02348nas a2200277 4500008004100000022001400041245005200055210005100107260001300158300001000171490000700181520163800188653000901826653001901835653003301854653001901887653001301906653001101919653002401930653001201954100001801966700001601984700001702000700001702017856003602034 1993 eng d a0194-911X00aProperties of the random zero sphygmomanometer.0 aProperties of the random zero sphygmomanometer c1993 May a632-70 v213 a

The random zero sphygmomanometer is widely used in studies involving blood pressure measurement because it is believed to eliminate digit preference and reduce measurement error. We performed blood pressure measurements sequentially using random zero and standard sphygmomanometers in random order in 1,356 participants in the Cardiovascular Health Study. Despite adherence to the manufacturer's instructions, we observed a substantially nonuniform distribution of zero levels generated by the random zero sphygmomanometer and a disturbing correlation between the zero level and blood pressures taken with the standard sphygmomanometer. With the random zero device, the pooled estimated slopes for the regression of standard systolic and diastolic pressures on the zero level were -0.71 and -0.17, respectively (both p < 0.0001). The only plausible explanation for this relation between the random zero device and the standard device is that by some unknown mechanism the subject's blood pressure is influencing the zero level. Systolic and diastolic blood pressures measured with the random zero device were, respectively, 1.65 and 1.84 mm Hg lower (both p < 0.0001) than standard blood pressures. Digit preference was detectable in the uncorrected blood pressure and zero level measured with the random zero device but was eliminated after calculation of the corrected blood pressure. For most epidemiological studies, the random zero sphygmomanometer offers no significant advantage over the standard sphygmomanometer. It may still be useful in those epidemiological studies and clinical trials where blinding is important.

10aAged10aBlood Pressure10aBlood Pressure Determination10aCohort Studies10aDiastole10aHumans10aRegression Analysis10aSystole1 aKronmal, R, A1 aRutan, G, H1 aManolio, T A1 aBorhani, N O uhttps://chs-nhlbi.org/node/144702942nas a2200373 4500008004100000022001400041245016600055210006900221260001300290300001000303490000700313520187400320653000902194653002202203653001002225653001902235653001902254653002102273653001102294653001902305653001102324653003402335653000902369653002402378653001802402100001502420700001602435700001802451700001502469700001602484700001502500700001702515856003602532 1994 eng d a0194-911X00aCorrelates of blood pressure in community-dwelling older adults. The Cardiovascular Health Study. Cardiovascular Health Study (CHS) Collaborative Research Group.0 aCorrelates of blood pressure in communitydwelling older adults T c1994 Jan a59-670 v233 a

Although elevated blood pressure is an important predictor of cardiovascular disease and stroke in the elderly, little information exists on the distribution and risk factor correlates of blood pressure in this group. As part of the Cardiovascular Health Study, a population-based cohort study of 5201 men and women aged 65 to 101 years, we investigated correlates of systolic and diastolic blood pressure. Multiple regression analyses were conducted for all participants and a subgroup of 2482 without coronary heart disease and not on antihypertensive therapy (the "healthier" subgroup). In the total group, independent predictors of diastolic blood pressure included heart rate, aortic root dimension, creatinine, hematocrit, alcohol use, and black race (positive associations) and internal carotid artery wall thickness, mitral early/late peak flow velocity, white blood cell count, cigarette smoking, and age (negative associations). Positive predictors of systolic blood pressure included mitral late peak flow velocity, left ventricular mass, common carotid artery wall thickness, serum albumin, factor VII, diabetes, alcohol use, and age; negative predictors were coronary heart disease, uric acid, height, and smoking. In the healthier subgroup, positive predictors of diastolic blood pressure included heart rate, hematocrit, serum albumin, creatinine, and body weight, whereas mitral early/late peak flow velocity, serum potassium, smoking, and age inversely related to diastolic pressure. For the same group, common carotid artery wall thickness, left ventricular mass, serum albumin, factor VII, high-density lipoprotein cholesterol, and age were directly related to systolic blood pressure, whereas serum potassium was inversely related. Both systolic and diastolic pressures varied considerably by geographic site.(ABSTRACT TRUNCATED AT 250 WORDS)

10aAged10aAged, 80 and over10aAging10aBlood Pressure10aCohort Studies10aCoronary Disease10aFemale10aHealth Surveys10aHumans10aHypertrophy, Left Ventricular10aMale10aRegression Analysis10aUnited States1 aTell, G, S1 aRutan, G, H1 aKronmal, R, A1 aBild, D, E1 aPolak, J, F1 aWong, N, D1 aBorhani, N O uhttps://chs-nhlbi.org/node/143702719nas a2200301 4500008004100000022001400041245009800055210006900153260001300222300001200235490000700247520191200254653000902166653002802175653001902203653001502222653001102237653001102248653000902259100001502268700001502283700001802298700001902316700001602335700001602351700001402367856003602381 1997 eng d a0895-706100aThe association of antihypertensive medication with serum creatinine changes in older adults.0 aassociation of antihypertensive medication with serum creatinine c1997 Dec a1368-770 v103 a

Many of the potential effects of antihypertensive therapy, including renal function, have been inadequately investigated in clinical trials in older adults. In an observational study, we examined the association between treatment with various classes of antihypertensive agents and 3-year changes in serum creatinine in 1296 older adults with treated hypertension and without prior renal disease (mean age 72.2 years; 60% female; 30% diabetic; 42% with cardiovascular disease (CVD)) from the Cardiovascular Health Study. Baseline antihypertensive medications included thiazides (HCT), beta-adrenergic blockers, angiotensin converting enzyme inhibitors (ACE-I), calcium channel blockers (CCB), vasodilators (VAS), HCT + BB, HCT + ACE-I, HCT + CCB, HCT + VAS, loop diuretics (LOOP), and other combinations. Unadjusted results indicated that minimal changes in mean serum creatinine occurred over time for all therapies and only a few changes were statistically significant (HCT: +0.02 mg/dL, ACE-I: +0.04, CCB: +0.04; all P < .05; LOOP: +0.06 mg/dL; P < .001). In multivariate analyses with HCT users as the reference group and adjusting for baseline serum creatinine, age, sex, smoking, diabetes mellitus, CVD, height, weight, common carotid intima-media thickness, and use of allopurinol, phenytoin, cimetidine, and nonsteroidal antiinflammatory drugs, all of the relative changes were small and statistically nonsignificant except for HCT + VAS users (+0.07 mg/dL; P < .05). When users of the same therapy at baseline and follow-up were restricted, only LOOP users had significant albeit small changes in serum creatinine (+0.05 mg/dL; P < .05). Although results from clinical trials are needed to confirm these findings, these observational data suggest no major differences between specific antihypertensive therapies in 3-year serum creatinine changes in older adults without prior renal disease.

10aAged10aAntihypertensive Agents10aCohort Studies10aCreatinine10aFemale10aHumans10aMale1 aSmith, N L1 aPsaty, B M1 aHeckbert, S R1 aLemaitre, R, N1 aKates, D, M1 aRutan, G, H1 aBleyer, A uhttps://chs-nhlbi.org/node/1493