Quality control aspects of blood pressure measurements in the multiple risk factor intervention trial

Dischinger, Patricia C.; DuChene, Alain G.

doi:10.1016/0197-2456(86)90164-9

Cited by 60 publications

(21 citation statements)

References 5 publications

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“…These variables included age; educational attainment (number of school years completed); number of years from menopause to brain imaging; use of hormone therapy (0 = never, 1 = former, 2 = current); body mass index (BMI; weight in kg / height in m 2 ); smoking status (0 = nonsmoker, 1 = former smoker, and 2 = current smoker); alcoholic beverage consumption (defined as the number of single-serving alcoholic beverages consumed per week). At the laboratory and MRI sessions, we measured three auscultatory blood pressure levels according to the protocol of the Multiple Risk Factor Intervention Trial (Dischinger et al, 1986). After discarding the first blood pressure measurement to allow for adaptation, the average of the remaining two measures combined across the sessions was taken as an estimate of seated resting blood pressure.…”

Section: Assessment Of Confounding Variablesmentioning

confidence: 99%

Prospective reports of chronic life stress predict decreased grey matter volume in the hippocampus

et al. 2007

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Chronic stress in non-human animals decreases the volume of the hippocampus, a brain region that supports learning and memory and that regulates neuroendocrine activity. In humans with stressrelated psychiatric syndromes characterized by impaired learning and memory and dysregulated neuroendocrine activity, surrogate and retrospective indicators of chronic stress are also associated with decreased hippocampal volume. However, it is unknown whether chronic stress is associated with decreased hippocampal volume in those without a clinical syndrome. We tested whether reports of life stress obtained prospectively over an approximate 20-year period predicted later hippocampal grey matter volume in 48 healthy postmenopausal women. Women completed the Perceived Stress Scale repeatedly from 1985 to 2004; in 2005 and 2006, their hippocampal grey matter volume was quantified by voxel-based morphometry. Higher Perceived Stress Scale scores from 1985 to 2004-an indicator of more chronic life stress-predicted decreased grey matter volume in the right orbitofrontal cortex and right hippocampus. These relationships persisted after accounting for age, total grey matter volume, time since menopause, use of hormone therapy, subclinical depressive symptoms, and other potentially confounding behavioral and age-related cerebrovascular risk factors. The relationship between chronic life stress and regional grey matter volume-particularly in the hippocampus and orbitofrontal cortex-appears to span a continuum that extends to otherwise healthy individuals. Consistent with animal and human clinical evidence, we speculate that chronicstress-related variations in brain morphology are reciprocally and functionally related to adaptive and maladaptive changes in cognition, neuroendocrine activity, and psychiatric vulnerability.Keywords chronic life stress; hippocampus; orbitofrontal cortex; voxel-based morphometry Stressful experiences can be both constructive and destructive to the body and brain. In the short term, acute stressful experiences mobilize adaptive changes in physiology and behavior that help to meet the demands of environmental challenges and protect against threats to internal homeostasis Selye, 1956). Over the long term, however, chronic

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Section: Assessment Of Confounding Variablesmentioning

confidence: 99%

Prospective reports of chronic life stress predict decreased grey matter volume in the hippocampus

et al. 2007

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“…Baseline BP was defined as the average of the second and third readings recorded at the second and third screening visits (18).…”

Section: Screening and Baseline Measurementsmentioning

confidence: 99%

Association of Single Measurements of Dipstick Proteinuria, Estimated Glomerular Filtration Rate, and Hematocrit with 25-Year Incidence of End-Stage Renal Disease in the Multiple Risk Factor Intervention Trial

Ishani¹,

Grandits²,

Grimm³

et al. 2006

Journal of the American Society of Nephrology

251

159

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The incidence of ESRD is increasing rapidly. Limited information exists regarding early markers for the development of ESRD. This study aimed to determine over 25 yr the risk for ESRD associated with proteinuria, estimated GFR (eGFR), and hematocrit in men who did not have identified kidney disease and were randomly assigned into the Multiple Risk Factor Intervention Study (MRFIT). A total of 12,866 men who were at high risk for heart disease were enrolled (1973 to 1975) and followed through 1999. Renal replacement therapy was ascertained by matching identifiers with the United States Renal Data System's data; vital status was from the National Death Index. Men who initiated renal replacement therapy or died as a result of kidney disease were deemed to have developed ESRD. Dipstick urine for proteinuria, eGFR, and hematocrit were related to development of ESRD. T he incidence of ESRD has increased rapidly in the past decade, and the number of people with ESRD is projected to double by the year 2010 (1). Despite this rapid increase, limited information exists regarding early markers for the development of ESRD. Previous groups have studied either individuals with established chronic kidney disease (CKD) or unknown baseline kidney function. Most studies of individuals with established kidney disease have had short durations of follow-up and used surrogate markers for ESRD, such as change in GFR or doubling of serum creatinine in addition to ESRD as end points (2-6). Whether these markers are useful in identifying individuals who are at high risk for developing ESRD over the long term is uncertain. Other studies, including investigations of the cohort of men who were screened for the Multiple Risk Factor Intervention Trial (MRFIT), have followed individuals for a long time (7-13). These studies established BP, diabetes, and black race as major risk factors for ESRD, but they did not include assessment of renal function at baseline. Recognizing the limitations of previous studies, we aimed to determine over 25 yr the risk for ESRD associated with casual dipstick proteinuria, estimated GFR (eGFR), and hematocrit in individuals who did not have identified kidney disease at baseline and were randomly assigned in the MRFIT study. Materials and MethodsMRFIT was a multicenter, randomized trial to study the effect of an intervention program that was designed to lower BP, to decrease serum cholesterol by dietary changes and to achieve smoking cessation in men who were at high risk for cardiovascular disease (CVD). Details concerning the screening have been published (14 -16). Briefly, between

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“…At the laboratory, we obtained a medical history and anthropometric and demographic information. At the laboratory and MRI sessions, we also recorded 3 auscultatory measures of resting blood pressure following the protocol of the Multiple Risk Factor Intervention Trial, 20 with resting blood pressure defined as the average of the final 2 readings combined across the sessions. Body mass index (BMI) was computed as weight (in kilograms)/height (in meters squared).…”

Section: Study Protocol and Covariate Assessmentmentioning

confidence: 99%

Heightened Functional Neural Activation to Psychological Stress Covaries With Exaggerated Blood Pressure Reactivity

et al. 2007

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Abstract-Individuals who show exaggerated blood pressure reactions to psychological stressors are at increased risk for hypertension, atherosclerosis, and stroke. We tested whether individuals who show exaggerated stressor-induced blood pressure reactivity also show heightened stressor-induced neural activation in brain areas involved in controlling the cardiovascular system. In a functional MRI study, 46 postmenopausal women (mean age: 68.04; SD: 1.35 years) performed a standardized Stroop color-word interference task that served as a stressor to increase blood pressure. Across individuals, a larger task-induced rise in blood pressure covaried with heightened and correlated patterns of activation in brain areas implicated previously in stress-related cardiovascular control: the perigenual and posterior cingulate cortex, bilateral prefrontal cortex, anterior insula, and cerebellum. Entered as a set in hierarchical regression analyses, activation values in these brain areas uniquely predicted the magnitude of task-induced changes in systolic (⌬R 2 ϭ0.54; PϽ0.001) and diastolic (⌬R 2 ϭ0.27; PϽ0.05) blood pressure after statistical control for task accuracy and subjective reports of task stress. Heightened stressor-induced activation of cingulate, prefrontal, insular, and cerebellar brain areas may represent a functional neural phenotype that characterizes individuals who are prone to show exaggerated cardiovascular reactivity. Key Words: blood pressure Ⅲ cardiovascular reactivity Ⅲ cerebellum Ⅲ cingulate Ⅲ insula Ⅲ orbitofrontal cortex Ⅲ psychological stress A cute psychological stress raises blood pressure in most individuals. A stress-induced rise in blood pressure results from autonomic-and neuroendocrine-mediated changes in cardiac contractility and peripheral vascular resistance. 1 These stressor-induced physiological changes are thought to provide metabolic support for adaptive behavior (eg, the "fight-or-flight" response). 2 Some individuals, however, have a tendency to show exaggerated rises in blood pressure that exceed the metabolic demands of psychological stressors. 3 Such exaggerated stressor-induced blood pressure reactions predict increased risk for hypertension, 4 stroke, 5 and preclinical atherosclerosis. 6,7 Blood pressure reactions to psychological stress are centrally controlled by brain systems that both cognitively process psychological stressors and coordinate autonomic, neuroendocrine, and cardiovascular activity with adaptive behavior. 8,9 Key among these brain systems are subdivisions of the cingulate, orbitofrontal, and insular cortices. 8 -15 Anatomically, subdivisions of the cingulate, orbitofrontal, and insular cortices can control peripheral physiology by reciprocal neural connections with cell groups in subcortical and brain stem areas that regulate autonomic, neuroendocrine, and cardiovascular activity. 8 -15 To date, however, it has not yet been established whether individuals who show exaggerated stressor-induced blood pressure reactivity also show greater stressor-induced neur...

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Quality control aspects of blood pressure measurements in the multiple risk factor intervention trial

Cited by 60 publications

References 5 publications

Prospective reports of chronic life stress predict decreased grey matter volume in the hippocampus

Prospective reports of chronic life stress predict decreased grey matter volume in the hippocampus

Association of Single Measurements of Dipstick Proteinuria, Estimated Glomerular Filtration Rate, and Hematocrit with 25-Year Incidence of End-Stage Renal Disease in the Multiple Risk Factor Intervention Trial

Heightened Functional Neural Activation to Psychological Stress Covaries With Exaggerated Blood Pressure Reactivity

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