Methods: A cross-sectional study was performed of all computerized medical records of hypertensive patients in Health Area 6 of Madrid (Spain). Of 63 167 hypertensive patients, we selected 48 744 with prescription of antihypertensive medication; of these, we selected those who met the American Heart Association criteria for resistant hypertension. Results: A total of 6292 patients had resistant hypertension, representing 9.9% of all hypertensive patients and 12.9% of those treated. A total of 5.5% were smaller than 50 years (8.5% men and 3.2% women) and 24.7% were bigger than 80 years (15.8% men and 31.4% women) (P smaller than .001). In patients smaller than
50 years, resistant hypertension was associated with male sex (odds ratio female/male = 0.006; BI 2536 datasheet 95% confidence interval, 0.000-0.042; P smaller than .001), systolic blood pressure, obesity, stroke, and chronic kidney disease (P smaller than .001). In those bigger than 80 years, resistant hypertension was associated with female sex (odds ratio female/male = 1.27;
95% buy Alvocidib confidence interval, 1.08-1,10; P = .004), systolic blood pressure, diabetes mellitus, obesity, chronic kidney disease, coronary heart disease, and atrial fibrillation (P smaller than .001). More than 50% of patients bigger than 80 years with resistant hypertension had cardiovascular disease. Conclusions: One in 4 patients with resistant hypertension is bigger than 80 years. Resistant hypertension is associated with cardiovascular disease, age smaller than 50 years in men and age bigger than 80 years in women. There is a high www.selleckchem.com/products/ipi-145-ink1197.html proportion of cardiovascular disease in elderly patients with resistant hypertension. (C) 2013 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S. L. All rights reserved.”
“This study was designed to examine the mechanism of heart rate (HR)
responses elicited by the stimulation of hypothalamic paraventricular nucleus (PVN). Experiments were done in urethane-anesthetized, barodenervated, adult, male Wistar rats. Chemical stimulation of the PVN by unilateral microinjections of N-methyl-D-aspartic acid (NMDA) elicited increases in HR which were attenuated by bilateral vagotomy. PVN-induced tachycardia was also attenuated by the blockade of the spinal ionotropic glutamate receptors (iGLURs) which was accomplished by intrathecal injections at T9-T10 or direct application at T1-T4 of iGLUR antagonists. The blockade of spinal iGLURs combined with bilateral vagotomy completely blocked PVN-induced tachycardia. Blockade of GABA receptors in the medial nucleus tractus solitarius (mNTS) also attenuated the PVN-induced tachycardia. Complete blockade of PVN-induced tachycardia was also observed after the blockade of iGLURs in both the spinal cord and mNTS. Combination of the blockade of mNTS GABA receptors and spinal iGLURs also abolished PVN-induced tachycardia. PVN-induced tachycardia was not altered.