Atenolol blunts blood pressure increase during dynamic resistance exercise in hypertensives.

AIMS: This study was conducted to determine whether atenolol was able to decrease BP level and mitigate BP increase during dynamic resistance exercise performed at three different intensities in hypertensives. METHODS: Ten essential hypertensives (systolic/diastolic BP between 140/90 and 160/105mmHg) were blindly studied after 6 weeks of placebo and atenolol. In each phase, volunteers executed, in a random order, three protocols of knee-extension exercises to fatigue: (i) one set at 100% of 1RM; (ii) three sets at 80% of 1RM; and (iii) three sets at 40% of 1RM. Intra-arterial radial blood pressure was measured throughout the protocols. RESULTS: Atenolol decreased systolic BP maximum values achieved during the three exercise protocols (100% = 186 ± 4 vs. 215 ± 7, 80% = 224 ± 7 vs. 247 ± 9 and 40% = 223 ± 7 vs. 252 ± 16mmHg, P < 0.05). Atenolol also mitigated an increase in systolic BP in the first set of exercises (100% =+38 ± 5 vs.+54 ± 9; 80% =+68 ± 11 vs. +84 ± 13 and 40% =+69 ± 7 vs.+84 ± 14, mmHg, P < 0.05). Atenolol decreased diastolic BP values and mitigated its increase during exercise performed at 100% of 1RM (126 ± 6 vs. 145 ± 6 and +41 ± 6 vs.+52 ± 6, mmHg, P < 0.05), but not at the other exercise intensities. CONCLUSIONS: Atenolol was effective in both reducing systolic BP maximum values and mitigating BP increase during resistance exercise performed at different intensities in hypertensive subjects.

Sympathetic nerve activity is decreased during device-guided slow breathing.

It is known that slow breathing (<10 breaths min(-1)) reduces blood pressure (BP), but the mechanisms involved in this phenomenon are not completely clear. The aim of this study was to evaluate the acute responses of the muscle sympathetic nerve activity, BP and heart rate (HR), using device-guided slow breathing (breathe with interactive music (BIM)) or calm music. In all, 27 treated mild hypertensives were enrolled. Muscle sympathetic nerve activity, BP and HR were measured for 5 min before the use of the device (n=14) or while subjects listened to calm music (n=13), it was measured again for 15 min while in use and finally, 5 min after the interventions. BIM device reduced respiratory rate from 16+/-3 beats per minute (b.p.m) to 5.5+/-1.8 b.p.m (P<0.05), calm music did not affect this variable. Both interventions reduced systolic (-6 and -4 mm Hg for both) and diastolic BPs (-4 mm Hg and -3 mm Hg, respectively) and did not affect the HR (-1 and -2 b.p.m respectively). Only the BIM device reduced the sympathetic nerve activity of the sample (-8 bursts min(-1)). In conclusion, both device-guided slow breathing and listening to calm music have decreased BP but only the device-guided slow breathing was able to reduce the peripheral sympathetic nerve activity.

[Evaluation of hypertensive retinopathy through the oscillatory potentials of the electroretinogram]. / Avaliação da retinopatia hipertensiva através do potencial oscilatório do eletrorretinograma.

PURPOSE: To evaluate the behavior of the scotopic Oscillatory Potentials (OP) of total field electroretinogram (ERG) in hypertensive retinopathy. METHODS: Forty-four patients (n=44) were submitted to clinical evaluation and subdivided in to 2 groups: hypertensives (HT) and normotensives (NT). The hypertensives patients were maintained under placebo during the period of the study. Soon afterwards, they were submitted to ophthalmological evaluation and accomplishment of ERG. Total field electroretinogram (ERG), with recording of the answers: scotopic, maximum scotopic, OP scotopic, photopic and flicker.For analysis of the OP answer the latency of the first 2 peaks and the average value of the width of the first 3 peaks of the compound of 3 consecutive answers, denominated Oscillatory Index (OI) were considered. RESULTS: The sample was composed of 44 patients, with a mean age of 51.55 +/- 7.2 range (34 to 68) years, 24 being females. Arterial hypertension affected 26 (59.1%) of the patients, while 18 (40.9%) were normotensives. The average of the obtained IO was 257.41 microv in the NT group and of 217.81 microv in HT (p=0.006). The averages of latencies obtained for peaks 1 (NT-18.42 and HT-17.91) and 2 (NT-24.54 and HT - 24.29) were not different between the groups (p>0.05). CONCLUSIONS: The hypertensive patients presented significantly smaller oscillatory index than the normotensives, suggesting that arterial hypertension might cause dysfunction of the internal retina.

Avaliação da retinopatia hipertensiva através do potencial oscilatório do eletrorretinograma / Evaluation of hypertensive retinopathy through the oscillatory potentials of the electroretinogram

OBJETIVO: Avaliar o comportamento do potencial oscilatório escotópico do eletrorretinograma de campo total (ERG) na retinopatia hipertensiva. MÉTODOS: Quarenta e quatro pacientes foram submetidos à avaliação clínica e subdivididos em dois grupos: 26 hipertensos (HT) com média de idade de 52,23 ± 5,79 anos divididos em 10 homens (38,46 por cento) e 16 mulheres (61,54 por cento) e 18 normotensos (NT) com média de idade de 51,79 ± 10,23 anos divididos em 5 homens (27,78 por cento) e 13 mulheres (72,22 por cento). Foram incluídos no estudo apenas hipertensos leves a moderados (estágio 1 e 2 respectivamente) sem lesões em outro órgão-alvo.Os pacientes hipertensos foram mantidos sob placebo durante o período do estudo. Em seguida, foram submetidos à avaliação oftalmológica e realização do ERG. O eletrorretinograma de campo total (ERG), com registro das respostas: escotópica, escotópica máxima, PO escotópico, fotópica e "flicker". Para análise da resposta do PO foi considerada a latência dos dois primeiros picos e o valor médio da amplitude dos três picos do complexo de três respostas consecutivas, denominado índice oscilatório (IO). RESULTADOS: A hipertensão arterial acometia 26 (59,1 por cento) dos pacientes, ao passo que 18 (40,9 por cento) eram normotensos. A média do IO obtido foi de 257,41µV no grupo de NT e de 217,81 µV no HT (p=0,006). As médias de latências obtidas para os picos 1 (NT-18,42 ms e HT-17,91 ms) e 2 (NT-24,54 ms e HT- 24,29 ms) não foram diferentes entre os grupos (p>0,05). CONCLUSÃO: Os hipertensos apresentam índice oscilatório significativamente menor que os normotensos, sugerindo que a hipertensão arterial pode ocasionar disfunção da retina interna.

PURPOSE: To evaluate the behavior of the scotopic Oscillatory Potentials (OP) of total field electroretinogram (ERG) in hypertensive retinopathy. METHODS: Forty-four patients (n=44) were submitted to clinical evaluation and subdivided in to 2 groups: hypertensives (HT) and normotensives (NT). The hypertensives patients were maintained under placebo during the period of the study. Soon afterwards, they were submitted to ophthalmological evaluation and accomplishment of ERG. Total field electroretinogram (ERG), with recording of the answers: scotopic, maximum scotopic, OP scotopic, photopic and flicker.For analysis of the OP answer the latency of the first 2 peaks and the average value of the width of the first 3 peaks of the compound of 3 consecutive answers, denominated Oscillatory Index (OI) were considered. RESULTS: The sample was composed of 44 patients, with a mean age of 51.55 ± 7.2 range (34 to 68) years, 24 being females. Arterial hypertension affected 26 (59.1 percent) of the patients, while 18 (40.9 percent) were normotensives. The average of the obtained IO was 257.41 µv in the NT group and of 217.81 µv in HT (p=0.006). The averages of latencies obtained for peaks 1 (NT-18.42 and HT-17.91) and 2 (NT-24.54 and HT - 24.29) were not different between the groups (p>0.05). CONCLUSIONS: The hypertensive patients presented significantly smaller oscillatory index than the normotensives, suggesting that arterial hypertension might cause dysfunction of the internal retina.

Amlodipine 2.5 mg once daily in older hypertensives: a Brazilian multi-centre study.

OBJECTIVES: The use of low-dose amlodipine has not yet been well established in the elderly. This study therefore aimed to evaluate the efficacy and tolerability of low-dose amlodipine in elderly patients with Joint National Committee VI stage I or II hypertension. PATIENTS AND METHODS: Sixty-five hypertensive individuals (aged 66.3 +/- 5.3 years) received amlodipine 2.5 mg per day for 12 weeks before and after two periods of 4 weeks of placebo. At weeks 0, 12 and 16, patients were submitted to office, 24 h ambulatory blood pressure monitoring and home blood pressure measurement. RESULTS: Office systolic and diastolic blood pressure showed decreases at weeks 8 (153 +/- 17, 90 +/- 9 mmHg) and 12 (152 +/- 16, 90 +/- 9 mmHg) compared with weeks 0 (164 +/- 16, 99 +/- 6 mmHg) and 16 (162 +/- 19, 95 +/- 9 mmHg). During ambulatory monitoring, a decrease was observed in the average 24 h systolic and diastolic pressure at week 12 (143 +/- 13, 86 +/- 7 mmHg) compared with weeks 0 (155 +/- 15, 93 +/- 6 mmHg) and 16 (152 +/- 16, 92 +/- 8 mmHg). A daytime and night-time reduction in systolic and diastolic pressure was observed on home blood pressure monitoring at week 12 (146 +/- 16/88 +/- 8, 144 +/- 16/93 +/- 8 mmHg) compared with weeks 0 (159 +/- 17/94 +/- 8, 161 +/- 19/93 +/- 8 mmHg) and 16 (153 +/- 16/93 +/- 8, 154 +/- 17/92 +/- 8 mmHg). Adverse reactions were infrequent. CONCLUSIONS: Amlodipine at a dose of 2.5 mg per day showed efficacy and good tolerability in elderly hypertensives.

Avaliação do aparelho automático oscilométrico de medida de pressão arterial DIXTAL DX-2710 pelos protocolos de validação da British Hypertension Society (BHS) e Association for de Advancement of Medical Instrumentation (AAMI) / Assessment of the DIXTAL DX-2710 automated oscillometric device for blood pressure measurement with the validation protocols of the British Hypertension Society (BHS) and the Association for the Advancement of Medical Instrumentation (AAMI)

OBJECTIVE: To assess the Dixtal DX2710 automated oscillometric device used for blood pressure measurement according to the protocols of the BHS and the AAMI. METHODS: Three blood pressure measurements were taken in 94 patients (53 females 15 to 80 years). The measurements were taken randomly by 2 observers trained to measure blood pressure with a mercury column device connected with an automated device. The device was classified according to the protocols of the BHS and AAMI. RESULT: The mean of blood pressure levels obtained by the observers was 148±38/93±25 mmHg and that obtained with the device was 148±37/89±26 mmHg. Considering the differences between the measurements obtained by the observer and those obtained with the automated device according to the criteria of the BHS, the following classification was adopted: "A" for systolic pressure (69 percent of the differences < 5; 90 percent < 10; and 97 percent < 15 mmHg); and "B" for diastolic pressure (63 percent of the differences < 5; 83 percent < 10; and 93 percent < 15 mmHg). The mean and standard deviation of the differences were 0±6.27 mmHg for systolic pressure and 3.82±6.21 mmHg for diastolic pressure. CONCLUSION: The Dixtal DX2710 device was approved according to the international recommendations

Assessment of the DIXTAL DX-2710 automated oscillometric device for blood pressure measurement with the validation protocols of the British Hypertension Society (BHS) and the Association for the Advancement of Medical Instrumentation (AAMI).

OBJECTIVE: To assess the Dixtal DX2710 automated oscillometric device used for blood pressure measurement according to the protocols of the BHS and the AAMI. METHODS: Three blood pressure measurements were taken in 94 patients (53 females 15 to 80 years). The measurements were taken randomly by 2 observers trained to measure blood pressure with a mercury column device connected with an automated device. The device was classified according to the protocols of the BHS and AAMI. RESULT: The mean of blood pressure levels obtained by the observers was 148+/-38/93+/-25 mmHg and that obtained with the device was 148+/-37/89+/-26 mmHg. Considering the differences between the measurements obtained by the observer and those obtained with the automated device according to the criteria of the BHS, the following classification was adopted: "A" for systolic pressure (69% of the differences < 5; 90% < 10; and 97% < 15 mmHg); and "B" for diastolic pressure (63% of the differences < 5; 83% < 10; and 93% < 15 mmHg). The mean and standard deviation of the differences were 0+/-6.27 mmHg for systolic pressure and 3.82+/-6.21 mmHg for diastolic pressure. CONCLUSION: The Dixtal DX2710 device was approved according to the international recommendations.