Dietary flaxseed is a Manitoban crop rich in the n3 fatty acid alpha-linolenic acid, fibre and antioxidant lignans. Addition of flaxseed to the diet decreased brachial blood pressure in patients with hypertension and peripheral artery disease over one year (n=110). With the addition of flaxseed to standard of care, 21% of patients improved from blood pressure above goal (>140/90 mmHg) to blood pressure within goal (<140/90 mmHg). Dietary flaxseed may have induced these anti-hypertensive effects through the reduction of vascular constriction and inflammation. Healthy older adults, who consumed flaxseed every day for 4 weeks, exhibited significantly decreased concentrations of plasma pro-inflammatory oxylipins such as 5-hydroxyeicosatetraenoic acid and trihydroxyoctadecenoic acid. In patients with hypertension and peripheral artery disease, flaxseed consumption for 1 year significantly decreased plasma oxylipins that are responsible for propagating inflammation and vascular constriction. The oxylipins that decreased in the flaxseed group were all produced by the same enzyme, soluble epoxide hydrolase. Alpha-linolenic acid decreased soluble epoxide hydrolase activity in an activity assay. Thus, flaxseed may exert its anti-hypertensive effects through an inhibition of soluble epoxide hydrolase by alpha-linolenic acid. Flaxseed also induced a significant decrease in central aortic blood pressure without cardiac or arterial elasticity involvement as measured by pulse wave analysis. Some of the same oxylipins that decreased with flaxseed consumption were significantly associated with higher central aortic blood pressure and a higher prevalence of cardiovascular and cerebrovascular events in patients with peripheral artery disease. Every 1 nM increase in plasma 16-hydroxyeicosatetraenoic acid increased the odds of a stroke by 55-fold, thus indicating the potential of particular oxylipins to act as diagnostic markers or therapeutic targets. New research is currently investigating if dietary flaxseed can lower blood pressure and prevent the need for anti-hypertensive medications in those newly diagnosed with hypertension. The implications of this research may change how standard of care is implemented for patients with hypertension and cardiovascular disease. The goal is to offer patients an additional effective strategy beyond anti-hypertensive medications for the management of hypertension in order to reduce the risk of cardiovascular events and to improve patient care and quality of life. / October 2016

M.Sc. (Med.), Faculty of health Sciences, University of the Witwatersrand, 2011 / Background: Hypertension is an important modifiable risk factor for cardiovascular disease, the leading cause of mortality and morbidity globally. Blood pressure can be reduced by vasodilators, such as drugs and the semi-essential amino acid arginine, the precursor of the potent vasodilator nitric oxide. Although arginine supplementation has been used to reduce blood pressure, plasma arginine concentrations have been shown to be increased in hypertension. This study measured the concentrations of urinary and plasma amino acids and described associations between arginine related amino acids and their associations with 24 hour ambulatory blood pressure concentrations in Black South African control subjects and patients with hypertension. Methods: Ninety-seven participants were recruited at the clinics, hospitals and laboratories in Johannesburg area. Twenty four hour ambulatory blood pressure readings were obtained and early morning fasting blood and urine sample were taken with a medical history. Amino acids concentrations were determined using high performance liquid chromatography and mass spectrometry. Results: Plasma and urinary amino acid concentrations were unchanged in patients with elevated blood pressure compared with normotension. Arginine concentrations correlated positively with amino acids using the same transporter, other urea cycle amino acids, the inhibitor asymmetric dimethylarginine , and strongly with its precursor proline (r2>0.9; p<0.0001) even after correcting for amino acid nitrogen (r2>0.7; p<0.0001). Elevated urinary arginine concentrations were found to be an independent determinant of both daytime systolic and diastolic blood pressures, with citrulline excretion determining both 24 hour and daytime diastolic pressures. Lysine also correlated with blood pressure and was found to be an independent predictor of blood pressure in multivariate analysis

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilfment of the requirements for the degree Master of Medicine in Family Medicine 18th April 2017 / INTRODUCTION: Jabulani Dumane Community Health Centre offers comprehensive care to hypertensive patients. Following the establishment of healthcare workers’ responsibilities in hypertension control by a quality improvement project, this study aimed to establish patient-related factors in hypertension control. A hypothesis understudy was done to affirm that the psychosocial characteristics and demographics of patients are among the most important contributors to the control of hypertension. It is believed that the findings of this study will provide healthcare workers with the information they need to counsel their patients. METHOD: This was a cross-sectional descriptive study. Patients were directly interviewed to obtain information about their demographics and psychosocial characteristics. Previous blood pressures were obtained directly from records. All information gathered was described and analysed. Association between each variable and control of hypertension was analysed. Statistical tests used were Chi-square and Fisher’s exact test. RESULTS: Results showed a statistically significant association between the following variables and hypertension control: marital status (p=0.002); adherence to medication (p=0.0060); adherence to physical exercises (p = 0.0029). CONCLUSION: Patient-related factors associated with control of hypertension included marital status, adherence to treatment, and physical exercise. Hypertension control can be enhanced by improving adherence to treatment and healthy lifestyle (physical exercise and diet). / MT2017

Thesis (Ph.D.) - University of Glasgow, 2008. / Ph.D. thesis submitted to the Faculty of Medicine, Division of Cardiovascular and Medical Sciences, University of Glasgow, 2008. Includes bibliographical references. Print version also available.

Thesis (Ph. D.)--Virginia Polytechnic Institute and State University, 1991. / Vita. Abstract. Includes bibliographical references (leaves 77-87). Also available via the Internet.

Thesis (M.S.)--Wisconsin. / Includes bibliographical references (leaves 48-53).

Thesis (Ph. D.)--Westfälische Wilhelms-Universität zu Münster, 1982. / Vita. Includes bibliographical references (p. 244-277).

Thesis (Ph. D.)--University of Wisconsin--Madison, 1981. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 123-132).

Granulestin, added to the basal diet of the rat, was found to be effective in lowering the blood pressure where-an elevation had been obtained by nicotine injections and choline deficiency. No significant decrease in blood pressure could be found in the case of male or female rats treated with estradiol dipropionate. Caffeine and desoxycorticosterone acetate injections were found to result in a slight transient hypertension and the effectiveness of Granulestin feeding could not be tested. / Science, Faculty of / Botany, Department of / Zoology, Department of / Graduate

Eleven rats were made hypertensive by intramuscular injection of desoxycorticosterone acetate. In elevation in blood pressure of over 40 mm. Hg. was maintained for periods of 1.3 to 8.3 months before the animals were sacrificed. Histological sections were prepared of kidneys, adrenals, heart, liver, pancreas and duodenum. Microscopical examination revealed slight degrees of tubular and glomerular degeneration in the kidneys of animals with hypertension of 3 to 8 months duration. No change in the juxtaglomerular apparatus was observed. Vascular disease was almost completely absent from any of the organs studied. It was concluded that an elevation in blood pressure can be maintained for periods up to 8 months without obvious renal or vascular damage Hypertension in this case was probably due to arteriolar spasms causing increased peripheral resistance. It was suggested that appearance of arteriolosclerosis might mark the onset of an irreversible phase of hypertension. / Science, Faculty of / Botany, Department of / Zoology, Department of / Graduate