OBJECTIVETo observe the clinical effects of acupuncture method of "Huoxue Sanfeng, Shugan Jianpi" (activating blood and eliminating wind, soothing liver and strengthening spleen) on morning blood pressure in patients with cerebral infraction combined with essential hypertension.

METHODSSixty-eight patients were randomly divided into an observation group and a control group, 34 cases in each one. The patients in the two groups were treated with acupuncture method of "Xingnao Kaiqiao" (consciousness-restoring resuscitation) and oral administration of nifedipine. In addition, patients in the observation group were treated with acupuncture method of "Huoxue Sanfeng, Shugan Jianpi" that met the criteria of standard manipulation, in which bilateral Renying (ST 9), Quchi (LI 11), Hegu (LI 4), Zusanli (ST 36) and Taichong (LR 3) were selected. The treatment was given once a day, five times a week, for totally six weeks. The improvement and control rate of morning blood pressure in the two groups were observed.

RESULTS(1) After treatment, the morning blood pressures were decreased significantly in the two groups (all P < 0.05); after 15 treatments, the reduction of systolic pressure and diastolic pressure in the observation group was superior to that in the control group, but the difference was not significant (both P > 0.05); after 30 treatments, the reduction of systolic pressure and diastolic pressure in the observation group was significantly superior to that in the control group (both P < 0.05). (2) After 30 treatments, the control rate of morning blood pressure in the observation group was significantly higher than that in the control group [82.4% (28/34) vs 58.8% (20/34), P < 0.05].

CONCLUSIONAcupuncture method of "Huoxue Sanfeng, Shugan Jianpi", characterized with standard manipulation criteria, can effectively control morning blood pressure in patients with cerebral infraction combined with essential hypertension.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Blood Pressure ; Cerebral Infarction ; physiopathology ; therapy ; Essential Hypertension ; Female ; Humans ; Hypertension ; physiopathology ; therapy ; Liver ; physiopathology ; Male ; Middle Aged ; Spleen ; physiopathology ; Treatment Outcome

The effects of angiotensin II receptor antagonist losartan on elastic properties of aorta in patients with mild to moderate essential hypertension were assessed. The ascending aortic distensibility in 26 patients (48 +/- 3 years) with mild to moderate essential hypertension before and after 12 weeks of treatment with losartan (50 mg/day) was evaluated by using two-dimensional echocardiography. M-mode measurements of aortic systolic (Ds) and diastolic diameter (Dd) were taken at a level approximately 3 cm above the aortic valve. Simultaneously, cuff brachial artery systolic (SBP) and diastolic (DBP) pressures were measured. Aortic pressure-strain elastic modulus (Ep) was calculated as Dd x (SBP-DBP)/(Ds-Dd) x 1333 and stiffness index beta (beta) was defined as Dd x Ln (SBP/DBP)/(Ds-Dd). Blood pressure significantly decreased from 148 +/- 13/95 +/- 9 mmHg to 138 +/- 12/88 +/- 8 mmHg (systolic blood pressure, P = 0.001; diastolic blood pressure, P = 0.003). There was no significant difference in pulse pressure before and after treatment with losartan (53 +/- 10 mmHg vs 50 +/- 7 mmHg). The distensibility of ascending aorta increased significantly as showed by the significant decrease in pressure-strain elastic modulus from 4.42 +/- 5.79 x 10(6) dynes/cm2 to 1.99 +/- 1.49 x 10(6) dynes/cm2 (P = 0.02) and stiffness index beta from 27.4 +/- 32.9 to 13.3 +/- 9.9 (P = 0.02). Although there was a weak correlation between the percent changes in pressure-strain elastic modulus and stiffness index beta and that in diastolic blood pressure after losartan treatment (r = 0.40, P = 0.04 and r = 0.55, P = 0.004, respectively), no correlation was found between the percent changes in pressure-strain elastic modulus and stiffness index beta and that in systolic blood pressure (r = 0.04, P = 0.8 and r = 0.24, P = 0.2, respectively). Our study demonstrated that angiotensin II receptor antagonist losartan has a beneficial effect on aortic distensibility in patients with mild to moderate essential hypertension and this effect is partly independent of blood pressure reduction.
Aorta/*physiopathology ; Aorta/ultrasonography ; Echocardiography ; Elasticity ; Hypertension/*drug therapy ; Hypertension/*physiopathology ; Hypertension/ultrasonography ; Losartan/*therapeutic use ; Receptors, Angiotensin/*antagonists & inhibitors

OBJECTIVETo study the effects of percutaneous renal artery intervention on renal function and blood pressure in patients with renal artery stenosis.

METHODSEighty-seven patients with severe uni- or bi-lateral renal artery stenosis (luminal diameter narrowing >/= 70%) and clinical hypertension received renal artery stenting between January 2002 and December 2002. The changes in blood pressure and serum creatinine level and creatinine clearance (CCr) 48 hours after intervention and during 6 months of follow-up were assessed.

RESULTSRenal stenting was performed in 98 stenotic arteries of 87 patients, and the procedural success rate was 100%. Serum creatinine level was slightly elevated from (176 +/- 21) micro mol/L to (179 +/- 11) micro mol/L (P = 0.15) 48 hours after the procedure, but significantly decreased to (149 +/- 15) micro mol/L at 6 months (P < 0.001). CCr was also greatly improved [(37 +/- 11) ml/min before versus (51 +/- 8) ml/min at 6 months, P < 0.001]. During follow-up, 61% of the patients experienced a normal renal function. Despite conventional medical treatment, systolic and diastolic blood pressures were also significantly decreased after stenting [(163 +/- 23)/(96 +/- 13) mm Hg before versus (148 +/- 12)/(79 +/- 15) mm Hg at 6 months, all P < 0.001], and hypertension was well controlled in 67% of the patients at 6 months' follow-up.

CONCLUSIONRenal artery stenting has a high success rate and is effective in improving renal function and blood pressure for patients with severe renal artery stenosis.

Aged ; Arteriosclerosis ; physiopathology ; therapy ; Blood Pressure ; Female ; Humans ; Hypertension, Renal ; physiopathology ; therapy ; Kidney ; physiopathology ; Male ; Renal Artery ; Renal Artery Obstruction ; physiopathology ; therapy ; Stents

OBJECTIVETo observe the aging law on anti-hypertensive effect of scrapping therapy on primary hypertension so as to provide the reference evidence for the best treatment frequency of scrapping therapy.

METHODSEighty-nine patients of primary hypertension complied with inclusive criteria were treated with scrapping therapy according to syndrome differentiation. The stimulated sites included the courses of the governor vessel and the bladder meridian on the neck and back region, the line from Quchi (LI 11) to Shousanli (LI 10) and that from Zusanli (ST 36) to Fenglong (ST 40). The strong stimulation for reducing attempt was applied to the case of excessi syndrome, determined by subcutaneous capillary rupture and subcutaneous blood stasis. The mild stimulation for reinforcing attempt was applied to the case of deficiency syndrome, determined by subcutaneous capillary hyperemia and skin flush. Each site was scrapped for 10 times, about 5 cm in width, for 15 min. One scrapping treatment was required. The blood pressure was taken as the observation index separately, named 2:00 pm, 2:30 pm, 3:00 pm, 3:30 pm, 4:00 pm, 5:00 pm, 6:00 pm and 8:00 pm one day before scrapping, the time before scrapping in the afternoon on the day of treatment, the moment (2:00 pm), 2:30 pm, 3:00 pm; 3:30 pm, 4:00 pm, 5:00 pm, 6:00 pm and 8:00 pm after scrapping, in 24 h and 48 h after scrapping.

RESULTS(1) After one scrapping, the blood pressure was reduced to be (137. 51±10. 24)/(81. 06±10. 56) mmHg half a hour after scrapping from (149. 00±10. 19)/(85. 30±10. 96) mmHg (1mmHg~0. 133 kPa) before scrapping (P<0. 01). (2) The differences were significant in blood pressure at each time point after scrapping as compared with that before scrapping (all P<0. 01). (3) Through nonlinear regression analysis, the systolic blood pressure after scrapping was increased up to 140 mmHg in 47. 2 h after scrapping.

CONCLUSIONScrapping therapy achieves the apparent immediate anti-hypertensive effect on primary hypertension. It is suitable to apply scrapping treatment once every other day.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Blood Pressure ; Essential Hypertension ; Female ; Humans ; Hypertension ; physiopathology ; therapy ; Male ; Meridians ; Middle Aged

Antihypertensive Agents ; therapeutic use ; Chronic Disease ; Drug Therapy, Combination ; Humans ; Hypertension ; drug therapy ; Proteinuria ; physiopathology

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

Tadalafil is an oral phosphodiesterase type-5 inhibitor for male erectile dysfunction (ED). It has been proved to improve erectile function, with safety and effectiveness lasting up to 36 h, allowing patients to choose when to have sexual activities. Tadalafil is also efficacious in the treatment of ED associated with such diseases as hypertension, diabetes mellitus, etc. This article reviews the available evidence for the efficacy of tadalafil on ED and related diseases.
Carbolines ; therapeutic use ; Diabetes Mellitus ; drug therapy ; physiopathology ; Erectile Dysfunction ; drug therapy ; physiopathology ; Humans ; Hypertension ; drug therapy ; physiopathology ; Male ; Phosphodiesterase Inhibitors ; therapeutic use ; Tadalafil ; Treatment Outcome

OBJECTIVETo explore safe, effective, simple and easy non-drug treatments for grade 1 essential hypertension.

METHODSAccording to TCM syndrome differentiation, 126 cases of grade 1 essential hypertension were classified into 4 types: liver-fire hyperactivity syndrome, yin-deficiency and yang-hyperactivity syndrome, excessive phlegm-dampness syndrome, yin-yang deficiency syndrome, and then the patients were randomly divided into a photoelectric combined with musical treatment group (group A), an acupuncture group(group B) and a placebo group (group C). The acupoints were selected according to TCM syndrome differentiation in group A and group B, and multi-mode audio frequency pulse photoelectric therapeutic apparatus and acupuncture were used in the two groups respectively, once daily. Taichong (LR 3) and Quchi (LI 11) were selected in liver-fire hyperactivity syndrome, Taixi (KI 3) and Sanyinjiao (SP 6) were selected yi yin-deficiency and yang-hyperactivity syndrome, Zusanli (ST 36) and Fenglong (ST 40) were selected in excessive phlegm-dampness syndrome, while Taixi (KI 3) and Guanyuan (CV 4) were selected yi yirryang deficiency syndrome. The group C was treated with oral administration of starch tablet (25 mg), one tablet each time,three times everyday. Ten days were considered as one course, totally three courses were required in the three groups. The blood pressure and scores of TCM syndromes before and after treatment were compared among the three groups.

RESULTSThe blood pressure decreased significantly after treatment in group A and group B (all P<0.01), and the decrease in systolic blood pressure was more significant in group A (P < 0.05). The total effective rate was 90.5 / (38/42) in group A, which was superior to 71. 4 (30/42, P < 0.05) in group B and 19.1% (18/34, P<0. 01) in group C. The scores of TCM syndromes were both improved in group A and group B, but without significant difference between the two groups (P > 0.05).

CONCLUSIONThe clinical effect of multi-mode audio frequency pulse photoelectric therapeutic apparatus for treatment of grade 1 essential hypertension is reliable. Meanwhile, it has the advantages of a non-invasive and simple operation.

Acupuncture Points ; Adult ; Aged ; Blood Pressure ; Combined Modality Therapy ; Electric Stimulation Therapy ; Essential Hypertension ; Female ; Humans ; Hypertension ; physiopathology ; therapy ; Laser Therapy ; Male ; Middle Aged ; Music Therapy ; Treatment Outcome

AIMTo investigate whether pulmonary vascular remodeling in hypoxic pulmonary hypertensive rats could be prevented by treatment with a selective K(ATP)CO, iptkalim (Ipt).

METHODSRats were fed in hypoxic and normobaric environment (10% +/- 0.5% O2, 8 h/day and 6 day/week) and divided into control group, hypoxia group (hypoxic rat treated with ig NS 5.0 ml x kg(-1) x d(-1)), treated group I (hypoxic rat treated with ig Ipt 0.75 mg x kg(-1) x d(-1)), treated group II (hypoxic rat treated with ig Ipt 1.5 mg x kg(-1) x d(-1)). After 4 wk, the mean pulmonary arterial pressure (mPAP), right ventricle/left ventricle and septum [RV/(LV + S)] were measured, and the small pulmonary arterial morphologic changes were observed with morphometric analysis under microscopes in four groups.

RESULTSThe level of mPAP and RV/(LV+ S) was significantly higher in the hypoxic group than those in control group (P < 0.01). Morphometric analysis revealed that the ratio of vascular medial wall thickness to external diameter (MT%) and the ratio of vascular medial cross-sectional area to total arterial cross-sectional area (MA%) were also significantly increased in the hypoxic group than those in control group (P < 0.01) and the ratio of vessel lumen cross-sectional area to total arterial cross-sectional area (VA%) was significantly lower in the hypoxic group than those in control group (P < 0.01). Ipt 0.75 mg x kg(-1) x d(-1) or 1.5 mg x kg(-1) x d(-1) decreased the level of mPAP(mmHg), RV/(LV+ S), and inhibited the small pulmonary arterial remodeling significantly. Ipt 1.5 mg x kg(-1) x d(-1) reversed all pathological indices.

CONCLUSIONK(ATP)CO iptkalim can be a very promising candidate for the treatment of hypoxic pulmonary hypertension.

Animals ; Hypertension, Pulmonary ; drug therapy ; etiology ; physiopathology ; Hypoxia ; physiopathology ; KATP Channels ; agonists ; Male ; Propylamines ; pharmacology ; Rats ; Rats, Sprague-Dawley

Hypertension is one of the common cardiovascular diseases, and the role of endothelial dysfunction in pathogenesis and development of hypertension was paid more and more attention to increasingly. The laboratory and clinical studies on the improvement of vascular endothelial function by Chinese herbal medicine in hypertensive patients were reviewed in this paper.
Animals ; Antihypertensive Agents ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Endothelium, Vascular ; metabolism ; physiopathology ; Humans ; Hypertension ; drug therapy ; metabolism ; physiopathology