Blood Pressure Risks and Management in Women
Vahini Pravalika K1*, Baanu Prakash G2
1Department of Pharmacology, Vivekananda College of Pharmacy, Hyderabad, Telangana India
2Department of Medicinal Chemistry, MNR College of Pharmacy, Hyderabad, Telangana India
- *Corresponding Author:
- Vahini Pravalika K
Masters in Pharmacology, Vivekananda College of Pharmacy
Hyderabad-500018, Telangana, India
E-mail: [email protected]
Received date: 25/07/2016; Accepted date: 08/08/2016; Published date: 20/08/2016
Visit for more related articles at Research & Reviews: Journal of Medical and Health Sciences
Circulatory blood pressure exerted is the real hazard component related to all the ailing conditions in the present day in association with the various wellbeing variables in women. As already known Circulatory blood pressure is communicated as the systolic (most extreme) pressure over diastolic (least) pressure and is measured in millimeters of mercury (mm Hg). Treatment and cure of hypertension in women has advanced in recent times with the association of majority of female population in scientific studies and trials. The risk element of Hypertension is comparable in both men and women however, after the onset of menopause; women confront higher dangers than men of growing hypertension. As per the recent reviews woman aged in mid-50’s and 60's are more inclined to diseases associated with circulatory blood pressure. Both high and low blood pressures have an uncommon impact upon the mental and physical capacities of the population. The decision of medications or sort of treatment utilized for the treatment assumes an imperative part in dealing with this silent killer disease.
Circulatory blood pressure, Hypertension, Antihypertensive, Albuminuria, Progestogen.
Antihypertensive Drugs For Women
High blood pressure is determined amongst 1 to 6% of young female population. Amongst the remedy objectives, the decrease in cardiovascular pressure is much less dependent on the absolute degree of blood stress (BP) than on related cardiovascular hazard factors. Continuous hypertension treatment to a targeted organ gradually leads to organ harm and/or concomitant sickness. It is very important for an individual to make lifestyle changes. The brink of BP at which antihypertensive remedy need to be initiated is based on absolute cardiovascular chance. Maximum younger women are at low threat and antihypertensive therapy is not recommended for them. Most of the antihypertensive marketers appear like similarly efficacious; the choice depends on personal preference, social instances and pharmaceutical agents affect the cardiovascular function or any targeted organ leading to concomitant disease. Despite the fact that maximum dealers are appropriate for, and tolerated well when used by young women, another consideration states the complicated cases that of pregnancy, 50% of which are unplanned. A clinician ought to be aware about a female's approach of birth control and the capacity of an antihypertensive agent to motive beginning defects following inadvertent exposure in early pregnancy . Conversely, if an oral contraceptive is powerful and nicely tolerated, however the individual females BP becomes mildly extended, persevering with the contraceptive and starting up antihypertensive remedy becomes complicated. Especially, in case the capability to manage pregnancy is critical. No commonly used antihypertensive is known to be teratogenic, despite the fact that ACE inhibitors and angiotensin receptor antagonists need to be discontinued, and any antihypertensive drugs should be persisted in being pregnant only if anticipated advantages outweigh capability reproductive danger(s). The hypertensive issues of pregnancy complicate to 10% of pregnancies and are a leading motive of maternal and perinatal mortality and morbidity. There may be consensus that extreme maternal high blood pressure (systolic BP> or =170 mm Hg and/or diastolic BP> or =110 mm Hg) have to be handled without delay to keep away from maternal stroke, demise and, possibly, eclampsia. Parenteral hydralazine may be related to a better risk of maternal hypotension, and intravenous labetalol with neonatal bradycardia. There may be no consensus as to whether moderate-to-mild hypertension in being pregnant must be treated: the risks of transient extreme hypertension, antenatal hospitalization, proteinuria at transport and neonatal respiration distress syndrome can be decreased by way of remedy, however intrauterine fetal increase will also be impaired, specifically by means of atenolol. Methyldopa and different beta-blockers had been used maximum extensively. Reporting bias and the uncertainty of outcomes as described warrant cautious interpretation of these findings and prevent treatment hints [2,3].
Oral Contraceptives In Relation To Blood Pressure
Oral contraceptives result in a gentle rise of circulatory strain in most ladies and clear hypertension in around 5%. In combination estrogen and progestogen are both responsible of the circulatory strain impact, yet the component is up 'til now obscure. The danger of cardiovascular entanglements is discovered fundamentally in ladies more than 35 years old and in the individuals who smoke. Arrangements with an estrogen substance of 30g and a progestogen substance of 1 mg or less have all the earmarks of being protected .
Preeclampsia During The Child Bearing Period
Preeclampsia is a circumstance all through the pregnancy period whilst there's a sudden, sharp upward thrust in blood stress, swelling (edema) and albuminuria (excess protein albumin leaks into the urine). Swelling has a tendency to arise inside the face, arms and legs. The occurrence of pre-eclampsia levels is up to 10% for nulliparous and 5% for multiparas. Pre-eclampsia is a first-rate cause of maternal mortality and morbidity, preterm start, perinatal death, and intrauterine increase restriction. Unfortunately, the pathophysiology of this multisystem ailment, characterized through odd vascular reaction to placentation, is still uncertain. In spite of great polymorphism of the disorder, the criteria for pre-eclampsia have no longer modified during the last decade (systolic BP>140 mm Hg or diastolic BP ≥ 90 mm Hg and 24 h proteinuria ≥ 0.3 g). Medical functions and laboratory abnormalities define and decide the severity of pre-eclampsia. Multidisciplinary control, related to an obstetrician, anesthetist, and pediatrician, is completed with consideration of the maternal dangers because of endured pregnancy and the fetal risks related to caused preterm transport. Screening women at excessive chance and preventing recurrences are key troubles within the management of pre-eclampsia .
The 2 important classifications of hypertension (BP) commonly noticed all through the pregnancy are chronic hypertension, indicated via regular blood pressure readings of 130/90 or higher, and Gestational Hypertension, marked through a steady upward push of the blood pressure after the twenty eighth week of gestation. The major risk in both types is to the fetus; blood circulation to the placenta is reduced, and vital oxygen is less available. Gestational hypertension can relate to pre-eclampsia, an intense problem. Various preventative measures can help stop gestational high blood pressure and become a crucial aspect of application of remedy for both form of excessive blood exerted.
Pregnancy Induced Hypertension
Increase in blood pressure during the pregnancy and the constant high blood pressure or irregularities in blood pressure induces Hypertension which is commonly termed as Pregnancy Induced Hypertension (PIH) which leads to abnormality causing striking maternal, fetal and neonatal mortality and morbidity each in developed and developing countries . PIH is observed in kinds of gestational high blood pressure, preeclampsia and eclampsia . Preeclampsia and gestational increased BP are observed in 8-10% of pregnancies around the globe . Increase in cesarean section, untimely placenta abruption, preterm delivery, low beginning weight, stillbirth, acute renal failure and intravascular coagulation had been more regularly located in girls who evolved hypertensive disorders of pregnancy [8,9]. Latest research have indicated higher hazard of PIH among ladies with family records of hypertension, preceding history of pregnancy triggered high blood pressure, pre-interesting diabetes, gestational diabetes mellitus, maternal age ≥ forty, more than one pregnancies, nulliparity and pre being pregnant weight problems [6-11]. Some previous studies have counseled that better pre pregnancy body mass index is related to multiply danger of gestational hypertension and preeclampsia [12-16]. But there are few studies wherein this affiliation had been no longer determined . Additionally, excessive gestational weight advantage has been proposed as a chance thing for hypertensive problems of being pregnant in some research [18-21]. PIH is followed through endothelial disorder, oxidative stress and inflammatory responses . It's been claimed that plasma C-reactive protein attention, which may be concerned in etiology of hypertensive disorder of being pregnant accelerated in obesity. Moreover, a few evidences have indicated that obesity expanded endothelial feature and induced systematic inflammatory responses related to atherosclerosis which can play a position in PIH . but, preceding research are limited by using fallacious classification of gestational weight advantage from time to time by limiting observe populace to 1 BMI class and additionally none of these research compare electricity consumption of subjects along different measurements which defiantly cause more correct determination [20,21]. Although hazard elements for growing gestational high blood pressure might also vary among numerous ethnics corporations  there are few statistics with reference to this trouble in Iranian populace. So the goal of present observational examine became to compare pre pregnancy frame mass index, mid arm circumference, gestational weight benefit and energy consumption of ladies who developed gestational hypertension with the ones of healthful pregnant women.
Menopause And Blood Pressure
In menopause transition many women have vasomotor signs and symptoms which can also have an effect on their regular daily activities. With the decline in estrogen ranges, chances for coronary heart disease (CHD) become more obvious, especially hypertension. The onset of high blood pressure facilitates a ramification of lawsuits which are often attributed to the menopause. Risk factor identity is poorly managed in middle-aged ladies and ought to be step one inside the evaluation and treatment of women with peri-menopausal signs and symptoms. In ladies at low chance for CHD, there's still a window of opportunity for safe hormone prescription in the first years proximal to menopause .
Premenopausal women have lower blood pressure (BP) than men within the same age group, and women have higher degree of increased BP than men as they age. Commonly these findings advise that gender or intercourse hormones have a prominent role in hypertension. Figuring out the position of intercourse hormones in the pathogenesis or development of hypertension is complicated given the results of getting old on the cardiovascular machine and its relationship to other powerful risk elements along with frame weight and cholesterol stage. Longitudinal and go-sectional research report is conflicting consequences concerning the role of menopause in the pathogenesis of high blood pressure. Massive randomized trials of hormone substitute remedy (HRT) have referred to as into question the long assumed protecting effect of estrogen in coronary heart disorder chance. There are fantastic reviews on the effects of gender and sex hormones on vascular tone and pathophysiologic abnormalities related to high blood pressure in animals [24,25]. This review makes a specialty of studies in postmenopausal ladies (PMW), the connection among menopause and high blood pressure, elements contributing to high blood pressure in PMW, and discussion of identity and treatment of hypertension in PMW [25-30].
High blood pressure still is poorly managed in diverse nations which include America. The main remedy of hypertensive therapy being pharmacotherapy, interventions along with lifestyle and dietary amendment often are overlooked. The 7th report of the Joint national Committee on Prevention, Detection, evaluation, and remedy of high Blood strain recommends way of life modification for all sufferers with hypertension (BP of 140/90 mm Hg) or prehypertension (BP of a 120/80 to 139/89 mm Hg), a brand new class developed by using JNC 7 to attract interest to earlier intervention. Even though some way of life modifications may additionally appear to provide best minimal blood strain–decreasing results, they must no longer be discounted. Fall in systolic blood stress of 5 mm Hg has been related in observational research with reductions of 14% in mortality resulting from stroke, 9% in mortality as a result of heart ailment, and 7% in all-reason mortality [31-42]. In addition, a weight loss of 10 lb (4.5 kg), a sensible goal for most individuals who are obese, can reduce or prevent high blood pressure [43-100].
- Pemu PI and Ofili E. Hypertension in women: Part I. J clin Hypertens. 2008;10:406-410.
- Magee LA. Drugs in pregnancy. Antihypertensives. Best Pract Res Clin Obstet Gynaecol. 2001;15:827-845.
- Magee LA, et al. Hydralazine for treatment of severe hypertension in pregnancy: Meta-analysis. BMJ. 2003;327:955-960.
- Fisch IR and Frank J. Oral contraceptives and blood pressure. JAMA. 1977;237:2499-2503.
- Uzan J, et al. Pre-eclampsia: Pathophysiology, diagnosis, and management. Vasc Health Risk Manag. 2011;7:467-474.
- Roberts JM, et al. Nutrient involvement in preeclampsia. J Nutr. 2003;133:1684S-1692S.
- Olafsdottir AS, et al. Relationship between high consumption of marine fatty acids in early pregnancy and hypertensive disorders in pregnancy. BJOG. 2006;113:301-309.
- Aali BSH and Janghorbani M. Epidemiology of preeclampsia in pregnant women referred to Shahid Bahonar Hospital of Kerman in 1994. J Kerman Univ Med Sci. 1997;4:20-25.
- Safari M. Prevalence of preeclampsia and its correlation to maternal and fetal complications in women referred to Emam Sajjad Hospital of Yasuj. Rmaghane-Dannesh. J Yasuj Univ Med Sci. 2002;24:28-34.
- Conde-Agudelo A and Belizán JM. Risk factors for pre-eclampsia in a large cohort of Latin American and Caribbean women. BJOG. 2000;107:75-83.
- Duckitt K and Harrington D. Risk factors for pre-eclampsia at antenatal booking: Systematic review of controlled studies. BMJ 2005;330:565.
- Shamsi U, et al. A multicentre matched case control study of risk factors for Preeclampsia in healthy women in Pakistan. BMC Women’s Health. 2010;10:14.
- Yamamoto S, et al. Waist to hip circumference ratio as a significant predictor of preeclampsia, irrespective of overall adiposity. J Obstet Gynaecol Res. 2001;27:27-31.
- Attahir A, et al. Association between maternal socio-economic status, polygamy and risk of pre-eclampsia in rural areas of northern Nigeria. J Fam and Reprod Health. 2010;4:47-52.
- Vasheghani F and Atarod Z. A comparision between plasma lipids concentration in pre-eclamptic and normotensive women. J Mazandaran Univ Med Sci. 2006;53:92-96.
- Vahidrodsari F, et al. Serum calcium and magnesium in pre-eclamptic and normal pregnancies: A comparative study. Med J Reprod & Infert. 2008;3:256-262.
- Aliyu MH, et al. Joint effect of obesity and teenage pregnancy on the risk of pre-eclampsia: A population-based study. J Adolesc Health. 2010;46:77-82.
- Sattar N, et al. Antenatal waist circumference and hypertension risk. Obstet Gynecol. 2001;97:268-271.
- Bodnar LM, et al. The risk of preeclampsia rises with increasing pre-pregnancy body mass index. Ann Epidemiol. 2005;15:475-482.
- Mbah AK, et al. Super-obesity and risk for early and late pre-eclampsia. BJOG. 2010;117:997-1004.
- Tabandeh A and Kashani E. Effects of maternal body mass index and weight gain during pregnancy on the outcome of delivery. J Gorgan Univ Med Sci. 2007;9:20-24.
- Saftlas A, et al. Pre-pregnancy body mass index and gestational weight gain as risk factors for preeclampsia and transient hypertension. Ann Epidemiol. 2000;10:475.
- Belogolovkin V, et al. Weight gain velocity in relation to the development of gestational hypertension and or preeclampsia. American J Obstet and Gyn. 2006;195:S12.
- Chen Z, et al. Pre-pregnancy body mass index, gestational weight gain, and pregnancy outcomes in China. Int J Gynecol Obstet. 2010;109:41-44.
- Fortner RT, et al. Pre-pregnancy body mass index, gestational weight gain and risk of hypertensive pregnancy among Latina women. Am J Obstet Gynecol. 2009;200:167e1-167e7.
- Vahidroudsari F, et al. The effect of pre-pregnancy body mass index on the development of gestational hypertension and preeclampsia. J Babol Univ Med Sci. 2009;p:11.
- Knuist M, et al. Risk factors for preeclampsia in nulliparous women in distinct ethnic groups: A prospective cohort study. Obstet Gynecol. 1998;92:174-178.
- Maas AHEM and Franke HR. Women’s health in menopause with a focus on hypertension. Netherlands Heart Journal. 2009;17:68-72.
- Coylewright M, et al. Menopause and hypertension: An age-old debate. Hypertension. 2008;51:952–959.
- Martins D, et al. The effect of gender on age-related blood pressure changes and the prevalence of isolated systolic hypertension among older adults: Data from NHANES III. J Gend Specif Med. 2001;4:10-13.
- Do KA, et al. Longitudinal study of risk factors for coronary heart disease across the menopausal transition. Am J Epidemiol. 2000;151:584–593.
- Anderson GL, et al. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: The women’s health initiative randomized controlled trial. JAMA. 2004;291:1701-1712.
- Manson JE, et al. Estrogen plus progestin and the risk of coronary heart disease. N Engl J Med. 2003;349:523-534.
- Orshal JM and Khalil RA. Gender, sex hormones, and vascular tone. Am J Physiol Regul Integr Comp Physiol. 2004;286:R233-R249.
- Reckelhoff JF and Fortepiani LA. Novel mechanisms responsible for postmenopausal hypertension. Hypertension. 2004;43:918-923.
- Chobanian AV, et al. Seventh report of the joint national committee on prevention, detection, evaluation and treatment of high blood pressure. Hypertension 2003;42:1206-1252.
- American Heart Association. Heart disease and stroke statistics-2004 update. Dallas, Tex. 2003.
- Fields LE, et al. The burden of adult hypertension in the United States 1999 to 2000: A rising tide. Hypertension. 2004;44:398-404.
- Hajjar I and Kotchen TA. Trends in prevalence, awareness, treatment and control of hypertension in the United States, 1988-2000. JAMA. 2003;290:199-206.
- Berlowitz DR, et al. Inadequate management of blood pressure in a hypertensive population. N Engl J Med. 1998;339:1957-1963.
- Whelton PK, et al. Primary prevention of hypertension: Clinical and public health advisory from the national high blood pressure education program. JAMA. 2002;288:1882-1888.
- He J, et al. Long-term effects of weight loss and dietary sodium reduction on incidence of hypertension. Hypertension. 2000;35:544-549.
- Silva R and Carvalho IS. In vitro antioxidant activity, phenolic compounds and protective effect against DNA damage provided by leaves, stems and flowers of Portulaca oleracea purslane. Nat Prod Commun. 2014;9:45-50.
- Zhao R, et al. Antitumor activity of Portulaca oleracea L. polysaccharides against cervical carcinoma in vitro and in vivo. Carbohydr Polym. 2013;96:376-383.
- Abdel Moneim AE. The neuroprotective effects of Purslane Portulaca oleracea on rotenone-induced biochemical changes and apoptosis in brain of rat. CNS Neurol Disord Drug Targets. 2013;12:830-841.
- Zhu H, et al. Analysis of flavonoids in Portulaca oleracea L. by UV–Vis spectrophotometry with comparative study on different extraction technologies. Food Anal Method. 2010;3:90-97.
- Xiang L, et al. Alkaloids from Portulaca oleracea L. Phytochemistry. 2005;66:2595-2601.
- El-Sayed MI. Effects of Portulaca oleracea L. seeds in treatment of type-2 diabetes mellitus patients as adjunctive and alternative therapy. J Ethnopharmacol. 2011;137:643-651.
- Liu L, et al. Preparation of Portulaca oleracea L. seed oil by ultrasound-assisted enzyme hydrolysis combined with Soxhlet extraction method and the analysis of its fatty acids. Food Ferment Ind. 2014;40:218-222.
- Fangfang A, et al. Comparison and analysis of fatty acids between oil-tea camellia seed oil and other vegetable oils. China Oils Fats. 2013;38:77-80.
- Liang X, et al. Rapid determination of eight bioactive alkaloids in Portulaca oleracea L. by the optimal microwave extraction combined with positive-negative conversion multiple reaction monitor +/-MRM technology. Talanta. 2014;120:167-172.
- Ghazanfar S. Handbook of Arabian medicinal plants. Crc Press, Boca Raton, Florida, United States 1994.
- Zhang X, et al. Experimental studies on antibiotic functions of Portulaca oleracea L. in vitro. Chin J Microecol. 2002;14:277-280.
- Simopoulos AP and Salem N Jr. Purslane: A terrestrial source of omega-3 fatty acids. N Engl J Med. 1986;315:833.
- Uddin MK, et al. Evaluation of antioxidant properties and mineral composition of Purslane Portulaca oleracea L. at different growth stages. Int J Mol Sci. 2012;13:10257-10267.
- The state administration of quality supervision inspection and quarantine of People’s Republic of china. Food safety national standards. Determination of peroxide value of animal and plant lipid. China standard press, Beijing. 2015.
- Kong H and Zhang J. Study on the scavenging free radical capacity of almond oil and grape seed oil. Gansu SciTechnol. 2008;3:57-58.
- KikalishviliBIu, et al. Fatty acids of grape seed oil and its biological activity as 1.0% and 2.5% food-additive. Georgian Med News. 2012;47-50.
- Kodad O, et al. Variability of oil content and of major fatty acid composition in almond Prunus amygdalus batsch and its relationship with kernel quality. J Agric Food Chem. 2008;56:4096-4101.
- Simopoulos AP. Omega-3 fatty acids and antioxidants in edible wild plants. Biol Res. 2004;37:263-277.
- Uddin MK, et al. Purslane weed Portulaca oleracea: A prospective plant source of nutrition, omega-3 fatty acid and antioxidant attributes. Sci World. J 2014:951-1019.
- Bouabdallah I, et al. Composition of fatty acids, triacylglycerols and polar compounds of different walnut varieties Juglans regia L. from Tunisia. Nat Prod Res. 2014;28:1826-1833.
- Long JJ, et al. Ultrasound-assisted extraction of flaxseed oil using immobilized enzymes. Bioresour Technol. 2011;102:9991-9996.
- De Schutter A, et al. Obesity paradox and the heart: Which indicator of obesity best describes this complex relationship? Curr Opin Clin Nutr Metab Care. 2013;16:517-524.
- James PA, et al. Evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee JNC 8. JAMA. 2014;311:507-520.
- Kent ST, et al. Antihypertensive medication classes used among medicare beneficiaries initiating treatment in 2007-2010. PLoS One. 2014;9:e105888.
- Yancy C, et al. ACCF/AHA guideline for the management of heart failure: Executive summary: A report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013;128:1810-1852.
- Clearfield M, et al. The "New Deadly Quartet" for cardiovascular disease in the 21st century: Obesity, metabolic syndrome, inflammation and climate change: How does statin therapy fit into this equation? Curr Atheroscler Rep. 2014;16:380.
- Dong CX, et al. Characterization of structures and antiviral effects of polysaccharides from Portulaca oleracea L. Chem Pharm Bull Tokyo. 2010;58:507-510.
- Gu J, et al. Comparison on hypoglycemic and antioxidant activities of the fresh and dried Portulaca oleracea L. in insulin-resistant HepG2 cells and streptozotocin-induced C57BL/6J diabetic mice. J Ethnopharmacol. 2014;161:214-223.
- Wanyin W, et al. Ethanol extract of Portulaca oleracea L. protects against hypoxia-induced neuro damage through modulating endogenous erythropoietin expression. J NutrBiochem. 2012;23:385-391.
- Zhang L, et al. Technology of extracting grape seed oil via supercritical fluid. J Chin Cereal Oil Assoc. 2007;22:60-62,65.
- Dunbar BS, et al. Omega 3 and omega 6 fatty acids in human and animal health: An African perspective. Mol Cell Endocrinol. 2014;398:69-77.
- Asif M. Health effects of omega-3,6,9 fatty acids: Perilla frutescens is a good example of plant oils. Orient Pharm Exp Med. 2011;11:51-59.
- Jing S, et al. Study on process optimizing of refining process and antibacterial effect of hurse oil. SciTechnol Food Ind. 2012;33:291-294,298.
- Xiao J, et al. Physicochemical characteristics of ultrasonic extracted polysaccharides from Cordyceps cephalosporium mycelia. Int J BiolMacromol. 2012;51:64-69.
- Ting H, et al. The in vitro and in vivo antioxidant properties of sea buckthorn Hippophae rhamnoides L. seed oil. Food Chem. 2011;125:652-659.
- Miao L, et al. Assessment on antioxidant activity of pomegranate seed oil in vivo. China Oils Fats. 2010;35:37-40.
- Ke H, et al. Comparative of Rancimat method and Schaal oven method for the determination of oxidation stability of peanut oil and peanut butter. Food Ferment Ind. 2011;37:145-148.
- Zhang J, et al. Studies on the active components and antioxidant activities of the extracts of Mimosa pudica Linn. from southern China? Pharmacogn Mag. 2011;7:35-39.
- Zhang LM, et al. Essential oil from Artemisia lavandulaefolia induces apoptosis and necrosis of HeLa cells. Zhong Yao Cai. 2013;36:1988-1992.
- Ito N, et al. Carcinogenicity of butylated hydroxyanisole in F344 rats. J Natl Cancer Inst 1983;70:343-352.
- Vattem DA, et al. Enhancing health benefits of berries through phenolic antioxidant enrichment: Focus on cranberry. Asia Pac J ClinNutr. 2005;14:120-130.
- Hosokawa M, et al. Fucoxanthin induces apoptosis and enhances the anti-proliferative effect of the PPARa ligand, trogitazone, on colon cancer cells. Biochim Biophys Acta. 2004;1675:113-119.
- Kohno H, et al. Pomegranate seed oil rich in conjugated linolenic acid suppresses chemically induced colon carcinogenesis in rats. Cancer Sci. 2004;95:481-486.
- Lip GYSF, et al. Blood pressure and prognosis in patients with incident heart failure: The Diet, Cancer and Health DCH cohort study Clin Res Cardiol. 2015;104:1088-1096.
- Fox CS. cardiovascular disease risk factors, type 2 diabetes mellitus, and the Framingham Heart Study. Trends Cardiovasc Med. 2010;20:90-95.
- Borden WB, et al. Impact of the 2014 expert panel recommendations for management of high blood pressure on contemporary cardiovascular practice: Insights from the NCDR PINNACLE registry. J Am CollCardiol 2014;64:2196-2203.
- Burchfield JS, et al. Pathological ventricular remodeling: Mechanisms: Part 1 of 2. Circulation. 2013;128:388-400.
- Klingbeil AU, et al. A meta-analysis of the effects of treatment on left ventricular mass in essential hypertension. Am J Med. 2003;115:41-46.
- Georgiopoulou VV, et al. Dilemmas of blood pressure management for heart failure prevention. Circ Heart Fail. 2011;4:528-533.
- Dunlay SM, et al. Risk factors for heart failure: A population-based case-control study. Am J Med. 2009;122:1023-1028.
- Shekelle PG, et al. Efficacy of angiotensin-converting enzyme inhibitors and beta-blockers in the management of left ventricular systolic dysfunction according to race, gender and diabetic status: A meta-analysis of major clinical trials. J Am CollCardiol 2003;41:1529-1538.
- Levy D, et al. Long-term trends in the incidence of and survival with heart failure. N Engl J Med. 2002;347:1397-1402.
- Guglin M. Congestion is the driving force behind heart failure. Curr Heart Fail Rep. 2012;9:219-227.
- Mant J et al. Management of chronic heart failure in adults: Synopsis of the National Institute for Health and clinical excellence guideline. Ann Intern Med. 2011;155:252-259.
- Manickavasagam S, et al. Management of hypertension in chronic heart failure. Expert Rev Cardiovasc Ther. 2009;7:423-433.
- Dunlay SM, et al. Risk factors for heart failure: A population-based case-control study. Am J Med 2009;122:1023-1028.
- Assmann G and Schulte H. Diabetes mellitus and hypertension in the elderly: Concomitant hyperlipidemia and coronary heart disease risk. Am J Cardiol. 1989;63:33H-37H.
- Mohamed-Ali V, et al. Production of soluble tumor necrosis factor receptors by human subcutaneous adipose tissue in vivo. Am J Physiol. 1999;277:E971-E975.