Average Blood Pressure Values Research Articles

#2649 Blood pressure tend to decrease following COVID-19 infection in patients with chronic kidney disease—lessons learned from a community based cohort

Abstract Background and Aims Pre-existing hypertension (HTN) has been implicated as one of the most common co-morbidities in COVID-19 patients, likely contributing to disease severity. Additionally, the port of viral entry to the host cell—ACE2 receptor, which is a part of the renin-angiotensin-aldosterone system, was initially thought to cause blood pressure (BP) dysregulation. Recently, several large cohorts have been published, connecting COVID-19 infection to new-onset HTN. Nevertheless, the association of HTN with COVID-19 in patients with chronic kidney disease (CKD) in a community setting has not been fully elucidated. We aimed to study the effect of COVID-19 infection on BP in patients with CKD. Method In this cohort study we utilized the Maccabi Healthcare Services (MHS) database during the COVID-19 pandemic. MHS is a nationwide health care payer-provider, providing health services to approximately 2.6 million Israelis. Data is automatically collected and includes comprehensive laboratory results from a single central lab, full pharmacy prescription and purchase data, physician visits, vital signs documentation, imaging and extensive demographic information on each patient. The database includes several automatically formulated registries including a well validated CKD registry. On July 31st 2023 we looked at point prevalence of patients registered as having CKD stages I-V, defined as eGFR <60 ml/min and/or albuminuria over 30 mg on 24 hour urine collection or 30 mg/g creatinine on urine albumin to creatinine ratio, or proteinuria above 150 mg either at spot urine protein to creatinine ratio or over 24 hour collection. We included CKD patients over the age of 18 years, who had mostly mild COVID-19 disease, detected by SARS-CoV-2 PCR or antigen test between January 1st 2020 and December 31st 2022. Examinees were included only if they had at least one blood pressure measurement documented, in their primary care clinic, in the year prior to infection, and at least one measurement during the 12 months period following COVID-19. Only the 1st documented COVID-19 infection of each patient was included. We compared the differences in BP values between pre and post COVID-19. Results Out of 1,821,685 adults at Maccabi HMS in 2023, 193,566 patients were registered as having CKD. Of those, 86,618 had a documented first COVID-19 infection between the years 2020-2022, and 44,410 of them had documented BP measurements both prior and after COVID-19 were analyzed. Mean age for all CKD patients who had COVID-19 was 69.2 (SD-12.9) years and 22,151 (49.9%) were males. Most patients had CKD stage III—26,939 (60%), and 535 (1.2%) were on dialysis. Not surprisingly, 76% of CKD patients had a preexisting diagnosis of HTN and 44% had diabetes mellitus. Average BP values during the year prior to COVID-19 were 133/76.5 mmHg (SD 14.8 and 8.55, respectively). Mean BP values post COVID-19 were 132/75/9 mmHg (SD 15.5 and 8.9, respectively). This translates into a reduction of 1 mmHg in systolic BP and 0.6 mmHg in diastolic BP in the year prior to COVID-19 infection as compared with pre-covid-19 infection (P-value 0.03 and 0.004, respectively). Conclusion Contrary to previous studies, that linked COVID-19 infection to a higher set-point of BP, our data demonstrates in a large community-based cohort of CKD patients, that BP does not increase and even trends down following COVID-19. As patients were one year older during their post-covid year, and some had withdrew ACE inhibitors or ARB, due to erroneous fear of adverse effect on Covid-19 infectivity, we believe that our results may even underestimate the extent of decrease in BP. Further investigation might reveal the possible mechanisms related to this favorable BP decrease after COVID-19 infection, in CKD patients.

Frequency of office blood pressure measurements and the seasonal variability of blood pressure: results of the Hungarian Hypertension Registry

Purpose Hypertension is a major public health problem, thus, its timely and appropriate diagnosis and management are crucial for reducing cardiovascular morbidity and mortality. The aim of the new Hungarian Hypertension Registry is to evaluate the blood pressure measurement practices of general practitioners (GPs), internists and cardiologists in outpatient clinics, as well as to assess the seasonal variability of blood pressure. Materials and methods Omron M3 IT devices were used during four-month periods between October 2018 and April 2023 in GP practices and in hypertension clinics. The blood pressure data were then transmitted online from the monitors’ cuffs to a central database using the Medistance system of Omron. Results Family physicians (n = 2491), and internists/cardiologists (n = 477) participated in the study. A total of 4804 821 blood pressure measurements were taken during 10 four-month evaluation periods. In the ten periods, the daily average number of measurements was between 3.0 and 5.6. Following ESH diagnostic criteria, the proportion of subjects in optimal, normal and high-normal blood pressure categories were 14, 13.4 and 16.7%, respectively. Altogether 56% of the measurements belonged to stage 1, stage 2 or stage 3 hypertension categories (31.6, 17.1 and 7.4%, respectively). On average, a difference of 5/2 mmHg was observed between winter and summer data in systolic and diastolic blood pressures, respectively. The average systolic blood pressure values were higher in GP practices with more than 2000 patients than in the ones with less than 1500 patients (141.86 mmHg versus 140.02 mmHg, p < 0.05). Conclusion In conclusion, the low daily average number of blood pressure measurements indicates a limited blood pressure screening awareness/capacity in the case of Hungarian family physicians. In GP practices with more patients, blood pressure is usually less well-controlled. These results suggest that the further promotion of home blood pressure monitoring is necessary.

Effect of Nonionic Iodinated Contrast Media on Blood Pressure during Contrast-enhanced Computed Tomography of Abdomen Examination: A Cross-sectional Study

ABSTRACT Introduction: Computed tomography (CT) scan has high sensitivity and specificity for numerous conditions. The images produced by a CT scanner can be enhanced using iodinated contrast media. Significant hemodynamic changes are seen with rapid intravenous contrast media injection. The average acceptable blood pressure (BP) value is 120/80 mmHg. Many studies have related hypertensive crises with high-osmolar contrast media, whereas its relation with low-osmolar contrast media is still unclear. This study aims to evaluate the effect of nonionic iodinated contrast media on BP during contrast-enhanced CT (CECT) of the abdomen. Materials and Methods: A cross-sectional study was conducted from April 2022 to August 2023. A total of 146 subjects (73 males and 73 females were included in the study). Statistical analysis of data was done using SPSS 23.0. A comparison of systolic BP and diastolic BP across the three periods was done using repeated measures of ANOVA. A between-group comparison was performed by unpaired t-test. The level of significance was set as 5%. All subjects underwent a CECT abdomen, including a plain, arterial, and venous phase. A bolus of 80 mL of Ultravist was administered. BP was measured before the contrast injection (baseline value), between the arterial and venous phases, and 3 min after the contrast injection. Results: Injection of nonionic contrast media caused a decrease in BP among subjects. The mean systolic BP readings before contrast injection in males and females were 127.5 ± 8 mmHg and 122.8 ± 8.4 mmHg, respectively. The mean diastolic BP before contrast injection was 79.2 ± 6.4 and 76 ± 6.4 mmHg among males and females, respectively. For systolic, these values decreased to 123 ± 10.3 mmHg in males and in females to 115 ± 14.6 mmHg when measured between arterial and venous phases. Similarly, for diastolic BP, the mean values recorded between the arterial-venous phase reduced to 76.7 ± 9.3 mmHg and 72.3 ± 10 mmHg, respectively. The BP readings, however, increased near baseline value when measured 3 min after the injection. The mean systolic BP measured 126.1 ± 8.5 mmHg and 124.9 ± 11.8 mmHg for males and females at 3 min after injection. Similarly, the mean diastolic BP values taken after 3 min of contrast injection were 78.3 ± 6.5 mmHg and 76.2 ± 7 mmHg in males and females, respectively, P &lt; 0.001. BP in both male and female groups was affected similarly. Conclusion: Bolus administration of 80 mL of Ultravist reduced BP. This reduction was short-term and got back to normal within a few minutes. The contrast media similarly affected both genders. The BP changes had no clinical significance.

Blood pressure in preterm infants with bronchopulmonary dysplasia in the first three months of life.

Neonatal hypertension is common in preterm infants with bronchopulmonary dysplasia (BPD). Our study aimed to examine blood pressure variation in the first three months of life in preterm BPD patients. We conducted a retrospective, single-centre study at the Neonatal Intensive Care Unit of the University of Szeged, Hungary. We collected blood pressure data from 26 preterm infants (born at < 30weeks gestation) with moderate or severe BPD over three years (2019-2021). We calculated the BPD group's daily average blood pressure values and used previously defined normal blood pressure values from a preterm patient group born at < 30weeks gestation as a reference. We used 19,481 systolic, diastolic and mean blood pressure measurement data separately to calculate daily average blood pressures. We found a statistically significant correlation between the blood pressure values of the BPD patient group and the reference data. The difference between the blood pressure curve of the group with BPD and that of the reference group was also statistically significant. We also analysed individual patients' daily average blood pressure values and found that 11 patients (42%) had hypertensive blood pressure values for three or more days within the first 90days of life. Within this group, our statistical analysis showed a 25% chance of acute kidney injury. The blood pressure of the BPD group not only correlated with but also significantly differed from the reference data. Hypertension lasting three or more days occurred more frequently in patients with acute kidney injury accompanied by BPD.

Pengaruh Pemberian Jus Mentimun Mix Air Kelapa Muda Terhadap Penurunan Tekanan Darah Pada Penderita Hipertensi di Posbindu Srikndi Rt.004/Rw.07 Kelurahan Lenteng Agung Tahun 2023

With an unhealthy lifestyle such as having a smoking habit, irregular and unhealthy eating patterns will have an impact on hypertension or high blood pressure, which later on from the bad habits above will have further impacts, namely complications of heart disease, heart failure, stroke. , and damage to the kidneys. Problems that can cause an increase in blood pressure can be controlled or prevented by using cucumber and young coconut water.To determine the effect of giving cucumber juice mixed with young coconut water on reducing blood pressure in hypertensive patients. This type of research is in the form of an experiment with a Pre Test and Post Test With Control Group Design research design. The sample in this study was 50 respondents who were divided into two groups, namely 25 samples of treatment group respondents who were given 200 grams of cucumber juice mixed with young coconut water and 25 samples of control group respondents who were not given treatment. The statistical test used to determine the effect uses the T-test. The results of this study indicate that there was an influence on blood pressure in the treatment group given cucumber juice mixed with young coconut water in hypertension sufferers, namely that the results of statistical tests obtained an average value of pre-systolic blood pressure of 161.12 mmHg and an average value of post-systolic blood pressure. systolic blood pressure was 128.48 mmHg and the average value of pre-diastolic blood pressure was 91.16 mmHg and the average value of post-diastolic blood pressure was 80.00 mmHg. A p-value of 0.000 (&lt; 0.05) for systolic blood pressure obtained a p-value of 0.000 (&lt; 0.05) and diastolic blood pressure obtained a p-value of 0.000 (&lt; 0.05). Due to the benefits of cucumber and young coconut water which are beneficial for lowering blood pressure. There is an effect of giving cucumber juice mixed with young coconut water on changes in systolic and diastolic blood pressure in the treatment group and can reduce blood pressure in patients suffering from hypertension aged 40 - 70 years at Posbindu Srikandi RT.004/RW.07 Kel. Lenteng Agung.

Effectiveness of Combination Therapy of Bay Leaf Decoction and Honey on Blood Pressure in Hypertension Sufferers

Background: Hypertension is a condition where systolic and diastolic pressures increase beyond normal pressure limits, systolic pressures above 140 mmHg and diastolic pressures above 90 mmHg, are one of the health problems that is quite dangerous throughout the world because hypertension is the main risk factor that leads to disease. cardiovascular diseases such as heart attack, heart failure, Objectives: To determine the effectiveness of combination therapy of boiled bay leaves and honey on blood pressure in hypertension sufferers at Posbindu Buncis in the working area of Kemiri Muka Health Center, Depok City Methods: This research uses a quantitative type of research. This type of research is a quasi-experimental method (Quasy Experiment) using a pretest-posttest design. The sample consisted of 40 people. The control group consisted of 20 people and the intervention group consisted of 20 people. The analysis uses the Independent T-test. Results: Independent test shows that the average systolic blood pressure value in the intervention and control groups has a p-value of 0.781 &lt; 0.05, so these results can be concluded that HO is accepted, for the average diastolic blood pressure in the intervention and control groups the p-value -value 0.304 &lt; 0.05, it can be concluded that in the intervention and control groups, Ho was accepted and Ha was rejected Conclusion: There is no effectiveness of the combination therapy of boiled bay leaves and honey on blood pressure in hypertension sufferers in Posbindu Beans in the working area of the Kemiri Muka Community Health Center, Depok City in 2022.

Peculiarities of ambulatory blood pressure monitoring in patients who have suffered from COVID-19

Violations of blood pressure control in patients who have had COVID-19 can be due to many pathophysiological factors. Further study of the features of blood pressure (BP) fluctuations in this category of patients will allow to diagnose arterial hypertension (AH) on time, to identify the uncontrolled course of AH and to select the optimal tactics of patients’ management. It was suggested to determine the characteristics of BP fluctuations in patients who have suffered from COVID-19 more than 12 weeks ago, based on the results of ambulatory (daily) blood pressure monitoring. 98 patients (51 men – 52.0%, 47 women – 47.9%) who have had COVID-19 infection more than 12 weeks ago were examined. Patients were divided into 2 groups – with and without a history of AH. The groups of examinees were homogeneous in age and gender. Ambulatory blood pressure monitoring (AM BP) was carried out on the CardioTens apparatus (Meditech, Hungary) according to the standard method. According to the data of AM BP in patients with AH in the anamnesis, who have suffered from COVID-19 more than 12 weeks ago, significantly higher average indicators of daily systolic blood pressure were recorded, and significant violations of the indicators of variability of systolic blood pressure during the day and night periods, pressure load during the day period, as well as a significantly higher degree and the rate of the morning rise in systolic blood pressure. In patients without a history of AH who have suffered from COVID-19 more than 12 weeks ago, in 21.4% cases there was newly diagnosed AH, in 33.3% of cases, increased variability of systolic blood pressure was observed, mainly during the day, in 21.4% of cases, the degree and speed of the morning rise of systolic blood pressure were increased, which indicated the presence of hypertensive reactions to household loads. In patients with a history of AH, in 55.3% of cases there was observed an increase in average blood pressure values per day, during the day and night periods, which was considered as ineffective blood pressure control and required an increase in the doses of previously prescribed antihypertensive drugs or the use of additional antihypertensive drugs in the treatment regimen. In patients with AH in the anamnesis, who have suffered from COVID-19 more than 12 weeks ago, reliable violations of many indicators of AM BP, deterioration of blood pressure control were recorded. In the patients, who did not have AH and who have suffered from COVID-19 more than 12 weeks ago, the presence of a hypertensive reaction to household loads and newly diagnosed AH were odserved.

A Novel Contactless Blood Pressure Measurement System and Algorithm Based on Vision Intelligence

The measurement of vital signs such as blood pressure plays a key role in human health. Usually, we encounter some problems when we check them in the traditional way; for example, it is impossible to check continuously, and measuring vital signs requires direct contact with the patient, which can be uncomfortable for certain individuals. In this research, we present a vision-based system for estimating blood pressure using pulse transit time (PTT) and the Eulerian video magnification (EVM) technique to amplify tiny color variations caused by blood flow to calculate arterial pulse waves traveling between two arterial sites. Calculating the PTT by processing the video signal for each subject, an oscillometer BP device was used to evaluate the performance between measurements in different conditions, including rest, exercise, and during recovery. Mean systolic BP was 115 mmHg at rest, 137 mmHg during high-intensity exercise, and 114 mmHg during recovery, respectively. The average value of diastolic blood pressure did not change significantly before, during, and after exercise. When we compared the systolic and diastolic blood pressure with ground-truth results, our system showed an accuracy of 91% for systolic blood pressure and 90% for diastolic blood pressure.

Characteristics of patients with non-specific aortoarteritis and arterial hypertension based on retrospective analysis

The aim was to study the medical history, laboratory and instrumental data, the trends of arterial hypertension (AH), risk factors for cardiovascular events, target organ damage (TOD), and the development of cardiovascular complications in patients with NSAA (Non-Specific Aortoarteritis).Materials and Methods. The study included 33 women with confirmed NSAA who had been treated at the 5th Cardiology Department of the E.I. Chazov National Medical Research Center of Cardiology since 2005. Complete blood count, biochemical blood analysis, urine analysis, the following instrumental examinations, such as, ECG, echocardiography, ultrasound of the brachial, femoral, aortic, and renal arteries, MRA or CT angiography with contrast, blood pressure measurement in the arms and legs were performed for all patients. Telephone interviews were conducted to assess some patient's condition over time.Results. The most common symptom (84% of patients) was AH, the average age of AH onset was 30 [19; 40] years and the AH average duration is 7,5 [2; 13] years. Nearly half of the patients (45%) had AH as the leading symptom that led them to perform the examination that helped to the diagnosis of NSAA. The average systolic and diastolic blood pressure values were 123±35 mmHg and 66±17 mmHg in the upper extremities, and 166±31 mmHg and 78±18 mmHg in the lower extremities, respectively. About half of patients (51%) had stage 3 AH, and almost all of them had type 3 according to E. Lupi-Herrera classification. The most common risk factors for cardiovascular events were dyslipidemia (82%), a family history of early cardiovascular events (51%), resting heart rate above 80 bpm (25%), and carbohydrate metabolism disorders (21%). When assessing cardiovascular risk, moderate risk of developing cardiovascular events was observed in 3 patients (10,7%), high risk in 16 patients (57,1%), and very high risk in 9 patients (32,1%). The most common TODs were nervous system damage (53%), including cerebrovascular ischemic events (14%) and left ventricular hypertrophy (42%). This group of patients was characterized by resistant hypertension, and combination with other risk factors for cardiovascular events, it leds to severe TOD and influenced survival rate. In terms of antihypertensive therapy, 61% of patients received combination therapy, with CCB, beta-blockers, and imidazoline receptor agonist being the most prescribed. Two fatal cases were identified in the long-term follow-up, and cardiovascular events, most frequently stroke, were the main complications observed. Additionally, AH progression and its uncontrolled course despite going through multiple drug therapy were characteristic.Conclusion: AH is often difficult to diagnostic in patients with NSAA, and it significantly contributes to the structure of complications and mortality in this patient cohort, progressively worsening over time. It is important to measure blood pressure in both arms and legs to detect elevated values early. The main goals of treatment are achieving NSAA remission and blood pressure control and preventing cardiovascular events.

Features of the course of traumatic shock when using respiratory mixtures with a high content of inert gases

This study evaluated the efficiency of using gas mixtures with increased concentrations of inert gases on a hemorrhagic shock model in experimental animals. Massive blood loss is considered a trigger mechanism of severe pathophysiological reactions (impaired peripheral perfusion, acidosis, hemostasis system dysfunction, and multiple organ failure). Inert gases (helium, argon, and xenon) attract attention as potentially useful in various pathological conditions. The study was conducted on 15 same-sex pigs of the same breed, weighing 40–50 kg, randomized into three groups with five each: control group, inhalation of 100% oxygen; “agohhep” group, inhalation of the “Aroxxen” gas mixture: 35% argon, 58% oxygen, 0.2% xenon, and nitrogen as the rest of the volume; and “agohhep-krypto” group, inhalation of the gas mixture “Aroxxen-krypto”: 35% argon, 40% oxygen, 10% krypton, and nitrogen as the rest of the volume. Dynamic monitoring of vital signs and sampling of materials were conducted before blood loss, with blood loss of 20% and 45% of the volume of the circulating blood 60, 120, and 180 min after blood loss. The survival rate of animals and respiratory and circulatory states were evaluated by clinical and laboratory indicators. With blood loss of 45% of the circulating blood volume, no statistically significant differences in mortality were found between the groups. All animals survived for 180 min in the post-hemorrhagic period. In the aggohep-krypto group, average blood pressure values after blood loss and throughout the follow-up period were significantly higher than those in the control and aggohep groups (p 0.05). During shock simulation as a result of blood loss, base deficiency gradually worsened in all groups. However, starting from the second hour of observation, base deficiency began to be compensated in the control and aggohep-krypto groups and the aggohep group, it continued to increase significantly (p 0.01). During the follow-up after blood loss, the level of lactatemia significantly increased in the aggohep group (by 10 times at the end of the follow-up), which is significant different from those in the control and aggohep-krypto groups (p 0.01). Thus, compared with the use of Arroxen gas, the use of Arroxen-krypto gas of the proposed composition in acute massive blood loss makes it possible to achieve a less pronounced attrition of the acid–base balance in experimental animals.

Implementation of Hypertension Exercise in Elderly with Hypertension in Cinta Rakyat Village Deli Serdang Regency

ABSTRACT Elderly is someone who is aged 60 years or more. Many problems are often found in the elderly, one of them is hypertension. Hypertension is a serious medical condition that can increase the risk of heart, brain, kidney, and other diseases. Hypertension is the main cause of premature death worldwide, most (two-thirds) live in low-and-middle-income countries. Various efforts can be made to control blood pressure, including hypertension exercise. Hypertension exercise is believed to be able to control blood pressure because when carrying out exercise movements, blood vessels will dilate and relax so that blood pressure decreases. This community service aimed to improve the community's healthy lifestyle in controlling hypertension by implementing Hypertension exercise. This activity was carried out on the elderly with 22 respondents. Before the implementation of this activity, the first was carried out by filling in demographic data, drugs consumed, and routine control history every month as well as measuring vital signs before and after the implementation of the Hypertension exercise. The findings show that the majority of respondents who participated in the implementation of this Hypertension Exercise were &gt;70 years old (45.5%); Female (59.1%); not taking hypertension medication (54.5%); not routine control (86.4%); and classification of hypertension majority degree 1 (31.8%). The average value of blood pressure before the implementation of the Hypertension Exercise was 2.95 and decreased significantly after the implementation of the Hypertension Exercise to 2.32. It can be concluded that there was a significant decrease in blood pressure after the implementation of hypertension exercises, the pre-test average value was 2.95 and the post-test was 2.32. It is recommended that village officials and Public Health Care officers conducted a Hypertension Exercise program as an implementation discourse in improving the quality of life of the Elderly with Hypertension. The implementation can be carried out in Cinta Rakyat Village, Deli Serdang Regency, regularly 2-3 times a week. Keywords: Elderly, Hypertension, Hypertension Exercise

Pengaruh Pemberian Labu Siam Dan Mentimum Terhadap Penurunan Tekanan Darah Pada Penderita Hipertensi Di Wilayah Puskesmas Cimanggu Kabupaten Pandeglang Banten

Introduction: Hypertension continues to increase every year, Pandglang Regency is the district with the highest presentation of hypertension with a total of 622,060 cases. The incidence of hypertension at the Cimanggu Health Center has increased every year. One way of a good diet is to reduce salt intake and increase potassium intake. Giving chayote juice and cucumber juice has high potassium which can lower blood pressure. Methods: Quasi-experimental design with pretest-posttest design with control group design. There were 56 samples in this study with 28 respondents in each group using the purposive sampling technique. Data analysis used paired sample t-test and Independent T-Test which were previously tested for normality and homogeneity. Results: The difference in the average value of blood pressure given by chayote was at systole 26,43 mmHg and 27,79 mmHg at giving chayote is more effective in reducing blood pressure in hypertensive patients than cucumber with a posttest systolic p-value of 0,007 and 0,000 diastolic. Discussion: Giving chayote is more effective in reducing blood pressure in hypertensive patients than cucumber. It is expected that people with hypertension besides using medicines from doctors can also use chayote juice or cucumber juice.

Monitoring of physical activity of patients with essential hypertension by the Actigraph accelerator – the influence of the environment

Background. The environment is an important determinant of physical behaviour and also affects the quality of life. A healthy lifestyle is considered to be the simplest form of hypertension prevention and therapy. Objective. The aim of our study was to find the correlation of physical behaviour of patients with essential hypertension depending on the environment. Method: We monitored the physical activity (PA) of 60 hypertensive patients from urban (n: 30) and rural (n: 30) environments with Actigraph accelerator. The average blood pressure values of the respondents were SBP 147 mmHg (± 8.24) and DBP 92.08 mmHg (± 8.08). Actigraph evaluated physical behaviour in the form of: sitting during the day, light, moderate and high physical activity (min/week) and steps (steps/week). The quality of life of the respondents was assessed by the Quality-of-Life SF36 – short version questionnaire. Results. We confirm the statistically significant difference between hypertensive patients from urban and rural environments in the following categories: sitting during the day (p = 0.000052), light PA (p = 0.022009), medium PA (p = 0.0012 steps (p = 0.006993). Comparing the Quality-of-Life SF 36 questionnaire data, we find a worse quality of life in hypertensive patients living in rural areas (ø 74.40) than in hypertensive patients living in urban areas (ø 78.57). Conclusion. Hypertensive patients living in rural areas have better physical behaviour than hypertensive patients living in urban areas, but larger population studies are needed to confirm the influence of the environment on physical activity and quality of life.

Perineal nerve block versus periprostatic block for patients undergoing transperineal prostate biopsy (APROPOS): a prospective, multicentre, randomised controlled study

We aimed to investigate perineal nerve block versus periprostatic block in pain control for men undergoing a transperineal prostate biopsy. In this prospective, randomised, blinded and parallel-group trial, men in six Chinese hospitals with suspected prostate cancer were randomly assigned (1:1) at the point of local anaesthesia to receive a perineal nerve block or periprostatic block and followed by a transperineal prostate biopsy. Centres used their usual biopsy procedure. Operators who performed anaesthesia were trained in both techniques before the trial and were masked to the randomised allocation until the time of anaesthesia and were not involved in the subsequent biopsy procedure and any assessment or analysis. Other investigators and the patients were masked until trial completion. The primary outcome was the level of the worst pain experienced during the prostate biopsy procedure. Secondary outcomes included pain (post-biopsy at 1, 6 and 24h), changes in blood pressure, heart rate and breathing rate during the biopsy procedure, external manifestations of pain during biopsy, anaesthesia satisfaction, the detection rate of PCa and clinically significant PCa. This trial is registered on ClinicalTrials.gov, NCT04501055. Between August 13, 2020, and July 20, 2022, 192 men were randomly assigned to perineal nerve block or periprostatic block, 96 per study group. Perineal nerve block was superior for the relief of pain during the biopsy procedure (mean 2.80 for perineal nerve block and 3.98 for periprostatic block; adjusted difference in means-1.17, P<0.001). Although the perineal nerve block had a lower mean pain score at 1h post-biopsy compared with the periprostatic block (0.23 vs 0.43, P=0.042), they were equivalent at 6h (0.16 vs 0.25, P=0.389) and 24h (0.10 vs 0.26, P=0.184) respectively. For the change in vital signs during biopsy procedure, perineal nerve block was significantly superior to periprostatic block in terms of maximum value of systolic blood pressure, maximum value of mean arterial pressure and maximum value of heart rate. There are no statistical differences in average value of systolic blood pressure, average value of mean, average value of heart rate, diastolic blood pressure and breathing rate. Perineal nerve block was also superior to periprostatic block in external manifestations of pain (1.88 vs 3.00, P<0.001) and anaesthesia satisfaction (8.93 vs 11.90, P<0.001). Equivalence was shown for the detection rate of PCa (31.25% for perineal nerve block and 29.17% for periprostatic block, P=0.753) or csPCa (23.96% for perineal nerve block and 20.83% for periprostatic block, P=0.604). 33 (34.8%) of 96 patients in the perineal nerve block group and 40 (41.67%) of 96 patients in the periprostatic block group had at least one complication. Perineal nerve block was superior to periprostatic block in pain control for men undergoing a transperineal prostate biopsy. Grant 2019YFC0119100 from the National Key Research and Development Program of China.

Analysis of Physical Condition of First-Year Military Higher Education Institution Cadets

The purpose of the study was to determine the dynamics of anthropometric and functional indicators of the physical condition of first-year cadets over three years (from 2019 to 2021). Materials and methods. 152 cadets from Ivan Kozhedub Air Force National University were involved in the experiment. The age of participants was from 17 to 22 years. All cadets were informed about the experiment and gave their consent. Anthropometric (measurement of anthropometric data) and medical-biological (rhythm inversion, electromanometry) methods of investigation were used to determine the assessment of the cadets’ physical condition. A highly informative method – the assessment of O. Pirogova index was used for analysis of the cadets’ physical condition. Pirogova physical condition index is a complex indicator based on the heart rate, systolic and diastolic blood pressure, age, body weight, and body height. Statistical analysis of the results was carried out using the EXCEL tables. The data was analyzed using Student’s test, p less than 0.05 was considered the level of significance. Results and discussion. The results of the study showed that the mean values of the anthropometric and functional indicators of the first-year cadets have not been changed statistically significant over three years. The exception is the difference in the average value of systolic blood pressure of control group 1 and control group 3 representatives, which is statistically reliable (p &lt;0.05). Current anthropometric indicators of cadets obtained during the experiment confirmed the data available in the scientific and methodological literature about the anthropometric indicators of candidates for training in higher military educational institutions of Ukraine. The Pirogova physical condition index calculating showed the following average values of the Pirogova physical condition index: control group 1 – 0.704 points, control group 2 – 0.688 points, control group 3 – 0.671 points. However, the results of the study show a statistically significant deterioration of the Pirogova physical condition index of the 2021 recruitment cadets by 4.7% compared to the representatives of 2019. The comparative analysis of the first-year cadets' physical condition assessments demonstrates a gradual, significant decrease in the number of “high” physical condition ratings: 12% among control group 1 cadets (2019 year of recruitment); 9% among control group 2 representatives (2020 year of recruitment) and only 3% among control group 3 cadets (2021 year of recruitment). However, over three years, the percentage of representatives with physical condition assessment rating “Lower than average” has increased significantly: 1% among cadets of control group 1 (2019 year of recruitment); 7% among cadets of control group 2 (2020 year of recruitment); 7% among representatives of control group 3 (2021 year of recruitment). Conclusion. Over the last 3 years, there has been a deterioration of the general physical condition of higher military educational institution cadets

Abstract 9881: Effects of CPAP on Very Short-Term Blood Pressure Variability Associated With Sleep-Disordered Breathing Determined by Pulse-Transit-Time-Based Blood Pressure Measurements

Background: Sleep-disordered breathing (SDB) and blood pressure (BP) variability are closely associated with cardiovascular diseases. We have recently reported that pulse-transit-time (PTT) has enabled to monitor the beat-to-beat BP, identifying a strong relationship between the severity of SDB and the extent to very short-term BP variability. Here, we investigated the effects of continuous positive airway pressure (CPAP) on very short-term BP variability. Methods: We studied 57 patients (mean age 61 years old, male 42) with SDB who underwent the full polysomnography on two consecutive days for diagnosis (baseline) and CPAP. PTT was continuously monitored together, and PTT-based BP values were measured on a beat-to-beat basis. PTT index was defined as the average number of acute transient rises in BP (≥12 mmHg) within 30 seconds per hour. Results: Apnea-hypopnea index (AHI) was decreased from 46.5±22.4 to 13.7±15.0 (P&lt;0.01) by CPAP. CPAP significantly lowered the average value of systolic PTT-based BP from 121±21 to 118±20 mmHg (P=0.04). Importantly, CPAP significantly reduced the PTT index from 31.4±20.1 to 20.8±15.6 (P&lt;0.01) as well as the standard deviation (SD) of systolic PTT-BP from 5.3±1.9 to 4.9±1.4 mmHg (P=0.01), suggesting that very short-term BP variability was improved by CPAP ( Figure ). The changes in PTT index after CPAP were significantly correlated with the improvement in AHI (R=0.55), oxygen desaturation index (R=0.36), minimal SpO 2 (R=0.48), mean SpO 2 (R=0.46), and arousal index (R=0.58). In multivariate linear regression analysis, the change in AHI was the independent factor to determine the reduction of the PTT index after CPAP. Conclusion: PTT-based BP discovered the improvement in very short-term BP variability associated with SDB events by CPAP therapy.

Cumulative exposure to elevated blood pressure better predicts cardiovascular disease risk in rural Chinese adults.

BackgroundTraditional risk estimations for cardiovascular disease (CVD) are based on current blood pressure (BP); however, whether cumulative exposure to elevated BP among rural individuals has additional prognostic value is unclear. We aimed to validate the association of cumulative BP with CVD occurrence and assess the prognostic value of cumulative BP in CVD risk prediction.MethodsA total of 13,057 participants who underwent three examinations from 2004 to 2010 were included in this rural epidemiological study and followed up until 2017. Cumulative BP was defined as the sum of the product of the average BP values between consecutive examinations and the time interval for each pair of successive tests prior to the follow-up period. CVD incidents that occurred during the follow-up period were noted and verified by qualified researchers. We used multivariate Cox models to assess the association of cumulative BP with CVD risk. The receiver operating characteristic curve was constructed to determine the predictive differentiation of single baseline BP measurements and cumulative BP values for CVD outcomes.ResultsDuring the follow-up period, 1,312 participants underwent CVD incidents. We found that cumulative systolic BP (hazard ratio = 1.334, 95% confidence interval: 1.245, 1.430) and cumulative diastolic BP (hazard ratio = 1.253, 95% confidence interval: 1.168, 1.343) were associated with CVD incidence above and beyond that of the current BP. These stronger associations persisted for stroke, myocardial infarction, and CVD mortality. The area under the curve for the model increased significantly (p < 0.001) from 0.735 (0.720, 0.750) to 0.742 (0.728, 0.757) when integrating cumulative systolic BP instead of baseline systolic BP.ConclusionCumulative BP in Chinese rural adults showed a stronger association with CVD incidence than that of current BP. Furthermore, cumulative BP slightly improved the predictive performance for CVD. Our findings underline the incremental predictive value of cumulative BP in CVD risk assessment among Chinese rural adults.

Influence Spironalactone on blood glucose, heart arrhythmias and arterial blood pressure

Spironolactone is a diuretic and is often used in the treatment of hypertension. This medicine is very good when it comes to lowering the blood pressure, and this is also a drug of choice when it comes to the stage of hypertensive urgencies and emergencies. It can be administered intravenously, and the effects reach a maximum within 30 minutes. Due to the fact that this medicine can causes hifher level of potassium ions it can a blood glucose and arrhythmias. A prospective random study was carried out in Hemodyalisis center of Public Health Institution Center “Zivinice’’, where we analyzed 120 patients which were suffering from hypertension heart disease, and diabetes. We included all 120 patient whom suffering from hypertension and diabetes. Clinical and laboratory data of patients were collected during period from February to August 2022. Looking at all the three groups of patients, it can be noticed that the maximum value of arterial blood pressure upon arrival at the Hemodyalisis ceneter had patients suffering from hypertension and diabetes, where the average value of arterial blood pressure was 173/113 mmHg. According to analysis for all three observed groups of patients, after treatment with spironolactone there is no statistical significance in the incidence of arrhythmias between the groups where. Looking at the summary for all three groups of patients, the average value increase of blood glucose after treatment with spironolactone is 0.9 mmol/l. Spironolactone is safe for the treatment of hypertension in diabetic patients.

PRENATAL MASSAGE TERHADAP PENURUNAN TEKANAN DARAH IBU HAMIL DENGAN HIPERTENSI KEHAMILAN DI PMB DINCE SYAFRINA, SST

ABSTRACT Hypertension in pregnancy is common and can be one of the top three (besides bleeding and infection) internal causes of death. The number of maternal deaths compiled from the recording of family health programs at the Ministry of Health in 2020 shows 4,627 deaths in Indonesia. Management of hypertension in pregnancy can be done with pharmacological therapy and also non-pharmacological therapy, one of which is by doing prenatal massage. Massage therapy has the advantage that it can reduce levels of the stress hormone cortisol, decrease levels of depression and anxiety, reduce the risk of heart attack, kidney failure, and stroke and improve blood flow. Thus, pregnancy massage can be used in therapy to lower blood pressure in pregnant patients. The purpose of this study was to determine the effectiveness of Prenatal Massage on reducing blood pressure of pregnant women with pregnancy hypertension at PMB Dince Syafrina. This type of research is quasi experimental with a one group pretest posttest approach. The sample in this study were pregnant women with hypertension during pregnancy who visited PMB Dince Syafrina from January-April 2022, totaling 35 pregnant women with hypertension. The analysis carried out is univariate and bivariate analysis. The results showed that the average pre-systolic blood pressure value for pregnant women was 136.03 mmHg with a standard deviation of 9,083and the average post-systolic blood pressure for pregnant women was 130.94 mmHg with a standard deviation of 8,775 while the average diastolic blood pressure value for pregnant women was pregnant women is 90.77 mmHg with a standard deviation of 6,399 and the average post diastolic blood pressure of pregnant women is 85.91 mmHg with a standard deviation of 4,925. Statistical test results show p value 0.001 which means &lt;0.05, it can be concluded that prenatal massage performed on pregnant women with high blood pressure can reduce blood pressure in pregnant women.

Senam Lansia terhadap Tekanan Darah pada Lansia dengan Hipertensi

This study aims to determine the effect of elderly exercise on blood pressure in the elderly with hypertension. The method used is a pre-experimental design with one group pre-test and post-test. The results showed that the mean systolic blood pressure before the elderly exercise intervention was 160.00 mmHg, with a standard deviation of 8.083. While the mean value of systolic blood pressure after the elderly exercise intervention was 131.77 mmHg with a standard deviation of 4.799. On diastolic blood pressure, it was found that the mean value of diastolic blood pressure before the elderly exercise intervention was 88.92 mmHg with a standard deviation of 6.211. The results of diastolic blood pressure showed that the average value of diastolic blood pressure after the elderly exercise intervention was 82.31 mmHg with a standard deviation of 3.276. The analysis showed that systolic and diastolic blood pressure decreased with a systolic value = 0.001 and a diastolic value = 0.001. In conclusion, there is an effect of elderly exercise on blood pressure in older adults with hypertension after elderly activity in RW 16 and Posbindu Kenanga Work area of ​​Cipageran Health Center, both systolic and diastolic. Keywords: Hypertension, Elderly, Elderly Gymnastics