YOU ARE NOW CONNECTED TO THE TOXLINE (1981 FORWARD, NON-ROYALTY) FILE. ==BLOOD PRESSURE - HIGH== 5 AUTHOR Kotchen TA AUTHOR Kotchen JM TITLE Dietary sodium and blood pressure: interactions with other nutrients. SOURCE Am J Clin Nutr; VOL 65, ISS 2 Suppl, 1997, P708S-711S (REF: 61) ABSTRACT This paper reviews the evidence that salt sensitivity of blood pressure is related both to the anion ingested with sodium as well as to other components of the diet. In several experimental models of salt-sensitive hypertension and in humans, blood pressure is not increased by a high sodium intake provided with anions other than chloride. Salt-induced increase of blood pressure depends on the concomitant ingestion of both sodium and chloride. Both epidemiologic and clinical evidence suggest that sodium chloride-induced increases of blood pressure are augmented by diets deficient in potassium or calcium. In experimental animals, a high intake of simple carbohydrates also augments sodium chloride sensitivity of blood pressure. These observations indicate that the effect of dietary sodium on blood pressure is modulated by other components of the diet. 6 AUTHOR Falkner B AUTHOR Michel S TITLE Blood pressure response to sodium in children and adolescents. SOURCE Am J Clin Nutr; VOL 65, ISS 2 Suppl, 1997, P618S-621S (REF: 27) ABSTRACT The predisposition to primary hypertension is composed of genetic factors, and aberrant mechanisms leading to the clinical expression of hypertension may be operational in children and adolescents. Dietary composition may play a role in the expression of hypertension. The effects of diet on blood pressure in the young may be indirect, reflecting the relation of diet with growth and body composition. Alternatively, there may be a direct effect of a specific dietary factor, such as sodium, on mechanisms regulating blood pressure. The average daily sodium intake by children and adolescents exceeds recommended amounts. Despite the high sodium intake among children, there are few data showing that decreasing sodium intake lowers blood pressure. Children who do express blood pressure sensitivity to sodium intake also have related risk factors for cardiovascular disease such as a positive family history or obesity. Prospective data are needed in children with characteristic risk factors to determine whether sodium intake contributes to the pathogenesis of hypertension and whether this course can be modified by alterations in diet. 10 AUTHOR Prichard BN AUTHOR Graham BR TITLE Effective antihypertensive therapy: blood pressure control with moxonidine. SOURCE J Cardiovasc Pharmacol; VOL 27 Suppl 3, 1996, PS38-48 (REF: 40) ABSTRACT Stimulation of the imidazoline I1-receptor represents a new mode of antihypertensive action, inhibiting peripheral alpha-adrenergic tone by a central mechanism. Moxonidine is an imidazoline I1-receptor modulator. Acute hemodynamic studies indicate that moxonidine results in an acute fall of both blood pressure and systemic vascular resistance, whereas heart rate, cardiac output, stroke volume, and pulmonary artery pressures are not affected. The ejection fraction is not significantly affected. Left ventricular end-systolic and -diastolic volumes are reduced. There is regression of left ventricular hypertrophy after 6 months of treatment. Epinephrine, norepinephrine, and renin levels are all reduced, a finding consistent with central inhibition of sympathetic tone. After oral administration Tmax is about 1 h and bioavailability approaches 90%. Moxonidine is mostly excreted unchanged; biotransformation is unimportant. The T1/2 is 2.5 h, prolonged by renal insufficiency. The antihypertensive effect lasts longer than would be expected from the half-life, suggesting possible retention in the CNS. Open studies with moxonidine have revealed decreases on the order of 20-30 mm Hg systolic and 10-20 mm Hg diastolic blood pressure. Most patients are controlled by 0.2-0.4 mg daily. Moxonidine has been compared with representatives from each important class of antihypertensive drugs, with diuretics, clonidine, calcium antagonists, angiotensin-converting enzyme inhibitors, and both alpha- and beta- blocking drugs. Blood pressure control has been similar with moxonidine and these other agents. The overall incidence of side effects was similar, although moxonidine has a lower incidence of side effects than clonidine. Meta-analysis of controlled studies with moxonidine indicates that moxonidine causes similar decreases in blood pressure in both male and female subjects, in those below 50 years, those 50-60 years, and those over 60 years old, regardless of body weight. As with some other drugs, higher systolic blood pressure are associated with larger falls of systolic blood pressure, and the same is true for diastolic blood pressure. 11 AUTHOR Staessen JA AUTHOR Bieniaszewski L AUTHOR Pardaens K AUTHOR Petrov V AUTHOR Thijs L AUTHOR Fagard R TITLE Life style as a blood pressure determinant. SOURCE J R Soc Med; VOL 89, ISS 9, 1996, P484-9 (REF: 89) ABSTRACT In Belgium, an affluent Western European country, participation in sports, alcohol intake, and living in a working class area were identified as the life style factors with the closest associations with the blood pressure level. Obesity was another important blood pressure correlate. Sodium intake, determined from the 24 h urinary output, and smoking were not associated with blood pressure. Controlled intervention studies have proven that weight reduction, endurance training and alcohol abstinence effectively reduce blood pressure. In the light of these intervention studies, the Belgian findings and the published work highlight the potential of preventive strategies aimed at these major life style factors. 17 AUTHOR Khaw KT TITLE Women, hormones and blood pressure. SOURCE Can J Cardiol; VOL 12 Suppl D, 1996, P9D-12D (REF: 16) ABSTRACT Raised blood pressure is an important risk factor for both coronary artery disease and stroke in women. In terms of exogenous sex hormones, use of premenopausal oral contraceptives has been consistently associated with higher blood pressure levels; both estrogenic and progestogenic components have been implicated. In contrast, a randomized trial has shown no effect of post-menopausal hormone use on blood pressure. Observational studies indicate a protective effect of postmenopausal estrogen use on coronary artery disease. This is probably largely mediated through effects on lipoproteins and not blood pressure; data on post-menopausal estrogen use and stroke risk are less consistent. Treatment trials have demonstrated beneficial effects of lowering blood pressure on cardiovascular disease, particularly regarding stroke in women. The women most likely to benefit from individually-based clinical preventive interventions for cardiovascular disease, such as hypertension treatment or estrogen replacement therapy, are women who have high absolute risk of cardiovascular disease, ie, older women with high risk factor levels with a family or existing history of cardiovascular disease. Nevertheless, the large international variation in rates of cardiovascular disease indicate the large potential for prevention and suggest that most women are likely to benefit from lifestyles conducive to cardiovascular health, that is increasing physical activity, not smoking and following diets low in sodium and saturated fat and high in fruits and vegetables. 18 AUTHOR Pisarik P TITLE Blood pressure-lowering effect of adding grapefruit juice to nifedipine and terazosin in a patient with severe renovascular hypertension. SOURCE Arch Fam Med; VOL 5, ISS 7, 1996, P413-6 (REF: 17) ABSTRACT Grapefruit juice had been fortuitously noted to elevate the concentration of felodipine in a pharmacological study of the effect of ethanol on felodipine. This effect was later confirmed not only for felodipine but also for three other dihydropyridine calcium channel blockers. I herein present what I believe to be the first case report describing a marked blood pressure-lowering effect of grapefruit juice in a person receiving an antihypertensive regimen of a dihydropyridine calcium channel blocker (nifedipine) and terazosin.