Blood Pressure ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hypertension ; complications ; drug therapy ; physiopathology ; Hypotension, Orthostatic ; complications ; drug therapy ; physiopathology ; Male ; Middle Aged ; Syncope ; complications ; drug therapy ; physiopathology

Adult ; Antihypertensive Agents ; therapeutic use ; Blood Pressure ; drug effects ; Depression ; complications ; drug therapy ; physiopathology ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hypertension ; complications ; drug therapy ; physiopathology ; Male ; Middle Aged ; Phytotherapy ; Powders ; Treatment Outcome

Portal hypertension as a consequence of liver cirrhosis is responsible for serious complications such as variceal bleeding, ascites and hepatic encephalopathy. Successful pharmacological treatment of portal hypertension can prevent the risk of the variceal bleeding, and contribute to reduce the morbidity and mortality in patients with liver cirrhosis. To identify the effect of drugs on portal hypertension, portal pressure was evaluated accurately before and after the drug administration. The hepatic venous pressure gradient has been accepted as the gold-standard method for assessing the severity of portal hypertension and the response to drug treatment. The mean hepatic venous pressure gradient was 15.1+/-5.4 mmHg in Korean cirrhotic patients who had experienced variceal bleeding. Non-selective beta blockers are the treatment of choice for primary and secondary prevention of variceal bleeding. The dose of propranolol should be subsequently adjusted until the resting heart rate had been reduced by 25% or less than 55 beats per minute. It has been reported that the optimal dose of propranolol is variable due to racial differences in cardiovascular receptor sensitivity. In Korean patients with portal hypertension and liver cirrhosis, the mean required dose of propranolol to reach target heart rate was 165 mg (range; 80-280 mg). This review covers mainly the results of the pharmacological therapy of portal hypertension in Korean cirrhotic patients.
Adrenergic beta-Antagonists/administration & dosage ; Hepatic Veins ; Humans ; Hypertension, Portal/diagnosis/*drug therapy/physiopathology ; Korea ; Liver Cirrhosis/complications/physiopathology ; Propranolol/administration & dosage ; Venous Pressure/drug effects

BACKGROUNDThis is a prospective clinical study based on a large sample gathered from multiple centers in China, subordinating to 10th Five-Year Plan of National Science & Technology Progression. We analyzed the high-risk factors inducing hypertensive disorders in pregnancy (HDP) and estimated the potential effect of anti-oxidants administration, including vitamin C (VC), vitamin E (VE) and Salvia Miltiorrhiza L (SML), a Chinese herb medicine, in amelioration of the high-risk factors in pregnancy.

METHODSFrom April 2005 to July 2006, 4814 pregnant women from 24 national wide cooperative hospitals were involved in this prospective research. The participants were randomly divided into two groups: 1607 cases were in anti-oxidants group with administration of vitamins and SML; 3207 cases were in control group without any medicine given. Every participant was under monitoring for the morbidity of HDP and the high-risk factors were investigated in HDP cases in each group.

RESULTS(1) The morbidity of HDP was 3.55% in anti-oxidants group vs. 4.18% in control group. No statistical difference existed between the two groups (P > 0.05). (2) In anti-oxidants group, the HDP morbidities among three subgroups: VC + VE + SML, VC + VE and SML only, were 5.51%, 3.05% and 5% respectively. It showed no statistical difference among three remedies (P > 0.05). (3) The related index of factors affecting HDP showed in intensity sequence as follows: family HDP history > profession > education level > age > body weight. The incidence of HDP in normal population was 3.51%, and the incidence of HDP in high-risk pregnant women (family HDP history, heavy physical labor, low education level (middle school and below), age ≥ 40, body mass index ≥ 24) was 5.84%, which was obviously higher than that in normal population (P < 0.01). In anti-oxidants group, the probability of HDP in women with high-risk factors was 3.81%, which was obviously lower than that in control group with high-risk factors at 7.14% (P < 0.01). (4) In control group, the morbidity of HDP in women with family HDP history (especially with sisters'), heavy physical labor, middle school and below, age ≥ 35 was: 50.00%, 15.22%, 6.33%, 26.28% and 5.75%, respectively, and that in anti-oxidants group was 0, 7.69%, 3.74%, 9.27% and 2.67%, respectively, which was obviously lower than that in control group.

CONCLUSIONSThe high-risk factors prone to induce HDP included: family history of HDP, heavy physical labor, low education level, aging and obesity. No impressive effect of anti-oxidants application was found in preventing HDP in general population but the remedy demonstrated positive effect on preventing HDP in pregnant women with high-risk factors.

Adolescent ; Adult ; Age Factors ; Antioxidants ; therapeutic use ; Body Weight ; Female ; Humans ; Hypertension ; drug therapy ; physiopathology ; Logistic Models ; Pregnancy ; Pregnancy Complications ; drug therapy ; Prospective Studies ; Risk Factors ; Young Adult

BACKGROUNDPatients with hypertension coupled with metabolic syndrome (MetS) are among the high risk population in cardiovascular and cerebrovascular diseases. To reduce the prevalence of cardiovascular and cerebrovascular diseases, it is essential to appropriately control blood pressure together with other cardiovascular risk factors.

OBJECTIVEThe current study was designed to investigate the therapeutic effects on blood pressure, blood pressure variability and other cardiovascular risk factors by giving Yiqi Huaju Formula, a compound traditional Chinese herbal medicine, in addition to routine treatment to hypertensive patients coupled with MetS.

DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONSA total of 43 patients with hypertension coupled with MetS were recruited into this study. The enrolled patients were randomly divided into the Chinese herbal formula group (anti-hypertensive drugs plus Yiqi Huaju Formula, CHF) and the control group (anti-hypertensive drugs plus placebo). The CHF group enrolled 22 patients while the control group received 21 cases. Treatments were given for 12 weeks in both groups.

MAIN OUTCOME MEASURESParameters examined include 24-hour ambulatory blood pressure monitoring, body mass index, waist circumference, waist-to-hip ratio, homeostatic model assessment for insulin resistance (HOMA-IR), fasting glycosylated hemoglobin (HbA1c), fasting plasma glucose, 2-hour postprandial plasma glucose (PPG), fasting plasma insulin, serum lipid, etc.

RESULTSCompared with the control group, the CHF group had significant improvement (P<0.01) in anthropometric parameters, FPG, HOMA-IR, blood pressure amplitude, blood pressure variability and blood pressure load.

CONCLUSIONThis study showed that integrated traditional Chinese and Western medicine treatment can achieve better results in controlling blood pressure as well as other cardiovascular risk factors. The mechanism of controlling of blood pressure may be associated with the improvement of insulin sensitivity due to the Yiqi Huaju intervention. TRIAL REGISTRATION IDENTIFIER: ChiCTR-TRC-11001633.

Adolescent ; Adult ; Aged ; Blood Glucose ; metabolism ; Blood Pressure ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glycated Hemoglobin A ; metabolism ; Humans ; Hypertension ; complications ; drug therapy ; metabolism ; physiopathology ; Lipids ; blood ; Male ; Metabolic Syndrome ; complications ; drug therapy ; metabolism ; physiopathology ; Middle Aged ; Treatment Outcome ; Young Adult

OBJECTIVETo study the mutual influences between intra-abdominal hypertension (IAH) and intestinal dysfunction, and to observe the efficacy of Tongfu Granule (TFG) in treating IAH of patients with multiorgan dysfunction syndrome (MODS).

METHODSAdopting randomized, double-blinded, controlled method, 60 MODS patients hospitalized in authors' ICU wards from August 2007 to January 2008 were equally assigned to two groups: A and B, that is, the TFG group and the placebo group, all were treated by conventional treatment but different in the administration of TFG and placebo, respectively 1 bag, three times per day, for 7 days via oral intake or gastric infusion. On the 1st, 3rd and 7th day or before death, patients were monitored in terms of symptoms (abdominal distention, defecation, borborygmus, abdominal circumference, intra-abdominal pressure, and occult blood in stool), gastrointestinal function score, APACHE II score, and 28-day outcome. The blind outcome was shown up by specified tester by the end of the observation of 60 cases, A is the TFG group, B is the placebo group.

RESULTSAs compared with the placebo group, intestinal peristalsis and borborygmus were increased, the intra-abdominal pressure and circumference were decreased in the TFG group significantly, which could reduce the possibility of gastrointestinal hemorrhage. Moreover, the gastrointestinal function score and APACHE II score were improved and the 28-day mortality was reduced to a certain degree in the TFG group.

CONCLUSIONTFG could promote the recovering of gastrointestinal function and relieve the heightened intra-abdominal pressure in patients with MODS so as to improve patients' prognosis to some extents.

Aged ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Intestines ; physiopathology ; Intra-Abdominal Hypertension ; complications ; physiopathology ; Male ; Middle Aged ; Multiple Organ Failure ; complications ; drug therapy ; physiopathology ; Phytotherapy

OBJECTIVETo observe the effect of Wendan Xiezhuo method (WXM) on carotid arteriosclerosis and vascular endothelial diastolic function in essential hypertension (EH) patients with turbid-phlegm syndrome (TPS).

METHODSForty-three EH patients of medium and low risk with TPS were randomly assigned to two groups, the Wendan Tablet (WT) group (23 cases) and the placebo group (20 cases), they were treated with WT and placebo respectively on the base of amlodipine treatment to control the blood pressure. Carotid intimamedia thickness (IMT), atherosclerotic plaque score of carotid artery, endothelium-dependent dilation (EDD) and flow-mediated vasodilation (FMD) of brachial artery after taking nitroglycerin were detected with ultrasonography before and after 6 months of treatment.

RESULTSAs compared with those in the placebo group, in the WT group after treatment, scores of TPS and carotid plaque were better, area of carotid plaque was lesser and IMT was lower significantly (P<0.05 or P<0.01). There was a negative correlation between brachial artery EDD and carotid IMT in EH patients with TPS (r = - 0.596, P < 0.05). After treatment EDD was improved more significantly in the WT group than that in the placebo group, however, no significant difference was found in non-endothelium-dependent dilation between the two groups.

CONCLUSIONA negative correlation exists between brachial artery EDD and carotid IMT, and the latter could be aggravated by TPS in EH patients. WXM shows favorable effects in improving carotid plaque and EDD.

Aged ; Atherosclerosis ; complications ; pathology ; physiopathology ; Carotid Arteries ; diagnostic imaging ; drug effects ; physiopathology ; Carotid Artery Diseases ; complications ; diagnostic imaging ; pathology ; Drugs, Chinese Herbal ; therapeutic use ; Endothelium, Vascular ; drug effects ; pathology ; physiopathology ; Female ; Humans ; Hypertension ; complications ; drug therapy ; pathology ; Male ; Middle Aged ; Phytotherapy ; Syndrome ; Treatment Outcome ; Ultrasonography

OBJECTIVETo observe the clinical efficacy and safety of sildenafil in the treatment of high altitude heart disease associated with severe pulmonary arterial hypertension (PAH) in children.

METHODSFifty children (aged 2 months to 2 years) with high altitude heart disease associated with severe PAH, who were continuously transferred to the Intensive Care Unit between January 2011 and October 2013, were randomly assigned to observation and control groups. The control group was given conventional treatment, while the observation group received oral sildenafil [1 mg/(kg . d)] three times daily for 7-10 days in addition to the conventional treatment. Before and after treatment, hemodynamics, blood gas, routine blood parameters, and blood biochemical parameters were recorded.

RESULTSAfter treatment, the observation group had a significantly higher decrease in mean pulmonary artery pressure and significantly higher increases in arterial partial pressure of oxygen, cardiac output, cardiac index, and oxygenation index compared with the control group (P<0.05). In the observation group, there were no significant changes in mean arterial pressure, routine blood parameters and blood biochemical parameters (P>0.05), and no obvious adverse reactions were found.

CONCLUSIONSFor children with high altitude heart disease associated with severe PAH, sildenafil can effectively reduce pulmonary artery pressure and improve cardiac function and does not cause adverse reactions. This therapy has good safety according to the preliminary evaluation.

Altitude ; Familial Primary Pulmonary Hypertension ; Female ; Heart Diseases ; drug therapy ; Humans ; Hypertension, Pulmonary ; complications ; physiopathology ; Infant ; Male ; Piperazines ; adverse effects ; therapeutic use ; Purines ; adverse effects ; therapeutic use ; Sildenafil Citrate ; Sulfones ; adverse effects ; therapeutic use ; Vasodilator Agents ; adverse effects ; therapeutic use

OBJECTIVETo explore the circadian blood pressure (BP) profile and its influencing factors in essential hypertensive patients after treatment.

METHODSCross-sectional surveillance was carried out in essential hypertensive subjects after treatment whose clinic blood pressure had been under control as 140/90 mm Hg (1 mm Hg = 0.133 kPa) for at least one month. All patients underwent a twenty-four-hour ambulatory blood pressure monitoring device (spacelabs 90207). The nocturnal fall of blood pressure (BP) was calculated from (daytime mean BP-night-time mean BP)/daytime BP, while 'daytime' values were recorded between 6 h and 22 h and 'night-time' values between 22 h and 6 h. Non-dippers were defined as those whose nocturnal decrease in mean systolic BP and/or mean diastolic BP was < 10% of the daytime BP. Binary logistic regression analysis was used to evaluate the correlation between circadian blood pressure profile and factors as gender, age, height, body mass index (BMI), family history of premature cardiovascular disease, women under age 65 or men under age 55, smoking habits, grade of hypertension, and strategy of antihypertensive drugs.

RESULTS208 treated essential hypertensive patients were enrolled in the study. 79 individuals were dippers and 129 were non-dippers. Data from logistic regression analysis showed that four factors as age, premature family history of cardiovascular disease, overweight or obesity, and strategy of antihypertensive drugs were significantly influencing the circadian blood pressure profile in treated hypertensive patients. The incidence of non-dippers in patients of 70 years of age or older and those between 60 and 69 were 3.3 and 2.3 times of those with less than 60 (P = 0.009 and 0.031, respectively). The prevalence of non-dippers in patients with a premature family history of cardiovascular disease was 3.7 times greater than those in subjects without a premature history of cardiovascular disease (P = 0.029). Similarly, the incidence of non-dippers in patients of overweight (24 /= 28) were 3.0 and 4.8 times of those in subjects of normal weight (P = 0.003 and 0.009, respectively). Compared with patients treated with long-acting calcium channel blockers (CCBs), patients treated with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) alone had less prevalence of nondippers (OR = 0.139, P = 0.010). Patients treated with joint antihypertensive scheme including ACE inhibitors or ARBs(but not including diuretics) had the tendency of lower incidence of abnormal circadian blood pressure rhythm (OR = 0.453, P = 0.118). Patients treated with joint antihypertensive scheme including diuretics (not including ACE inhibitors or ARBs) and with joint antihypertensive strategy including diuretics and ACE inhibitors or ARBs had lower incidence of nondippers (OR = 0.378 and 0.273, respectively; P = 0.030 and 0.011, respectively).

CONCLUSIONSApproximately 2/3 treated essential hypertensive patients had a non-dipper blood pressure profile. Age, premature family history of cardiovascular disease, overweight/obesity, and antihypertensive drugs strategy were correlated with circadian blood pressure profile. Compared with long-acting CCBs, diuretics, ACE inhibitors or ARBs might be helpful in keeping the circadian blood pressure rhythm at normal range.

Adult ; Aged ; Antihypertensive Agents ; therapeutic use ; Blood Pressure ; drug effects ; Blood Pressure Monitoring, Ambulatory ; Circadian Rhythm ; drug effects ; Cross-Sectional Studies ; Female ; Humans ; Hypertension ; drug therapy ; physiopathology ; Logistic Models ; Male ; Middle Aged ; Obesity ; complications ; Risk Factors

Animals ; Colon ; blood supply ; pathology ; Colonic Diseases ; drug therapy ; etiology ; physiopathology ; Hemodynamics ; Hepatic Veins ; pathology ; physiopathology ; Hypertension, Portal ; complications ; physiopathology ; Intestinal Mucosa ; blood supply ; drug effects ; pathology ; Liver Cirrhosis, Experimental ; complications ; Losartan ; administration & dosage ; therapeutic use ; Male ; Microscopy ; Portal Pressure ; drug effects ; Random Allocation ; Rats ; Rats, Wistar