nucleoside and orthophosphate. EC 3.1.3.-. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nutritional Status: State of the body in relation to the consumption and utilization of nutrients. [NIH] Nutritive Value: An indication of the contribution of a food to the nutrient content of the diet. This value depends on the quantity of a food which is digested and absorbed and the amounts of the essential nutrients (protein, fat, carbohydrate, minerals, vitamins) which it contains. This value can be affected by soil and growing conditions, handling and storage, and processing. [NIH] Nystagmus: Rhythmical oscillation of the eyeballs, either pendular or jerky. [NIH] Observational study: An epidemiologic study that does not involve any intervention, experimental or otherwise. Such a study may be one in which nature is allowed to take its course, with changes in one characteristic being studied in relation to changes in other characteristics. Analytical epidemiologic methods, such as case-control and cohort study designs, are properly called observational epidemiology because the investigator is observing without intervention other than to record, classify, count, and statistically analyze results. [NIH] Occult: Obscure; concealed from observation, difficult to understand. [EU] Occupational Exposure: The exposure to potentially harmful chemical, physical, or biological agents that occurs as a result of one's occupation. [NIH] Octreotide: A potent, long-acting somatostatin octapeptide analog which has a wide range of physiological actions. It inhibits growth hormone secretion, is effective in the treatment of hormone-secreting tumors from various organs, and has beneficial effects in the management of many pathological states including diabetes mellitus, orthostatic
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hypertension, hyperinsulinism, hypergastrinemia, and small bowel fistula. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Ocular Hypertension: A condition in which the intraocular pressure is elevated above normal and which may lead to glaucoma. [NIH] Odds Ratio: The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases. [NIH] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Operating Rooms: Facilities equipped for performing surgery. [NIH] Opsin: A protein formed, together with retinene, by the chemical breakdown of metarhodopsin. [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]
Optic Disk: The portion of the optic nerve seen in the fundus with the ophthalmoscope. It is formed by the meeting of all the retinal ganglion cell axons as they enter the optic nerve. [NIH]
Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Organ Culture: The growth in aseptic culture of plant organs such as roots or shoots, beginning with organ primordia or segments and maintaining the characteristics of the organ. [NIH] Organ Transplantation: Transference of an organ between individuals of the same species or between individuals of different species. [NIH] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Orlistat: A lipase inhibitor used for weight loss. Lipase is an enzyme found in the bowel that assists in lipid absorption by the body. Orlistat blocks this enzyme, reducing the amount of fat the body absorbs by about 30 percent. It is known colloquially as a "fat blocker." Because more oily fat is left in the bowel to be excreted, Orlistat can cause an oily anal leakage and fecal incontinence. Orlistat may not be suitable for people with bowel conditions such as irritable bowel syndrome or Crohn's disease. [NIH] Orthostatic: Pertaining to or caused by standing erect. [EU] Osmolality: The concentration of osmotically active particles in solution expressed in terms of osmoles of solute per kilogram of solvent. The osmolality is directly proportional to the
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colligative properties of solutions; osmotic pressure, boiling point elevation, freezing point depression, and vapour pressure lowering. [EU] Osmoles: The standard unit of osmotic pressure. [NIH] Osmosis: Tendency of fluids (e.g., water) to move from the less concentrated to the more concentrated side of a semipermeable membrane. [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Otolith: A complex calcareous concretion in the inner ear which controls man's sense of balance and reactions to acceleration. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]
Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Oximetry: The determination of oxygen-hemoglobin saturation of blood either by withdrawing a sample and passing it through a classical photoelectric oximeter or by electrodes attached to some translucent part of the body like finger, earlobe, or skin fold. It includes non-invasive oxygen monitoring by pulse oximetry. [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxygenase: Enzyme which breaks down heme, the iron-containing oxygen-carrying constituent of the red blood cells. [NIH] Oxygenation: The process of supplying, treating, or mixing with oxygen. No:1245 oxygenation the process of supplying, treating, or mixing with oxygen. [EU]
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Oxygenator: An apparatus by which oxygen is introduced into the blood during circulation outside the body, as during open heart surgery. [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Panniculitis: General term for inflammation of adipose tissue, usually of the skin, characterized by reddened subcutaneous nodules. [NIH] Papilla: A small nipple-shaped elevation. [NIH] Papillary: Pertaining to or resembling papilla, or nipple. [EU] Paraganglia, Chromaffin: Small bodies containing chromaffin cells occurring outside of the adrenal medulla, most commonly near the sympathetic ganglia and in organs such as the kidney, liver, heart and gonads. [NIH] Parathyroid: 1. Situated beside the thyroid gland. 2. One of the parathyroid glands. 3. A sterile preparation of the water-soluble principle(s) of the parathyroid glands, ad-ministered parenterally as an antihypocalcaemic, especially in the treatment of acute hypoparathyroidism with tetany. [EU] Parathyroid Glands: Two small paired endocrine glands in the region of the thyroid gland. They secrete parathyroid hormone and are concerned with the metabolism of calcium and phosphorus. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Paresis: A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Particle: A tiny mass of material. [EU] Particle Accelerators: Devices which accelerate electrically charged atomic or subatomic particles, such as electrons, protons or ions, to high velocities so they have high kinetic energy. [NIH] Parturition: The act or process of given birth to a child. [EU] Passive resistance: Airflow resistance + tissue resistance. [NIH] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Patch-Clamp Techniques: An electrophysiologic technique for studying cells, cell
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membranes, and occasionally isolated organelles. All patch-clamp methods rely on a very high-resistance seal between a micropipette and a membrane; the seal is usually attained by gentle suction. The four most common variants include on-cell patch, inside-out patch, outside-out patch, and whole-cell clamp. Patch-clamp methods are commonly used to voltage clamp, that is control the voltage across the membrane and measure current flow, but current-clamp methods, in which the current is controlled and the voltage is measured, are also used. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Patient Participation: Patient involvement in the decision-making process in matters pertaining to health. [NIH] Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial. [NIH] Peak flow: The maximum amount of air breathed out; the power needed to produce this amount. [EU] Pedigree: A record of one's ancestors, offspring, siblings, and their offspring that may be used to determine the pattern of certain genes or disease inheritance within a family. [NIH] Pelvic: Pertaining to the pelvis. [EU] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peptide Hydrolases: A subclass of enzymes from the hydrolase class that catalyze the hydrolysis of peptide bonds. Exopeptidases and endopeptidases make up the sub-subclasses for this group. EC 3.4. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]
Perimenopausal: The time of a woman's life when menstrual periods become irregular. Refers to the time near menopause. [NIH] Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU] Perindopril: An angiotensin-converting enzyme inhibitor. It is used in patients with
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hypertension and heart failure. [NIH] Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Nervous System Diseases: Diseases of the peripheral nerves external to the brain and spinal cord, which includes diseases of the nerve roots, ganglia, plexi, autonomic nerves, sensory nerves, and motor nerves. [NIH] Peripheral Vascular Disease: Disease in the large blood vessels of the arms, legs, and feet. People who have had diabetes for a long time may get this because major blood vessels in their arms, legs, and feet are blocked and these limbs do not receive enough blood. The signs of PVD are aching pains in the arms, legs, and feet (especially when walking) and foot sores that heal slowly. Although people with diabetes cannot always avoid PVD, doctors say they have a better chance of avoiding it if they take good care of their feet, do not smoke, and keep both their blood pressure and diabetes under good control. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peritoneal Dialysis: Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Periventricular Leukomalacia: Rare form of epilepsy. [NIH] Petechiae: Pinpoint, unraised, round red spots under the skin caused by bleeding. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Pharmaceutic Aids: Substances which are of little or no therapeutic value, but are necessary in the manufacture, compounding, storage, etc., of pharmaceutical preparations or drug dosage forms. They include solvents, diluting agents, and suspending agents, and emulsifying agents. Also, antioxidants; preservatives, pharmaceutical; dyes (coloring agents); flavoring agents; vehicles; excipients; ointment bases. [NIH] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacist: A person trained to prepare and distribute medicines and to give information about them. [NIH] Pharmacodynamic: Is concerned with the response of living tissues to chemical stimuli, that is, the action of drugs on the living organism in the absence of disease. [NIH]
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Pharmacokinetics: Dynamic and kinetic mechanisms of exogenous chemical and drug absorption, biotransformation, distribution, release, transport, uptake, and elimination as a function of dosage, and extent and rate of metabolic processes. It includes toxicokinetics, the pharmacokinetic mechanism of the toxic effects of a substance. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenobarbital: A barbituric acid derivative that acts as a nonselective central nervous system depressant. It promotes binding to inhibitory GABA subtype receptors, and modulates chloride currents through receptor channels. It also inhibits glutamate induced depolarizations. [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phenylephrine: An alpha-adrenergic agonist used as a mydriatic, nasal decongestant, and cardiotonic agent. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphoric Monoester Hydrolases: A group of hydrolases which catalyze the hydrolysis of monophosphoric esters with the production of one mole of orthophosphate. EC 3.1.3. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylated: Attached to a phosphate group. [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Photoplethysmography: Plethysmographic determination in which the intensity of light reflected from the skin surface and the red cells below is measured to determine the blood volume of the respective area. There are two types, transmission and reflectance. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Fitness: A state of well-being in which performance is optimal, often as a result of physical conditioning which may be prescribed for disease therapy. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]
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Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigmentation: Coloration or discoloration of a part by a pigment. [NIH] Pigments: Any normal or abnormal coloring matter in plants, animals, or micro-organisms. [NIH]
Pilocarpine: A slowly hydrolyzed muscarinic agonist with no nicotinic effects. Pilocarpine is used as a miotic and in the treatment of glaucoma. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pitch: The subjective awareness of the frequency or spectral distribution of a sound. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Plasma Volume: Volume of plasma in the circulation. It is usually measured by indicator dilution techniques. [NIH] Plasmid: An autonomously replicating, extra-chromosomal DNA molecule found in many bacteria. Plasmids are widely used as carriers of cloned genes. [NIH] Plasticity: In an individual or a population, the capacity for adaptation: a) through gene changes (genetic plasticity) or b) through internal physiological modifications in response to changes of environment (physiological plasticity). [NIH] Plastids: Self-replicating cytoplasmic organelles of plant and algal cells that contain pigments and may synthesize and accumulate various substances. Plastids are used in phylogenetic studies. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH]
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Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]
Plethysmograph: An instrument for measuring swelling or expansion of the body or part of it, such as a limb or digit, commonly used for the indirect measurement of blood flow or other displacement of internal fluids. [NIH] Plethysmography: Recording of change in the size of a part as modified by the circulation in it. [NIH] Podiatrist: A doctor who treats and takes care of people's feet. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Policy Making: The decision process by which individuals, groups or institutions establish policies pertaining to plans, programs or procedures. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polyethylene: A vinyl polymer made from ethylene. It can be branched or linear. Branched or low-density polyethylene is tough and pliable but not to the same degree as linear polyethylene. Linear or high-density polyethylene has a greater hardness and tensile strength. Polyethylene is used in a variety of products, including implants and prostheses. [NIH]
Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polyunsaturated fat: An unsaturated fat found in greatest amounts in foods derived from plants, including safflower, sunflower, corn, and soybean oils. [NIH] Polyuria: Urination of a large volume of urine with an increase in urinary frequency, commonly seen in diabetes. [NIH] Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars ventralis. [NIH] Pontine: A brain region involved in the detection and processing of taste. [NIH] Porphyria: A group of disorders characterized by the excessive production of porphyrins or their precursors that arises from abnormalities in the regulation of the porphyrin-heme pathway. The porphyrias are usually divided into three broad groups, erythropoietic, hepatic, and erythrohepatic, according to the major sites of abnormal porphyrin synthesis. [NIH]
Porphyrins: A group of compounds containing the porphin structure, four pyrrole rings connected by methine bridges in a cyclic configuration to which a variety of side chains are attached. The nature of the side chain is indicated by a prefix, as uroporphyrin,
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hematoporphyrin, etc. The porphyrins, in combination with iron, form the heme component in biologically significant compounds such as hemoglobin and myoglobin. [NIH] Port: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port-a-cath. [NIH] Port-a-cath: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port. [NIH] Portal Pressure: The venous pressure measured in the portal vein. [NIH] Portal System: A system of vessels in which blood, after passing through one capillary bed, is conveyed through a second set of capillaries before it returns to the systemic circulation. It pertains especially to the hepatic portal system. [NIH] Portal Vein: A short thick vein formed by union of the superior mesenteric vein and the splenic vein. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postoperative: After surgery. [NIH] Postprandial: Occurring after dinner, or after a meal; postcibal. [EU] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-synaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Postural: Pertaining to posture or position. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Preeclampsia: A toxaemia of late pregnancy characterized by hypertension, edema, and proteinuria, when convulsions and coma are associated, it is called eclampsia. [EU] Pre-Eclampsia: Development of hypertension with proteinuria, edema, or both, due to pregnancy or the influence of a recent pregnancy. It occurs after the 20th week of gestation, but it may develop before this time in the presence of trophoblastic disease. [NIH]
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Pregnancy Tests: Tests to determine whether or not an individual is pregnant. [NIH] Prejudice: A preconceived judgment made without adequate evidence and not easily alterable by presentation of contrary evidence. [NIH] Preload: The tension in the heart muscle at the end of diastole (before the contraction). [EU] Premedication: Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (antibiotic prophylaxis) and anti-anxiety agents. It does not include preanesthetic medication. [NIH] Premenopausal: Refers to the time before menopause. Menopause is the time of life when a women's menstrual periods stop permanently; also called "change of life." [NIH] Premenstrual: Occurring before menstruation. [EU] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Presbyopia: The normal decreasing elasticity of the crystalline lens that leads to loss of accommodation. [NIH] Pressoreceptors: Receptors in the vascular system, particularly the aorta and carotid sinus, which are sensitive to stretch of the vessel walls. [NIH] Presumptive: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Primary endpoint: The main result that is measured at the end of a study to see if a given treatment worked (e.g., the number of deaths or the difference in survival between the treatment group and the control group). What the primary endpoint will be is decided before the study begins. [NIH] Primary Prevention: Prevention of disease or mental disorders in susceptible individuals or populations through promotion of health, including mental health, and specific protection, as in immunization, as distinguished from the prevention of complications or after-effects of existing disease. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Problem Solving: A learning situation involving more than one alternative from which a selection is made in order to attain a specific goal. [NIH] Prodrug: A substance that gives rise to a pharmacologically active metabolite, although not itself active (i. e. an inactive precursor). [NIH] Progeny: The offspring produced in any generation. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is
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emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Propofol: A widely used anesthetic. [NIH] Proportional: Being in proportion : corresponding in size, degree, or intensity, having the same or a constant ratio; of, relating to, or used in determining proportions. [EU] Propranolol: A widely used non-cardioselective beta-adrenergic antagonist. Propranolol is used in the treatment or prevention of many disorders including acute myocardial infarction, arrhythmias, angina pectoris, hypertension, hypertensive emergencies, hyperthyroidism, migraine, pheochromocytoma, menopause, and anxiety. [NIH] Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring
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secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protective Agents: Synthetic or natural substances which are given to prevent a disease or disorder or are used in the process of treating a disease or injury due to a poisonous agent. [NIH]
Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Protein Subunits: Single chains of amino acids that are the units of a multimeric protein. They can be identical or non-identical subunits. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychometric testing: Psychological and mental testing and quantitative analysis of an individual's psychological traits or attitudes or mental processes. [NIH] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychosomatic: Pertaining to the mind-body relationship; having bodily symptoms of psychic, emotional, or mental origin; called also psychophysiologic. [EU] Psychosomatic Medicine: A system of medicine which aims at discovering the exact nature of the relationship between the emotions and bodily function, affirming the principle that the mind and body are one. [NIH]
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Psychotomimetic: Psychosis miming. [NIH] Psychotropic: Exerting an effect upon the mind; capable of modifying mental activity; usually applied to drugs that effect the mental state. [EU] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]
Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Pulmonary Valve: A valve situated at the entrance to the pulmonary trunk from the right ventricle. [NIH] Pulmonary Veins: The veins that return the oxygenated blood from the lungs to the left atrium of the heart. [NIH] Pulmonary Ventilation: The total volume of gas per minute inspired or expired measured in liters per minute. [NIH] Pulsatile Flow: Rhythmic, intermittent propagation of a fluid through a vessel or piping system, in contrast to constant, smooth propagation, which produces laminar flow. The quality of blood flow, whether smooth (laminar) or pulsatile, is important to the integrity of the tissues being artificially perfused by various heart assist devices or in regional perfusion. [NIH]
Pulsation: A throb or rhythmical beat, as of the heart. [EU] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Pupil: The aperture in the iris through which light passes. [NIH] Purines: A series of heterocyclic compounds that are variously substituted in nature and are known also as purine bases. They include adenine and guanine, constituents of nucleic acids, as well as many alkaloids such as caffeine and theophylline. Uric acid is the metabolic end product of purine metabolism. [NIH] Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radial Artery: The direct continuation of the brachial trunk, originating at the bifurcation of
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the brachial artery opposite the neck of the radius. Its branches may be divided into three groups corresponding to the three regions in which the vessel is situated, the forearm, wrist, and hand. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radiography: Examination of any part of the body for diagnostic purposes by means of roentgen rays, recording the image on a sensitized surface (such as photographic film). [NIH] Radioisotope: An unstable element that releases radiation as it breaks down. Radioisotopes can be used in imaging tests or as a treatment for cancer. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiopharmaceutical: Any medicinal product which, when ready for use, contains one or more radionuclides (radioactive isotopes) included for a medicinal purpose. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Radius: The lateral bone of the forearm. [NIH] Raloxifene: A second generation selective estrogen receptor modulator (SERM) used to prevent osteoporosis in postmenopausal women. It has estrogen agonist effects on bone and cholesterol metabolism but behaves as a complete estrogen antagonist on mammary gland and uterine tissue. [NIH] Ramipril: A long-acting angiotensin-converting enzyme inhibitor. It is a prodrug that is transformed in the liver to its active metabolite ramiprilat. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Randomized Controlled Trials: Clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Treatment allocations using coin flips, odd-even numbers, patient social security numbers, days of the week, medical record numbers, or other such pseudo- or quasi-random processes, are not truly randomized and trials
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employing any of these techniques for patient assignment are designated simply controlled clinical trials. [NIH] Reabsorption: 1. The act or process of absorbing again, as the selective absorption by the kidneys of substances (glucose, proteins, sodium, etc.) already secreted into the renal tubules, and their return to the circulating blood. 2. Resorption. [EU] Reactive Oxygen Species: Reactive intermediate oxygen species including both radicals and non-radicals. These substances are constantly formed in the human body and have been shown to kill bacteria and inactivate proteins, and have been implicated in a number of diseases. Scientific data exist that link the reactive oxygen species produced by inflammatory phagocytes to cancer development. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reference point: The midpoint of a line connecting the centers of the two end faces of the acoustic test fixture. [NIH] Reference Values: The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regression Analysis: Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see linear models) the relationship is constrained to be a straight line and least-squares analysis is used to determine the best fit. In logistic regression (see logistic models) the dependent variable is qualitative rather than continuously variable and likelihood functions are used to find the best relationship. In multiple regression the dependent variable is considered to depend on more than a single independent variable. [NIH]
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Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Relative risk: The ratio of the incidence rate of a disease among individuals exposed to a specific risk factor to the incidence rate among unexposed individuals; synonymous with risk ratio. Alternatively, the ratio of the cumulative incidence rate in the exposed to the cumulative incidence rate in the unexposed (cumulative incidence ratio). The term relative risk has also been used synonymously with odds ratio. This is because the odds ratio and relative risk approach each other if the disease is rare ( 5 percent of population) and the number of subjects is large. [NIH] Relaxation Techniques: The use of muscular relaxation techniques in treatment. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]
Renal Artery: A branch of the abdominal aorta which supplies the kidneys, adrenal glands and ureters. [NIH] Renal Circulation: The circulation of the blood through the vessels of the kidney. [NIH] Renal cysts: Abnormal fluid-filled sacs in the kidney that range in size from microscopic to much larger. Many simple cysts are harmless, while other types can seriously damage the kidneys. [NIH] Renal Dialysis: Removal of certain elements from the blood based on the difference in their rates of diffusion through a semipermeable membrane. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Renin: An enzyme which is secreted by the kidney and is formed from prorenin in plasma and kidney. The enzyme cleaves the Leu-Leu bond in angiotensinogen to generate angiotensin I. EC 3.4.23.15. (Formerly EC 3.4.99.19). [NIH] Renin-Angiotensin System: A system consisting of renin, angiotensin-converting enzyme, and angiotensin II. Renin, an enzyme produced in the kidney, acts on angiotensinogen, an alpha-2 globulin produced by the liver, forming angiotensin I. The converting enzyme contained in the lung acts on angiotensin I in the plasma converting it to angiotensin II, the most powerful directly pressor substance known. It causes contraction of the arteriolar smooth muscle and has other indirect actions mediated through the adrenal cortex. [NIH] Reperfusion: Restoration of blood supply to tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. It is primarily a procedure for treating infarction or other ischemia, by enabling viable ischemic tissue to recover, thus limiting further necrosis. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing reperfusion injury. [NIH] Reperfusion Injury: Functional, metabolic, or structural changes, including necrosis, in ischemic tissues thought to result from reperfusion to ischemic areas of the tissue. The most common instance is myocardial reperfusion injury. [NIH] Research Support: Financial support of research activities. [NIH] Reserpine: An alkaloid found in the roots of Rauwolfia serpentina and R. vomitoria. Reserpine inhibits the uptake of norepinephrine into storage vesicles resulting in depletion of catecholamines and serotonin from central and peripheral axon terminals. It has been used as an antihypertensive and an antipsychotic as well as a research tool, but its adverse effects limit its clinical use. [NIH] Resolving: The ability of the eye or of a lens to make small objects that are close together,
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separately visible; thus revealing the structure of an object. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respirator: A mechanical device that helps a patient breathe; a mechanical ventilator. [NIH] Respiratory failure: Inability of the lungs to conduct gas exchange. [NIH] Respiratory Paralysis: Complete or severe weakness of the muscles of respiration. This condition may be associated with motor neuron diseases; peripheral nerve disorders; neuromuscular junction diseases; spinal cord diseases; injury to the phrenic nerve; and other disorders. [NIH] Respiratory System: The tubular and cavernous organs and structures, by means of which pulmonary ventilation and gas exchange between ambient air and the blood are brought about. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Reticular: Coarse-fibered, netlike dermis layer. [NIH] Reticular Formation: A region extending from the pons & medulla oblongata through the mesencephalon, characterized by a diversity of neurons of various sizes and shapes, arranged in different aggregations and enmeshed in a complicated fiber network. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinal Ganglion Cells: Cells of the innermost nuclear layer of the retina, the ganglion cell layer, which project axons through the optic nerve to the brain. They are quite variable in size and in the shapes of their dendritic arbors, which are generally confined to the inner plexiform layer. [NIH] Retinoids: Derivatives of vitamin A. Used clinically in the treatment of severe cystic acne, psoriasis, and other disorders of keratinization. Their possible use in the prophylaxis and treatment of cancer is being actively explored. [NIH] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retinopathy: 1. Retinitis (= inflammation of the retina). 2. Retinosis (= degenerative, noninflammatory condition of the retina). [EU] Retrobulbar: Behind the pons. [EU]
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Retroperitoneal: Having to do with the area outside or behind the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Rheumatic Heart Disease: Disease of the heart resulting from rheumatic fever and characterized by inflammatory changes in the myocardium or scarring of the valves. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rhinitis: Inflammation of the mucous membrane of the nose. [NIH] Rhombencephalon: That part of the brain stem constituting the medulla oblongata (myelencephalon) and pons (metencephalon). [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Risk patient: Patient who is at risk, because of his/her behaviour or because of the type of person he/she is. [EU] Rod: A reception for vision, located in the retina. [NIH] Rosiglitazone: A drug taken to help reduce the amount of sugar in the blood. Rosiglitazone helps make insulin more effective and improves regulation of blood sugar. It belongs to the family of drugs called thiazolidinediones. [NIH] Rubber: A high-molecular-weight polymeric elastomer derived from the milk juice (latex) of Hevea brasiliensis and other trees. It is a substance that can be stretched at room temperature to atleast twice its original length and after releasing the stress, retractrapidly, and recover its original dimensions fully. Synthetic rubber is made from many different chemicals, including styrene, acrylonitrile, ethylene, propylene, and isoprene. [NIH] Sagittal: The line of direction passing through the body from back to front, or any vertical plane parallel to the medial plane of the body and inclusive of that plane; often restricted to the medial plane, the plane of the sagittal suture. [NIH] Saline: A solution of salt and water. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saphenous: Applied to certain structures in the leg, e. g. nerve vein. [NIH] Saphenous Vein: The vein which drains the foot and leg. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics
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when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Sarcoplasmic Reticulum: A network of tubules and sacs in the cytoplasm of skeletal muscles that assist with muscle contraction and relaxation by releasing and storing calcium ions. [NIH] Saturated fat: A type of fat found in greatest amounts in foods from animals, such as fatty cuts of meat, poultry with the skin, whole-milk dairy products, lard, and in some vegetable oils, including coconut, palm kernel, and palm oils. Saturated fat raises blood cholesterol more than anything else eaten. On a Step I Diet, no more than 8 to 10 percent of total calories should come from saturated fat, and in the Step II Diet, less than 7 percent of the day's total calories should come from saturated fat. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Scrotum: In males, the external sac that contains the testicles. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Secretory Vesicles: Vesicles derived from the golgi apparatus containing material to be released at the cell surface. [NIH] Sedentary: 1. Sitting habitually; of inactive habits. 2. Pertaining to a sitting posture. [EU]
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Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Selective estrogen receptor modulator: SERM. A drug that acts like estrogen on some tissues, but blocks the effect of estrogen on other tissues. Tamoxifen and raloxifene are SERMs. [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Self-Examination: The inspection of one's own body, usually for signs of disease (e.g., breast self-examination, testicular self-examination). [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semicircular canal: Three long canals of the bony labyrinth of the ear, forming loops and opening into the vestibule by five openings. [NIH] Seminal vesicles: Glands that help produce semen. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false negatives. [NIH] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Sequela: Any lesion or affection following or caused by an attack of disease. [EU] Sequence Analysis: A multistage process that includes the determination of a sequence (protein, carbohydrate, etc.), its fragmentation and analysis, and the interpretation of the resulting sequence information. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary
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sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Sigmoidal: S-shaped; shaped like the letter sigma. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Silicon: A trace element that constitutes about 27.6% of the earth's crust in the form of silicon dioxide. It does not occur free in nature. Silicon has the atomic symbol Si, atomic number 14, and atomic weight 28.09. [NIH] Silicon Dioxide: Silica. Transparent, tasteless crystals found in nature as agate, amethyst, chalcedony, cristobalite, flint, sand, quartz, and tridymite. The compound is insoluble in water or acids except hydrofluoric acid. [NIH] Simvastatin: A derivative of lovastatin and potent competitive inhibitor of 3-hydroxy-3methylglutaryl coenzyme A reductase (hydroxymethylglutaryl CoA reductases), which is the rate-limiting enzyme in cholesterol biosynthesis. It may also interfere with steroid hormone production. Due to the induction of hepatic LDL receptors, it increases breakdown of LDL-cholesterol (lipoproteins, LDL cholesterol). [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skin graft: Skin that is moved from one part of the body to another. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Sleep apnea: A serious, potentially life-threatening breathing disorder characterized by repeated cessation of breathing due to either collapse of the upper airway during sleep or absence of respiratory effort. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Soaps: Sodium or potassium salts of long chain fatty acids. These detergent substances are obtained by boiling natural oils or fats with caustic alkali. Sodium soaps are harder and are used as topical anti-infectives and vehicles in pills and liniments; potassium soaps are soft, used as vehicles for ointments and also as topical antimicrobials. [NIH] Social Class: A stratum of people with similar position and prestige; includes social stratification. Social class is measured by criteria such as education, occupation, and income. [NIH]
Social Desirability: A personality trait rendering the individual acceptable in social or
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interpersonal relations. It is related to social acceptance, social approval, popularity, social status, leadership qualities, or any quality making him a socially desirable companion. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solitary Nucleus: Gray matter located in the dorsomedial part of the medulla oblongata associated with the solitary tract. The solitary nucleus receives inputs from most organ systems including the terminations of the facial, glossopharyngeal, and vagus nerves. It is a major coordinator of autonomic nervous system regulation of cardiovascular, respiratory, gustatory, gastrointestinal, and chemoreceptive aspects of homeostasis. The solitary nucleus is also notable for the large number of neurotransmitters which are found therein. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Somatostatin: A polypeptide hormone produced in the hypothalamus, and other tissues and organs. It inhibits the release of human growth hormone, and also modulates important physiological functions of the kidney, pancreas, and gastrointestinal tract. Somatostatin receptors are widely expressed throughout the body. Somatostatin also acts as a neurotransmitter in the central and peripheral nervous systems. [NIH] Somnipathy: The state of being hypnotized. [NIH] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Soybean Oil: Oil from soybean or soybean plant. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH]
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Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spermatozoa: Mature male germ cells that develop in the seminiferous tubules of the testes. Each consists of a head, a body, and a tail that provides propulsion. The head consists mainly of chromatin. [NIH] Sphygmomanometer: Consisting of a blood pressure cuff which is applied to the arm and inflated to approximately 100 mm Hg, in order to distend and locate the anticubital vessel; to measure blood pressure. [NIH] Spike: The activation of synapses causes changes in the permeability of the dendritic membrane leading to changes in the membrane potential. This difference of the potential travels along the axon of the neuron and is called spike. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Diseases: Pathologic conditions which feature spinal cord damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord. [NIH] Spinal tap: A procedure in which a needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give anticancer drugs intrathecally. Also called a lumbar puncture. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Splenic Vein: Vein formed by the union (at the hilus of the spleen) of several small veins from the stomach, pancreas, spleen and mesentery. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Stabilization: The creation of a stable state. [EU] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]
Statistically significant: Describes a mathematical measure of difference between groups. The difference is said to be statistically significant if it is greater than what might be expected to happen by chance alone. [NIH] Steady state: Dynamic equilibrium. [EU] Steatosis: Fatty degeneration. [EU] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Stent: A device placed in a body structure (such as a blood vessel or the gastrointestinal
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tract) to provide support and keep the structure open. [NIH] Sterile: Unable to produce children. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Steroid therapy: Treatment with corticosteroid drugs to reduce swelling, pain, and other symptoms of inflammation. [NIH] Stethoscope: An instrument used for the detection and study of sounds within the body that conveyed to the ears of the observer through rubber tubing. [NIH] Stillbirth: The birth of a dead fetus or baby. [NIH] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]
Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stress management: A set of techniques used to help an individual cope more effectively with difficult situations in order to feel better emotionally, improve behavioral skills, and often to enhance feelings of control. Stress management may include relaxation exercises, assertiveness training, cognitive restructuring, time management, and social support. It can be delivered either on a one-to-one basis or in a group format. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stroke Volume: The amount of blood pumped out of the heart per beat not to be confused with cardiac output (volume/time). [NIH] Styrene: A colorless, toxic liquid with a strong aromatic odor. It is used to make rubbers, polymers and copolymers, and polystyrene plastics. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subfornical Organ: A structure, situated close to the intraventricular foramen, which induces drinking behavior after stimulation with angiotensin II. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally
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conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]
Substrate: A substance upon which an enzyme acts. [EU] Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Sudden death: Cardiac arrest caused by an irregular heartbeat. The term "death" is somewhat misleading, because some patients survive. [NIH] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Superoxide: Derivative of molecular oxygen that can damage cells. [NIH] Superoxide Dismutase: An oxidoreductase that catalyzes the reaction between superoxide anions and hydrogen to yield molecular oxygen and hydrogen peroxide. The enzyme protects the cell against dangerous levels of superoxide. EC 1.15.1.1. [NIH] Supine: Having the front portion of the body upwards. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppuration: A pathologic process consisting in the formation of pus. [NIH] Supraspinal: Above the spinal column or any spine. [NIH] Supraventricular: Situated or occurring above the ventricles, especially in an atrium or atrioventricular node. [EU] Sural Nerve: A branch of the tibial nerve which supplies sensory innervation to parts of the lower leg and foot. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Synapses: Specialized junctions at which a neuron communicates with a target cell. At classical synapses, a neuron's presynaptic terminal releases a chemical transmitter stored in synaptic vesicles which diffuses across a narrow synaptic cleft and activates receptors on the postsynaptic membrane of the target cell. The target may be a dendrite, cell body, or axon of another neuron, or a specialized region of a muscle or secretory cell. Neurons may also communicate through direct electrical connections which are sometimes called electrical
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synapses; these are not included here but rather in gap junctions. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Synchronism: Occurring at the same time. [NIH] Syncope: A temporary suspension of consciousness due to generalized cerebral schemia, a faint or swoon. [EU] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Systole: Period of contraction of the heart, especially of the ventricles. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Systolic blood pressure: The maximum pressure in the artery produced as the heart contracts and blood begins to flow. [NIH] Systolic pressure: The highest pressure to which blood pressure rises with the contraction of the ventricles. [NIH] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tacrolimus: A macrolide isolated from the culture broth of a strain of Streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro. [NIH] Tamponade: The inserting of a tampon; a dressing is inserted firmly into a wound or body cavity, as the nose, uterus or vagina, principally for stopping hemorrhage. [NIH] Tape Recording: Recording of information on magnetic or punched paper tape. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Terbutaline: A selective beta-2 adrenergic agonist used as a bronchodilator and tocolytic. [NIH]
Terminalis: A groove on the lateral surface of the right atrium. [NIH] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH]
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Tetany: 1. Hyperexcitability of nerves and muscles due to decrease in concentration of extracellular ionized calcium, which may be associated with such conditions as parathyroid hypofunction, vitamin D deficiency, and alkalosis or result from ingestion of alkaline salts; it is characterized by carpopedal spasm, muscular twitching and cramps, laryngospasm with inspiratory stridor, hyperreflexia and choreiform movements. 2. Tetanus. [EU] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threonine: An essential amino acid occurring naturally in the L-form, which is the active form. It is found in eggs, milk, gelatin, and other proteins. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombolytic Therapy: Use of infusions of fibrinolytic agents to destroy or dissolve thrombi in blood vessels or bypass grafts. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]
Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thromboxanes: Physiologically active compounds found in many organs of the body. They are formed in vivo from the prostaglandin endoperoxides and cause platelet aggregation, contraction of arteries, and other biological effects. Thromboxanes are important mediators of the actions of polyunsaturated fatty acids transformed by cyclooxygenase. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroid Hormones: Hormones secreted by the thyroid gland. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH]
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Tibial Nerve: The medial terminal branch of the sciatic nerve. The tibial nerve fibers originate in lumbar and sacral spinal segments (L4 to S2). They supply motor and sensory innervation to parts of the calf and foot. [NIH] Tidal Volume: The volume of air inspired or expired during each normal, quiet respiratory cycle. Common abbreviations are TV or V with subscript T. [NIH] Time Management: Planning and control of time to improve efficiency and effectiveness. [NIH]
Timolol: A beta-adrenergic antagonist similar in action to propranolol. The levo-isomer is the more active. Timolol has been proposed as an antihypertensive, antiarrhythmic, antiangina, and antiglaucoma agent. It is also used in the treatment of migraine and tremor. [NIH]
Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Culture: Maintaining or growing of tissue, organ primordia, or the whole or part of an organ in vitro so as to preserve its architecture and/or function (Dorland, 28th ed). Tissue culture includes both organ culture and cell culture. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Tonicity: The normal state of muscular tension. [NIH] Tonometer: For testing the intra-ocular tension. [NIH] Tonometry: The standard to determine the fluid pressure inside the eye (intraocular pressure). [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Topical: On the surface of the body. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Tourniquet: A device, band or elastic tube applied temporarily to press upon an artery to stop bleeding; a device to compress a blood vessel in order to stop bleeding. [NIH] Toxaemia: 1. The condition resulting from the spread of bacterial products (toxins) by the bloodstream. 2. A condition resulting from metabolic disturbances, e.g. toxaemia of pregnancy. [EU] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH]
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Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Tracer: A substance (such as a radioisotope) used in imaging procedures. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Traction: The act of pulling. [NIH] Tractus: A part of some structure, usually that part along which something passes. [NIH] Transcendental meditation: TM. A mental technique used to promote relaxation, reduce stress, and improve quality of life. [NIH] Transcutaneous: Transdermal. [EU] Transdermal: Entering through the dermis, or skin, as in administration of a drug applied to the skin in ointment or patch form. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Translating: Conversion from one language to another language. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [NIH] Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Triage: The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment. [NIH] Trigeminal: Cranial nerve V. It is sensory for the eyeball, the conjunctiva, the eyebrow, the
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skin of face and scalp, the teeth, the mucous membranes in the mouth and nose, and is motor to the muscles of mastication. [NIH] Triglyceride: A lipid carried through the blood stream to tissues. Most of the body's fat tissue is in the form of triglycerides, stored for use as energy. Triglycerides are obtained primarily from fat in foods. [NIH] Trimethaphan: A nicotinic antagonist that has been used as a ganglionic blocker in hypertension, as an adjunct to anesthesia, and to induce hypotension during surgery. [NIH] Troglitazone: A drug used in diabetes treatment that is being studied for its effect on reducing the risk of cancer cell growth in fat tissue. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tuber Cinereum: Layer of gray matter in the hypothalamus that also forms part of the floor of the third ventricle and merges anteriorly into the infundibulum (pituitary gland, posterior). [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Tunica Intima: The innermost coat of blood vessels, consisting of a thin lining of endothelial cells longitudinally oriented and continuous with the endothelium of capillaries on the one hand and the endocardium of the heart on the other. [NIH] Tunica Media: The middle coat of blood vessel walls, composed principally of thin, cylindrical, smooth muscle cells and elastic tissue. It accounts for the bulk of the wall of most arteries. The smooth muscle cells are arranged in circular layers around the vessel, and the thickness of the coat varies with the size of the vessel. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Ulnar Artery: The larger of the two terminal branches of the brachial artery, beginning about one centimeter distal to the bend of the elbow. Like the radial artery, its branches may be divided into three groups corresponding to their locations in the forearm, wrist, and hand. [NIH]
Ultrafiltration: The separation of particles from a suspension by passage through a filter with very fine pores. In ultrafiltration the separation is accomplished by convective transport; in dialysis separation relies instead upon differential diffusion. Ultrafiltration occurs naturally and is a laboratory procedure. Artificial ultrafiltration of the blood is referred to as hemofiltration or hemodiafiltration (if combined with hemodialysis). [NIH]
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Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Unconditioned: An inborn reflex common to all members of a species. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Unsaturated Fats: A type of fat. [NIH] Urban Population: The inhabitants of a city or town, including metropolitan areas and suburban areas. [NIH] Urbanization: The process whereby a society changes from a rural to an urban way of life. It refers also to the gradual increase in the proportion of people living in urban areas. [NIH] Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethane: Antineoplastic agent that is also used as a veterinary anesthetic. It has also been used as an intermediate in organic synthesis. Urethane is suspected to be a carcinogen. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Uric: A kidney stone that may result from a diet high in animal protein. When the body breaks down this protein, uric acid levels rise and can form stones. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinate: To release urine from the bladder to the outside. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Urogenital Diseases: Diseases of the urogenital tract. [NIH] Urokinase: A drug that dissolves blood clots or prevents them from forming. [NIH] Urologic Diseases: Diseases of the urinary tract in both male and female. It does not include the male genitalia for which urogenital diseases is used for general discussions of diseases of both the urinary tract and the genitalia. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Uterine Contraction: Contraction of the uterine muscle. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH]
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Uvula: Uvula palatinae; specifically, the tongue-like process which projects from the middle of the posterior edge of the soft palate. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vacuoles: Any spaces or cavities within a cell. They may function in digestion, storage, secretion, or excretion. [NIH] Vagal: Pertaining to the vagus nerve. [EU] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge. [NIH] Vagus Nerve: The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx). [NIH] Valine: A branched-chain essential amino acid that has stimulant activity. It promotes muscle growth and tissue repair. It is a precursor in the penicillin biosynthetic pathway. [NIH]
Valves: Flap-like structures that control the direction of blood flow through the heart. [NIH] Varices: Stretched veins such as those that form in the esophagus from cirrhosis. [NIH] Vas Deferens: The excretory duct of the testes that carries spermatozoa. It rises from the scrotum and joins the seminal vesicles to form the ejaculatory duct. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular Resistance: An expression of the resistance offered by the systemic arterioles, and to a lesser extent by the capillaries, to the flow of blood. [NIH] Vasoactive: Exerting an effect upon the calibre of blood vessels. [EU] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilatation: A state of increased calibre of the blood vessels. [EU] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vasomotor: 1. Affecting the calibre of a vessel, especially of a blood vessel. 2. Any element or agent that effects the calibre of a blood vessel. [EU] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vegetarianism: Dietary practice of consuming only vegetables, grains, and nuts. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Vena: A vessel conducting blood from the capillary bed to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [NIH] Venous Pressure: The blood pressure in a vein. It is usually measured to assess the filling
678 Blood Pressure
pressure to the ventricle. [NIH] Ventilation: 1. In respiratory physiology, the process of exchange of air between the lungs and the ambient air. Pulmonary ventilation (usually measured in litres per minute) refers to the total exchange, whereas alveolar ventilation refers to the effective ventilation of the alveoli, in which gas exchange with the blood takes place. 2. In psychiatry, verbalization of one's emotional problems. [EU] Ventilator: A breathing machine that is used to treat respiratory failure by promoting ventilation; also called a respirator. [NIH] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Ventricular Dysfunction: A condition in which the ventricles of the heart exhibit a decreased functionality. [NIH] Ventricular Function: The hemodynamic and electrophysiological action of the ventricles. [NIH]
Ventricular Pressure: The pressure within a cardiac ventricle. Ventricular pressure waveforms can be measured in the beating heart by catheterization or estimated using imaging techniques (e.g., Doppler echocardiography). The information is useful in evaluating the function of the myocardium, cardiac valves, and pericardium, particularly with simultaneous measurement of other (e.g., aortic or atrial) pressures. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Verapamil: A calcium channel blocker that is a class IV anti-arrhythmia agent. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Vestibulocochlear Nerve: The 8th cranial nerve. The vestibulocochlear nerve has a cochlear part (cochlear nerve) which is concerned with hearing and a vestibular part (vestibular nerve) which mediates the sense of balance and head position. The fibers of the cochlear nerve originate from neurons of the spiral ganglion and project to the cochlear nuclei (cochlear nucleus). The fibers of the vestibular nerve arise from neurons of Scarpa's ganglion and project to the vestibular nuclei. [NIH] Vestibulocochlear Nerve Diseases: Diseases of the vestibular and/or cochlear (acoustic) nerves, which join to form the vestibulocochlear nerve. Vestibular neuritis, cochlear neuritis, and acoustic neuromas are relatively common conditions that affect these nerves. Clinical manifestations vary with which nerve is primarily affected, and include hearing loss, vertigo, and tinnitus. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU]
Dictionary 679
Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral Afferents: The sensory fibers innervating the viscera. [NIH] Visceral fat: One of the three compartments of abdominal fat. Retroperitoneal and subcutaneous are the other two compartments. [NIH] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Vitreous Hemorrhage: Hemorrhage into the vitreous body. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Void: To urinate, empty the bladder. [NIH] Volition: Voluntary activity without external compulsion. [NIH] Voltage-gated: It is opened by the altered charge distribution across the cell membrane. [NIH]
Vomica: The profuse and sudden expectoration of pus and putrescent matter. An abnormal cavity in an organ especially in the lung, caused by suppuration and the breaking down of tissue. [NIH] Vulgaris: An affection of the skin, especially of the face, the back and the chest, due to chronic inflammation of the sebaceous glands and the hair follicles. [NIH] Waist circumference: To define the level at which the waist circumference is measured, a bony landmark is first located and marked. The subject stands, and the technician, positioned to the right of the subject, palpates the upper hip bone to locate the right ileum. Just above the uppermost lateral border of the right ileum, a horizontal mark is drawn and then crossed with a vertical mark on the midaxillary line. The measuring tape is then placed around the trunk, at the level of the mark on the right side, making sure that it is on a level horizontal plane on all sides. The tape is then tightened slightly without compressing the skin and underlying subcutaneous tissues. The measure is recorded in centimeters to the nearest millimeter. [NIH] Wakefulness: A state in which there is an enhanced potential for sensitivity and an efficient responsiveness to external stimuli. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]
Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as
680 Blood Pressure
may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Xenograft: The cells of one species transplanted to another species. [NIH] Xerostomia: Decreased salivary flow. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zygote: The fertilized ovum. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]
681
INDEX A Abdomen, 579, 581, 594, 615, 631, 632, 637, 652, 665, 670, 671, 674, 679, 681 Abdominal, 94, 187, 236, 562, 581, 582, 609, 621, 633, 634, 641, 650, 652, 663, 665, 681 Abdominal fat, 94, 581, 681 Abdominal Pain, 562, 581, 621, 634 Abducens, 581, 584 Aberrant, 68, 581 Accommodation, 581, 657 Acculturation, 274, 292, 581 Acetaldehyde, 149, 581 Acetylcholine, 286, 581, 600, 646 Acidosis, 170, 581 Acoustic, 321, 347, 361, 366, 411, 458, 467, 581, 662, 680 Acrylonitrile, 581, 665 Actin, 76, 581, 643 Activities of Daily Living, 16, 581 Adaptation, 58, 65, 92, 94, 581, 654 Adenine, 581, 582, 660 Adenocarcinoma, 582, 626 Adenosine, 65, 80, 214, 582, 595, 653 Adenovirus, 50, 582 Adipocytes, 582, 636 Adipose Tissue, 101, 473, 581, 582, 650 Adjunctive Therapy, 307, 582 Adjustment, 4, 6, 7, 8, 275, 330, 353, 406, 581, 582 Adolescence, 60, 117, 143, 190, 215, 280, 291, 582 Adrenal Cortex, 564, 582, 583, 605, 606, 616, 628, 657, 663 Adrenal Glands, 562, 564, 582, 663 Adrenal Medulla, 582, 598, 600, 615, 647, 650 Adrenalin, 19, 582 Adrenaline, 563, 582 Adrenergic beta-Antagonists, 582, 588 Adverse Effect, 43, 225, 226, 582, 601, 663, 668 Aerobic, 13, 15, 18, 61, 106, 272, 274, 275, 280, 509, 519, 582, 642 Aerobic Exercise, 15, 61, 274, 275, 280, 509, 582 Aeroembolism, 582, 592 Afferent, 19, 52, 87, 582, 636
Affinity, 55, 57, 582, 583, 590, 601, 637, 669 Afterload, 583 Agar, 583, 654 Age of Onset, 94, 583, 677 Ageing, 98, 149, 201, 583 Agonist, 10, 39, 60, 76, 583, 611, 615, 630, 642, 644, 646, 653, 654, 661, 673 Air Sacs, 563, 583, 584 Airway, 85, 87, 121, 145, 583, 595, 668 Albumin, 4, 32, 50, 63, 170, 189, 583, 654 Albuminuria, 84, 583 Alcohol Drinking, 137, 583 Alertness, 583, 595 Algorithms, 583, 593 Alimentary, 212, 584, 634, 650 Alkaline, 581, 584, 585, 595, 674 Alkaloid, 584, 601, 646, 663 Alleles, 17, 584, 636 Allergen, 563, 584, 608 Allograft, 159, 204, 584 Allylamine, 584 Alpha Particles, 584, 661 Alpha-1, 75, 584, 611 Alternans, 155, 584 Alternative medicine, 43, 526, 584 Alveoli, 563, 584, 680 Ameliorating, 70, 95, 584 Amine, 26, 88, 584, 627 Amino Acid Neurotransmitters, 24, 584 Amino Acid Sequence, 584, 587, 592, 617 Amino Acids, 250, 279, 280, 584, 586, 590, 592, 645, 651, 655, 659, 665, 667, 672, 676, 678 Amlodipine, 12, 13, 78, 131, 143, 150, 250, 530, 585 Ammonia, 584, 585, 678 Amniotic Fluid, 585, 622 Amphetamine, 585, 608 Amplification, 101, 321, 373, 585 Ampulla, 585, 599, 614 Amputation, 511, 585 Amyloid, 585, 599 Anabolic, 423, 585, 609 Anaesthesia, 169, 195, 204, 585, 631 Anal, 37, 280, 585, 615, 637, 648 Analgesic, 215, 233, 585, 604, 609, 614, 630, 636
682 Blood Pressure
Analog, 26, 50, 310, 335, 342, 351, 416, 424, 585, 634, 647 Analogous, 325, 409, 474, 585, 611, 676 Anaphylatoxins, 585, 603 Anaphylaxis, 237, 563, 585 Anatomical, 309, 381, 585, 591, 604, 610, 613, 630, 666 Androgens, 582, 585, 605 Anemia, 227, 585, 593, 619, 625 Anesthesia, 65, 142, 158, 163, 197, 198, 583, 586, 587, 590, 604, 606, 612, 613, 633, 677 Anesthetics, 586, 615 Aneurysm, 124, 586, 621, 679 Angina, 37, 42, 115, 237, 443, 582, 585, 586, 646, 658 Angina Pectoris, 443, 582, 585, 586, 658 Anginal, 586, 646 Angiography, 66, 586 Angioma, 568, 586 Angiopathy, 452, 586, 599 Angiotensin converting enzyme inhibitor, 10, 12, 13, 114, 144, 586 Angiotensin I, 100, 143, 250, 586 Angiotensin II, 100, 143, 250, 586 Angiotensin-Converting Enzyme Inhibitors, 128, 218, 490, 586, 588 Angiotensinogen, 42, 77, 98, 99, 109, 195, 586, 663 Animal model, 15, 17, 46, 66, 92, 308, 586 Anions, 583, 586, 634, 672 Ankle, 109, 381, 437, 453, 587 Anorexia, 237, 564, 587, 621 Antagonism, 587, 595, 601 Anterior Cerebral Artery, 587, 599 Anterior Hypothalamic Nucleus, 47, 587 Anthropometric measurements, 185, 587 Antiallergic, 587, 605 Anti-Anxiety Agents, 587, 657 Antiarrhythmic, 587, 675 Antibacterial, 587, 670 Antibiotic, 587, 657, 670 Antibiotic Prophylaxis, 587, 657 Antibodies, 80, 474, 587, 624, 626, 630, 639, 654 Antibody, 515, 583, 587, 588, 602, 624, 627, 630, 631, 640, 642, 661, 669 Anticoagulant, 402, 587, 659 Anticonvulsant, 307, 587 Antidiuretic, 587, 644 Antidote, 587, 612 Antiepileptic, 307, 587
Antigen, 583, 585, 587, 588, 602, 622, 627, 629, 630, 631, 640 Antigen-Antibody Complex, 588, 602 Antihypertensive Agents, 44, 120, 122, 138, 146, 201, 213, 276, 588 Anti-infective, 588, 619, 628, 633, 668 Anti-Infective Agents, 588, 619 Anti-inflammatory, 50, 123, 197, 213, 588, 590, 598, 605, 608, 609, 622, 630 Anti-Inflammatory Agents, 588, 590, 598, 605 Antineoplastic, 588, 605, 678 Antioxidant, 588, 590, 620, 649 Antipsychotic, 588, 601, 645, 663 Antipyretic, 588, 609 Anuria, 588, 634 Anus, 166, 585, 588, 594 Anxiety, 20, 188, 235, 271, 274, 405, 515, 577, 582, 587, 588, 604, 658 Aortic Coarctation, 133, 589 Aortic Valve, 467, 589 Aortitis, 472, 589 Aperture, 330, 366, 402, 589, 660 Apnea, 48, 52, 116, 194, 244, 589 Apnoea, 589 Apolipoproteins, 45, 589, 637 Aponeurosis, 589, 620 Aqueous, 589, 592, 607, 613, 628, 636 Arachidonic Acid, 589, 612, 636, 658 Arginine, 22, 46, 53, 82, 138, 177, 250, 585, 589, 646 Aromatic, 589, 616, 671 Arrhythmia, 159, 238, 456, 466, 563, 587, 589, 680 Arteries, 65, 69, 76, 78, 100, 172, 215, 300, 310, 317, 332, 350, 366, 377, 386, 393, 394, 471, 496, 498, 504, 514, 527, 553, 555, 563, 567, 586, 588, 589, 590, 593, 594, 597, 598, 605, 632, 634, 638, 641, 643, 660, 674, 677 Arteriolar, 25, 56, 74, 328, 589, 594, 618, 663 Arterioles, 74, 77, 78, 589, 593, 596, 641, 643, 679 Arteriolosclerosis, 589, 632 Arteriosclerosis, 117, 153, 237, 281, 423, 453, 456, 467, 589, 629, 643 Arteriosus, 589, 660 Arteriovenous, 589, 599, 641 Arteritis, 527, 589 Articular, 589, 649 Artifacts, 89, 305, 341, 363, 470, 589
Index 683
Ascites, 518, 590 Ascorbic Acid, 123, 210, 217, 227, 590, 628 Aspirin, 4, 38, 79, 105, 154, 212, 531, 590 Astringents, 590, 640 Astrocytes, 42, 590, 642 Asymptomatic, 139, 590 Ataxia, 590, 630 Atenolol, 111, 130, 196, 251, 590 Atherectomy, 590, 613 Atheromatosis, 452, 590 Atmospheric Pressure, 334, 582, 590, 628 Atopic, 590 Atrial, 20, 65, 80, 91, 159, 590, 625, 680 Atrial Natriuretic Factor, 80, 91, 590 Atrioventricular, 590, 672 Atrioventricular Node, 590, 672 Atrium, 467, 590, 591, 597, 642, 660, 672, 673, 680 Atrophy, 107, 564, 591 Attenuated, 19, 31, 44, 68, 90, 112, 591, 610 Attenuation, 42, 90, 275, 373, 388, 465, 591, 616 Atypical, 591, 601, 647 Auditory, 591, 624, 639, 679 Aural, 335, 591 Auscultation, 321, 325, 378, 456, 591 Autacoids, 90, 591 Autonomic Nervous System, 20, 21, 53, 89, 92, 232, 287, 548, 564, 565, 566, 567, 591, 652, 669, 672 Autonomic Neuropathy, 185, 543, 591 Autoradiography, 591 Axillary, 591, 594, 641 Axillary Artery, 591, 594 Axons, 86, 591, 645, 648, 664 B Back Pain, 59, 199, 242, 591 Backcross, 591 Bacteria, 587, 588, 591, 592, 608, 613, 614, 617, 626, 641, 654, 662, 670, 679 Bacterial Physiology, 581, 591 Bactericidal, 592, 616 Bacteriophage, 592, 654 Baroreflex, 13, 21, 23, 25, 44, 89, 104, 106, 145, 155, 592 Basal Ganglia, 588, 590, 592, 599, 620 Basophils, 592, 623, 636 Bed Rest, 592 Bends, 334, 592 Benign, 237, 460, 589, 592, 620, 624, 644, 661 Benzene, 592, 634
Beta blocker, 9, 10, 111, 490, 509, 528, 555, 592 Beta-Endorphin, 33, 592 Bewilderment, 592, 604 Bile, 592, 620, 627, 634, 637, 671 Bile Pigments, 592, 634 Biliary, 592, 599 Bilirubin, 583, 592, 620, 628 Bioavailability, 71, 592 Biochemical, 57, 82, 90, 180, 491, 584, 593, 635, 649, 667 Biological Factors, 62, 593 Biological Transport, 593, 609 Biometry, 593 Biophysics, 80, 92, 593 Biopsy, 593 Biosynthesis, 86, 423, 589, 593, 638, 667, 668 Biotechnology, 97, 102, 507, 526, 541, 593 Bladder, 134, 301, 302, 304, 308, 359, 360, 361, 362, 366, 367, 373, 374, 382, 383, 402, 403, 435, 446, 464, 564, 591, 593, 620, 631, 645, 659, 678, 681 Blastocyst, 593, 603, 654 Blood Cell Count, 593, 625 Blood Coagulation, 593, 595, 674 Blood Flow Velocity, 25, 89, 229, 593 Blood Pressure Determination, 197, 326, 329, 362, 593 Blood transfusion, 593, 626 Blood Viscosity, 285, 593, 626 Blood Volume, 13, 19, 49, 57, 80, 285, 377, 445, 457, 594, 653 Blot, 74, 594 Body Composition, 16, 28, 38, 146, 154, 186, 270, 274, 594 Body Fluids, 513, 517, 594, 595, 611, 669 Body Mass Index, 4, 119, 122, 135, 140, 199, 272, 594, 649 Bolus, 197, 215, 594 Bolus infusion, 594 Bolus injection, 215, 594 Bone Density, 79, 285, 562, 594 Bone Marrow, 237, 592, 594, 606, 630, 638, 642 Bone scan, 594, 666 Bowel, 564, 585, 594, 609, 632, 648, 652 Bowel Movement, 594, 609 Brachytherapy, 594, 632, 661 Bradycardia, 16, 594 Bradykinin, 14, 286, 594, 634, 646, 654 Brain Stem, 24, 594, 598, 665
684 Blood Pressure
Branch, 86, 403, 575, 594, 613, 638, 639, 651, 660, 663, 669, 672, 674, 675 Breakdown, 517, 595, 609, 621, 648, 668 Breast Self-Examination, 595, 667 Breeding, 92, 595 Broadband, 51, 595 Bromine, 296, 595 Bronchi, 595, 615, 634, 676 Bronchial, 518, 595, 627 Bronchiectasis, 518, 595 Bronchioles, 584, 595 Bronchitis, 238, 243, 518, 595, 600 Bronchodilator, 595, 634, 673 Buccal, 595, 638 Buffers, 54, 71, 592, 595 Butyric Acid, 297, 595 Bypass, 111, 155, 210, 303, 516, 524, 595, 674 C Caffeine, 123, 127, 175, 253, 271, 490, 554, 595, 660 Calcification, 38, 187, 454, 472, 589, 595 Calcium blocker, 150, 596 Calcium channel blocker, 9, 10, 291, 528, 555, 585, 588, 596, 680 Calcium Channel Blockers, 528, 555, 588, 596 Calcium Channels, 596 Candidiasis, 238, 515, 596 Candidosis, 596 Cannula, 316, 401, 402, 596 Capillary, 55, 57, 562, 563, 594, 596, 622, 656, 679, 680 Capillary Permeability, 594, 596 Capsules, 596, 621, 622 Captopril, 56, 147, 212, 253, 596 Carbohydrate, 45, 63, 146, 156, 273, 596, 605, 623, 647, 667 Carbon Dioxide, 48, 442, 596, 597, 607, 621, 629, 654, 664, 679 Carcinogen, 597, 678 Carcinogenic, 592, 597, 599, 631, 658, 671 Carcinoma, 597 Cardiomyopathy, 135, 238, 597 Cardiopulmonary, 13, 134, 163, 597, 626 Cardiopulmonary Bypass, 163, 597, 626 Cardiorespiratory, 28, 61, 87, 134, 582, 597 Cardioselective, 590, 597, 658 Cardiotonic, 597, 653 Cardiovascular Abnormalities, 151, 597 Cardiovascular Physiology, 75, 597
Cardiovascular System, 31, 60, 310, 423, 460, 514, 591, 597 Carotene, 252, 597, 664 Carotid Arteries, 37, 597 Carotid Body, 597, 599 Carotid Sinus, 168, 228, 597, 657 Carrier Proteins, 597, 654 Catecholamine, 29, 86, 206, 598, 611, 653 Catheterization, 64, 598, 633, 680 Caudal, 24, 87, 598, 609, 629, 656 Causal, 67, 598, 615, 626, 632 Cause of Death, 81, 598 Celecoxib, 102, 115, 147, 598 Cell, 52, 57, 73, 78, 81, 83, 86, 92, 227, 448, 581, 583, 585, 589, 591, 592, 593, 596, 597, 598, 600, 603, 607, 608, 612, 614, 616, 617, 620, 621, 622, 626, 627, 630, 631, 632, 633, 636, 640, 642, 643, 644, 648, 649, 650, 653, 654, 655, 658, 662, 664, 666, 667, 672, 673, 674, 675, 676, 677, 679, 681 Cell Division, 591, 598, 640, 642, 654, 658, 667 Cell Hypoxia, 73, 598 Cell membrane, 593, 596, 597, 598, 608, 617, 621, 633, 651, 653, 681 Cell proliferation, 589, 598 Cell Respiration, 598, 642, 664 Central Nervous System Infections, 598, 624 Centrifugation, 93, 598, 625 Cerebellar, 52, 92, 590, 598, 676 Cerebellum, 92, 598, 619, 655 Cerebral Aqueduct, 598, 619, 674 Cerebral Arteries, 31, 76, 78, 598 Cerebral hemispheres, 592, 594, 598, 599 Cerebral Hemorrhage, 443, 599 Cerebral Infarction, 15, 103, 443, 599 Cerebrospinal, 124, 599, 638, 670 Cerebrospinal fluid, 124, 599, 638, 670 Cerebrum, 598, 599 Cervical, 134, 599, 625 Cervix, 599, 618 Chaos, 599, 620, 646 Character, 328, 586, 599, 607, 623 Checkup, 211, 599 Check-up, 110, 599 Chemoreceptor, 52, 588, 599 Chemotactic Factors, 599, 603 Chest Pain, 211, 502, 599 Chlorine, 296, 599 Chlorogenic Acid, 443, 599
Index 685
Cholestasis, 518, 599 Cholesterol Esters, 600, 637 Cholinergic, 588, 600, 646 Cholinergic Agonists, 600 Chromaffin Cells, 86, 600, 650 Chromic, 600 Chromosomal, 17, 37, 38, 51, 585, 600, 654 Chromosome, 71, 272, 273, 600, 636, 667 Chronic Disease, 60, 521, 600, 602 Chronic Obstructive Pulmonary Disease, 518, 600 Chronic renal, 47, 53, 114, 120, 154, 175, 190, 600, 620, 655 Chronotropic, 600 Chylomicrons, 600, 637 Circadian, 43, 126, 127, 137, 139, 171, 183, 211, 228, 384, 600 Circadian Rhythm, 183, 600 Circulatory system, 309, 328, 359, 425, 438, 458, 600, 614, 633 CIS, 600, 664 Citrus, 590, 600 Clamp, 64, 74, 426, 427, 600, 651 Claudication, 14, 600 Clinical Medicine, 60, 601, 656 Clinical study, 601, 604 Clitoral, 56, 601 Clone, 601 Cloning, 92, 593, 601 Clozapine, 207, 601 Coagulation, 200, 297, 593, 601, 654, 674 Coca, 601 Cocaine, 170, 601 Cochlea, 601, 632 Cochlear, 601, 675, 680 Cochlear Diseases, 601, 675 Coenzyme, 228, 254, 255, 291, 590, 601, 638, 668 Cofactor, 601, 659, 674 Cognition, 6, 68, 602, 645 Cognitive restructuring, 602, 671 Cohort Studies, 118, 602, 615 Collagen, 66, 423, 602, 621, 628, 654, 658 Collagen disease, 602, 628 Collapse, 312, 563, 585, 595, 602, 668 Collateral Circulation, 602 Colloidal, 583, 602 Colonoscopy, 235, 602 Comorbidity, 26, 602 Complement, 49, 585, 602, 603, 621, 654 Complementary and alternative medicine, 225, 226, 268, 292, 603
Complementary medicine, 226, 603 Complementation, 603 Compress, 304, 366, 603, 626, 675 Computational Biology, 541, 603 Computed tomography, 5, 594, 603, 666 Computer Simulation, 170, 197, 603 Computerized axial tomography, 603, 666 Computerized tomography, 603 Concentric, 283, 589, 603 Conception, 60, 68, 603, 604, 618 Concomitant, 543, 603 Concretion, 603, 649 Conditioned stimulus, 603 Cone, 303, 604 Confusion, 562, 604, 610, 645, 678 Congestion, 371, 372, 438, 588, 604, 607 Congestive heart failure, 50, 195, 349, 463, 516, 551, 553, 554, 604, 637 Conjugated, 604, 607 Conjunctiva, 603, 604, 676 Connective Tissue, 590, 594, 602, 604, 618, 620, 621, 638, 665 Conscious Sedation, 311, 604 Consciousness, 578, 585, 587, 604, 608, 610, 673 Constrict, 286, 330, 361, 407, 604 Constriction, 78, 88, 286, 357, 565, 604, 634, 679 Constriction, Pathologic, 604, 679 Consumption, 27, 50, 175, 395, 463, 489, 551, 604, 608, 621, 647, 649 Continuous infusion, 92, 604 Continuum, 542, 604 Contraceptive, 121, 271, 604 Contractility, 69, 285, 315, 316, 586, 604, 612 Contraindications, ii, 84, 604 Contralateral, 460, 584, 604, 640, 648 Contrast Media, 215, 604 Control group, 15, 28, 65, 604, 657 Controlled clinical trial, 56, 604, 662 Controlled study, 105, 605 Conus, 605, 660 Convulsions, 587, 605, 612, 656 Convulsive, 605, 613 Coordination, 32, 34, 35, 36, 39, 40, 41, 565, 598, 605 Coronary Artery Bypass, 155, 158, 181, 605 Coronary Circulation, 586, 605, 646 Coronary Disease, 287, 291, 548, 605
686 Blood Pressure
Coronary heart disease, 4, 8, 63, 64, 70, 128, 202, 291, 551, 597, 605, 627 Coronary Thrombosis, 605, 641, 643 Coronary Vessels, 605 Corpus, 270, 605, 638, 657, 674 Corpus Luteum, 605, 638, 657 Cortex, 73, 83, 562, 590, 598, 605, 616, 617 Cortical, 61, 605, 617, 667 Corticosteroid, 562, 605, 671 Cortisol, 33, 62, 83, 187, 234, 463, 564, 583, 606 Cortisone, 606, 608 Cranial, 598, 606, 624, 633, 648, 652, 676, 679, 680 Craniocerebral Trauma, 599, 606, 624, 675 C-Reactive Protein, 87, 606 Creatinine, 57, 173, 517, 606, 635 Critical Care, 143, 150, 163, 174, 178, 202, 327, 329, 348, 457, 606 Crossing-over, 606, 662 Cross-Sectional Studies, 606, 615 Cues, 92, 606 Curare, 606, 612 Curative, 368, 606, 674 Cutaneous, 596, 606, 638 Cyanosis, 344, 563, 606, 626 Cyclic, 14, 272, 428, 595, 606, 624, 646, 655, 658 Cyclosporine, 137, 255, 531, 606 Cysteine, 255, 474, 606, 672 Cystine, 606 Cytochrome, 8, 606 Cytokine, 134, 607 Cytoplasm, 592, 598, 607, 612, 615, 623, 643, 646, 665, 666 Cytoskeleton, 76, 92, 607 D Dairy Products, 27, 75, 100, 280, 607, 666 Data Collection, 67, 96, 226, 607 Databases, Bibliographic, 541, 607 Deamination, 607, 678 Decarboxylation, 607, 627 Deception, 508, 607 Decision Making, 4, 607 Decompression, 582, 607, 610 Decongestant, 260, 607, 653 Degenerative, 605, 607, 626, 649, 664 Dehydration, 515, 562, 564, 607 Deletion, 101, 607 Delivery of Health Care, 607, 625 Dementia, 5, 6, 64, 66, 79, 147, 237, 239, 244, 588, 608
Dendrites, 608, 645 Dendritic, 608, 640, 664, 670 Density, 7, 38, 55, 74, 96, 135, 310, 412, 594, 598, 608, 612, 627, 637, 648, 655, 669 Dental Care, 519, 608 Dental Caries, 515, 608, 619 Depolarization, 78, 608 Depressive Disorder, 608, 637 Deprivation, 31, 608 Dermatitis, 608 Desensitization, 275, 608 Detergents, 608, 618 Developed Countries, 459, 608, 619 Dexamethasone, 142, 608 Dextroamphetamine, 585, 608, 641 Diabetes Insipidus, 98, 206, 608, 628 Diabetes Mellitus, 4, 47, 62, 63, 100, 110, 153, 170, 188, 194, 198, 202, 239, 517, 557, 566, 609, 622, 626, 647 Diabetic Retinopathy, 543, 609, 653 Diagnostic procedure, 295, 526, 609 Dialysate, 327, 609 Dialyzer, 355, 514, 609, 625 Diaphragm, 310, 311, 322, 329, 330, 334, 399, 428, 448, 609 Diarrhea, 239, 515, 609, 634, 635 Diastole, 304, 324, 366, 475, 479, 482, 486, 609, 657 Diclofenac, 50, 609 Diclofenac Sodium, 50, 609 Diencephalon, 609, 629, 674 Dietary Fats, 513, 609, 637 Dietitian, 64, 609 Diffusion, 57, 593, 596, 609, 610, 624, 631, 633, 663, 677 Digestion, 584, 592, 594, 609, 631, 632, 637, 671, 679 Digestive system, 293, 609 Digestive tract, 591, 609, 668 Dihydrotestosterone, 609, 662 Dilatation, 586, 595, 610, 632, 657, 679 Dilatation, Pathologic, 610, 679 Dilate, 286, 534, 610 Dilated cardiomyopathy, 181, 610 Dilation, 65, 518, 590, 594, 610, 679 Dilator, 311, 610, 646 Dilution, 25, 610, 616, 654 Dipeptides, 448, 610 Diploid, 603, 610, 654 Discrimination, 69, 70, 378, 610 Disinfectant, 610, 616 Disorientation, 604, 610
Index 687
Disparity, 95, 610 Dissociation, 139, 583, 610 Distention, 310, 610 Diuresis, 22, 140, 595, 610 Diuretic, 39, 45, 610, 620, 628, 631 Diuretics, Thiazide, 532, 588, 610 Diurnal, 107, 140, 183, 184, 186, 284, 610 Diving, 87, 610 Docosahexaenoic Acids, 231, 611 Dopamine, 585, 588, 601, 608, 611, 642 Dorsal, 88, 134, 611, 656 Dorsum, 611, 620 Dose-dependent, 100, 214, 227, 611 Doxazosin, 10, 98, 144, 187, 256, 532, 611 Drinking Behavior, 611, 671 Drip, 328, 611 Drive, ii, vi, 24, 44, 209, 297, 373, 375, 387, 392, 394, 511, 513, 519, 550, 611, 633, 636 Drug Design, 567, 611 Drug Interactions, 212, 535, 536, 611 Drug Resistance, 611 Drug Tolerance, 611, 675 Duct, 585, 596, 598, 611, 617, 665, 679 Duodenum, 592, 611, 614, 621, 671 Dyes, 585, 592, 611, 619, 646, 652 Dysgenesis, 81, 611 Dyslipidemia, 69, 512, 612 Dysplasia, 562, 563, 612 Dystrophy, 564, 565, 567, 612 E Echocardiography, 16, 84, 94, 135, 612, 680 Eclampsia, 612, 656 Edema, 25, 76, 102, 115, 147, 239, 449, 493, 518, 609, 612, 620, 626, 628, 633, 645, 656 Edrophonium, 612 Effector, 39, 42, 581, 602, 612, 645 Effector cell, 612, 645 Egg Yolk, 423, 612 Eicosanoids, 91, 612 Ejection fraction, 612 Elasticity, 310, 369, 441, 589, 612, 657 Elastin, 66, 602, 612 Elective, 190, 612 Electric Wiring, 390, 612 Electroacupuncture, 228, 234, 612 Electrocardiogram, 5, 135, 312, 319, 436, 456, 460, 612 Electrocardiograph, 401, 446, 612 Electrocoagulation, 601, 612 Electroconvulsive Therapy, 612 Electrode, 314, 319, 367, 397, 412, 470, 613
Electrolyte, 9, 11, 22, 53, 148, 171, 534, 564, 583, 605, 613, 626, 635, 642, 656, 669 Electrons, 588, 592, 613, 634, 649, 650, 661 Electrophysiological, 11, 613, 680 Electroshock, 307, 613 Emboli, 462, 613 Embolization, 462, 613 Embolus, 613, 631 Embryo, 593, 612, 613, 631 Emergency Treatment, 348, 382, 433, 613 Emphysema, 518, 600, 613 Empirical, 613 Emulsion, 591, 613 Enalapril, 12, 13, 103, 120, 138, 182, 256, 532, 613 Enamel, 608, 613 Endarterectomy, 69, 590, 613 Endemic, 614, 670 Endocarditis, 596, 614 Endocrine System, 614, 645 Endocrinologist, 520, 614 Endocrinology, 75, 117, 157, 163, 170, 199, 614 Endometrium, 614, 640 Endorphin, 34, 592, 614 Endoscope, 311, 614, 635 Endoscopic, 311, 602, 614, 630 Endoscopy, 311, 614 Endothelial cell, 54, 614, 674, 677 Endothelium, 20, 49, 53, 68, 91, 614, 646, 677 Endothelium, Lymphatic, 614 Endothelium, Vascular, 614 Endothelium-derived, 53, 614, 646 Endotoxic, 614, 637 Endotoxin, 614, 677 End-stage renal, 12, 13, 49, 119, 550, 600, 614, 655 Energy balance, 176, 614, 636 Energy Intake, 63, 614, 615 Enhancers, 615 Enkephalin, 592, 615 Environmental Exposure, 38, 615 Environmental Health, 86, 126, 151, 540, 542, 615 Enzymatic, 12, 81, 474, 596, 597, 603, 608, 615, 618, 627, 664 Enzyme Inhibitors, 98, 615, 654 Eosinophils, 615, 623, 636 Ephedrine, 198, 615 Epidemic, 32, 84, 212, 459, 615, 670 Epidemiologic Studies, 86, 289, 615
688 Blood Pressure
Epidemiological, 70, 85, 114, 128, 149, 615 Epidermis, 615, 629, 660 Epidural, 163, 615 Epigastric, 615, 650 Epinephrine, 563, 582, 600, 611, 615, 634, 647, 677 Epithelial, 10, 44, 75, 79, 582, 593, 615, 642 Epithelial Cells, 10, 615, 642 Epithelium, 56, 92, 614, 615 Epoxide Hydrolases, 58, 616 Equalization, 366, 616 Equipment and Supplies, 519, 616 Erythrocyte Volume, 594, 616 Erythrocytes, 585, 593, 594, 616, 626, 662 Erythropoiesis, 514, 616 Esophageal, 84, 279, 311, 616 Esophageal Varices, 84, 311, 616 Esophagus, 84, 311, 609, 616, 653, 662, 671, 679 Estradiol, 18, 31, 33, 81, 83, 616 Estrogen, 31, 33, 46, 81, 82, 146, 232, 273, 616, 658, 661, 667 Estrogen receptor, 616 Ethanol, 616 Ethanolamine, 616, 642 Ether, 296, 616 Ethnic Groups, 136, 616 Eukaryotic Cells, 616, 631, 648 Evacuation, 303, 616, 621 Evoke, 616, 671 Excipients, 616, 619, 652 Excitability, 616, 645 Excitation, 74, 369, 599, 617 Excitatory, 24, 584, 617, 623, 630 Excrete, 39, 588, 617, 634 Exocrine, 617, 650 Exocytosis, 86, 617 Exogenous, 19, 34, 54, 596, 617, 621, 653, 677 Exon, 180, 275, 617 Expert Systems, 617, 620 Expiration, 194, 617, 664 External-beam radiation, 617, 661 Extracellular, 22, 48, 51, 74, 585, 590, 604, 617, 641, 669, 674 Extracellular Space, 617, 641 Extracorporeal, 355, 617, 626 Extraction, 15, 327, 617 Extrapyramidal, 588, 611, 617 Extravasation, 60, 617, 625 Extremity, 127, 330, 332, 430, 467, 617, 650 Eye Infections, 582, 617
F Facial, 584, 617, 639, 650, 669 Facial Paralysis, 584, 617 Failure to Thrive, 518, 617 Family Planning, 119, 541, 617 Family Practice, 113, 141, 175, 196, 617 Fatigue, 25, 238, 320, 520, 562, 564, 618, 625 Fatty acids, 63, 81, 213, 222, 423, 514, 583, 611, 612, 618, 658, 668 Fatty Liver, 423, 618 Felodipine, 128, 138, 192, 257, 532, 618 Femoral, 97, 597, 618 Femoral Artery, 597, 618 Femur, 618 Ferritin, 134, 618 Fetus, 83, 618, 654, 657, 671, 678 Fibrinogen, 87, 161, 618, 654, 674 Fibrinolytic, 618, 674 Fibrinolytic Agents, 618, 674 Fibrosis, 467, 515, 584, 618, 666 Filtration, 25, 74, 513, 618, 635 Fish Oils, 212, 611, 618 Fistula, 445, 618, 648 Flaccid, 401, 618 Flatus, 618, 621 Flavoring Agents, 618, 619, 652 Flexion, 42, 618 Fluorescence, 618, 619 Fluorescent Dyes, 72, 619 Fluorine, 296, 619 Flush, 402, 619 Flushing, 402, 563, 619 Folate, 619 Fold, 302, 619, 641, 649 Folic Acid, 619 Follicular Phase, 33, 48, 619 Food Additives, 211, 619 Food Coloring Agents, 619 Food Preservatives, 619 Foot Care, 512, 619 Foramen, 619, 639, 652, 671 Forearm, 69, 82, 275, 286, 369, 381, 463, 593, 619, 661, 677 Fossa, 403, 598, 619 Fourth Ventricle, 598, 619, 637, 674 Fractals, 619, 647 Friction, 620, 638 Frontal Lobe, 587, 599, 620 Fructose, 463, 620, 623, 633 Functional magnetic resonance imaging, 52, 620
Index 689
Fundus, 618, 620, 648 Fungus, 596, 620 Furosemide, 10, 43, 147, 620, 631 Fuzzy Logic, 620 G Gallate, 228, 620 Gallbladder, 214, 581, 592, 609, 620 Gallstones, 620, 627 Gamma Rays, 620, 661 Ganglia, 22, 581, 620, 645, 650, 652, 672 Ganglion, 169, 620, 648, 664, 680 Ganglionic Blockers, 588, 620 Gap Junctions, 621, 673 Gas exchange, 621, 664, 679, 680 Gastric, 154, 279, 311, 621, 627 Gastric Emptying, 154, 621 Gastrin, 621, 627 Gastroenteritis, 595, 621 Gastrointestinal, 311, 594, 615, 616, 621, 635, 636, 667, 669, 670, 672 Gastrointestinal tract, 616, 621, 635, 636, 667, 669, 671 Gelatin, 621, 623, 674 Gene Dosage, 51, 621 Gene Duplication, 21, 621 Gene Expression, 17, 21, 31, 78, 82, 87, 621 Gene Targeting, 11, 51, 621 Generator, 314, 350, 621 Genetic Engineering, 593, 601, 621 Genetic Markers, 282, 622 Genital, 56, 591, 622, 678 Genotype, 6, 32, 34, 35, 36, 37, 40, 41, 196, 622, 653 Geriatric, 155, 157, 228, 622 Germ Cells, 622, 640, 649, 669, 670, 673 Gestation, 8, 61, 65, 68, 137, 622, 651, 654, 656 Gestational, 8, 20, 60, 117, 151, 232, 240, 284, 520, 566, 622 Gestational Age, 117, 622 Giant Cells, 622, 666 Ginseng, 250, 251, 258, 264, 266, 622 Gland, 582, 606, 622, 638, 650, 654, 659, 661, 666, 671, 674 Glomerular, 8, 9, 10, 46, 47, 50, 65, 74, 527, 622, 633, 634, 663 Glomerular Filtration Rate, 8, 9, 10, 47, 50, 65, 74, 622, 634 Glomeruli, 622 Glomerulonephritis, 517, 622 Glomerulus, 622
Glucocorticoid, 101, 191, 199, 608, 622, 628, 642 Glucose Intolerance, 609, 622 Glucose tolerance, 16, 146, 520, 622, 623 Glucose Tolerance Test, 16, 520, 622, 623 Glutamate, 584, 623, 653 Glutamic Acid, 584, 619, 623, 626, 658 Gluten, 423, 623 Glycerol, 595, 623, 653 Glycine, 233, 623, 667 Glycogen, 126, 623 Glycogen Storage Disease, 126, 623 Glycoprotein, 618, 622, 623, 674, 677 Glycoside, 623, 628, 665 Goats, 607, 623 Gonadal, 623, 671 Governing Board, 623, 656 Government Agencies, 510, 623, 656 Grade, 276, 623 Graft, 155, 158, 179, 623, 630 Grafting, 155, 605, 623, 630 Granulocytes, 623, 636, 681 Grasses, 619, 624 Gravis, 612, 624 Guanylate Cyclase, 46, 624, 646 H Habitual, 33, 127, 599, 624 Haematoma, 624 Haemodialysis, 624 Haemorrhage, 120, 624 Hair Cells, 624, 639 Hair follicles, 624, 681 Haptens, 583, 624 Hate, 212, 624 Headache, 56, 242, 532, 595, 624 Headache Disorders, 624 Head-Down Tilt, 61, 624 Health Behavior, 20, 624 Health Care Costs, 624, 625 Health Expenditures, 625 Health Promotion, 510, 519, 625 Health Status, 26, 67, 69, 274, 290, 624, 625 Heart failure, 14, 104, 147, 187, 286, 443, 490, 527, 586, 615, 625, 652 Heart Sounds, 443, 625 Hemato, 318, 625 Hematocrit, 50, 593, 625 Hematoma, 625, 626 Heme, 73, 592, 606, 625, 626, 649, 655, 656 Hemiparesis, 625 Hemiplegia, 568, 584, 625 Hemodiafiltration, 625, 677
690 Blood Pressure
Hemodialysis, 49, 109, 146, 168, 182, 206, 327, 457, 513, 516, 517, 609, 625, 626, 634, 635, 677 Hemodilution, 57, 626 Hemodynamics, 50, 69, 80, 137, 145, 174, 433, 626 Hemofiltration, 625, 626, 677 Hemoglobin, 7, 55, 56, 57, 63, 65, 272, 512, 586, 593, 606, 616, 625, 626, 634, 636, 649, 656 Hemoglobin A, 56, 626, 656 Hemoglobin C, 65, 626 Hemoglobin E, 57, 626 Hemoglobin M, 606, 626 Hemolysis, 179, 626 Hemorrhage, 57, 76, 89, 234, 443, 606, 612, 624, 626, 660, 671, 673, 681 Hemorrhagic stroke, 210, 626 Hepatic, 64, 279, 583, 623, 626, 655, 656, 668 Hepatitis, 240, 245, 279, 518, 626 Hepatocellular, 518, 626 Hepatocellular carcinoma, 518, 626 Hepatocyte, 599, 627 Heredity, 516, 517, 551, 552, 554, 555, 621, 622, 627 Heterogeneity, 184, 583, 627 High blood cholesterol, 519, 627 Histamine, 585, 588, 627 Histidine, 627 Holidays, 519, 627 Homeostasis, 21, 50, 71, 73, 79, 90, 91, 157, 627, 669 Homicide, 510, 627 Homogenate, 627 Homogeneous, 38, 106, 589, 604, 627 Homologous, 11, 21, 88, 584, 606, 621, 626, 627, 667, 673 Hormonal, 10, 18, 48, 74, 121, 161, 164, 188, 513, 562, 591, 600, 605, 627 Hormone Replacement Therapy, 141, 143, 147, 627 Hormone therapy, 168, 627 Humoral, 53, 73, 91, 146, 627 Humour, 627 Hybrid, 591, 601, 628 Hydralazine, 10, 260, 533, 535, 628 Hydration, 171, 628 Hydrochlorothiazide, 13, 102, 211, 530, 531, 533, 535, 628 Hydrocortisone, 562, 628
Hydrogen, 581, 584, 592, 595, 596, 628, 637, 642, 646, 649, 652, 659, 672 Hydrogen Peroxide, 628, 637, 672 Hydrolases, 58, 628, 653 Hydrolysis, 628, 633, 651, 653, 655, 659 Hydrophobic, 608, 628, 637 Hydroxylation, 628 Hydroxylysine, 602, 628 Hydroxyproline, 602, 628 Hyperalgesia, 59, 628 Hyperbaric, 334, 628 Hyperbaric oxygen, 628 Hyperbilirubinemia, 628, 634 Hypercalcemia, 527, 628 Hypercalciuria, 527, 629 Hypercholesterolemia, 21, 185, 241, 287, 612, 629 Hyperglycemia, 512, 629 Hyperlipidemia, 423, 612, 629 Hyperpigmentation, 564, 629 Hyperplasia, 117, 237, 629 Hypersensitivity, 14, 563, 584, 585, 608, 629, 636, 665 Hyperthermia, 44, 629 Hyperthyroidism, 241, 629, 658 Hypertriglyceridemia, 612, 629 Hypertrophic cardiomyopathy, 155, 206, 207, 629 Hypertrophy, 66, 75, 91, 118, 124, 196, 205, 283, 629 Hyperventilation, 120, 629 Hypnotic, 215, 233, 629 Hypoglycemia, 241, 519, 520, 629 Hypotensive, 14, 19, 39, 44, 64, 83, 87, 142, 170, 297, 327, 328, 368, 463, 629, 634 Hypothalamic, 31, 47, 232, 629 Hypothalamus, 587, 591, 609, 615, 629, 654, 669, 674, 677 Hypothermia, 241, 626, 629 Hypovolemia, 25, 629 Hypoxia, 48, 50, 55, 73, 85, 101, 563, 629 Hysteroscopy, 179, 630 I Ibotenic Acid, 88, 630 Ibuprofen, 50, 518, 630 Id, 216, 236, 548, 557, 561, 574, 576, 630 Idiopathic, 181, 630, 666 Ileum, 230, 630, 681 Imaging procedures, 630, 676 Immune function, 29, 630 Immune response, 588, 606, 624, 630, 672, 681
Index 691
Immune system, 515, 563, 612, 630, 636, 639, 679, 681 Immunization, 630, 657 Immunodeficiency, 515, 630 Immunodeficiency syndrome, 515, 630 Immunogenic, 630, 637 Immunoglobulin, 587, 630, 642 Immunohistochemistry, 83, 630 Immunologic, 599, 622, 630, 661 Immunology, 583, 619, 630, 633 Immunosuppressive, 622, 630, 673 Immunotherapy, 608, 630 Impairment, 8, 22, 66, 114, 166, 513, 550, 564, 590, 592, 599, 617, 630, 640 Implant radiation, 630, 632, 661 Implantation, 21, 461, 603, 630 In situ, 630 In Situ Hybridization, 631 In vitro, 11, 55, 76, 78, 593, 631, 673, 675 In vivo, 11, 22, 46, 57, 65, 78, 214, 229, 631, 641, 673, 674 Incision, 446, 631, 633 Incompetence, 472, 631 Incontinence, 615, 631, 648 Indapamide, 147, 260, 533, 631 Indigestion, 241, 631, 635 Induction, 13, 163, 585, 588, 613, 621, 631, 658, 668 Infancy, 60, 61, 631 Infant Mortality, 510, 631 Infarction, 15, 124, 134, 242, 271, 599, 626, 631, 633, 663 Inferior vena cava, 631 Infiltration, 527, 622, 631 Infusion, 53, 72, 76, 77, 82, 83, 163, 164, 170, 173, 328, 594, 631, 676 Ingestion, 175, 619, 623, 631, 655, 674 Inhalation, 107, 631, 655 Initiation, 85, 406, 631 Inner ear, 555, 601, 632, 649 Innervation, 632, 672, 675 Inorganic, 297, 632, 646 Inotropic, 317, 590, 611, 618, 632 Inpatients, 93, 632 Insight, 24, 30, 34, 37, 58, 85, 94, 189, 191, 566, 632 Insulin-dependent diabetes mellitus, 291, 632 Intensive Care, 204, 305, 348, 370, 371, 372, 433, 440, 632 Intensive Care Units, 305, 348, 632 Interindividual, 281, 632
Intermittent, 14, 103, 311, 314, 368, 464, 468, 632, 638, 652, 660 Internal radiation, 632, 661 Interpersonal Relations, 632, 669 Interstitial, 50, 72, 81, 594, 617, 632, 663 Intervention Studies, 632 Intestinal, 279, 516, 597, 623, 632 Intestine, 594, 632, 635 Intoxication, 625, 632, 682 Intracellular, 36, 72, 595, 596, 631, 632, 646, 656, 658 Intracranial Aneurysm, 599, 632, 633 Intracranial Arteriosclerosis, 599, 632 Intracranial Hypertension, 624, 633, 675 Intracranial Pressure, 143, 163, 633 Intramuscular, 13, 328, 633, 650 Intraocular, 72, 275, 633, 648, 675 Intraocular pressure, 72, 633, 648, 675 Intraperitoneal, 633 Intravascular, 55, 76, 184, 328, 633 Intravenous, 15, 138, 164, 314, 328, 594, 631, 633, 650 Intrinsic, 12, 42, 53, 66, 101, 583, 633 Intubation, 195, 197, 598, 633 Inulin, 622, 633 Investigative Techniques, 18, 633 Involuntary, 564, 565, 567, 633, 644, 662 Iodine, 296, 633 Ion Channels, 172, 590, 633, 646, 673 Ion Transport, 8, 92, 287, 633, 642 Ionizing, 584, 615, 634, 639, 661 Ions, 592, 595, 596, 610, 613, 628, 633, 634, 650, 666 Irritable Bowel Syndrome, 634, 648 Ischemia, 15, 73, 76, 459, 460, 591, 626, 634, 663 Ischemic stroke, 15, 114, 125, 132, 202, 634 Isoflavones, 81, 230, 261, 634 Isoleucine, 586, 634 Isoproterenol, 84, 634 J Jaundice, 518, 628, 634 K Kallidin, 594, 634 Kb, 540, 634 Keratolytic, 608, 634 Kidney Failure, 16, 516, 517, 527, 542, 549, 552, 553, 554, 560, 614, 634, 635 Kidney Failure, Acute, 634 Kidney Failure, Chronic, 634, 635 Kidney stone, 635, 678
692 Blood Pressure
Kidney Transplantation, 161, 513, 516, 517, 635 Kinetic, 64, 634, 635, 650, 653 L Labetalol, 15, 261, 635 Labile, 272, 602, 635 Labyrinth, 601, 632, 635, 667, 680 Labyrinthine, 92, 93, 635 Lactation, 543, 635, 658 Lactose Intolerance, 513, 635 Lag, 384, 635 Large Intestine, 609, 632, 635, 662, 668 Laryngoscopy, 195, 197, 635 Larynx, 635, 676, 679 Latency, 635 Latent, 179, 635, 656 Least-Squares Analysis, 635, 662 Lens, 636, 657, 663 Leptin, 179, 186, 636 Lesion, 9, 60, 584, 605, 636, 637, 667, 677 Lethal, 78, 592, 636 Leucine, 592, 636 Leucocyte, 584, 636 Leukocytes, 592, 593, 594, 599, 615, 623, 636, 642, 646, 677 Leukotrienes, 589, 612, 636 Levo, 636, 675 Libido, 55, 585, 636 Library Services, 574, 636 Ligament, 636, 659 Ligation, 59, 636 Likelihood Functions, 636, 662 Linear Models, 636, 662 Linkage Disequilibrium, 38, 636 Lip, 515, 636 Lipase, 636, 648 Lipid A, 16, 130, 165, 637, 648 Lipid Peroxidation, 637, 649 Lipophilic, 637 Lipopolysaccharides, 637 Lipoprotein, 7, 45, 135, 187, 612, 627, 637, 638 Lipoprotein(a), 45, 187, 637 Lisinopril, 127, 129, 262, 291, 524, 637 Lithium, 154, 287, 288, 289, 588, 637 Liver cancer, 518, 637 Liver scan, 637, 666 Lobe, 461, 587, 599, 637 Localization, 10, 272, 273, 630, 637 Localized, 608, 624, 625, 631, 637, 654, 666, 677, 678 Locus Coeruleus, 60, 637
Logistic Models, 637, 662 Longitudinal study, 68, 171, 288, 637 Long-Term Care, 140, 638 Loop, 22, 262, 301, 302, 328, 345, 350, 354, 355, 359, 364, 405, 475, 478, 481, 485, 531, 638 Lovastatin, 638, 668 Low-density lipoprotein, 612, 637, 638 Lubricants, 638 Lubrication, 56, 638 Lumbar, 509, 591, 638, 670, 675 Lumbar puncture, 509, 638, 670 Lumen, 37, 76, 299, 311, 352, 589, 596, 614, 638 Lupus, 56, 510, 515, 602, 638 Luteal Phase, 33, 638 Lutein Cells, 638, 658 Lymph, 442, 515, 527, 591, 599, 600, 614, 627, 638, 666 Lymph node, 527, 591, 599, 638, 666 Lymphatic, 586, 614, 631, 638, 670 Lymphatic system, 638, 670 Lymphocyte, 588, 639, 640 Lymphoid, 448, 587, 636, 639 Lysine, 626, 628, 639 M Magnetic Resonance Imaging, 13, 94, 639, 666 Malignant, 10, 550, 582, 588, 589, 637, 639, 644, 661 Malnutrition, 583, 591, 639 Mammary, 605, 639, 661 Mammogram, 595, 639, 641 Manic, 588, 637, 639 Manifest, 625, 639 Man-made, 89, 639 Mass Screening, 332, 639 Mastication, 48, 639, 677 Maternal Mortality, 46, 639 Maximum Tolerated Dose, 611, 639 Meat, 156, 232, 609, 639, 666 Meat Products, 609, 639 Meatus, 639, 679 Mechanoreceptors, 13, 624, 639 Medial, 84, 124, 587, 589, 639, 648, 665, 675 Mediate, 20, 46, 48, 70, 92, 611, 639, 640 Mediator, 49, 56, 640, 667 Medical Staff, 406, 640 Medicament, 297, 640 MEDLINE, 541, 640 Medullary, 8, 10, 48, 50, 52, 71, 73, 81, 160, 640
Index 693
Megaloblastic, 619, 640 Meiosis, 640, 673 Melanin, 637, 640, 677 Melanocytes, 629, 640 Menarche, 640 Meninges, 598, 606, 640, 670 Menopause, 18, 31, 46, 81, 143, 146, 157, 242, 640, 651, 656, 657, 658 Menstrual Cycle, 33, 48, 230, 619, 638, 640, 657 Menstruation, 242, 619, 638, 640, 657 Mental Disorders, 293, 640, 657, 659 Mental Health, iv, 8, 70, 165, 293, 508, 540, 544, 640, 657, 660 Mesencephalic, 637, 640 Mesenteric, 54, 77, 83, 641, 656 Mesentery, 641, 652, 670 Meta-Analysis, 144, 149, 166, 183, 198, 214, 227, 235, 280, 641 Metabolic disorder, 518, 566, 608, 623, 641 Metabolite, 46, 638, 641, 647, 657, 661 Methionine, 229, 592, 641, 672 Methylphenidate, 641 Methyltransferase, 124, 641 Microbe, 641, 676 Microbiology, 581, 591, 641 Microcalcifications, 595, 641 Microcirculation, 50, 55, 77, 91, 172, 626, 641 Microdialysis, 22, 71, 124, 641 Micronutrients, 211, 641 Microorganism, 601, 641, 681 Micro-organism, 608, 641, 654 Microscopy, 66, 74, 92, 641 Midaxillary line, 641, 681 Midodrine, 25, 26, 534, 642 Migration, 274, 642 Milliliter, 594, 642 Millimeter, 9, 642, 681 Mineralocorticoid, 75, 642 Minority Groups, 28, 642 Miotic, 642, 654 Mitochondria, 642, 648 Mitral Valve, 242, 467, 642 Mobilization, 642 Modeling, 51, 54, 69, 70, 171, 179, 273, 611, 642 Modification, 47, 56, 57, 67, 133, 147, 167, 233, 285, 616, 621, 642, 660 Modulator, 22, 642 Molecule, 588, 592, 596, 601, 602, 610, 612, 614, 617, 623, 628, 642, 649, 654, 661, 662
Monoamine, 585, 608, 642 Monoclonal, 642, 661 Monocytes, 636, 642 Mononuclear, 642, 643, 677 Monophosphate, 14, 643 Monotherapy, 307, 643 Monounsaturated fat, 45, 63, 643 Morphological, 583, 613, 620, 640, 643 Morphology, 124, 643 Motility, 643, 667 Motion Sickness, 643, 644 Motor Activity, 13, 605, 643 Mucinous, 620, 643 Mucins, 643, 665 Mucosa, 56, 638, 643, 658 Multiple Trauma, 89, 643 Muscle Contraction, 585, 643, 666 Muscle Relaxation, 231, 275, 596, 643 Muscle tension, 43, 643 Muscular Dystrophies, 612, 643 Mutagenesis, 643 Mutagens, 643 Myasthenia, 612, 643 Mydriatic, 610, 643, 653 Myocardial infarction, 16, 37, 131, 138, 140, 176, 443, 463, 605, 641, 643, 658 Myocardial Ischemia, 586, 605, 643 Myocardium, 586, 641, 643, 644, 665, 680 N Nadir, 311, 644 Naloxone, 59, 592, 644 Naltrexone, 30, 644 Narcolepsy, 608, 615, 641, 644 Narcotic, 581, 644 Natriuresis, 14, 21, 22, 32, 50, 72, 80, 170, 586, 644 Nausea, 515, 563, 588, 621, 631, 644, 678 NCI, 1, 292, 539, 600, 644 Necrosis, 599, 631, 641, 643, 644, 663, 666 Neonatal, 133, 172, 273, 312, 343, 348, 631, 644 Neoplasia, 644 Neoplasm, 644, 677 Neoplastic, 81, 595, 628, 644 Nephrogenic, 206, 644 Nephrologist, 517, 644 Nephron, 39, 58, 88, 206, 622, 644 Nephropathy, 56, 75, 81, 116, 146, 180, 291, 520, 525, 634, 644 Nephrosis, 644, 645 Nephrotic, 56, 516, 645 Nephrotic Syndrome, 56, 516, 645
694 Blood Pressure
Nephrotoxic, 518, 645 Nerve Fibers, 645, 675 Nervous System, 11, 24, 31, 286, 287, 296, 504, 564, 565, 567, 581, 582, 584, 585, 591, 592, 595, 596, 598, 600, 601, 608, 615, 620, 623, 624, 636, 639, 640, 641, 645, 648, 652, 653, 655, 667, 672, 673 Nervousness, 405, 645 Networks, 32, 34, 35, 39, 40, 41, 281, 282, 292, 645 Neural, 11, 18, 19, 24, 31, 46, 53, 193, 464, 582, 585, 620, 627, 639, 645 Neuroeffector Junction, 86, 645 Neuroendocrine, 11, 16, 30, 31, 33, 645 Neurogenic, 53, 282, 645 Neuroleptic, 588, 601, 645 Neurologist, 116, 645 Neuromuscular, 581, 617, 645, 664 Neuromuscular Junction, 581, 645, 664 Neuronal, 21, 31, 76, 596, 645 Neuropathy, 94, 452, 453, 512, 520, 591, 645 Neuropeptide, 90, 448, 645 Neurophysiology, 608, 645 Neurotoxin, 60, 645 Neurotransmitters, 503, 584, 643, 645, 669 Neutrons, 584, 646, 661 Neutrophils, 623, 636, 646 Nicotine, 64, 272, 646 Nifedipine, 127, 128, 138, 212, 264, 291, 646 Nitrates, 83, 646 Nitric acid, 646 Nitrogen, 71, 584, 585, 635, 646, 677 Nitroglycerin, 286, 646 Nitroprusside, 286, 646 Nocturia, 140, 518, 646 Nonlinear Dynamics, 51, 620, 646 Norepinephrine, 21, 31, 47, 64, 84, 232, 280, 582, 611, 615, 647, 663 Nortriptyline, 145, 647 Nuclear, 584, 592, 613, 616, 620, 639, 644, 647, 664 Nuclei, 52, 92, 584, 587, 613, 617, 621, 639, 646, 647, 648, 659, 680 Nucleic acid, 631, 643, 646, 647, 660 Nucleotidases, 628, 647 Nutritional Status, 47, 647 Nutritive Value, 619, 647 Nystagmus, 635, 647 O Observational study, 97, 101, 118, 647
Occult, 647 Occupational Exposure, 87, 647 Octreotide, 84, 647 Ocular, 72, 93, 95, 129, 648, 675 Ocular Hypertension, 95, 129, 648 Odds Ratio, 5, 6, 31, 648, 663 Oliguria, 634, 635, 648 Opacity, 608, 648 Operating Rooms, 305, 457, 648 Opsin, 648, 664 Optic Chiasm, 629, 648 Optic Disk, 605, 609, 648 Optic Nerve, 94, 648, 664 Organ Culture, 648, 675 Organ Transplantation, 567, 648 Organelles, 92, 598, 607, 640, 643, 648, 651, 654 Orlistat, 177, 185, 648 Osmolality, 50, 648 Osmoles, 648, 649 Osmosis, 649 Osmotic, 11, 55, 57, 583, 649 Osteoarthritis, 102, 115, 131, 147, 649 Osteoporosis, 38, 242, 292, 562, 649, 661 Otolith, 93, 141, 649 Outpatient, 78, 179, 451, 649 Ovary, 39, 605, 616, 649 Overweight, 28, 146, 216, 307, 308, 520, 549, 551, 649 Ovulation, 33, 619, 638, 649 Ovum, 605, 622, 649, 657, 658, 682 Oxidation, 588, 606, 626, 637, 649 Oxidative Stress, 69, 133, 187, 229, 230, 599, 649 Oximetry, 358, 445, 649 Oxygen Consumption, 274, 649, 664 Oxygenase, 73, 649 Oxygenation, 48, 55, 57, 73, 89, 147, 184, 626, 649 Oxygenator, 597, 650 P Palate, 650, 679 Palliative, 650, 674 Palsy, 584, 650 Pancreas, 161, 242, 516, 581, 609, 632, 637, 650, 669, 670 Panniculitis, 518, 650 Papilla, 650 Papillary, 650 Paraganglia, Chromaffin, 600, 650 Parathyroid, 243, 274, 650, 674 Parathyroid Glands, 650
Index 695
Parenteral, 615, 650 Paresis, 617, 625, 650 Parotid, 650, 666 Paroxysmal, 586, 624, 650 Particle, 87, 639, 650, 669 Particle Accelerators, 639, 650 Parturition, 650, 658 Passive resistance, 311, 424, 650 Patch, 74, 78, 605, 650, 676 Patch-Clamp Techniques, 78, 650 Pathogenesis, 24, 38, 53, 58, 69, 77, 81, 91, 283, 651 Pathologic, 20, 581, 593, 596, 605, 628, 629, 651, 670, 672 Pathophysiology, 14, 18, 42, 49, 68, 83, 88, 543, 651 Patient Education, 511, 512, 513, 549, 550, 556, 560, 572, 574, 580, 651 Patient Participation, 3, 651 Patient Satisfaction, 651 Peak flow, 26, 651 Pedigree, 54, 86, 651 Pelvic, 25, 179, 651, 659 Peptide, 11, 21, 30, 51, 53, 80, 86, 91, 99, 100, 112, 159, 179, 423, 448, 590, 592, 628, 636, 651, 655, 659 Peptide Hydrolases, 628, 651 Perception, 48, 276, 604, 651, 666 Perforation, 589, 619, 651 Perfusion, 44, 52, 53, 72, 77, 90, 93, 103, 112, 315, 316, 629, 651, 660 Pericardium, 651, 680 Perimenopausal, 113, 651 Perinatal, 77, 170, 631, 651 Perindopril, 131, 147, 205, 651 Peripheral blood, 85, 173, 384, 441, 652 Peripheral Nervous System, 625, 650, 652, 669, 672 Peripheral Nervous System Diseases, 625, 652 Peripheral Vascular Disease, 16, 90, 520, 652 Peritoneal, 109, 151, 513, 516, 517, 590, 609, 633, 652 Peritoneal Cavity, 590, 633, 652 Peritoneal Dialysis, 109, 151, 513, 516, 517, 609, 652 Peritoneum, 641, 652, 665 Periventricular Leukomalacia, 89, 652 Petechiae, 624, 652 PH, 66, 147, 200, 594, 652 Pharmaceutic Aids, 619, 652
Pharmaceutical Preparations, 463, 616, 621, 652 Pharmacist, 78, 161, 652 Pharmacodynamic, 56, 652 Pharmacokinetics, 611, 653 Pharmacologic, 15, 27, 64, 512, 543, 586, 591, 653, 676 Pharmacotherapy, 115, 158, 160, 161, 174, 190, 653 Pharynx, 653, 679 Phenobarbital, 26, 653 Phenotype, 32, 34, 35, 36, 37, 40, 41, 81, 82, 88, 184, 603, 653 Phenylephrine, 83, 534, 653 Phospholipids, 617, 637, 653 Phosphoric Monoester Hydrolases, 628, 653 Phosphorus, 249, 265, 595, 650, 653 Phosphorylated, 601, 653 Phosphorylation, 39, 653 Photocoagulation, 601, 653 Photoplethysmography, 653 Physical Examination, 5, 286, 355, 381, 599, 622, 627, 653 Physical Fitness, 274, 510, 653 Physical Therapy, 191, 653 Pigmentation, 629, 654 Pigments, 592, 597, 654, 664 Pilocarpine, 515, 654 Pilot study, 47, 79, 125, 143, 654 Pitch, 93, 654 Pituitary Gland, 605, 654, 677 Placenta, 616, 654, 657 Plants, 584, 595, 596, 600, 601, 622, 623, 633, 643, 647, 654, 655, 665, 676 Plaque, 20, 37, 590, 654 Plasma cells, 587, 654 Plasma protein, 65, 117, 583, 606, 614, 654 Plasma Volume, 594, 642, 654 Plasmid, 654 Plasticity, 92, 626, 654 Plastids, 648, 654 Platelet Aggregation, 585, 646, 654, 674 Platelets, 274, 646, 654, 655, 667, 674 Platinum, 638, 655 Plethysmograph, 445, 469, 655 Plethysmography, 25, 26, 286, 445, 655 Podiatrist, 556, 655 Poisoning, 54, 239, 621, 632, 640, 644, 655 Policy Making, 623, 655 Polycystic, 12, 13, 123, 517, 655 Polyethylene, 55, 655
696 Blood Pressure
Polymorphic, 82, 180, 281, 655 Polypeptide, 10, 584, 602, 618, 655, 658, 669, 682 Polyunsaturated fat, 100, 233, 655, 674 Polyuria, 140, 655 Pons, 584, 594, 617, 619, 655, 664, 665 Pontine, 24, 655 Porphyria, 103, 655 Porphyrins, 655 Port, 106, 207, 304, 311, 317, 329, 374, 428, 451, 456, 568, 656 Port-a-cath, 656 Portal Pressure, 311, 656 Portal System, 311, 656 Portal Vein, 279, 311, 518, 656 Posterior, 92, 585, 589, 590, 591, 598, 611, 641, 650, 656, 677, 679 Postmenopausal, 18, 28, 81, 105, 113, 121, 144, 146, 157, 230, 649, 656, 661 Postnatal, 61, 656, 670 Postoperative, 163, 656 Postprandial, 147, 154, 181, 194, 656 Postsynaptic, 645, 656, 672, 673 Post-synaptic, 86, 656 Postural, 25, 26, 93, 656 Potentiation, 155, 656 Practice Guidelines, 544, 557, 656 Preclinical, 32, 656 Precursor, 48, 586, 589, 590, 611, 612, 615, 647, 656, 657, 677, 679 Predisposition, 520, 656 Preeclampsia, 9, 19, 46, 68, 77, 243, 543, 548, 656 Pre-Eclampsia, 164, 204, 656 Pregnancy Tests, 622, 657 Prejudice, 70, 657 Preload, 657 Premedication, 198, 657 Premenopausal, 18, 657 Premenstrual, 49, 657 Prenatal, 65, 273, 502, 613, 657 Presbyopia, 417, 418, 419, 421, 657 Pressoreceptors, 592, 657 Presumptive, 657 Presynaptic, 21, 645, 657, 672, 673 Primary endpoint, 62, 84, 657 Primary Prevention, 164, 212, 214, 276, 507, 657 Probe, 52, 86, 273, 455, 457, 641, 657 Problem Solving, 657 Prodrug, 657, 661 Progeny, 37, 657
Progesterone, 33, 657, 658, 671 Projection, 647, 648, 657 Prolactin, 112, 658 Proline, 448, 602, 628, 658 Promoter, 86, 109, 112, 135, 137, 658 Prone, 31, 61, 214, 231, 658 Prophase, 658, 673 Propofol, 198, 658 Proportional, 6, 26, 53, 286, 325, 328, 403, 424, 432, 648, 658 Propranolol, 26, 265, 590, 658, 675 Prospective Studies, 658 Prospective study, 100, 151, 192, 283, 637, 658 Prostaglandin, 50, 60, 80, 81, 586, 658, 674 Prostaglandins A, 658 Prostate, 237, 527, 659 Protease, 448, 659 Protective Agents, 596, 659 Protein C, 423, 583, 584, 589, 592, 618, 637, 659, 678 Protein S, 11, 92, 285, 507, 593, 659, 665 Protein Subunits, 92, 659 Proteinuria, 12, 13, 46, 47, 139, 154, 159, 183, 493, 645, 656, 659 Proteolytic, 584, 602, 618, 659 Protocol, 26, 27, 45, 63, 141, 204, 208, 659 Protons, 584, 628, 634, 650, 659, 661 Proximal, 39, 42, 92, 317, 337, 398, 412, 429, 454, 610, 657, 659 Psychiatric, 5, 20, 60, 183, 640, 659 Psychiatry, 20, 24, 33, 84, 143, 659, 680 Psychic, 636, 659, 667 Psychometric testing, 16, 659 Psychomotor, 67, 645, 659 Psychosomatic, 148, 206, 226, 659 Psychosomatic Medicine, 206, 226, 659 Psychotomimetic, 585, 608, 660 Psychotropic, 660 Public Policy, 541, 660 Publishing, 97, 489, 498, 660 Pulmonary Artery, 593, 660, 680 Pulmonary Edema, 243, 599, 634, 660 Pulmonary hypertension, 563, 567, 660 Pulmonary Valve, 625, 660 Pulmonary Veins, 563, 660 Pulmonary Ventilation, 629, 660, 664 Pulsatile Flow, 358, 660 Pulsation, 319, 337, 349, 415, 441, 660 Pupil, 610, 642, 643, 660 Purines, 660, 667 Purpura, 624, 660
Index 697
Q Quality of Life, 15, 28, 38, 198, 467, 518, 660, 676 R Race, 6, 70, 94, 271, 285, 296, 489, 493, 508, 515, 551, 552, 554, 555, 642, 660 Radial Artery, 309, 321, 322, 356, 369, 441, 444, 464, 473, 660, 677 Radiation, 198, 515, 586, 591, 615, 617, 618, 620, 628, 629, 632, 634, 639, 661, 666, 682 Radiation therapy, 515, 617, 628, 632, 661 Radioactive, 591, 594, 628, 630, 632, 637, 639, 647, 661, 666 Radiography, 586, 604, 622, 661 Radioisotope, 616, 661, 676 Radiolabeled, 661 Radiopharmaceutical, 621, 661 Radiotherapy, 594, 661 Radius, 56, 93, 375, 661 Raloxifene, 105, 661, 667 Ramipril, 56, 132, 265, 661 Randomized clinical trial, 15, 27, 47, 79, 235, 661 Randomized Controlled Trials, 198, 227, 661 Reabsorption, 44, 71, 92, 628, 662 Reactive Oxygen Species, 22, 71, 662 Reagent, 599, 616, 662 Recombinant, 662 Recombination, 21, 37, 88, 621, 622, 662 Rectum, 588, 594, 609, 618, 621, 631, 635, 659, 662 Recurrence, 600, 662 Red blood cells, 517, 616, 649, 662, 666 Reductase, 219, 291, 638, 662, 668 Refer, 1, 542, 595, 602, 637, 638, 645, 646, 662, 680 Reference point, 384, 473, 662 Reference Values, 139, 456, 662 Reflex, 14, 19, 25, 42, 564, 565, 567, 662, 678 Reflux, 240, 662 Refraction, 662, 670 Refractory, 191, 461, 612, 662 Regimen, 10, 45, 271, 512, 612, 653, 662 Regression Analysis, 54, 166, 370, 508, 509, 662 Relapse, 663 Relative risk, 6, 47, 663 Relaxation Techniques, 247, 663 Reliability, 101, 119, 181, 276, 287, 346, 374, 439, 444, 452, 453, 663
Renal Artery, 53, 83, 663 Renal Circulation, 54, 542, 663 Renal cysts, 12, 13, 663 Renal Dialysis, 459, 663 Renal failure, 10, 47, 64, 663 Renin-Angiotensin System, 42, 88, 91, 168, 170, 186, 190, 586, 596, 663 Reperfusion, 76, 663 Reperfusion Injury, 663 Research Support, 663 Reserpine, 210, 535, 663 Resolving, 94, 663 Respiration, 317, 469, 502, 507, 589, 596, 599, 606, 642, 664 Respirator, 664, 680 Respiratory failure, 664, 680 Respiratory Paralysis, 581, 664 Respiratory System, 20, 583, 664 Restoration, 76, 653, 663, 664 Reticular, 24, 664 Reticular Formation, 24, 664 Retina, 605, 609, 636, 648, 664, 665 Retinal, 188, 604, 609, 610, 648, 664 Retinal Ganglion Cells, 648, 664 Retinoids, 664 Retinol, 210, 664 Retinopathy, 185, 244, 520, 609, 664 Retrobulbar, 72, 145, 174, 664 Retroperitoneal, 582, 665, 681 Rheumatic Heart Disease, 556, 665 Rheumatism, 630, 665 Rheumatoid, 29, 111, 131, 515, 602, 665 Rheumatoid arthritis, 29, 111, 131, 515, 602, 665 Rhinitis, 615, 665 Rhombencephalon, 619, 665 Ribose, 582, 665 Ribosome, 665, 676 Rigidity, 446, 633, 654, 665 Risk patient, 518, 665 Rod, 600, 665 Rosiglitazone, 189, 286, 665 Rubber, 286, 367, 374, 454, 581, 665, 671 S Sagittal, 93, 665 Saline, 26, 52, 402, 446, 665 Saliva, 148, 515, 665 Salivary, 515, 609, 665, 682 Salivary glands, 515, 609, 665 Saphenous, 605, 665 Saphenous Vein, 605, 665 Saponins, 665, 671
698 Blood Pressure
Sarcoidosis, 244, 527, 666 Sarcoplasmic Reticulum, 74, 666 Saturated fat, 27, 45, 63, 666 Scans, 152, 153, 285, 666 Schizoid, 666, 682 Schizophrenia, 613, 666, 682 Schizotypal Personality Disorder, 666, 682 Scleroderma, 244, 515, 589, 666 Sclerosis, 162, 194, 472, 589, 602, 632, 666 Scrotum, 666, 679 Sebaceous, 666, 681 Secretion, 11, 21, 50, 82, 565, 600, 605, 627, 632, 635, 642, 643, 647, 666, 667, 679 Secretory, 16, 86, 600, 645, 666, 672, 673 Secretory Vesicles, 600, 666 Sedentary, 18, 28, 61, 463, 520, 525, 666 Segregation, 662, 667 Seizures, 46, 307, 650, 667 Selective estrogen receptor modulator, 18, 661, 667 Self Care, 490, 519, 581, 667 Self-Examination, 373, 667 Semen, 659, 667 Semicircular canal, 632, 667 Seminal vesicles, 667, 679 Senile, 103, 244, 649, 667 Sensibility, 585, 628, 667 Sequela, 667 Sequence Analysis, 667 Sequencing, 347, 667 Serine, 39, 448, 667 Serotonin, 588, 601, 653, 663, 667, 677 Serous, 614, 667 Sex Characteristics, 582, 585, 667, 673 Sexually Transmitted Diseases, 510, 668 Shock, 244, 316, 337, 344, 385, 399, 405, 467, 580, 585, 613, 628, 629, 668, 676 Side effect, 56, 98, 211, 449, 490, 517, 529, 550, 552, 553, 555, 556, 582, 588, 668, 675 Sigmoidal, 44, 668 Signs and Symptoms, 663, 668 Silicon, 299, 352, 668 Silicon Dioxide, 668 Simvastatin, 291, 668 Skeletal, 19, 83, 90, 276, 585, 600, 606, 634, 643, 666, 668 Skeleton, 296, 581, 618, 634, 658, 668 Skin graft, 334, 668 Skull, 606, 633, 668, 673 Sleep apnea, 72, 85, 104, 121, 133, 135, 145, 490, 668 Small intestine, 600, 611, 627, 630, 632, 668
Soaps, 618, 668 Social Class, 524, 668 Social Desirability, 84, 668 Social Environment, 660, 669 Social Support, 70, 669, 671 Sodium, 8, 22, 27, 32, 36, 39, 44, 50, 52, 53, 55, 71, 73, 74, 75, 79, 101, 112, 136, 142, 148, 154, 160, 163, 170, 173, 185, 188, 192, 210, 230, 234, 270, 280, 284, 286, 287, 288, 289, 290, 291, 327, 463, 489, 506, 509, 517, 552, 555, 556, 561, 562, 564, 579, 583, 609, 610, 628, 642, 644, 662, 668, 669 Soft tissue, 464, 594, 668, 669 Solitary Nucleus, 591, 669 Solvent, 592, 616, 623, 648, 649, 669 Soma, 505, 669 Somatic, 88, 508, 582, 627, 640, 652, 669, 679 Somatostatin, 647, 669 Somnipathy, 385, 669 Sound wave, 286, 669 Soybean Oil, 655, 669 Specialist, 176, 517, 568, 610, 669 Specificity, 12, 583, 596, 669 Spectrum, 3, 68, 369, 518, 670 Sperm, 585, 600, 670 Spermatozoa, 667, 670, 679 Spike, 525, 670 Spinal cord, 202, 590, 594, 598, 599, 600, 615, 620, 625, 640, 645, 652, 662, 664, 670, 672 Spinal Cord Diseases, 625, 664, 670 Spinal tap, 638, 670 Spleen, 527, 638, 666, 670 Splenic Vein, 656, 670 Sporadic, 563, 670 Stabilization, 670 Staging, 666, 670 Statistically significant, 15, 670 Steady state, 14, 44, 670 Steatosis, 618, 670 Steel, 600, 670 Stem Cells, 21, 670 Stent, 69, 132, 670 Sterile, 650, 671 Steroid, 83, 527, 606, 627, 665, 668, 671 Steroid therapy, 527, 671 Stillbirth, 520, 671 Stimulant, 585, 595, 608, 627, 634, 641, 671, 679
Index 699
Stimulus, 48, 59, 78, 461, 591, 603, 604, 611, 612, 613, 617, 632, 633, 635, 662, 671, 674 Strand, 671 Stress management, 565, 671 Stroke Volume, 19, 26, 445, 597, 671 Styrene, 665, 671 Subacute, 103, 631, 671 Subarachnoid, 443, 619, 624, 671 Subclinical, 8, 135, 273, 631, 667, 671 Subcutaneous, 270, 441, 518, 582, 612, 650, 671, 681 Subfornical Organ, 31, 671 Subspecies, 669, 671 Substance P, 641, 666, 672 Substrate, 22, 53, 465, 615, 628, 672 Suction, 618, 651, 672 Sudden death, 206, 672 Sulfur, 220, 641, 672 Superoxide, 76, 672 Superoxide Dismutase, 672 Supine, 25, 194, 232, 672 Supplementation, 22, 68, 100, 227, 229, 230, 232, 233, 235, 274, 290, 672 Support group, 562, 564, 565, 672 Suppression, 95, 605, 672 Suppuration, 672, 681 Supraspinal, 42, 60, 672 Supraventricular, 105, 672 Sural Nerve, 42, 672 Sympathetic Nervous System, 31, 32, 85, 147, 565, 567, 586, 591, 600, 672 Sympathomimetic, 272, 585, 608, 611, 615, 634, 647, 672 Symphysis, 659, 672 Synapses, 645, 646, 670, 672 Synapsis, 673 Synaptic, 86, 646, 672, 673 Synaptic Transmission, 646, 673 Synchronism, 305, 340, 386, 388, 396, 398, 399, 441, 466, 673 Syncope, 44, 93, 191, 244, 457, 578, 673 Synergistic, 45, 658, 673 Systemic disease, 10, 515, 673 Systole, 304, 321, 324, 366, 428, 475, 479, 482, 486, 625, 673 Systolic blood pressure, 5, 7, 8, 26, 28, 36, 45, 64, 88, 97, 109, 128, 131, 132, 138, 145, 150, 151, 159, 165, 166, 169, 179, 181, 184, 188, 190, 192, 194, 195, 199, 201, 205, 233, 304, 315, 317, 321, 322, 333, 340, 345, 353, 357, 366, 380, 383,
388, 401, 404, 407, 415, 426, 429, 436, 439, 453, 456, 457, 458, 463, 464, 509, 673 T Tachycardia, 25, 26, 105, 673 Tacrolimus, 137, 673 Tamponade, 311, 673 Tape Recording, 306, 673 Temporal, 11, 60, 104, 199, 341, 624, 639, 673 Terbutaline, 673 Terminalis, 31, 673, 674 Testicular, 667, 673 Testis, 616, 673 Testosterone, 662, 673 Tetany, 650, 674 Therapeutics, 38, 98, 102, 131, 135, 145, 185, 469, 493, 536, 633, 674 Thermal, 33, 610, 646, 674 Thigh, 343, 381, 618, 674 Third Ventricle, 629, 674, 677 Thoracic, 25, 445, 591, 609, 674, 681 Thorax, 581, 638, 674, 679 Threonine, 667, 674 Threshold, 33, 43, 76, 333, 357, 378, 439, 440, 551, 616, 629, 674 Thrombin, 618, 654, 659, 674 Thrombolytic, 76, 131, 674 Thrombolytic Therapy, 131, 674 Thrombomodulin, 659, 674 Thrombosis, 117, 153, 214, 226, 231, 633, 659, 671, 674 Thromboxanes, 589, 612, 674 Thrombus, 605, 631, 634, 643, 654, 674 Thyroid, 144, 505, 629, 633, 650, 674, 677 Thyroid Gland, 629, 650, 674 Thyroid Hormones, 144, 674, 677 Thyroxine, 583, 674 Tibial Nerve, 672, 675 Tidal Volume, 629, 675 Time Management, 671, 675 Timolol, 72, 267, 675 Tinnitus, 555, 675, 680 Tissue Culture, 92, 675 Tolerance, 33, 80, 84, 93, 174, 198, 623, 675 Tomography, 15, 675 Tonic, 21, 24, 59, 90, 597, 675 Tonicity, 626, 675 Tonometer, 299, 352, 392, 468, 675 Tonometry, 440, 675 Tooth Preparation, 581, 675 Topical, 56, 261, 590, 616, 628, 668, 675 Torsion, 66, 631, 675
700 Blood Pressure
Tourniquet, 33, 48, 331, 675 Toxaemia, 656, 675 Toxic, iv, 592, 606, 615, 624, 645, 646, 653, 671, 675, 676 Toxicity, 517, 579, 611, 639, 640, 676 Toxicology, 11, 52, 107, 215, 542, 676 Toxins, 588, 596, 631, 675, 676 Trace element, 619, 668, 676 Tracer, 88, 676 Trachea, 595, 635, 653, 674, 676 Traction, 600, 676 Tractus, 676 Transcendental meditation, 676 Transcutaneous, 232, 676 Transdermal, 146, 676 Transfection, 593, 676 Transfusion, 57, 504, 515, 676 Translating, 3, 375, 676 Translation, 297, 676 Transmitter, 86, 581, 590, 611, 633, 640, 647, 672, 676 Trauma, 97, 517, 567, 644, 676 Trees, 665, 676 Tremor, 640, 675, 676 Triage, 89, 676 Trigeminal, 87, 676 Triglyceride, 7, 148, 629, 677 Trimethaphan, 22, 677 Troglitazone, 64, 677 Tryptophan, 602, 667, 677 Tuber Cinereum, 587, 677 Tuberculosis, 604, 638, 677 Tumor Necrosis Factor, 49, 677 Tumour, 620, 677 Tunica Intima, 613, 677 Tunica Media, 472, 677 Tyrosine, 262, 267, 611, 677 U Ulcer, 243, 677 Ulceration, 556, 677 Ulnar Artery, 464, 677 Ultrafiltration, 146, 327, 626, 677 Ultrasonography, 25, 622, 678 Unconditioned, 678 Unconscious, 586, 630, 678 Unsaturated Fats, 618, 678 Urban Population, 122, 140, 678 Urbanization, 106, 271, 678 Urea, 50, 635, 678 Uremia, 634, 663, 678 Ureters, 635, 663, 678 Urethane, 355, 678
Urethra, 659, 678 Uric, 523, 660, 678 Urinary tract, 678 Urinate, 678, 681 Urogenital, 678 Urogenital Diseases, 678 Urokinase, 76, 678 Urologic Diseases, 510, 518, 678 Urticaria, 585, 678 Uterine Contraction, 336, 425, 678 Uterus, 599, 605, 614, 618, 620, 630, 640, 657, 673, 678, 679 Uvula, 92, 679 V Vaccine, 659, 679 Vacuoles, 648, 679 Vagal, 16, 25, 679 Vagina, 596, 599, 640, 673, 679 Vaginal, 56, 638, 679 Vaginitis, 596, 679 Vagus Nerve, 461, 669, 679 Valine, 586, 679 Valves, 298, 304, 305, 330, 379, 409, 413, 429, 665, 679, 680 Varices, 84, 279, 311, 679 Vas Deferens, 230, 679 Vasoactive, 21, 32, 50, 53, 57, 78, 86, 90, 104, 146, 317, 679 Vasoconstriction, 25, 31, 53, 57, 58, 78, 90, 101, 586, 615, 679 Vasodilatation, 93, 597, 634, 679 Vasodilation, 14, 32, 38, 46, 54, 85, 586, 679 Vasodilator, 46, 49, 56, 77, 78, 85, 588, 594, 611, 627, 628, 646, 679 Vasomotor, 24, 180, 679 VE, 48, 99, 111, 210, 211, 679 Vegetarianism, 509, 679 Vein, 84, 279, 402, 586, 589, 631, 633, 647, 650, 656, 665, 670, 679 Vena, 679 Venous, 25, 26, 64, 163, 311, 349, 355, 429, 589, 593, 599, 646, 656, 659, 679 Venous blood, 349, 355, 429, 593, 599, 679 Venous Pressure, 25, 311, 356, 656, 679 Ventilation, 680 Ventilator, 48, 664, 680 Ventral, 52, 507, 629, 655, 680 Ventricle, 323, 467, 589, 590, 642, 660, 673, 680 Ventricular Dysfunction, 612, 680 Ventricular Function, 161, 680 Ventricular Pressure, 680
Index 701
Venules, 593, 596, 614, 641, 680 Verapamil, 182, 267, 535, 680 Vertebrae, 670, 680 Vestibular, 92, 93, 141, 624, 635, 680 Vestibule, 601, 632, 667, 680 Vestibulocochlear Nerve, 675, 680 Vestibulocochlear Nerve Diseases, 675, 680 Veterinary Medicine, 521, 541, 680 Viral, 240, 245, 474, 622, 680 Virulence, 591, 676, 681 Virus, 240, 515, 592, 598, 615, 621, 622, 654, 680, 681 Viscera, 641, 669, 681 Visceral, 63, 160, 591, 652, 679, 681 Visceral Afferents, 591, 679, 681 Visceral fat, 160, 681 Viscosity, 55, 57, 442, 593, 681 Vitreous Hemorrhage, 609, 681 Vitro, 681 Vivo, 22, 46, 66, 78, 86, 681 Void, 58, 681
Volition, 633, 681 Voltage-gated, 77, 172, 681 Vomica, 249, 681 Vulgaris, 251, 681 W Waist circumference, 200, 681 Wakefulness, 48, 681 Weight Gain, 164, 516, 562, 617, 681 White blood cell, 87, 587, 636, 638, 639, 654, 681 Windpipe, 653, 674, 681 Withdrawal, 25, 42, 83, 100, 681 X Xenograft, 586, 682 Xerostomia, 514, 515, 682 X-ray, 215, 579, 594, 603, 618, 620, 639, 647, 661, 666, 682 Y Yeasts, 596, 620, 653, 682 Z Zygote, 603, 682 Zymogen, 659, 682
702 Blood Pressure
Index 703
704 Blood Pressure
