2This study was performed to investigate whether intensive antihypertensive treatment with achieved blood pressure (BP) 140/90 mm Hg, as compared with standard treatment with achieved BP 150/90 mm Hg, could further improve cardiovascular outcomes in Chinese hypertensive patients older than 70 years. A total of 724 participants were randomly assigned to intensive or standard antihypertensive treatment. After a mean follow-up of 4 years, the mean achieved BP was 135.7/76.2 mm Hg in the intensive treatment group and 149.7/82.1 mm Hg in the standard treatment group. The visit-to-visit variability in systolic BP and diastolic BP was lower in the intensive group than that in the standard group. Intensive antihypertensive treatment, compared with the standard treatment, decreased total and cardiovascular mortality by 41.7% and 50.3%, respectively, and reduced fatal/nonfatal stroke by 42.0% and heart failure death by 62.7%. Cox regression analysis indicated that the mean systolic BP (P=.020; 95% confidence interval, 1.006-1.069) and the standard deviation of systolic BP (P=.033; 95% confidence interval, 1.006-1.151) were risk factors for cardiovascular endpoint events. Intensive antihypertensive treatment with achieved 136/76 mm Hg was beneficial for Chinese hypertensive patients older than 70 years. Longterm visit-to-visit variability in systolic BP was positively associated with the incidence of cardiovascular events. J Clin Hypertens (Greenwich). 2013;15:420-427. ª2013 Wiley Periodicals, Inc.Hypertension is one of the most common diseases associated with the elderly. It is a significant risk factor for senile congestive heart failure, stroke, coronary heart disease, renal failure, and aortic aneurysm and has become an important public-health challenge worldwide.1 The risks associated with hypertension are greater in older than in younger patients, and antihypertensive treatment is reported to be actually more cost-effective for the elderly.2 The results of the study for the Hypertension in the Very Elderly Trial (HYVET) suggest that antihypertensive treatment with the achieved blood pressure (BP) of 143.5/77.9 mm Hg was beneficial in hypertensive patients older than 80 years, associated with a 30% reduction in the rate of fatal or nonfatal stroke, a 39% reduction in the rate of death from stroke, a 21% reduction in the rate of death from any cause, a 23% reduction in the rate of death from cardiovascular causes, and a 64% reduction in the rate of heart failure, compared with the placebo group with the achieved BP of 158.5/84.0 mm Hg.3 Thus, BP reduction in preventing stroke and other cardiovascular events for elderly hypertensive patients has evoked great focus in the past decade. Although many guidelines for the management of hypertension proposed the goal of systolic BP (SBP) as <150 mm Hg for the elderly, 4,5 it is unclear whether further reduction is still beneficial. In addition, although it has been suggested that BP variability derived from 24-hour ambulatory monitoring may be an independent risk factor for ...

The title compound, (C6H9N2)2[Zn(II)Cl4], consists of two 2-amino-6-methylpyridinium (AMP) cations and one [ZnCl4]2- anion, which are held together by N-H...Cl hydrogen bonds. Bond lengths within the AMP cation indicate that the imine tautomer makes a significant contribution to the structure. The molecules are associated by two different pi-pi interactions between identical antiparallel AMP cations, with face-to-face distances of 3.627 (4) and 3.342 (3) A, to form a one-dimensional chain.

No abstract

Objectives: To investigate current evidence linking ischemic postconditioning (IPC) to cardioprotection in patients receiving primary percutaneous coronary intervention (PCI). Methods: We performed searches of PubMed, Embase, MEDLINE and Cochrane databases from January 1998 to May 2011 for identifying relevant studies comparing IPC with usual care in patients undergoing primary PCI. A meta-analysis of eligible studies was assessed by Review Manager 5.0. Results: Thirteen studies were eligible. Compared to the control, observed outcomes such as peak creatine kinase [weighted mean difference (WMD) –537.48, 95% confidence interval (CI) –779.32 to –295.65 IU/l], peak creatine kinase-myocardial band (WMD –61.11, 95% CI –76.56 to –45.66 U/l), complete ST-segment resolution (risk ratio 1.38, 95% CI 1.07 to 1.77), blush grade during reflow (WMD 0.64, 95% CI 0.49 to 0.78), corrected TIMI frame count, single-photon emission computed tomography determining infarct size, long-term left ventricular ejection fraction and short-term and long-term wall motion score indexes were improved in IPC group, with less occurrence of heart failure during the 3-month to 3.4-year follow-up. Conclusions: Though current evidence indicates that IPC provides potential cardioprotection to patients receiving primary PCI, larger adequately powered studies should be undertaken to confirm its advantages.