Alter Blood Pressure Research Articles

Case report on- Management and complication of vesicular calculi with obstructive Hydronephrosis with CKD

Hydronephrosis is the swelling of a kidney due to a build-up of urine. It happens when urine cannot drain out from a blockage or obstruction. Hydronephrosis can occur in one or both kidneys. The primary function of the urinary tract is to remove wastes and fluid from the body. In today's urology, multiple giant vesical calculi are a rare occurrence. In the English literature, only a few examples of vesical calculi weighing more than 100 g have been described. Arthur et al. created the world's most extensive vesical calculus, weighing 6294 g. Bladder stones can be asymptomatic and only detected by chance. Rat kidney transplantation is a common experimental model for the creation of general microsurgical or transplantation procedures, immunologic research, and the examination of transplant-related long-term alterations in arterial blood pressure. Main symptoms and Important clinical Findings:- A 45 years old male was admitted to a rural hospital in the medicine ward on date 11-01-2022 with the chief complaint of Vomiting, Nausea, fever and Urinary, Fatigue, high blood pressure, loss of appetite, malaise, or water-electrolyte imbalance Problem 1 week. The primary diagnosis, therapeutic interventions and outcome:-This case were diagnosed after a physical examination and research. Vesicular calculi with obstructive Hydronephrosis with CKD chief complaint pain, vomiting, and blood in the urine for one week. Weakness, severe muscle, severe loss of appetite and two weeks. Nursing perspective:- - NS and RL nebulization are examples of fluid replacement. Vitals are being monitored on an hourly basis.Conclusion:-vesicular calculi with obstructive Hydronephrosis with CKD case was rare. CysC more accurately depicts changes in renal function in patients with hydronephrosis brought on by ureteral calculi, and the CKD-EPI CysC equation has the highest accuracy. Early diagnosis and early treatment are necessary to prevent further complications. He responded to all medication, and her recovery was good.

The effect of metformin on cardiovascular markers in female mice consuming a high fat diet

BackgroundMetformin, widely used to treat diabetes, is now considered a candidate therapeutic for treatment of cardiovascular disease. This study aimed to assess whether metformin’s non-glycaemic effects could mitigate cardiovascular disease indices in female mice consuming a high fat diet (HFD). MethodsFour-week old female Arc:Arc(S) mice were placed on a standard (std) chow diet or Western-style HFD (22% fat, 0.15% cholesterol). At ∼8 months, the mice were administered 150 mg/kg metformin or vehicle (control) via intraperitoneal injection for 11 days. Blood pressure was measured (tail cuff plethysmography) at Day 9 and 11 of treatment. On Day 11, mice were weighed and culled. The mesenteric arcade and kidneys were collected for assessment of vascular reactivity (wire myography), and assessment of expression of cardiometabolic markers (qPCR), respectively. ResultsThe HFD fed female mice were significantly heavier than those receiving the std diet at 1–12 weeks on diet, and at cull. Mice on a std diet with metformin treatment were significantly heavier at cull than the mice on a std diet administered the control treatment. Metformin treatment did not alter the weight of the mice receiving the HFD. Neither the HFD (compared to the std diet), nor metformin treatment (compared to control treatment) altered blood pressure, vascular reactivity, or expression of cardiometabolic markers in the kidney. ConclusionConsumption of a Western-style HFD (without high salt/sugar levels) did not alter the cardiovascular markers measured. Further studies are required to establish the non-glycaemic, cardio-protective effects of metformin in high-risk cohorts.

The effects of cardiorespiratory fitness and ageing on arterial stiffness in athletic older populations

Introduction: Arterial stiffening is a physiological occurrence where there is a decrease in arterial wall compliance, which alters blood pressure and flow. This causes significant aetiological consequences such as hypertension and cardiovascular events, and, as such, arterial stiffness can be used as a subclinical marker for cardiovascular disease. Importantly, arterial stiffness increases in parallel with ageing, even in the absence of disease, thus the prevention of arterial stiffening is of considerable clinical importance for reducing cardiovascular morbidity and mortality.

Hypertension is linked to enhanced lymphatic contractile response via RGS16/RhoA/ROCK pathway.

Lymph capillary network can be expected to alter blood pressure via regulating interstitial electrolyte and volume balance. However, the pathophysiology of lymphatic vessel in hypertension is poorly understood. In this study, we examined lymph vessel function focusing on contractile response in hypertensive rats. It was found that thoracic ducts isolated from adult (10-14 wk old) spontaneously hypertensive rats (SHRs) exhibited increased agonist-mediated contraction compared with age-matched Wistar-Kyoto (WKY) rats, whereas lymphatic contractions in younger (4 wk old) SHRs, exhibiting normal blood pressure, were no different compared with age-matched control rats. Tight regulation of blood pressure with antihypertensive drugs (hydrochlorothiazide/hydralazine) did not prevent the augmented lymphatic contraction in adult SHRs; however, treatment of SHRs with angiotensin II (ANG II) type 1 receptor blocker (losartan) for 6 wk abolished the augmentation of lymphatic contractions. In addition, ANG II infusion in Wistar rat caused augmented lymphatic contractile responses in the thoracic duct. The augmented contractions in adult SHRs were diminished by a ROCK inhibitor (Y-27632). Consistently, the thoracic ducts in SHRs showed significantly higher phosphorylation of myosin phosphatase targeting protein-1 than WKY rats. Furthermore, gene expression profiling of adult SHR lymphatics showed marked loss of regulator of G-protein signaling 16 (RGS16) mRNA, which was confirmed by the real-time PCR. Treatment with the RGS inhibitor CCG-63808 enhanced contractions in thoracic ducts from Wistar rats, which were abolished by the ROCK inhibitor. It is concluded that lymphatic contractile function was enhanced in hypertensive model rats, which could be mediated by dysregulation of the ROCK pathway possibly through RGS16.NEW & NOTEWORTHY Lymph capillary controls interstitial electrolyte and volume balance, which may blunt increased blood pressure. However, the function of lymphatic vessel in hypertension is poorly understood. Our study showed that the lymphatic smooth muscle contractility is hyperreactive in two different hypertensive models. The lymphatic dysfunction could be mediated by dysregulation of ROCK pathway possibly through RGS16. The present finding supports a new concept showing the functional relationship between lymphatic contractile activity and hypertension.

Comparing Fentanyl Dosages of 1 Microgram per Kilogram of Body Weight and of 1.5 Micrograms per Kilogram of Body Weight in Relation to Cough Suppression during Bronchoscopy Procedures

BACKGROUND: Anaesthesia at bronchoscopy is a unique challenge for the anaesthesiologist as both the anaesthesiologist and operator work in the same airway. It is essential that administration of sedative agents must achieve the desired depth of sedation without risking airway patency, ventilation function and cardiovascular function. About 25% of bronchoscopy patients cite cough as the most unpleasant effect of this procedure. Fentanyl is widely chosen for a sedative agent because of their analgesic, sedative, and antitussive effects, however there has been no data regarding the optimal dose of fentanyl to suppress cough in bronchoscopy procedures. METHODS: We designed a research with 18 subjects received fentanyl in a dose of 1 μg / kgBW, 18 subjects received fentanyl in a dose of 1.5 μg / kgBW and 18 subjects received propofol in a dose of 2 mg / kgBW as a control group. We observed the depth of sedation using the Ramsay sedation score and duration of cough suppression in their bronchoscopy procedures. We also observed the alteration of blood pressure, pulse rate, respiratory rate and oxygen saturation. RESULTS: There was a significant difference in the depth of patient sedation between the control group and the treatment groups; as patients without fentanyl treatment were sedated deeper on the Ramsay 4 scale, patients in the treatment groups with either fentanyl of 1 µg / kgBW or 1.5 µg / kgBW had the depth of sedation on the Ramsay 2 scale and unable to reach moderate sedation as expected. Subjects with fentanyl treatments showed significantly better suppression effects against coughing compared to control group patients. As there also was a significance difference in suppression effects for coughing between the group receiving fentanyl treatment of 1 µg / kgBW and the group receiving fentanyl treatment of 1.5 µg / kgBW, we noticed a fentanyl treatment of 1 µg / kgBW was adequate to suppress cough although a dose of 1.5 µg / kgBW would show better cough suppression effect. Subjects in control group with 2 mg / kgBW of propofol experienced a more significant alteration in vital signs than the fentanyl group, either with a dose of 1 µg / kgBW or 1.5 µg / kgBW. Comparing and statistically analysing the two treatment groups of different dose of fentanyl, we found no significant difference in vital signs alteration between the two groups. DISCUSSION: Our study revealed that as fentanyl significantly suppressed cough reflex and larger dose would provide longer period of suppression. Subjects with fentanyl treatment showed more favourable altercation in systolic and diastolic blood pressure, pulse rate, respiratory rate and oxygen saturation compared to subjects in control group with 2 mg / kgBW of propofol, but comparing and statistically analysing the two groups of different dose of fentanyl, we found no significant difference in vital signs alteration

237 POTENTIALLY INAPPROPRIATE PRESCRIBING IN HOSPITALISED FRAIL OLDER ADULTS: DEVELOPMENT OF THE OPTI-3S PRELIMINARY STATEMENTS

Abstract Background Few assessment criteria exist for Potentially Inappropriate Medications (PIMs) in the hospital setting. This study aims to develop the preliminary statements of OPTI-3S, criteria for optimising medicines by stopping, stepping down or switching to safer alternatives. These are designed to be of value to clinical practitioners in the routine care of hospitalised, frail older adults. Methods A systematic literature review was conducted in the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed, CINAHL, EMBASE and Scopus (2010-2021). Search terms included the concepts of inappropriate prescribing, deprescribing and the target population (e.g. older, frail, hospitalized). This was supplemented with a PubMed focused search (2010-2021) using key words pertaining to the index diseases/conditions or inappropriate medications. The structured reviews included clinical based guidelines, PIMs lists, systematic/non-systematic reviews, or clinical/observational trials that assessed safe and/or effective use of medications in older adults. The preliminary statements were then drafted based on the available relevant evidence. Results Searches yielded ~1500 articles. These were included in structured reviews, yielding a total of 109 initial statements across seven physiological systems, and one patient-centred point of care (perioperative care). In addition to detailed PIMs statements (n=98), 11 statements address clinically important Potential Prescribing Omissions (PPOs) (e.g. anticoagulant underdosing) and altered blood pressure and glycaemic targets. Uniquely for criteria of this kind, 23 statements suggest PIMs be considered based on the different frailty levels, according to the Clinical Frailty Scale. 11/98 PIMs statements concern prescribing cascades and suggest tapering regimens for six inappropriate medication classes (e.g. antipsychotics, benzodiazepines). Several statements address medication appropriateness in other frailty related circumstances (e.g. non-compliance, overlapping co-morbidities, feeding tube incompatibility, pill burden/ polypharmacy). Conclusion Literature provides a large body of evidence to support prescribing optimization. This has been distilled into consensus-based statements, which should guide hospital-based health care professionals caring for frail older adults.

Dexmedetomidine compared to ketofol for sedation in pediatric patients undergoing dental procedures: a double-blind, randomized clinical trial

Background & objective: Hospital phobia and anxiety are still prevalent issues in the pediatric patients. Various sedative regimes have been in dental practice, but the evidence for safe and effective sedative drugs in this population is scarce. We compared the safety and efficacy of intravenous combination of ketamine plus propofol (ketofol) with dexmedetomidine (Dex) as a sedative premedication in anxious children undergoing dental pulp therapy.
 Methodology: This double-blind, randomized clinical study recruited 40 anxious children who were to undergo dental pulp therapy. The study participants were allocated into two groups (20 subjects each). Subjects in Group I received ketofol solution (ketamine/propofol mixture, each mL contains 2 mg of ketamine plus 4 mg of propofol). A loading dose of 0.3125 mL/kg was administered intravenously (IV) over 10 min, followed by maintenance infusion at a rate of 0.05-0.125 mL/kg/h. Subjects in Group II received the Dex solution (4 µg/mL). A loading dose of 2 µg/kg was administered IV over 10 min, followed by a maintenance infusion of 0.1-1 µg/kg/h. Non-invasive blood pressure, SpO2, heart rate (HR), and respiratory rate (RR) were assessed at baseline, at 2 min, and then at 5 min intervals till 60 min. Ramsay sedation score was assessed before, during, and after the procedure and Aldrete's recovery rating score was assessed at the end of the procedure.
 Results: Compared to the Dex group, the ketofol group showed a statistically significant shorter sedation onset (P = 0.017) but longer discharge time as well as higher rescue dose and a number of interruptions (P < 0.001). There was more stable respiration in Dex group, but with significantly more bradycardia. The mean arterial blood pressure showed some episodes of significant elevations with ketofol compared to Dex, while a biphasic response was observed in the Dex group.
 Conclusion: The use of Dex induced successful sedation of children who underwent tooth pulp therapy in terms of minimizing the number of interruptions during the procedure, the frequency of rescue drugs administration as well as the total procedure and discharge times. Dexmedetomidine showed no adverse respiratory effects but was associated with bradycardia and biphasic mean blood pressure alterations that require careful titration.
 Abbreviations: HR: heart rate; IV: Intravenous; RSS: NMDA: N-Methyl D-Aspartate PACU: Post Anesthesia Care Unit; Ramsay sedation score
 Citation: Hussien RM, Emam DF, Shoukry AA. Dexmedetomidine compared to ketofol for sedation in pediatric patients undergoing dental procedures: a double-blind, randomized clinical trial. Anaesth. pain intensive care 2022;26(5):595-601; DOI: 10.35975/apic.v26i5.2016

The intrarenal blood pressure modulation system is differentially altered after renal denervation guided by different intensities of blood pressure responses.

The aim of this study was to investigate alterations in the intrarenal blood pressure (BP) regulation system after renal denervation (RDN) guided by renal nerve stimulation (RNS). Twenty-one dogs were randomized to receive RDN at strong (SRA group, n = 7) or weak (WRA group, n = 7) BP-elevation response sites identified by RNS or underwent RNS only (RNS-control, RSC, n = 7). After 4 weeks of follow-up, renal sympathetic components, the main components of renin-angiotensin system (RAS) and the major transporters involved in sodium and water reabsorption were assessed by immunohistochemical analysis. Compared with RSC treatment, RDN therapy significantly reduced renal norepinephrine and tyrosine hydroxylase levels, decreased the renin content and inhibited the onsite generation of angiotensinogen. Moreover, the expression of exciting axis components, including angiotensin-converting enzyme (ACE), angiotensin II and angiotensin II type-1 receptor, was downregulated, while protective axis components for the cardiovascular system, including ACE2 and Mas receptors, were upregulated in both WRA and SRA groups. Moreover, RDN reduced the abundance of aquaporin-1 and aquaporin-2 in kidneys. Although RDN had a minimal effect on overall NKCC2 expression, its activation (p-NKCC2) and directional enrichment in the apical membrane (mNKCC2) were dramatically blunted. All these changes were more obvious in the SRA group than WRA group. Selective RDN guided by RNS effectively reduced systemic BP by affecting the renal neurohormone system, as well as the sodium and water transporter system, and these effects at sites with a strong BP response were more superior.

Blood pressure alterations in recently COVID-19 vaccinated patients

Abstract Background A non-immediate hypertensive response short after COVID-19 vaccination has been reported. Mild to moderate elevated arterial blood pressure (BP) levels have been documented few days after a single or two-doses vaccine. This study sought to investigate this observation as a potential side effect in patients with known hypertension and healthy controls. Methods A total of 100 vaccinated patients between the age of 50 to 70 years old were studied. They were randomly assigned to one of the approved and available vaccines (Pfizer, Astra Zeneca, Moderna, Johnson & Johnson). Half of them were hypertensives under medical treatment and half of them were not. All participants had systolic BP <140mmHg and diastolic BP <90mmHg before vaccination and volunteered for standard daily home BP measurements (HBPM) and ambulatory BP measurements (ABPM) between the 1st and the 21st day after considered fully COVID-19 vaccinated. Results All patients, hypertensives or not, had at some point a recorded hypertensive response for both systolic (SBP) and diastolic (DBP) BP after considered fully vaccinated. Hypertensives were older and with higher body mass index (BMI). Some of the hypertensive patients received additional medication whereas some of the non-hypertensive patients started life modification changes and systematic BP measurements for a possible diagnosis of hypertension. Conclusions Vaccination for COVID-19 seems to be related with a short period of hypertensive response. This phenomenon was partial and mostly observed in older overweight hypertensives. Funding Acknowledgement Type of funding sources: None.

Circadian blood pressure variations in normotensive and hypertensive Indian adults: An exploratory study

Background and Objectives: Though 24hours BP monitoring is a useful tool that provide insights in masked and white coat hypertension as well as can be used as a marker of allostatic load (by monitoring circadian variations) and applicable in chronotherapy, is still sparingly used clinically. Hence, the objective of present study is to explore the pattern of circadian variation of blood pressure in normotensive and hypertensive Indians to pave the way for future chronobiological research and predictive medicine. Materials and Methods: In this cross-sectional study, total 125 volunteers, referred from the medicine OPD/IPD, enrolled. All the volunteers underwent 24 hour ambulatory blood pressure monitoring. BP recording of 100 participants (37 female and 63 male, mean age = 43.15±14.47 years) was used for final analysis. On the basis of guidelines provided for diagnosis of hypertension by European Society of Heart, individuals were grouped as i) normotensives (n=37) and ii) hypertensives (n=63). For descriptive analysis, different blood pressure parameters from three segments viz. overall, awake period and asleep period were used. Between groups comparison was done using Mann-Whitney and ANNOVA test. P-value < 0.05 had been considered as significant.Observation and Results: A significance difference in circadian systolic, diastolic and mean arterial BP was observed between groups. Although a higher percentage of non-dippers (65%) was observed in hypertensives but 38% of normotensives have also shown non- dipping status that indicates altered circadian rhythm or allostatic load. Conclusion: We observed altered circadian blood pressure pattern in both groups though higher percentage of non -dipping status in hypertensive patients. In normotensives it could subserve as an early marker of disease process, in hypertensives, it may be useful for application of Chrono-pharmacology.

Cardioprotective Effect of Polymyxin-B and Dantrolene Combination on Isoproterenol-Induced Hypertrophic Cardiomyopathy in Rats, via Attenuation of Calmodulin-Dependent Protein Kinase II.

Hypertrophic cardiomyopathy is a major cause of mortality worldwide. In this study, we hypothesized that the combination of Dantrolene and Polymyxin-B will provide cardioprotective action against isoproterenol-induced hypertrophic cardiomyopathy via attenuation of Calmodulin-dependent protein kinase II (CaMKII). Hypertrophic cardiomyopathy was induced in rats by subcutaneous administration of isoproterenol (5 mg/kg) for 14 days. Simultaneously, animals were treated with Polymyxin-B per se, Dantrolene per se, and Dantrolene and Polymyxin-B combination for 14 days. Hemodynamic parameters, biochemical parameters, and histological analysis were performed. Administration of isoproterenol for 14 days resulted in severe myocardial damage, characterized by cardiac hypertrophy and increase serum CK-MB, CK-Nac, LDH, AST, and ALT levels. It also caused alteration in electrocardiogram and blood pressure. A significant increase in CaMKII was observed in heart homogenate. Treatment with the Polymyxin-B and Dantrolene combination significantly ameliorated cardiac hypertrophy, biochemical parameters, ECG parameters, and heart histopathology. Further, significant attenuation in CaMKII levels was observed. The effect of the combination was more than per se treatment. Results of the current study showed that the combination of Polymyxin-B and Dantrolene prevented the development of isoproterenol-induced hypertrophic cardiomyopathy in rats via attenuation of the CaMKII.

Effects of high-absorption curcumin for the prevention of hypertensive heart disease: a double-blind, placebo-controlled, randomized clinical study.

AimsHypertension is a strong risk factor for heart failure with preserved ejection fraction. Curcumin has p300-specific histone acetyltransferase inhibitory activity, suppresses cardiomyocyte hypertrophy and fibrosis, and significantly reduces myocardial brain natriuretic peptide (BNP) expression without altering blood pressure in a rat model of hypertensive heart disease. This double-blind, placebo-controlled, randomized study, for the first time, aimed to examine the efficacy of a high-absorption curcumin for the prevention of hypertensive heart disease in humans.Methods and resultsPatients exhibiting initial signs of hypertensive heart disease with left ventricular ejection fraction ≥60% and stable blood pressure <140/90 mmHg orally took a double-blinded capsule (either a 90 mg curcumin capsule or placebo) twice daily for 24 weeks. The primary endpoint was per cent changes in left ventricular diastolic function (E/E′) from baseline to 6 months after administration. The secondary endpoint was the per cent change in plasma BNP levels. The E/E′ ratio per cent change from baseline to 6 months after administration was similar between the placebo (n = 69) and the curcumin (n = 73) groups. The per cent change in plasma BNP levels was significantly lower in the curcumin group than in the placebo group. In patients <65 years, BNP per cent changes were significantly lower in the curcumin group than in the placebo group, but similar between groups in ≥65 years (<65 vs. ≥65 years: P for interaction = 0.011).ConclusionsA high-absorption curcumin agent did not affect the E/E′ ratio, rather it significantly inhibited the increase in plasma BNP levels in patients with initial signs of hypertensive heart disease.

Pilot project. Resveratrol intake by physical active and sedentary older adult women and blood pressure.

Although the use of resveratrol is widespread, there is a lack of studies concerning its use in older adults who practice regular physical activity. The present study aimed to evaluate how resveratrol influenced anthropometric parameters, heart measures, blood analytes in women participants, aged 60 to 80years old, distributed in four groups consisting of those who regularly exercise or not, and those who were under resveratrol treatment or not. The older adult women exercised in a Community Center. A prospective, comparative clinical pilot study was carried out based on convenience non-probability sampling. Resveratrol 300mg/daily/60days was orally-administered to 43 participants that were regularly accompanied and checked for anthropometrical parameters, heart measures, blood analytes, leukogram, and plaquetogram indices. The effect of resveratrol and exercise was not significant in most of the parameters evaluated in the study. Nonetheless, both systolic (p=0.0120) and diastolic (p=0.0241) blood pressures (BP) were elevated in sedentary older adult women in comparison with older women that regularly exercised. However, they remained within the normal BP range considered for the age. Mean corpuscular volume (MCH; p=0.0198) and red blood cell distribution width (RDW; p<0.0001) were improved in the groups receiving resveratrol and exercises compared to the sedentary group receiving resveratrol. The sedentary group receiving resveratrol showed diminished segmented cells (p=0.0459), basophils (p<0.0001), and lymphocytes (p<0.0001). Present findings showed that resveratrol consumption for sedentary older women could lead to dysregulated blood pressure. Although resveratrol consumption is indicated to treat inflammation, its use must be discussed with a health professional and not be inadvertently self-administered due to significant alterations in blood pressure in older adult women, primarily if not related to exercise practice.

Abstract P329: Moderate Dietary Sodium Restriction Does Not Alter Insulin Sensitivity Or Secretion In Metabolic Syndrome

We previously demonstrated that maximal dietary sodium restriction (10mmol/d) decreases insulin secretion and impairs insulin secretion. It is unclear if dietary changes other than NaCL account for this and if more moderate sodium restriction reflecting clinically achievable ranges would alter glucose metabolism. We therefore hypothesized that moderate diet-induced stimulation of the renin-angiotensin-aldosterone system would impair insulin secretion in participants with the metabolic syndrome. We conducted a randomized, double-blind cross-over study in 29 volunteers in which we provided a standardized 50mmol Na/day diet for 7 days. Participants were provided encapsulated NaCl 150 mEq/d (High Sodium, HS) or matching placebo capsule (Low Sodium, LS) for 7 days. Insulin sensitivity was assessed with hyperinsulinemic clamp and insulin secretion was assessed with hyperglycemic clamp at 5 and 7 days of diet, respectively. LS diet increased plasma aldosterone compared to HS diet (15.2±6.2 vs 10.8±3.2; P &lt;0.001) but did alter blood pressure (126.5±13.6 vs 128.7±13.9 mmHg; P =0.49). Fasting glucose and insulin were similar during LS diet. As assessed by hyperinsulinemic clamps, insulin sensitivity was similar (0.2756 ± 0.0771 vs 0.2917 ± 0.0722 mg/kg/min per uU/mL Insulin; P =0.49). Insulin clearance tended to decrease during the LS period (980 ± 410 vs 1127 ± 366; P=0.10). There was no difference in glucose-stimulated insulin secretion assessed by hyperglycemic clamp (55.3 ± 47.7 vs 50.0 ± 36.7 uU/ml; P=0.7). Dietary sodium restriction achievable dose not alter glucose and insulin metabolism in the short term.

Abstract 097: Seasonal Travel Stressors Modulates Hypertension In Adult Female Lupus Mice

Systemic lupus erythematosus (SLE) is an autoimmune disorder linked to chronic renal inflammation and prevalent hypertension. We use an established murine model of SLE (NZBWF1) to mechanistically link renal inflammation to the development of hypertension. SLE mice travel to our university pre-puberty (3-6 weeks), develop autoantibodies by 20 weeks, and are consistently hypertensive by 35 weeks. We observed that when mice travel in the summer, autoantibody production is higher as the mice age vs. those that travel in the winter. This association was heightened in a subset of SLE mice that traveled to our university as adults (18-19 weeks), suggesting a role of seasonal factors, travel stressors, and age in altering disease severity. It is unknown whether these seasonal and environmental stressors can also alter blood pressure and inflammatory processes. Thus, we hypothesized that travel-induced seasonal stressors exacerbate hypertension and renal inflammation in adult SLE-prone mice. Female SLE mice traveled to our university in summer or winter at 3-6 or 18-19 weeks and were implanted with carotid catheters once they reached 35 weeks to assess mean arterial pressure (MAP). Mice were then euthanized and tissues collected to monitor plasma and renal interleukin (IL)-6, a proinflammatory cytokine. No seasonal differences were found in MAP of mice that traveled pre-puberty in summer (n = 17) and winter (n = 39) (143.6 ± 3.5 vs. 140.2 ± 2.2 mmHg; p = 0.4096) nor in plasma IL-6 (26.06 ± 7.25 vs. 15.54 ± 8.622 pg/mL; p = 0.2370) or renal IL-6 (0.01156 ± 0.00603 vs. 0.01099 ± 0.00523 pg/μg; p = 0.9445). Conversely, adult SLE mice that traveled in summer had higher MAP than those that traveled in winter (136.12 ± 2.63 vs. 128.81 ± 1.55 mmHg; p = 0.0339; n = 5-7), as well as higher plasma IL-6 (723.28 ± 220.72 vs. 280.73 ± 67.99 pg/mL; p = 0.0339) and renal IL-6 (0.078956 ± 0.017192 vs. 0.023413 ± 0.003801 pg/μg; p &lt; 0.0001). Together, our data indicate that hypertension and renal inflammation in mice subjected to travel stress as adults is seasonally dependent. Since there were no seasonal differences in hypertension in SLE mice that traveled pre-puberty, there may be a factor related to age, seasonal environmental factors, and/or timing of the stressors that is causing the detrimental effect.

Cardiorespiratory Fitness Level Alters Blood Pressure Responses Induced By Histamine H1- And H2-receptor Blockade During Dynamic Exercise

INTRODUCTION: Epidemiological studies have reported that greater cardiorespiratory fitness (CRF) is associated with lower blood pressure (BP). Histamine receptor-mediated peripheral vasodilation contributes to post-exercise hypotension and lowing exercising BP responses. Previously, our laboratory found that overactive BP responses to exercise were induced by the inability of histamine receptors in individuals with prehypertension. However, it is still unknown that CRF can impact BP responses elicited by the inability of the receptors. PURPOSE: This study was to assess whether aerobic fitness is effective in lowering excessive BP responses induced by the blockade of histamine receptors METHODS: In twelve male and female subjects (6 high CRF and 6 low CRF), we examined the effects of histamine H1- and H2- receptor blockades on heart rate (HR), stroke volume (SV), cardiac output (CO), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and total peripheral resistance (TPR) at workloads corresponding to 40% and 60% workloads of VO2peak during cycling exercise. RESULTS: Our study indicated that compared to the high CRF group, changes in MAP from the baselines were higher in the low CRF group before the blockade at each workload (40%: D14±2 vs. 8±1 mmHg; 60%: D21±3 vs. 15±2 mmHg). The changes in MAP in response to the blockade during exercise were substantially lower in the high CRF group (40%: D18±2 vs. 11±1 mmHg; 60%: D29±3 vs. 19±2 mmHg). CONCLUSIONS: Our study suggests that an improvement in CRF likely reduces exaggerated BP responses elicited due to the inability of histamine receptors in pathological conditions such as prehypertension and hypertension.

Correlation Between Body Mass Index Waist Hip Ratio and Body Fat Percentage with Blood Pressure in Sedentary Females Sedentary Lifestyle and Body Mass Index Alter Blood Pressure

Introduction: The adoption of a sedentary lifestyle is a major contributor to the development of disease as well as to morbidity and mortality rates. People who have high blood pressure can benefit from regular physical activity since it lowers their blood pressure. A lower body fat percentage is connected with a lower risk of developing high blood pressure when engaging in physical activity. There is a clear correlation between the body mass index (BMI) and the percentage of body fat (BF%) in terms of the resting rate of sympathetic nerve discharge to skeletal muscle. A greater proportion of fat stored in the abdomen, as opposed to the gluteal region, is associated with an increased risk of a variety of health problems, including diabetes and cardiovascular disease. As a result, the waist-to-hip ratio should be determined in order to conduct an analysis of fat distribution that is separate from an assessment of total obesity. The materials and procedures: Random selection was used to choose from the general population one hundred healthy sedentary volunteers and one hundred healthy non-sedentary subjects. Subjects in the age group (22-55 years) who had a BMI that was greater than 30 (kg/m2) were considered to be obese. Non-obese subjects were defined as having a body mass index (BMI) between 17.50 and 25.20 kg/m2 and an age range of 22 to 55 years. The purpose of this study was to investigate the differences between healthy sedentary and non-sedentary individuals in terms of parameters such as body mass index (BMI), waist-to-hip ratio (WHR), and body fat percentage (BF%). The participants ranged in age from 22 to 55 years old, and the correlation between these parameters and blood pressure was determined. Results: The findings showed that sedentary subjects had higher levels of body mass index, waist circumference, and body fat percentage than non-sedentary subjects did, and there was a positive link between these parameters and blood pressure. Conclusion: The conclusion is that a sedentary lifestyle is linked to an increase in Body Mass Index, Waist Hip Ratio, Blood Pressure, as well as Body fat percentage and fat mass. There was a link between BMI, WHR, BF%, and FM and blood pressure that was in the positive. Keywords: Body fat; body mass index; sedentary lifestyle; waist-hip ratio

Contrasting effects of sleep fragmentation and angiotensin-II treatment upon pro-inflammatory responses of mice

Disordered sleep promotes inflammation in brain and peripheral tissues, but the mechanisms that regulate these responses are poorly understood. One hypothesis is that activation of the sympathetic nervous system (SNS) from sleep loss elevates blood pressure to promote vascular sheer stress leading to inflammation. As catecholamines produced from SNS activation can directly regulate inflammation, we pharmacologically altered blood pressure using an alternative approach-manipulation of the renin-angiotensin system (RAS). Male C57BL6/J mice were treated with angiotensin or captopril to elevate and reduce blood pressure, respectively and then exposed to 24-h of sleep fragmentation (SF) or allowed to sleep (control). Pro- and anti-inflammatory cytokine gene expression and as endothelial adhesion gene expression as well as serum glucocorticoids (corticosterone) were measured. RAS manipulation elevated cytokines and endothelial adhesion expression in heart and aorta while SF increased cytokine expression in peripheral tissues, but not brain. However, there were interactive effects of angiotensin-II and SF upon cytokine gene expression in hippocampus and hypothalamus, but not prefrontal cortex. SF, but not RAS manipulation, elevated serum corticosterone concentration. These findings highlight the contrasting effects of RAS manipulation and SF, implying that inflammation from SF is acting on different pathways that are largely independent of RAS manipulation.

Correlation of vascular structural changes in a cadaveric model and obesity-related cardiovascular non-communicable diseases

IntroductionCarrying excess body weight is a vital risk factor for obesity-related chronic diseases affecting blood vessels. Obesity influences cardiovascular non-communicable diseases (NCDs) via vascular structural changes, which involve alterations in lipids, blood pressure, coagulation, fibrinolysis, and inflammation, leading to endothelial dysfunction due to vascular remodeling and stiffness. Small peripheral vessels are the first to be impacted; however, it is unclear whether this change is followed by microscopic changes in the aorta. ObjectivesTo determine the correlation of vascular structure with the incidence of NCDs and subcutaneous fat thickness and to study micro-scale changes in vascular structure, especially concerning collagen in the aorta, using a cadaveric model. MethodsTwenty-four cadaveric models were classified into a control group and an NCD group. The subcutaneous fat thickness was measured on the arm, anterior abdomen, and thigh. The aorta was collected and stained with hematoxylin, eosin, and Masson's trichrome for collagen evaluation. The vessel thickness was morphometrically analyzed. Scanning electron microscopy was performed to identify the extracellular matrix organization in the vessel. ResultsDisorganization of the extracellular matrix and fragments of the vascular wall were found in the NCDs group. The tunica intima of the NCDs group represented endothelial dysfunction with macrophage foam cells. The thickness of the tunica intima of the NCDs group slightly increased without being significantly different compared to control group with 144.63 ± 124.38 µm and 105.60 ± 27.49 µm, respectively. However, the thickness of tunica media of the NCDs group significantly decreased compared to control group with 956.58 ± 27.80 µm and 1167.43 ± 48.6 µm, respectively. Collagen deposits in the aortic wall significantly increased by 15% in the NCDs group especially in tunica media by 17.4% compared to control. The results showed a correlation between the amount of collagen fiber and subcutaneous fat on the thigh. ConclusionThere was a change toward irregular microstructural patterns and increased collagen fibers in NCDs. In addition, there was a correlation between collagen fiber density and the subcutaneous fat thickness of the thigh in cadavers with a history of NCDs.

AARC Clinical Practice Guidelines: Capillary Blood Gas Sampling for Neonatal and Pediatric Patients.

In the absence of an indwelling arterial catheter, capillary blood gas sampling may be used to evaluate the acid/base and ventilation status of neonatal and pediatric patients with cardiorespiratory conditions. These guidelines were developed from a comprehensive review of the literature to provide guidance for the collection, handling, and interpretation of blood obtained from an arterialized capillary sample. Capillary and venous blood gas measurements are a useful alternative to arterial blood gas measurements for neonatal and pediatric patients who do not require close monitoring of [Formula: see text] In the presence of alterations in body temperature, blood pressure, or peripheral perfusion, agreement between a capillary blood gas with an arterial sample is recommended to determine whether changes in these physiologic conditions reduce reliability. Perfusion to the sample site should be assessed and preference given to blood sampling from a well perfused site, and blood should be analyzed within 15 min of sampling to minimize the propensity for pre-analytical errors. Clinicians should consider re-collecting a blood sample, obtained from an artery, vein, or capillary, when the blood gas or analyte result interpretation does not align with the patient's clinical presentation. A pneumatic tube system can be reliably used to transport blood gas samples collected in a syringe and capillary tube to a clinical laboratory for analysis. To reduce the cumulative pain effect and risk of complications, the capillary puncture procedure should be minimized when possible. Non-pharmacologic interventions should be used to reduce pain associated with capillary blood gas sampling. Automatic lancets are preferred to puncture the skin for capillary blood gas collection.