Association between COVID-19 Pandemic, Blood Pressure and Pulse Rate in Young Slovak Women

The scientific evidence on whether long-term use of snuff is associated with high blood pressure is limited, inconsistent and based only on cross-sectional data. We aimed at studying the risk of hypertension in relation to long-term use of snuff based on longitudinal data. Repeated health check-ups were offered to all employees in the Swedish construction industry between 1978 and 1993. Blood pressure was measured at the health check-up and information on tobacco use and other risk factors was collected through questionnaires. In total, 120 930 never smoking men with information on blood pressure and snuff use at baseline were included. The association of high blood pressure and snuff use at baseline was estimated by logistic regression. Further, 42 055 men were identified as normotensive at baseline and had at least one subsequent health check-up. Through repeated blood pressure measurements and linkage to the Swedish National Inpatient Register, information on hypertension was obtained. Relative risk estimates were derived from Cox proportional hazards regression model. Almost 30% of all men had used snuff. The adjusted odds ratio of high blood pressure amongst snuff users at baseline was 1.23 (95% CI 1.15-1.33) compared to never snuff users. The relative risk of high blood pressure during follow-up was 1.39 (95% CI 1.08-1.79) amongst snuff users and 1.36 (95% CI 1.07-1.72) for hypertension as recorded in the Inpatient Register. Use of Swedish moist snuff appears to be associated with a moderately increased risk of hypertension.

Overweight is an increasingly prevalent condition throughout the world. Current estimates, which are probably conservative, indicate that at least 500 000 000 people worldwide are overweight as defined by a body mass index (BMI) of between 25.0 and 29.9 and an additional 250 000 000 are obese with a BMI of 30.0 or higher.1 In the United States, recent data indicate that as much as 66% of the adult population is overweight or obese.2 Overweight and obesity are established risk factors for cardiovascular disease (CVD), stroke, noninsulin dependent diabetes (NIDDM), certain cancers, and numerous other disorders.3,4,5,6,7 It is also a risk factor for hypertension.8 Hypertension, defined as a systolic blood pressure in excess of 140 mm Hg or a diastolic blood pressure higher than 90 mm Hg, is also a globally increasing public health concern. Roughly 1 billion individuals worldwide are estimated to exhibit clinically significant elevated blood pressure with about 50 million of those residing in the United States.8 Hypertension, in turn, is associated with increased risk for CVD, stroke, renal disease, and all-cause mortality.9,10,11,12 The JNC VII report defines Stage 1 hypertension as blood pressure levels between 140 and 159 mm Hg systolic and 90 and 99 diastolic. Additionally, the report establishes a category of Prehypertension (Systolic blood pressure between 120 and 140 mm Hg or diastolic between 80 and 89 mm Hg). These 2 blood pressure classifications are deemed to be appropriate primary targets for lifestyle modification interventions, including weight loss. Higher levels of blood pressure, or stage 1 hypertension that is maintained over a long period, should be addressed primarily with medications or other physician directed treatments. There is a positive relationship between overweight or obesity and blood pressure and risk for hypertension. As early as the 1920s, a significant …

Using Pedometers to Promote Physical Activity Among Clinical Populations

This clinical advisory statement from the Coordinating Committee of the National High Blood Pressure Education Program is intended to advance and clarify the recommendations of the Sixth Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI, 1997).1 The advisory addresses several interrelated issues about blood pressure (BP) that affect people approaching the later decades of life. On the basis of the wealth of currently available evidence, the committee now recommends a major paradigm shift in urging that systolic BP become the major criterion for diagnosis, staging, and therapeutic management of hypertension, particularly in middle-aged and older Americans. Several lines of strong evidence support the initiative to emphasize systolic BP. Pathophysiologically, there are strong associations among aging, increased stiffness of large arteries, increased systolic BP, increased pulse pressure, and the prevalence of cardiac and vascular disease. Epidemiologically, isolated systolic hypertension is the most common form of hypertension and is present in approximately two thirds of hypertensive individuals >60 years of age. Diagnostically, classification and staging of hypertension are more precise when systolic rather than diastolic BP is used as the principal criterion. Risk stratification for major complications of hypertension (stroke, myocardial infarction, heart failure, and kidney failure) is actually confounded by the use of diastolic BP; in older people with systolic hypertension, diastolic BP is inversely related to cardiovascular risk. Clinical benefits of treatment of isolated systolic hypertension include reductions in stroke, myocardial infarction, heart failure, kidney failure, and overall cardiovascular disease morbidity and mortality. Currently, only 1 in 4 Americans with hypertension falls below JNC VI–recommended values of 140/90 mm Hg in uncomplicated hypertension or 130/85 mm Hg in individuals with kidney disease or diabetes. Hypertension control rates are poorest in older people, primarily as a result of inadequate …

Introduction: Sympathetic hyperactivity is one of the most important causes of resistant hypertension. Ambulatory blood pressure monitoring (ABPM) allows measurement of blood pressure (BP) and pulse rate (PR) throughout the day, as well as measurement of diurnal variations in BP and PR, which are controlled by the autonomic nervous system. Hypothesis: We hypothesized that abnormal diurnal change of BP and PR are associated with resistant hypertension. Methods: We evaluated 1003 patients with hypertension who were enrolled in the Japan Morning Surge Home Blood Pressure Study and were using ABPM. Resistant hypertension was defined as clinic BP≧140/90 mmHg despite the use of optimal doses of 3 classes of antihypertensive drugs, including a diuretic. BP or PR dipper status was defined as (awake systolic BP (SBP) or PR-sleep SBP or PR)/awake SBP or PR ≧0.1. BP or PR nondipper status was defined as (awake SBP or PR-sleep SBP or PR)/awake SBP or PR <0.1 and ≧0. BP and PR riser status were defined as awake SBP or PR < sleep SBP or PR. Results: The numbers of PR nondippers and PR risers in the resistant hypertensive groups were significantly greater than those in the non-resistant hypertensive groups (x2=9.35, p=0.009), but there were no significant differences in the diurnal variation of BP between the resistant hypertensive and non-resistant hypertensive groups (x2=3.10, p=0.21). In the resistant hypertensive groups, the proportion of PR risers was approximately three-fold greater than that in the non-resistant hypertensive groups after adjustment for age, gender, 24-h BP, PR, and BP variation (Hazard ratio 2.94, 95%Cl 1.25-6.91, p=0.013), but there were no significant differences in the proportion of PR nondippers (Hazard ratio 1.36, 95%Cl 0.82-2.26, p=0.23). Conclusions: A riser pattern of PR was associated with resistant hypertension. ABPM may be useful to identify resistant hypertensive patients who have autonomic nervous system dysfunction.

Recent epidemiological studies have shown that arterial stiffness, measured through carotid-femoral pulse wave velocity (PWV), has an independent predictive value for cardiovascular (CV) events in several populations, including patients with uncomplicated essential hypertension1,2 and type 2 diabetes.3 Arterial stiffness is thus an intermediate end point for CV events, predicting CV events independently of and beyond peripheral pulse pressure (PP). Peripheral PP, central PP, and augmentation index, which provide additional information on wave reflection, are considered “surrogates” of arterial stiffness, because their pathophysiological meaning is clearly different.4–6 Central PP and augmentation index are dependent on the speed of wave travel, the amplitude of reflected wave, the reflectance point, and the duration and pattern of ventricular ejection, especially with respect to change in heart rate and ventricular contractility. Aortic PWV, which is the speed of wave travel, represents intrinsically arterial stiffness, according to the Bramwell-Hill formula.4–6 Two articles7,8 in the present issue of Hypertension raise the issue of the predictive value of “surrogates of arterial stiffness” for CV events. Li et al7 studied the dynamic relationship between diastolic blood pressure (DBP0 and systolic blood pressure (SBP) in ambulatory blood pressure monitoring (ABPM) data throughout the day and calculated a novel index as 1− the regression slope of DBP on SBP. This index was named ambulatory arterial stiffness index (AASI) on the basis that “average distending BP …

Oral microflora associated with periodontal disease (PD) has been proposed to be a causal factor for cardiovascular disease (CVD).Data from NHANES I and its 21-year follow-up were used to test this hypothesis.Baseline periodontal status was categorized into (1)no PD, (2)gingivitis, (3)periodontitis, and (4) edentulousness.CVD events during follow-up were ascertained by hospital records for non-fatal events and death certificates for fatal events.Relative risk (RR) and 95% confidence interval (CI) were derived from Cox regression after adjusting for demographic variables and several well-established CVD risk factors.9,962 people were free from coronary heart disease (CHD), heart failure, and cancer at baseline.2,844 CVD, 1,468 CHD, and 803 stroke events occurred during the follow-up.Compared to no PD, RRs (CI) of CVD were 1.05 (0.93-1.18) for gingivitis, 1.17 (1.04-1.31)for periodontitis, and 1.22 (1.10-1.34)for edentulousness.RRs (CI) at similar PD levels for CHD were 1.03 (0.87-1.21), 1.14 (0.98-1.34), and 1.13 (0.98-1.32), and for stroke were 1.03 (0.81-1.31), 1.33 (1.07-1.66),and 1.30 (1.06-1.60),respectively.Analyses stratified by age group indicated that elevated risk for CVD associated with PD is manifested mainly in those aged 25-54 years at baseline.Among this age group, RRs (CI) of CVD were 1.13 (0.96-1.33) for gingivitis, 1.40 (1.16-1.68)for periodontitis, and 1.36 (1.11-1.68)for edentulousness in comparison to no PD; RRs (CI) of CHD were 1.13 (0.80-1.29), 1.33 (1.03-1.72),and 1.25 (0.93-1.67); and RRs (CI) of stroke were 0.96 (0.64-1.46), 1.57 (1.05-2.36),and 1.46 (0.92-2.33), respectively.This study suggests that periodontal disease is a significant risk factor for CVD, CHD, and stroke especially in adults aged 25-54. P2 Stress in the workplace and early atherosclerosis. The Los Angeles

Increasing adiposity with a clinical endpoint of obesity is associated with a progressive increase in risk of cardiovascular diseases (CVD). However, we are only beginning to understand the physiological and pathophysiological mechanisms by which excessive body fat storage causes CVD. In this issue of Hypertension , the findings of Wildman et al1 extend and strengthen previous observations2–5 by showing that changes in arterial stiffness, as measured by aortic pulse-wave velocity (PWV), are related to changes in body weight over a 2-year follow-up period in healthy men and women aged 20 to 40 years. Weight gain was associated with an increase, whereas weight loss was associated with a decrease in aortic PWV, independent of changes in blood pressure. The greatest increases in aortic PWV were observed in those subjects who gained the most weight (≥4.5 kg). Importantly, the changes in aortic PWV were related to changes in body mass index (BMI), indicating that the associations with body weight were mediated by changes in adiposity (rather than fat-free mass). Changes in aortic PWV over time also were related to baseline body weight, BMI, and waist circumference (an indirect measure of abdominal adiposity), providing evidence that higher initial levels of total and abdominal body fatness are associated with greater future increases in arterial stiffness. The study included subjects with a broad range of BMI, suggesting that the findings are applicable to both nonobese and obese adults in the general population. An important finding was that black adults demonstrated greater increases in weight gain-adjusted and blood pressure-adjusted aortic PWV over time, suggesting that they undergo greater increases in arterial stiffness in response to the same age-associated weight gain compared with whites. These observations provide further support for the emerging concept that adiposity-driven weight gain during adulthood contributes significantly to the adverse changes …

The clinical presentation of autonomic failure is orthostatic hypotension. Severely affected patients require pharmacological treatment to prevent presyncopal symptoms or frank syncope. We previously reported in a proof of concept study that pediatric doses of the norepinephrine transporter blockade, atomoxetine, increases blood pressure in autonomic failure patients with residual sympathetic activity compared with placebo. Given that the sympathetic nervous system is maximally activated in the upright position, we hypothesized that atomoxetine would be superior to midodrine, a direct vasoconstrictor, in improving upright blood pressure and orthostatic hypotension-related symptoms. To test this hypothesis, we compared the effect of acute atomoxetine versus midodrine on upright systolic blood pressure and orthostatic symptom scores in 65 patients with severe autonomic failure. There were no differences in seated systolic blood pressure (means difference=0.3 mm Hg; 95% confidence interval, -7.3 to 7.9; P=0.94). In contrast, atomoxetine produced a greater pressor response in upright systolic blood pressure (means difference=7.5 mm Hg; 95% confidence interval, 0.6-15; P=0.03) compared with midodrine. Furthermore, atomoxetine (means difference=0.4; 95% confidence interval, 0.1-0.8; P=0.02), but not midodrine (means difference=0.5; 95% confidence interval, -0.1 to 1.0; P=0.08), improved orthostatic hypotension-related symptoms as compared with placebo. The results of our study suggest that atomoxetine could be a superior therapeutic option than midodrine for the treatment of orthostatic hypotension in autonomic failure.

A cross sectional study on hypertension was done on 294 subjects aged 30 years and above. 150 households were selected randomly representing 50 households from each locality inhabited exclusively by the rural Mizos, indigenous rural Assamese and the tea-garden workers respectively, in the northeastern region of India. Blood pressure was measured by sphygmo-manometer in sitting posture. Anthro-pometric measurements were taken using standard procedure for measuring height, weight, waist and hip girth. Information on age, sex, ethnicity, literacy, alcohol intake, smoking pattern, physical activity, occupation, amount of salt consumption was collected using a standard and pre-tested questionnaire. Significant differences were observed in both the systolic and diastolic blood pressure levels among the three different ethnic groups selected for this study (p < 0.0001). Multiple regression analyses indicated that in Mizos, age, waist circumference and alcohol intake were independently associated with increase in systolic blood pressure whereas smoking was found to be negatively associated with systolic blood pressure (R2 = 0.391, p < 0.001). Factors, which were the best predictors of diastolic blood pressure, were age and body mass index [(kg/m2) (R2 = 0.227, p < 0.001)]. In the rural Assamese population, the best predictors of systolic blood pressure were age and waist circumference (R2 = 0.263, p = 0.018). For the diastolic blood pressure, age, alcohol intake and body mass index were important correlates (R2 = 0.131, p < 0.001). In the tea garden community, important predictors of systolic blood pressure were age, gender and marital status (R2 = 0.187, p < 0.001). On the other hand, age and alcohol intake were best predictors for diastolic blood pressure (R2 = 0.09, p < 0.001).

Background: The studies on the assessment of Pupil to Limbus Diameter (PLD) ratio correlation with autonomic activity were sparse. Aims and Objectives: The study correlates the PLD ratio with the autonomic activity in hypertensive patients. Materials and Methods: One hundred participants both male and female were recruited for the study. The two-box method was used to record the PLD ratio. A digital sphygmomanometer was used to record the autonomic parameters. Results: PLD ratio of the right eye was having significantly negative correlation with pulse rate. PLD ratio of the right eye was having a significantly positive correlation with systolic blood pressure. PLD ratio of the right eye was having significantly negative correlation with diastolic blood pressure. The PLD ratio of the left eye was having a positive correlation with the pulse rate. However, it was not significantly different. The pupil-to-limbus diameter ratio PLD ratio of the left eye was having significantly positively correlated with blood pressure. The PLD ratio of the left eye positively correlated with diastolic blood pressure. However, it was not statistically significant. Conclusion: The association between PLD ratio of the right eye and systolic blood pressure was positive correlation. The association between the PLD ratio of the right eye with pulse rate and diastolic blood pressure is negative correlation. There was a positive correlation between systolic blood pressure, diastolic blood pressure, pulse rate, and PLD ratio.

Objective To study the effect of acupuncture on systolic and diastolic blood pressure and pulse rate of patients with different diseases. Methods Blood Pressure and Pulse Rate of 106 patients older than 18 without history of needling during the last month, were measured before and immediately after every treatment session. Also history of hypertension, history of needling and acupoints were recorded for every patient. Results After acupuncture, systolic blood pressure, diastolic blood pressure and pulse rate significantly decreased comparing to the levels before acupuncture (P 0.05) . There is a correlation between acupuncture in some acupoints and blood pressure or pulse rate (P<0.05 or P<0.01) . Conclusion Acupuncture in some acupoints has certain effects on blood pressure and pulse rate. Key words: Systolic blood pressure; Diastolic blood pressure; Pulse rate; Acupuncture

Background: Today, women are constantly under stress to maintain stability between home and work place. This stress influences their physical fitness and mental health. The immune system is lowered by stress and the adrenal glands are overworked. Yoga is one of the most useful, significant, and precious tools for overcoming various physical and mental issues. Aims and Objectives: The aim of the study was to determine how yoga training affected women's blood pressure and pulse rate. Material and Methods: A total of 50 women, ages 25-50, had their pulse rates and blood pressure monitored before and after yoga exercise. The same individuals were selected for the study and the control group. The findings of the statistical study, which used the paired t-test, are presented as mean ± standard deviation. Results: Out of 50 women, 18 were working, and 32 were not working but were doing housework. Pulse rate before yoga (74.04 ± 3.307) and after yoga training (67.78 ± 2.950) was found, respectively. Systolic blood pressure before yoga (123.20 ± 5.86) and after yoga training (114.00 ± 6.38) was found, respectively. Diastolic blood pressure before yoga (80.40 ± 4.499) and after yoga training (77.20 ± 4.96) was found, respectively. Systolic and diastolic blood pressure, as well as the pulse rate, all significantly decreased (P < 0.0001). Conclusion: Daily yoga practice enhances a variety of physiological factors, such as pulse rate and blood pressure, which are greatly improved even when no other physical activity is being done.

Although elevated blood pressure is an important predictor of cardiovascular disease and stroke in the elderly, little information exists on the distribution and risk factor correlates of blood pressure in this group. As part of the Cardiovascular Health Study, a population-based cohort study of 5201 men and women aged 65 to 101 years, we investigated correlates of systolic and diastolic blood pressure. Multiple regression analyses were conducted for all participants and a subgroup of 2482 without coronary heart disease and not on antihypertensive therapy (the "healthier" subgroup). In the total group, independent predictors of diastolic blood pressure included heart rate, aortic root dimension, creatinine, hematocrit, alcohol use, and black race (positive associations) and internal carotid artery wall thickness, mitral early/late peak flow velocity, white blood cell count, cigarette smoking, and age (negative associations). Positive predictors of systolic blood pressure included mitral late peak flow velocity, left ventricular mass, common carotid artery wall thickness, serum albumin, factor VII, diabetes, alcohol use, and age; negative predictors were coronary heart disease, uric acid, height, and smoking. In the healthier subgroup, positive predictors of diastolic blood pressure included heart rate, hematocrit, serum albumin, creatinine, and body weight, whereas mitral early/late peak flow velocity, serum potassium, smoking, and age inversely related to diastolic pressure. For the same group, common carotid artery wall thickness, left ventricular mass, serum albumin, factor VII, high-density lipoprotein cholesterol, and age were directly related to systolic blood pressure, whereas serum potassium was inversely related. Both systolic and diastolic pressures varied considerably by geographic site.(ABSTRACT TRUNCATED AT 250 WORDS)

Introduction: Tooth extraction is a common dental procedure that can lead to physiological changes, including alterations in blood pressure (BP) and pulse rate (PR). The administration of local anesthesia, particularly lidocaine with epinephrine, can temporarily impact cardiovascular parameters. This study aimed to evaluate changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate before and after tooth extraction. Aim of study: To evaluate changes in blood pressure and pulse rate during tooth extraction procedures and assess the impact of anxiety and stress on cardiovascular responses in dental patients. Material and method: This study was carried out during the period from October 2024 till February 2025, which included a sample size of 40 patient (31 were male and 9 were female), and was selected from the Faculty of Dentistry at Tikrit University / Iraq. Three readings were taken for both systolic and diastolic blood pressure were measured (in mmHg), and heart rate, the measurements were carried out with the aid of a digital oximeter. Result: The results showed a significant increase in SBP and DBP following lidocaine administration (SBP: 124±9 mmHg to 133±8 mmHg, DBP: 81±8 mmHg to 89±6 mmHg). However, after extraction, these values returned closer to baseline (SBP: 125±8 mmHg, DBP: 83±5 mmHg). Pulse rate followed a similar pattern, rising from 86±8 bpm to 90±6 bpm after lidocaine and stabilizing at 88±7 bpm post-extraction. No statistically significant differences were found between males and females or between different age groups. Conclusion: The study confirms that local anesthesia with epinephrine causes temporary elevations in blood pressure and pulse rate, likely due to both physiological responses and patient anxiety. While these changes are self-limiting in healthy individuals, they highlight the importance of preoperative monitoring, particularly in hypertensive or anxiety-prone patients. Future research should focus on the long-term cardiovascular effects of local anesthetics in different patient populations.