Hypertension and cognitive function

Previous research indicates that blood pressure may impact a variety of cognitive functions, including short-term memory, abstract reasoning, visual-spatial abilities, and attention (Boller, Vrtunski, Mack, & Kim, 1977; Elias, Robbins, Schultz, & Pierce, 1990; Franceschi, Tancredi, Smirne, Mercinelli, & Canal, 1982; Mazzucchiet al., 1986). However, studies which have assessed the cognitive functioning of hypertensive adults have offered conflicting results, particularly when hypertension levels were in the mild range (e.g., Bolleret al., 1977; Eliaset al., 1990; Elias, Wolf, D'Agostino, Cobb, & White, 1993; Farmeret al., 1987, 1990; Franceschiet al., 1982; Pérez-Stable, Coates, Halliday, Gardiner, & Hauck, 1992; Schmidtet al., 1991; Waldstein, Ryan, Manuck, Parkinson, & Bromet, 1991). A number of factors may contribute to the inconsistent findings in this area. Researchers have employed a wide range of neuropsychological instruments to assess varying domains of cognitive function. Sample sizes in some studies have been too small to ensure sufficient power. Finally, studies have employed varying methodological control over potential confounding factors such as concurrent medical conditions, alcohol abuse, psychiatric disorders, or antihypertensive medication. This study compared male veterans with blood pressures in the mildly hypertensive range (n=166) to normotensive veterans (n=176) on neuropsychological measures of verbal fluency, visual-spatial ability, verbal and visual memory, dexterity, attention, and executive functions. Results revealed that, after controlling for differences in education and income, there was no relationship between mild hypertension and combined measures of cognitive performance. The present findings suggest that mild hypertension alone has little effect on cognitive function in adults.     

难治性高血压的干预

首先通过改变生活方式进行干预,药物治疗首先要排除精神压力引起的血压过度反应,干预难治性高血压通过联合用药与改变用药的时间。     

从高血压的新定义分析难治性高血压

ASH公布了高血压新的定义,其中高血压的过度反应需与真性难治性高血压鉴别,从三个层面分析难治性高血压。     

Cognitive antecedents to adolescent health risk: Discriminating between behavioral intention and behavioral willingness

Abstract

A model of adolescent health risk behavior that is both cognitive and social-psychological in orientation is described, and an aspect of the model is tested empirically. The model suggests that health risk behaviors (e.g., smoking or drunk driving), especially among adolescents, are not always intended or premeditated, but instead are often reactions to risk-conducive circumstances. Because they are not entirely premeditated, such behaviors are not accurately predicted by “traditional” behavioral intention measures, but are predicted by a central construct in the model labeled behavioral willingness. Results of two studies indicate that both intention (expectation) and willingness measures predict future risk behaviors, and do so independent of one another. Additional analyses provide further evidence of discriminant validity between the two constructs by indicating that they relate differently to perceptions of personal vulnerability to the health risks associated with these behaviors.     

Cognitive and behavioral distancing from the poor

The author argues that distancing is the dominant response to poor people on the part of those who are not poor and that distancing, separation, exclusion, and devaluing operationally define discrimination. Such responses, together with stereotypes and prejudice, define classism. The article focuses on classism in the United States. Classism is examined in the context of theoretical propositions about the moral exclusion of stigmatized others and is illustrated by cognitive distancing, institutional distancing (in education, housing, health care, legal assistance, politics, and public policy), and interpersonal distancing. The adoption of the Resolution on Poverty and Socioeconomic Status by the American Psychological Association Council of Representatives in August 2000 is cited as an important step in the direction of eliminating the invisibility of low-income persons in psychological research and theory.     

控制论的目的论思想与高血压病诊治

20世纪中叶以来,随着控制论的兴起与广泛应用,目的论问题成为生物学哲学以及系统科学哲学的重要议题。运用控制论原理及其目的论思想对高血压病诊治中的有关问题进行了分析和探索,以期对高血压病做到更有效的控制。     

Cognitive behavioral perspectives on women and guilt

This paper discusses the application of cognitive behavior therapies to the treatment of the guilt difficulties that women experience in Western industrialized societies. Evidence on the relevance of guilt to women is reviewed, including psychological problems common to women that involve high guilt, sex differences in personality traits, and sex-typing in social roles. Cognitive behavioral theories of guilt are summarized. Areas of inquiry in assessment of dysfunctional guilt are discussed. Three cognitive behavioral treatment strategies for women's guilt are presented. In permission-giving, guilt-provoking behavior is reframed as acceptable. Interventions to lessen discrepancies between guilt-provoking behavior and core roles that are central to self-definition can focus on revising core role requirements and on making behavior more consistent with core roles. Rational-emotive therapy focuses on reduction of irrational beliefs that support self-blame and conditional selfworth and developing more adaptive cognitions. Treatment recommendations for specific guilt problems in assertive refusal and in the aftermath of assault are also reviewed.Ellen Tobey Klass, PhD, associate professor of psychology at Hunter College, City University of New York, and has a private practice in New York City.     

降压治疗的决策思考

尽管降压药物有了很大发展,高血压的控制率仍很低下。降压治疗中还存在包括医生和患者两方面的许多误区。目前已取得的共识是:降压治疗的益处主要来自血压控制。因此,非常重要的是要达到血压的有效和长期稳定的降低。根据患者的年龄、基线血压、伴随的临床状况等,因人而异地选择副作用小、降压效果好的药物,提高顺应性是改善高血压控制率的关键。     

高血压药物基因组学研究现状

抗高血压药物基因组学的发展,促进了药物反应种族差异的发现及其机制的阐明。药物反应遗传学标记的确定和遗传学背景的分析,有助于临床医生选择更适合个体的抗高血压治疗,从而达到最有利于患者的治疗效果。药物基因组学是高血压个体化治疗的分子生物学基础。     

Psychoanalytic and behavioral considerations in antagonist and methadone programs

Whatever view we hold it must be shown Why every lover has a wish to make Some other kind of otherness his own: Perhaps, in fact, we never are alone. (2)     

女性不同时期高血压的临床特征与治疗原则

女性因在不同时期内分泌的变化使其血压变化规律与男性有异,本文阐述了女性不同时期血压的临床特征和治疗原则;妊娠前及妊娠期慢性高血压的治疗及降压药物的选择;妊娠高血压综合征的处理原则及授乳期安全哺乳方法。     

高血压治疗：百年历程、日益细化

人类对高血压的治疗是百年以来医学的重要成就。越来越多的证据表明,有效控制高血压是降低相关疾病发病、死亡、致残的重要手段。医学对高血压治疗药物、手段、方案的探索尚未止步,许多正在进展中。     

Clinical application of conditioning and other behavioral techniques: Conceptual and professional considerations

It is only recently that conditioning and allied techniques have been applied on any large scale outside the laboratory. With the emergence of these procedures into the clinical world, in particular, a new class of problems present themselves. It is no longer sufficient to focus upon narrowly technical or theoretical problems; philosophies, social and practical issues must be taken into consideration and the new techniques evaluated conceptually and practically in direct comparison with their psychodynamic alternatives. Selected issues are presented and discussed.     

Cognitive behavioral therapy for compulsive buying disorder

To our knowledge, no psychotherapy treatment studies for compulsive buying have been published. The authors conducted a pilot trial comparing the efficacy of a group cognitive behavioral intervention designed for the treatment of compulsive buying to a waiting list control. Twenty-eight subjects were assigned to receive active treatment and 11 to the waiting list control group. The results at the end of treatment showed significant advantages for cognitive behavioral therapy (CBT) over the waiting list in reductions in the number of compulsive buying episodes and time spent buying, as well as scores on the Yale–Brown Obsessive Compulsive Scale—Shopping Version and the Compulsive Buying Scale. Improvement was well-maintained at 6-month follow-up. The pilot data suggests that a cognitive behavioral intervention can be quite effective in the treatment of compulsive buying disorder. This model requires further testing.     

血清胆红素水平与原发性高血压患者动脉粥样硬化关系的探讨

为探讨原发性高血压患者颈动脉粥样硬化斑块形成与胆红素水平的关系,对156例原发性高血压男性患者进行颈动脉彩色多普勒超声检查,根据有无颈动脉粥样硬化斑块将其分为颈动脉粥样硬化斑块组74例,正常对照组82例,对两组的年龄、体重指数、血脂及胆红素水平进行比较。原发性高血压患者颈动脉粥样硬化斑块组总胆红素及间接胆红素水平显著低于正常对照组（P〈0.05）,原发性高血压患者颈动脉粥样硬化斑块形成与总胆红素及间接胆红素水平呈负相关。     

Cognitive and behavioral functioning in Coffin-Siris syndrome and epilepsy: a case presentation

The authors characterized the cognitive, adaptive, and behavioral sequelae of Coffin-Siris (CS) syndrome and epilepsy in a 7.5-year-old child. Little is known about the early neurobehavioral presentation of CS. Clinical features consistent with this genetic anomaly include underdeveloped tips and nails of the fifth fingers, extended infranasal depression, and craniofacial abnormalities. MRI findings often reveal callosal agenesis. The authors conducted a neuropsychological evaluation and obtained parental ratings of behavioral and adaptive functioning. Attentional abilities were limited. As assessed by the Mullen Scales of Early Learning, receptive language abilities (age equivalent [AE]: 3-3) were relatively stronger than expressive skills (AE: 1-4). Adaptive functioning was low across all domains (Vineland Adaptive Behavior Composite AE: 1-9). On the Behavior Assessment for Children (BASC-2), social skills dysfunction, stereotyped and self-stimulatory behaviors, restricted interests, ritualistic play, and inappropriate object usage were noted. No significant mood disturbances were endorsed. Study findings indicate a diffuse pattern of neurobehavioral deficits in a child with CS and epilepsy. Further clinical assessment and research should include multidimensional assessment techniques, including evaluation of adaptive behavior, in an effort to capture the full range developmental sequelae in children with CS.