Reduction In Average Blood Pressure Research Articles

Learning implementation of a guideline based decision support system to improve hypertension treatment in primary care in China: pragmatic cluster randomised controlled trial

ObjectiveTo evaluate the effectiveness of a clinical decision support system (CDSS) in improving the use of guideline accordant antihypertensive treatment in primary care settings in China.DesignPragmatic, open label, cluster randomised...

Effects Of A Combination Of Microscopic Handgrip And Nature's Voice On A Client's Blood Pressure With Hypertension

Background: Hypertension is the number one cause of death in the world every year because it causes complex cardiovascular problems. Semarang City Department's 2023 health profile data shows the number of hypertension is 24,949. Practicing holding a handgrip is a non-pharmacological therapy for treating hypertension because it stabilizes blood pressure and heart rate. Many combination therapies are used, including combining handgrip exercises with sound waves. Natural sounds will stimulate the hypothalamus, resulting in a feeling of calm and have an effect on the blood pressure regulation mechanism. The aim of this study was to determine the effect of a combination of handgrip exercise and natural sounds on the blood pressure of clients with hypertension. This research method is a pre-experimental one group pre and post test design and sampling using purposive sampling technique. The population of this study were clients who were recorded as suffering from hypertension at the Sekaran Semarang Community Health Center. The research instrument uses a digital spygmomanometer and SOP for action. The research stages consist of preparation, implementation and processing of research data. The steps in the preparation stage are literature study, field survey, discussions with lecturers and experts, developing procedures for the combination of handgrip exercise and natural sounds, expert review, and socialization of the combination of handgrip exercise and natural sounds to clients and families. The implementation stage is carried out by collecting data on clients registered at the Sekaran Semarang Community Health Center, pre and post tests by measuring blood pressure using a spygmomanometer, implementing actions according to the prepared SOP, observing implementation using an observation sheet. In the data processing stage, a Paired Sample T-test was carried out to assess the effect of the combination of handgrip exercise and natural sounds on the blood pressure of clients with hypertension. The targeted output is publication in national journals indexed by Sinta and HAKI. The TKT target for this combination of handgrip exercise and natural sounds is level 2. The research results showed that 91.67% of respondents experienced an average reduction in systolic blood pressure of 10.69 mmHg and diastolic blood pressure of 6.11 mmHg. Based on the Paired Sample T-test, the results obtained were 0.000 for the systolic value and 0.001 for the diastolic value, both of which were smaller than the p value of 0.05, so it was concluded that there was an influence of the combination of handgrip exercise and natural sounds on the blood pressure of clients with hypertension. The results of this research can be input for related parties to implement a combination of handgrip exercise and natural sounds as non-pharmacological therapy for hypertension sufferers.

Effects of vitamin C on the pharmacokinetics and pharmacodynamics of nimodipine in rats.

In recent years, researchers have shown a growing interest in the interactions between different pharmaceutical agents. An intriguing instance lies in the possible interaction between nimodipine and vitamin C. To investigate the pharmacokinetic and pharmacodynamic effects of vitamin C on nimodipine in rats, rats were randomly divided into a nimodipine only group and a combination group (nimodipine + vitamin C). The two groups were given intragastric administration and nimodipine blood concentrations were determined using high-performance liquid chromatography-tandem mass spectrum at different time points. Blood pressure and heart rate were measured via carotid artery cannulation. Pharmacokinetic differences were observed between the nimodipine only group and the combination group at the same dose. Compared with the nimodipine only group, the combination group's main pharmacokinetic parameters of peak concentration and area under the curve increased significantly, and the difference was statistically significant (p < 0.05); furthermore, the combination group exhibited a significant reduction in average blood pressure, while no significant effects on heart rate were observed. Vitamin C did not affect the activity of CYP450 in rat liver. The pharmacokinetic characteristics and pharmacodynamics of nimodipine were changed by vitamin C administration in rats.

PENGARUH TELEHEALTH TERHADAP PENGENDALIAN TEKANAN DARAH

Hypertension is a chronic condition that attacks adults of all ages. Having an effective method or way to manage this condition is the key to successful treatment of hypertension. The design of this research is a cohort study that examines data on hypertensive patients obtained from health service databases. The research took place in October until December 2021. The inclusion criteria in this study were adults (≥45 years) with prehypertension and hypertension, residing in rural areas. An assessment was carried out on respondents who could access the telehealth application at home, and it was validated for monitoring blood pressure using mobile phone or other device with an internet connection that allows monitoring from the respondent's home and telehealth services. Respondents were asked to fill in the results of blood pressure measurements. Based on the results, 55 respondents (100%) carried out data collection. Linear regression analysis found an average reduction in systolic blood pressure of 19.2 mmHg. Respondents in the decreasing systolic blood pressure group had a higher frequency of self-measured blood pressure monitoring (OR = 0.85; 95% CI= 0.81 - 0.89; p = 0.002) than other patients. The use of telehealth at home combined with care management by health workers is considered effective in improving blood pressure control in hypertensive patients.

Blood Pressure Fluctuation Pattern Associated with 90-Day Ischemic Stroke and Transient Ischemic Attack After Total Knee Arthroplasty-A Retrospective Study.

Blood pressure (BP) fluctuation has been demonstrated to be closely associated with stroke. However, at present, no attention is paid to the BP fluctuation following total knee arthroplasty (TKA). The aim of this study is to investigate what is BP fluctuation patterns in stroke and transient ischemic attack (TIA) patients after primary TKA, compare clinical characteristics among different BP fluctuation patterns and determine whether it could predict the occurrence of a 90-day stroke. A retrospective study was conducted from February 1, 2011 to February 15, 2021. Stroke or TIA patients within 90 days after TKA were included. Data from a hospitalization management system were analyzed, including demographics, smoking status, comorbidities, medications, surgical variables, and 90-day stroke, mortality, and readmission rates. BP fluctuation patterns were defined based on the average BP in the first 3 days after TKA. A logistic regression analysis model was used to identify risk factors for 90-day stroke or TIA following TKA. Of the 1687 patients who underwent primary TKA, 4.0% (68/1687) experienced a 90-day stroke or TIA. A total of 63 patients met the inclusion criteria, with an average age of 67.5 years and 55.6% (35/63) female. The number of stroke or TIA patients in each BP fluctuation pattern (T1-T5) was 6 (9.5%), 5 (7.9%), 4 (6.3%), 13 (20.6%), and 35 (55.6%) respectively. Patients with a T5 pattern tended to be older and had a greater reduction in average systolic blood pressure (SBP) 3 days after surgery compared to other patterns. The T5 pattern was associated with a higher occurrence of stroke and a lower occurrence of TIA. Patients with a T5 pattern also had a longer length of stay within 90 days following TKA. After adjusting for confounding factors, average SBP fluctuation ≥40 mmHg and the T5 pattern of BP fluctuation remained risk factors for 90-day stroke or TIA after TKA. BP fluctuation patterns in the early postoperative period are associated with 90-day stroke and TIA following primary TKA.

Verification of the effect of an exercise programme using walking and diet adjustment in hypertension

One of the leading risk factors for cardiovascular disease is hypokinesis. Therefore, an exercise regimen is emphasized for the prevention and control of hypertension, while at the same time aiming to reduce overall cardiovascular risk in addition to achieving normal blood pressure values.&#x0D; The aim of this study was to verify the effect of an exercise programme using walking and dietary modification on the reduction of blood pressure values in hypertension, while the effect of the intervention on weight reduction and change in body composition was also studied.&#x0D; The research method in our work was case study. The proband was a physically inactive overweight woman, age 55 years, treated hypertensive, whose blood pressure at entry to the program reached the values of mild hypertension even with treatment. Baseline data were resting blood pressure values measured for 7 days in the morning and evening, a two-day record of physical activity, a seven-day record of diet, diagnosis and analysis of body composition with the InBody device, and calculation of the WHR index. The proband developed a physical activity intervention program using walking for 12 weeks, a minimum of 5 times per week, at moderate intensity, with a gradual increase in daily walking time from 30 to 60 min/day. As an adjunct to the exercise intervention, she was recommended a dietary modification. At the end of the follow-up period, blood pressure values were measured in the same way, a diagnostic and body composition analysis was performed with the InBody device, and the WHR index was calculated. The intervention program was also evaluated in relation to overweight and body composition as important factors in hypertension.&#x0D; After 12 weeks of the intervention programme, the mean reduction in systolic blood pressure was 6,29 mmHg in the morning and 4,86 mmHg in the evening. The average reduction in diastolic blood pressure was 4,57 mmHg in the morning and 3,14 mmHg in the evening. There was also a decrease in heart rate by an average of 4,07 beats per minute. At the same time, the intervention program led to a reduction in the proband's body weight (by 7,2 kg), a decrease in BMI (from 27,8 to 25,5 kg/m2), a decrease in body fat percentage (by 3,9 %) and a decrease in WHR index (from 0,91 to 0,88).&#x0D; These results confirmed that regular physical activity and dietary modification play an important role in the treatment of high blood pressure and verified the effectiveness of expert recommendations in hypertension. They also confirmed the positive effect of these recommendations on weight reduction and body composition. In summary, this work verified the beneficial effects of walking supported by dietary modification on the following risk factors for cardiovascular disease - high blood pressure, overweight, body fat, and central obesity.

Nanopartikel Daun Kelor (Moringa Oleifera Lamk.) terhadap Perubahan Kadar Kalsium Darah dan Tekanan Darah pada Wanita Usia Subur Hipertensi

This study aims to analyze the effectiveness of giving moringa leaf nanoparticles to changes in blood calcium levels and blood pressure in women of childbearing age with hypertension. The method used in this research is Quasi Experiment with Pretest–Posttest With a Control Group design. The results showed that the average increase in calcium levels in the intervention group after treatment was 0.49, and in the control group was 0.18. The average decrease in diastolic blood pressure was 18.50 mmHg in the intervention group and 6.81 mmHg in the control group. The average reduction in systolic blood pressure was 16.19 mmHg in the intervention group and 6.00 mmHg in the control group. In conclusion, the administration of moringa leaf nanoparticles effectively increases blood calcium levels and reduces blood pressure in women of childbearing age with hypertension.&#x0D; &#x0D; Keywords: Hypertension, Blood Calcium Levels, Moringa Leaf Nanoparticles, Blood Pressure, Women of Reproductive Age

DASH dijeta u prevenciji i lečenju arterijske hipertenzije

It is estimated that almost half of the adult population suffers from arterial hypertension in the Republic of Serbia. The development of arterial hypertension and its complications can be successfully controlled and prevented. The Dietary Approaches to Stop Hypertension, that is, the DASH diet is one of the most efficient dietary eating patterns in the control of hypertension. It leads to an average reduction in blood pressure by 4 to 15 mmHg, supports the optimization of body mass and lipids in the blood serum. The DASH diet promotes rational and balanced diet. In order to bring principles of the DASH diet closer to patients, it is necessary to adequately engage a nutritionist - dietician in working with high-risk patients. The paper presents practical recommendations for the implementation of the DASH diet and includes illustrations that serve to improve counseling work with patients in primary health care.

PENGARUH PEMBERIAN PRODUK BERBAHAN KACANG KEDELAI (Glycine max) TERHADAP PENURUNAN TEKANAN DARAH

Background : The prevalence of hypertension in West Nusa Tenggara in 2013 was 24.3%, this figure increased in 2018 to 27.8%. Treatment of hypertension can be done in two ways, namely, pharmacology and non pharmacology. Non-pharmacological treatment can be done with the Dietary Approaches to Stop Hypertension (DASH) diet and consuming functional foods, one of which is soybeans. Soybeans contain isoflavones and the amino acid tryptophan which can reduce the risk of cardiovascular disease, one of which is hypertension. Objectives : Objectives in this literature study is to examine the effect of giving soybean based products on reducing blood pressure from various literature sources.Methods : The literature search in this literature study uses three databases, namely Google Scholar, Microsoft Academia, and Garuda Portal. The keywords used in the literature search were "soybean products and blood pressure", "product soybean and blood pressure", "product soybean and hypertension".Results : From 10 journals that have been reviewed, it is found that all of them stated that soy products can reduce blood pressure. The average reduction in blood pressure after the intervention of soybean-based products was 10,84/7,57 mmHg. Conclusion : From 10 journals that have been reviewed, it can be concluded that the provision of soy products can reduce blood pressure.

Impact of Victoria's first dedicated endocrine hypertension service on the pattern of primary aldosteronism diagnoses.

Primary aldosteronism (PA) accounts for 3.2-12.7% of hypertension in primary care but is often diagnosed late, if at all. A delayed or missed diagnosis leads to poor blood pressure control and greater cardiovascular risk. To analyse the impact of Victoria's first dedicated endocrine hypertension service (EHS) on the pattern of PA diagnosis. Socio-demographic and clinical data from all patients who attended the EHS since July 2016 (n = 267) was collected prospectively. Patients were divided into Year 1 (Y1), Year 2 (Y2) and Year 3 (Y3), based on their first visit. The proportion of primary care referrals increased (20% in Y1, 47% in Y2, 52% in Y3) with more referrals being made for treatment-naive hypertension (3% in Y1, 14% in Y2, 19% in Y3). Among PA patients, the median duration of hypertension prior to their first visit decreased (11 years in Y1, 10 years in Y2, 7 years in Y3), and the prevalence of end-organ damage decreased (44% in Y1, 42% in Y2, 33% in Y3). Targeted management of PA improved clinical and biochemical outcomes. The average blood pressure reduction following targeted management increased from 16/12 mmHg in Y1 to 23/12 mmHg in Y3. The EHS, with its strong component of general practitioner engagement, led to increased primary care referrals and PA detection earlier in the course of hypertension. Referred patients were on fewer antihypertensives and had less end-organ damage which simplified the diagnostic process, allowing targeted treatment to be commenced earlier and patient outcomes optimised.

Efficacy of Hypertension Self-Management Classes Among Patients at a Federally Qualified Health Center.

Structural racism has contributed to persistent racial disparities in hypertension control, with Black men suffering the highest prevalence of uncontrolled hypertension. Lincoln Community Health Center, our urban Federally Qualified Health Center (FQHC), aimed to use hypertension self-management classes to improve hypertension control among our clinic patients, particularly Black men. Patients attending classes learned about hypertension, were given blood pressure cuffs to use at home, and had the opportunity to speak to physicians in a group setting. We used a nonexperimental quality improvement intervention design to identify baseline differences between participants who attended multiple classes and those who attended only 1 class. Participants who attended multiple classes, most of whom were Black men, achieved an average blood pressure reduction of 19.1/14.8 mm Hg. Although the classes were effective, current policies around health insurance reimbursement and federal quality reporting standards hamper the ability of health care providers to implement such patient education initiatives.

Effect of diuretics on plasma renin activity in primary hypertension: A systematic review and meta-analysis.

Plasma renin activity (PRA) is regarded as a marker of sodium and fluid homeostasis in patients with primary hypertension. Whether effects of diuretics on PRA differ according to class of diuretic, whether diuretics lead to a sustained increase in PRA, and whether changes in PRA relate to those in blood pressure (BP) is unknown. We performed a systematic review and meta-analysis of trials investigating the antihypertensive effects of diuretic therapy in which PRA and/or other biomarkers of fluid homeostasis were measured before and after treatment. Three databases were searched: MEDLINE, EMBASE and The Cochrane Central Register of Controlled Trials. Titles were firstly screened by title and abstract for relevancy before full-text articles were assessed for eligibility according to a predefined inclusion/exclusion criteria. A total of 1684 articles were retrieved of which 61 met the prespecified inclusion/exclusion criteria. PRA was measured in 30/61 studies. Diuretics led to a sustained increase in PRA which was similar for different classes of diuretic (standardised mean difference [95% confidence interval] 0.481 [0.362, 0.601], 0.729 [0.181, 1.28], 0.541 [0.253, 0.830] and 0.548 [0.159, 0.937] for thiazide, loop, mineralocorticoid receptor antagonists/potassium-sparing and combination diuretics respectively, Q = 0.897, P = .826), and did not relate to the average decrease in blood pressure. In antihypertensive drug trials, diuretics lead to a sustained increase in average PRA, which is similar across different classes of diuretic and unrelated to the average reduction in blood pressure.

‘Teaching: individual’ to improve adherence in hypertension and type 2 diabetes

Educational interventions with a multifaceted approach have proven effective to improve adherence to therapeutic regimens in people with chronic diseases. The present study aimed to evaluate the efficacy of a nursing intervention involving individual teaching compared with usual care to improve adherence with therapeutic regimens in people with hypertension and/or type-2 diabetes mellitus (T2DM). This was a parallel randomised two-arm clinical trial in 200 patients from a primary care programme. After 6 months of follow-up, there was a significant improvement in treatment adherence with a score of 0.87 (95% CI 0.30 to 1.44) on a 13 point scale, and an average reduction in systolic blood pressure (SBP) of 3.79 mmHg (95% CI: -6.85 to -0.73) in the intervention group, but not in glycated haemoglobin (HbA1c) levels (-0.16% 95% CI: -0.41 to 0.09). The individual teaching intervention was effective in improving therapeutic adherence and improving blood pressure values among the participants from the primary care programme.

Safety and efficacy of intravenous hydralazine and labetalol for the treatment of asymptomatic hypertension in hospitalised patients: A systematic review.

Current guidelines for the management of asymptomatic hypertension (HTN) in the inpatient setting recommend the use of oral antihypertensives. However, in clinical practice, intravenous (IV) antihypertensives are commonly utilised with little supporting evidence. The objective of this study was to evaluate literature examining the safety/efficacy of IV hydralazine and labetalol in hospitalised patients with non-emergent, asymptomatic HTN. The PRISMA guidelines were utilised to structure the systematic review. A search strategy composed of drug-, inpatient- and HTN-related terms was conducted utilising PubMed, Embase and Scopus databases through May 2020. Full-text, English-language articles describing IV labetalol and/or hydralazine use for non-emergent HTN in an inpatient setting that focused on clinical outcomes (ie vitals, adverse effects, healthcare utilisation) were included. Identified studies were screened/extracted using DistillerSR by two reviewers at each stage, and studies were evaluated qualitatively for the presence of bias. From 3362 records identified in the search, a final set of 10 articles were identified. Four studies focused on labetalol (40%), five studies on hydralazine and labetalol (50%), and one study on hydralazine (10%). The included studies presented a variety of outcomes, but several trends were identified, including reduction in average blood pressure in eight (80%) studies, a risk of adverse effects in six (60%) and increased length of stay in one (10%). The studies identified in this review raise concerns regarding the safety of IV hydralazine and labetalol in non-emergent HTN. Despite relatively broad clinical experience with these drugs, experimental investigations regarding their utility are recommended.

Do-search: A Tool for Causal Inference and Study Design with Multiple Data Sources.

Epidemiologic evidence is based on multiple data sources including clinical trials, cohort studies, surveys, registries, and expert opinions. Merging information from different sources opens up new possibilities for the estimation of causal effects. We show how causal effects can be identified and estimated by combining experiments and observations in real and realistic scenarios. As a new tool, we present do-search, a recently developed algorithmic approach that can determine the identifiability of a causal effect. The approach is based on do-calculus, and it can utilize data with nontrivial missing data and selection bias mechanisms. When the effect is identifiable, do-search outputs an identifying formula on which numerical estimation can be based. When the effect is not identifiable, we can use do-search to recognize additional data sources and assumptions that would make the effect identifiable. Throughout the article, we consider the effect of salt-adding behavior on blood pressure mediated by the salt intake as an example. The identifiability of this effect is resolved in various scenarios with different assumptions on confounding. There are scenarios where the causal effect is identifiable from a chain of experiments but not from survey data, as well as scenarios where the opposite is true. As an illustration, we use survey data from the National Health and Nutrition Examination Survey 2013-2016 and the results from a meta-analysis of randomized controlled trials and estimate the reduction in average systolic blood pressure under an intervention where the use of table salt is discontinued.

Efficacy of Nardostachys jatamansi (D.Don) DC in essential hypertension: A randomized controlled study

BackgroundNardostachys jatamansi (D.Don) DC, commonly known as muskroot and Indian spikenard, is a small, perennial, flowering, rhizomatous species of the Caprifoliaceae family. Nardostachys jatamansi (D.Don) DC (Sumbul-ut-teeb) has been used in Unani Medicine since antiquity. It is one of the important drugs mentioned by Ibn-e-Sina (Avicenna) in his treatise “Kitab al-Adwiya al- Qalbiya” for cardiac diseases. The drug has been shown to exhibit anxiolytic, sedative, antispasmodic, tranquillizing, and anti hypertensive activity. AimThe aim of the present study was to examine the efficacy of Nardostachys jatamansi in reducing blood pressure in hypertensive patients. MethodsThe single blind randomized, placebo controlled study was conducted with 40 patients aged between 35–70 years. The participants were randomly allocated to receive either a total of 3 g of N. Jatamansi (1capsule 3 times a day) or placebo for 4 weeks. Patients using ≤ 2 antihypertensive drugs with stage 1 hypertension were included in the study. Systolic and diastolic Blood pressure was recorded at baseline and at every week for four weeks. MINICHAL score (for Quality of Life) was recorded at baseline and at the end of the trial. ResultsAfter the four weeks of treatment, there was a statistically significant reduction in average systolic blood pressure 144.20 ± 11.35 mmHg (CI, 138.89–149.51) to 134.30 ± 10.08 mmHg (CI, 129.58–139.02), p < 0.001) and diastolic blood pressure (94.9. ± 3.4 mmHg (CI 93.30–96.49) to 83.10 ± 5.29 mmHg (CI 80.62–85.57), p < 0.001) in the N. Jatamansi group whereas there was no significant difference in systolic blood pressure (143.40 ± 8.39 mmHg (CI, 139.47–147.33) to 142. ± 11.68 mmHg (CI, 136.53–147.47) p = 0.148) and diastolic blood pressure 95.10 ± 3.70 mmHg (CI, 93.37–96.83) to 94.80 ± 3.69 mmHg, (CI93.07–96.52) p = 0.186) in placebo group. A comparison between baseline and post treatment, MINICHAL score in N. Jatamansi group showed significant reduction 10.85 ± 1.27 (CI, 10.25–11.44) to 6.20 ± 1.77, (CI, 5.37–7.02) p < 0.001) whereas there was no significant difference in placebo group 11.05 ± 1.50 (CI, 10.34–11.75) to 10.85 ± 1.26, 95 % (CI, 10.25–11.44) p = 0.103). ConclusionThe present findings suggest that N. Jatamansi is effective in reducing both systolic and diastolic blood pressure in essential hypertension. Moreover studies on efficacy of different doses and treatment duration of test drug are required to finetune these observations.

Building a Viable Weight Management Program in a Patient-Centered Medical Home.

The growing prevalence of obesity in the United States and globally highlights the need for innovative strategies to provide obesity treatment in primary care settings. This report describes and evaluates the Weight Management Program (WMP), an interprofessional program in an academic family medicine clinic delivering intensive behavioral therapy (IBT) following evidenced-based guidelines. We extracted WMP participant health data from the electronic health record and evaluated retrospectively. Eligible participants completed at least four WMP visits and had a baseline weight, blood pressure, and hemoglobin A1c (HbA1c) recorded within 1 year prior to their first visit. Paired t tests were used to assess changes in, weight, HbA1c and systolic and diastolic blood pressures from baseline. WMP counseled 673 patients over 3,895 visits from September 2015 to June 2019. Of these, 186 met eligibility criteria (at least four visits), with a median of eight visits (mean=11.3, SD=8.1). Participants saw an average weight decrease during program participation of 9.7 lbs (P&lt;.001), an average decrease in HbA1c of 0.2 points (P=.004), and an average blood pressure reduction of 2.8 mmHg systolic (P=.002) and 1.9 mmHg diastolic (P=.03). One-third of participants (n=60) achieved clinically significant weight loss (&gt;5%) at 18 months. The program has become financially sustainable through billing for preventive counseling services and a $125 out-of-pocket enrollment fee. WMP provides one model for primary care practices to develop a financially sustainable and evidence-based behavioral therapy weight management program for their patients with obesity. Future work will include assessment of longer-term program benefits, quality metrics, and health care costs.

Senam Lansia Menurunkan Tekanan Darah pada Lansia

The purpose of this study was to determine whether there is an influence of elderly exercise on decreasing hypertension in elderly who experience hypertension in Posbindu Cempaka Permai Bengkulu City. This study uses a pre-experimental method. The results showed in the intervention group, the average reduction in systolic blood pressure was 21.00 mmHg, from 171.50 mmHg to 150.50 mmHg. In contrast, the average reduction in diastolic blood pressure was 13.00 mmHg, from 103.00 mmHg to 90, 00 mmHg. Based on the t-dependent test results, obtained (p-value = 0,000) for systolic results and for diastolic results (p-value = 0,000). In conclusion, there is the influence of elderly exercise on decreasing blood pressure before and after the elderly's exercise in hypertensive elderly in Posbindu Cempaka Permai Bengkulu City.&#x0D; &#x0D; Keywords: Hypertension, Elderly Gymnastics, Blood Pressure

Impact of renal denervation on 24-hour blood pressure pattern in patients with resistant hypertension

Aim. To estimate the dynamics of 24-hour blood pressure pattern in patients with resistant hypertension after renal denervation in comparison with the conservative treatment group.Methods. We enrolled 45 patients (21 men and 24 women, mean age 53 (43-66) years) with resistant hypertension. Renal denervation was performed in 25 patients using Vessix renal denervation system while the conservative treatment group included 20 patients. Monitoring of 24-hour blood pressure pattern was performed before renal denervation and after 1 year of follow-up.Results. Twelve months after renal denervation, patients with resistant hypertension had a significant reduction in office blood pressure (33 and 15 mmHg for systolic and diastolic blood pressure, respectively) and 24-hour average blood pressure (29 and 12 mmHg, for systolic and diastolic blood pressure, respectively). Another beneficial effect of renal denervation was a decrease in systolic blood pressure variability both throughout the day and at night (6 (5-12) and 7 (7-10) mmHg, respectively); however, no changes in diastolic blood pressure variability have been registered. Despite renal denervation did not affect the morning blood pressure surge, morning systolic blood pressure reduced from 174 (130180) mmHg to 156 (130-165) mmHg. After 1 year of follow-up, the proportion of dippers increased from 16 to 44%. In contrast to the patients who underwent renal denervation, there were no significant changes in 24-hour blood pressure pattern in the conservative treatment group.Conclusion. After 1 year of follow-up, renal denervation can be considered as an option superior to conservative treatment in patients with resistant hypertension, as it significantly improved 24-hour blood pressure pattern.

PERAN SMOOTHIES KURMA TERHADAP TEKANAN DARAH PENDERITA PREHIPERTENSI

Patients with prehypertension have doubled the risk of hypertension. However, these prehypertensive conditions are often ignored. The sinterable dates of Smoothies can control blood pressure due to the high content of potassium and magnesium. This research aims to determine the influence of date smoothies to decrease blood pressure in patients with prehypertension in the workplace Puskesmas South Cimahi City Cimahi. The research design used is quasy groups experimental by using pre test and post test, dividing group intervention and control. In the intervention group is given the delivery of date smoothies consisting of 100 grams of Halawi dates and 150 ml of pasteurised skim milk, while in the control group was given the giving of banana fruit ambon as much as 100 grams. This treatment is given 1 time a day for 7 consecutive days. The results of the study on the intervention group occurred an average reduction in systolic blood pressure of 11.27 mmHg and diastolic of 6.35 mmHg. In the control group occur an average decrease in systolic blood pressure of 7.35 mmHg and diastolic of 2.15 mmHg. Statistical test results show, there is a significant influence of systolic blood pressure (P = 0.012) and diastolic (p = 0.001) between the intervention and control group. Advice for subsequent research is to conduct similar research in different groups and socialize with the general public about the control of blood pressure.