Engineering Commons^™

Medical Foods For Lowering Homocysteine In Hypertensive Patients, Merrill F. Elias, Craig J. Brown

Maine-Syracuse Longitudinal Papers

In a recent commentary, Elias and Brown review the history of skepticism about the value of homocysteine for preventing hypertension and stroke. They argue that this skepticism is not supported by recent literature. This paper was stimulated by a recent comprehensive review of the literature on this topic by Smith and Refsum. Prior to these papers, a commentary and review by Skeete and DiPette provided evidence for the value of homocysteine-lowering in the treatment of hypertension. Elias and Brown supported this conclusion. Both papers emphasized that more work is needed to clarify the beneficial effects of lowering homocysteine.

Elias and …

New Evidence For Homocysteine Lowering For Management Of Treatment-Resistant Hypertension, Merrill F. Elias, Craig J. Brown

Maine-Syracuse Longitudinal Papers

Treatment-resistant hypertension is a topic of great importance and the subject of editorial comments in the American Journal of Hypertension. Homocysteine is an intermediate compound in the vitamin regulated One Carbon Methylation pathway which affects glutathione, methionine, and nitric oxide metabolism. Elevated homocysteine, triggered by genetic mutations or insufficient body stores of active vitamins B6, B12, folate, riboflavin, indicates oxidative stress and is associated with impaired nitric oxide synthesis causing small vessel vasoconstriction in the central nervous system. High homocysteine (defined later) is also a risk factor for hypertension.

Human Errors In Automated Office Blood Pressure Measurement, Merrill F. Elias, Amanda L. Goodell

Maine-Syracuse Longitudinal Papers

In this review of the literature and commentary, we examine the literature on automated blood pressure (BP) measurements in the office and clinic. Our purpose is to revisit issues as to the pros and cons of automated BP measurement published in Hypertension in June 2020 and to identify areas needing additional research. Despite initial reservations about automated BP, it is here to stay. A number of experts suggest that human error will be reduced when we move from the more complex skills required by aneroid sphygmomanometer measurement to the fewer skills and steps required by automated BP measurement. Our review …

Systolic Orthostatic Hypotension Is Related To Lowered Cognitive Function: Findings From The Maine-Syracuse Longitudinal Study, Rachael V. Torres, Merrill Elias, Georgina E. Crichton, Gregory A. Dore, Adam Davey

Maine-Syracuse Longitudinal Papers

The aim of the present study was to examine the relationship between orthostatic changes in blood pressure (BP) and cognition, with consideration given to cardiovascular risk factors and lifestyle variables. The cross-sectional analysis included 961 community-dwelling participants of the Maine-Syracuse Longitudinal Study, for whom BP clinic measures (five sitting, five recumbent, and five standing) were obtained. Eighteen percent of participants had orthostatic hypotension (fall in systolic BP ≥20 mm Hg or diastolic BP ≥10 mm Hg upon standing) and 6% had orthostatic hypertension (rise in systolic BP ≥20 mm Hg). Orthostatic hypotension and hypertension defined using traditional criteria were unrelated …

High Rates Of Uncontrolled Blood Pressure: Pulse Wave Velocity And Future Opportunities, Merrill Elias, Kevin Sullivan, Gregory A. Dore, Michael A. Robbins

Maine-Syracuse Longitudinal Papers

The recent commentary on high rates of uncontrolled blood pressure (BP) and opportunities for health care providers in this Journal prompted an examination of treated but uncontrolled BP in relation to pulse wave velocity (PWV) in the Maine Syracuse Longitudinal Study (MSLS). Cohen and Townsend noted that a Center for Disease Control analysis2 of National Health and Nutrition Examination Survey (NHANES) data (2003–2010) indicated that the presence of uncontrolled hypertension (≥140 mm Hg systolic and ≥90 mm Hg diastolic) in US adults was 53.5%. They further noted that approximately 45% of these individuals with uncontrolled hypertension were aware of their …

Anxiety And Depression In Young And Middle Aged Hypertensive And Normotensive Subjects, W. Gibson Wood, Merrill F. Elias, Norman R. Schultz, Clyde A. Pentz

Maine-Syracuse Longitudinal Papers

This study examined the effects of essential hypertension on measures of anxiety and depression for two age groups of hypertensive (free from hypertension-related pathology and/or cardiovascular disease) and normotensive subjects. Hypertensive subjects had significantly higher State Anxiety scores and Zung Depression scores than did normotensive subjects. These differences between the blood pressure groups were due largely to the scores of the younger hypertensive subjects. The results of the present study are consistent with previous results from our laboratory that have found that younger hypertensives differed (relative to controls) from middle aged hypertensives on measures, such as, symptoms reported on the …