Differences In Blood Pressure Research Articles

Risk Factors and Clinical Characterization of Cardiovascularand Cerebrovascular Events in Elderly Hemodialysis Patients.

The purpose of this study was to assess the risk factors and clinical characteristics of cardiovascular and cerebrovascular events in elderly hemodialysis patients. Elderly patients undergoing hemodialysis (HD) at Deqing County People's Hospital in Zhejiang, China, from May 2020 to May 2023 were enrolled in this study. They were divided into two groups depending on the occurrence of cardiovascular or cerebrovascular events: the case group and the control group. A total of 106 patients were enrolled in this study. Among them, 49 patients experienced cardiovascular or cerebrovascular events, resulting in an incidence rate of 46.23%. According to whether cardiovascular or cerebrovascular events occurred, 57 patients were assigned to the control group, and 49 patients were assigned to the case group. Comparing the basic information and clinical indicators of the two groups, significant differences were observed in patients with hypertensive nephropathy and diabetic nephropathy (P < .05). There were also significant differences in dialysis duration, smoking history, systolic and diastolic blood pressures, uric acid, blood glucose, total cholesterol (TC), lowdensity lipoprotein cholesterol (TG), C-reactive protein (CRP), and PTH (parathyroid hormone) levels and platelet-to-lymphocyte ratio (PLR), between the two groups (P < .05). Multivariate logistic regression analysis revealed that longer dialysis duration, higher systolic and diastolic blood pressures, elevated uric acid, TC, TG, LDL-C, PTH, and blood glucose levels, smoking history, elevated PLR, and CRP were independent risk factors for cardiovascular and cerebrovascular events. The ROC curve showed that these risk factors predicted cardiovascular and cerebrovascular events in patients. Patients with underlying diseases such as hypertensive or diabetic nephropathy are more likely to experience cardiovascular and cerebrovascular events. Longer dialysis duration, higher systolic and diastolic blood pressures, elevated uric acid, TC, TG, LDL-C, PTH and blood glucose levels, and boosted inflammatory reaction are risk factors for these events among elderly HD patients. The purpose of this study is to provide practical guidelines for clinical treatment. Comprehensive measures such as active intervention of risk factors, rational drug use and regular examination should be taken to improve the overall health level to the greatest extent for elderly patients with high-risk HD. DOI: 10.52547/ijkd.7877.

Arm and ankle blood pressure indices, and peripheral artery disease, and mortality: a cohort study.

Few studies have compared arm and ankle blood pressures (BPs) with regard to peripheral artery disease (PAD) and mortality. These relationships were assessed using data from three large prospective clinical trials. Baseline BP indices included arm systolic BP (SBP), diastolic BP (DBP), pulse pressure (arm SBP minus DBP), ankle SBP, ankle-brachial index (ABI, ankle SBP divided by arm SBP), and ankle-pulse pressure difference (APPD, ankle SBP minus arm pulse pressure). These measurements were categorized into four groups using quartiles. The outcomes were PAD (the first occurrence of either peripheral revascularization or lower-limb amputation for vascular disease), the composite of PAD or death, and all-cause death. Among 40 747 participants without baseline PAD (age 65.6 years, men 68.3%, diabetes 50.2%) from 53 countries, 1071 (2.6%) developed PAD, and 4955 (12.2%) died during 5 years of follow-up. Incident PAD progressively rose with higher arm BP indices and fell with ankle BP indices. The strongest relationships were noted for ankle BP indices. Compared with people whose ankle BP indices were in the highest fourth, adjusted hazard ratios (95% confidence interval) for each lower fourth were 1.64 (1.31-2.04), 2.59 (2.10-3.20), and 4.23 (3.44-5.21) for ankle SBP; 1.19 (0.95-1.50), 1.66 (1.34-2.05), and 3.34 (2.75-4.06) for ABI; and 1.41 (1.11-1.78), 2.04 (1.64-2.54), and 3.63 (2.96-4.45) for APPD. Similar patterns were observed for mortality. Ankle BP indices provided the highest c-statistics and classification indices in predicting future PAD beyond established risk factors. Ankle BP indices including the ankle SBP and the APPD best predicted PAD and mortality.

Association of interarm blood pressure difference with selected body circumferences among Walter Sisulu University community

BackgroundA high interarm blood pressure difference (IAD) has been identified as a precursor of vascular diseases. Anthropometric measures for obesity such as body circumferences including waist circumference (WC), mid-upper arm circumference (MUAC) and neck circumference (NC) have been associated with a high IAD in Western countries. However, the prevalence of IAD and its association with body circumferences in South African communities such as universities is not well established. Therefore, this study aimed at investigating the correlation of IAD with selected body circumferences among the Walter Sisulu University (WSU) community.MethodsA total of 230 participants, 117 males and 113 females, consisting of 185 students and 45 staff members from WSU, aged 18–27 and 18–63 years respectively, participated in this cross-sectional study. The selected body circumferences: WC, MUAC, and NC were measured using standard procedures. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured in both arms simultaneously using automated machines. IAD was achieved by calculating differences in SBP and DBP between the left (L) and right (R) arms, (R -L), and getting the absolute value, L–R (|L–R|).Results14.78% of the participants had an interarm SBP difference (IASBPD) ≥ 10 mmHg, and 4.35% of participants had an interarm DBP difference (IADBPD) ≥ 10 mmHg.In a Pearson’s correlation analysis, IASBPD was positively correlated with the selected body circumferences (WC, r = 0.29; P < 0.001; MUAC, r = 0.35; P < 0.001; NC, r = 0.27; P < 0.001) and mean arterial pressure (MAP) (r = 0.30; P < 0.001). In the multivariable-adjusted regression analyses, IASBPD was positively associated with MUAC (adjusted R2 = 0.128, β = 0.271 (95% CI = 0.09; 0.60), P = 0.008), and NC (adjusted R2 = 0.119, β = 0.190 (95% CI = 0.01; 0.32), P = 0.032) only, adjusted for MAP, age, gender, body mass index, smoking, and alcohol. There was no association of body circumferences with IADBPD.ConclusionA high IAD is common among students and staff members of the WSU community. Furthermore, IAD showed a positive correlation with MUAC and NC. These body circumferences can serve as indicators of high IAD, aiding in the early detection and prevention of vascular diseases.

Perbedaan Pemberian Jus Apel Hijau dan Air Rebusan Daun Seledri terhadap Tekanan Darah Wanita Menopause Hipertensi di Kabupaten Bojonegoro

Hypertension or high blood pressure is a chronic condition characterized by increased blood pressure on the walls of the arteries. Hypertension is caused by high sodium intake while vegetable and fruit intake is low. This study aims to determine the difference in blood pressure reduction in groups given green apple juice and boiled water from celery leaves in menopausal women who experience hypertension in Bojonegoro Regency. This type of research is quantitative research with a "True experimental" design, with a "Two Group Pre-test and Post-test Design". This sample consisted of 36 respondents who were divided into 18 respondents of green apple juice and 18 respondents of boiled celery leaf water using a purposive sampling technique. Data collection using a Stethoscope Tensimeter measuring instrument and observation sheets will be analyzed using the Paired T-Test and Independent Sample T-Test. The research results were analyzed using the Paired T-Test, it was found that there was a significant difference in systolic blood pressure (p-value = 0.003) and diastolic blood pressure (p-value 0.032) before and after administration of green apple juice. In the celery leaf boiled water group, significant results were also found to reduce systolic blood pressure (p-value = 0.000) and diastolic blood pressure (p-value = 0.017) before and after administering celery leaf boiled water. From the description above, it can be concluded that giving green apple juice and boiled water from celery leaves can significantly reduce systole and diastole. Keywords: green apple, celery, hypertension, menopausal women

Perbedaan Pemberian Jus Apel Hijau dan Air Rebusan Daun Seledri terhadap Tekanan Darah Wanita Menopause Hipertensi di Kabupaten Bojonegoro

Hypertension or high blood pressure is a chronic condition characterized by increased blood pressure on the walls of the arteries. Hypertension is caused by high sodium intake while vegetable and fruit intake is low. This study aims to determine the difference in blood pressure reduction in groups given green apple juice and boiled water from celery leaves in menopausal women who experience hypertension in Bojonegoro Regency. This type of research is quantitative research with a "True experimental" design, with a "Two Group Pre-test and Post-test Design". This sample consisted of 36 respondents who were divided into 18 respondents of green apple juice and 18 respondents of boiled celery leaf water using a purposive sampling technique. Data collection using a Stethoscope Tensimeter measuring instrument and observation sheets will be analyzed using the Paired T-Test and Independent Sample T-Test. The research results were analyzed using the Paired T-Test, it was found that there was a significant difference in systolic blood pressure (p-value = 0.003) and diastolic blood pressure (p-value 0.032) before and after administration of green apple juice. In the celery leaf boiled water group, significant results were also found to reduce systolic blood pressure (p-value = 0.000) and diastolic blood pressure (p-value = 0.017) before and after administering celery leaf boiled water. From the description above, it can be concluded that giving green apple juice and boiled water from celery leaves can significantly reduce systole and diastole.

A pilot study exploring novel contexts for out-of-office blood pressure measurement.

Out-of-office blood pressure (BP) monitoring is increasingly valuable in the diagnosis and management of hypertension. With advances in wearable BP technologies, the ability to gain insight into BP outside of traditional centers of care has expanded greatly. Here we explore the usability of a novel, wrist-worn BP cuff monitor for out-of-office data collection with participants following digital cues rather than in-person instruction. Transmitted measurements were used to evaluate BP variation with the time of day and day of week, BP variation with mood, and orthostatic measurements. Fifty participants, with a mean age of 44.5 years, were enrolled and received the BP monitor. 82% of the participants transmitted data via the smartphone application, and the median wear time of the device during the 4-week study was 11 days (IQR 8-17). This prospective digital pilot study illustrates the usability of wearable oscillometric BP technology combined with digital cues via a smartphone application to obtain complex out-of-office BP measurements, including orthostatic vital signs and BP associated with emotion. 25 out of 32 participants who attempted orthostatic vital signs based on in-app instruction were able to do so correctly, while 24 participants transmitted BP readings associated with emotion, with a significant difference in BP noted between calm and stressed emotional states.

Perbandingan Hipertensi pada Masyarakat Yang Tinggal di Pesisir Pulau Maitara dan Daerah Dataran Tinggi Gurabunga Tidore

Hypertension is a commonly encountered disease in daily clinical practice, but often goes unnoticed by its sufferers. Complications can occur in various organs, with the most significant being complications affecting the heart. The environment plays a role in hypertension, where inhabitants living in coastal areas tend to suffer from hypertension due to high sodium consumption, while in highland areas, hypertension is more influenced by acute hyperbaric hypoxia conditions, although its pathophysiology is not yet precisely known. Various studies have yielded diverse results. North Maluku Province is an archipelagic region with a large coastal area, and no research has been conducted there, prompting this study. An analytical observational study was conducted using a cross-sectional approach, focusing on the population of hypertensive individuals residing in the coastal area of Maitara and the highland area of Gurabunga, Tidore. Samples were consecutively selected until the required sample size was met. Variables examined included gender, age, occupation, salt consumption patterns, body mass index, ancestry, alcohol consumption habits, systolic blood pressure, and diastolic blood pressure. Analysis was performed using an independent t-test when sample homogeneity conditions were met. Significant differences were found in some demographic-clinical variables. There was a significant difference in diastolic blood pressure between the Gurabunga area and the coastal area of Maitara, but no significant difference was observed in systolic blood pressure.&#x0D; &#x0D;

Validation of the Raycome model M2 ambulatory blood pressure monitor in the general population according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization Universal Standard (ISO 81060-2:2018).

The aim of this study was to evaluate the accuracy of the Raycome model M2 oscillometric upper-arm blood pressure (BP) monitor developed for ambulatory BP measurement in the general population according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Universal Standard (ISO 81060-2:2018) at rest and during dynamic exercise. Subjects were recruited to fulfill the age, gender, BP and cuff distribution criteria of the AAMI/ESH/ISO Universal Standard in the general population using the same arm sequential BP measurement method. Three cuffs of the test device were used for arm circumference 18-22 cm (small), 22-32 cm (medium) and 32-42 cm (large). For the general validation study, 106 subjects were recruited and 85 were analyzed. For validation criterion 1, the mean ± SD of the differences between the test device and reference BP readings was 0.5 ± 6.2/-0.2 ± 5.1 mmHg (systolic/diastolic). For criterion 2, the SD of the mean BP differences between the test device and reference BP per subject was 5.23/4.50 mmHg (systolic/diastolic). In the ambulatory validation study ( N = 35), the mean difference was 0.4 ± 5.9/-1.1 ± 5.8 mmHg. The Raycome model M2 performed well against the standard in both the general and ambulatory validations and the Bland-Altman plots did not show any systematic variation in the error. These data show that the Raycome model M2 monitor meets the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018) and in the ambulatory setting, indicating its suitability for measuring BP in the general population.

Safety of SGLT-2 inhibitors in the management of heart failure in the adult congenital heart disease patient population

BackgroundSodium glucose transporter 2 inhibitors (SGLT-2i) have shown safety and efficacy in patients with heart failure (HF). However, evidence for the use of SGLT-2i in adult congenital heart disease (ACHD) patients with HF is limited. MethodsWe performed a retrospective, single center analysis of 18 patients (>18 years of age) with ACHD and a diagnosis of HF who were initiated on an SGLT-2i. Patient characteristics, including vital signs, laboratory values, concomitant medications, clinical outcomes, and echocardiograms, were obtained as part of standardized clinical care at our ACHD program before and 2–6 months after initiation of SGLT-2i. The primary outcome was to demonstrate safety of SGLT-2i initiation via potential changes in systolic blood pressure, serum sodium, and serum creatinine. ResultsOf the 18 patients, 11 (61%) had moderate complexity congenital heart disease while 7 (39%) had great complexity congenital heart disease. Post initiation, there were no significant differences in systolic blood pressure (121.8 ± 20.8 mmHg to 114.4 ± 14.9 mmHg, p = 0.06), sodium level (138.7 ± 2.9 mMol/L to 138.0 ± 2.2 mMol/L, p = 0.75), and creatinine level (0.85 ± 0.18 mg/dL to 0.89 ± 0.18 mg/dL, p = 0.07). There was a statistically significant decline in weight (78.9 ± 22.9 kg to 76.0 ± 23.0 kg, p = 0.0039) but without a statistically significant change in NT-pro NBP (1358.2 ± 2735.0 pg/mL to 601.6 ± 786.1 pg/mL, p = 0.36). ConclusionsWe demonstrated the use of SGLT-2i in a small cohort of ACHD population, including patients with complex congenital heart disease, appears safe and well tolerated. The safety and potential efficacy of SGLT-2i in patients with ACHD will require further evaluation in prospective multicenter studies.

Accuracy and Performance of Triage Blood Pressure Measurements in A Real-World Clinic Setting

ObjectivesTo investigate the agreement and accuracy of triage blood pressure (BP) in a real-world clinic setting, compared with the reference standard. Study designPaired triage and standardized BP measurements from patients 4 through 21 years old evaluated in an obesity-related hypertension clinic were obtained via chart-review. Triage BPs were measured by a medical assistant or nurse, often by automated device. Triplicate manual BPs were obtained by the clinic physician. Bland-Altman analyses determined mean differences between paired triage and mean standardized BPs. GEE-based multivariable relative risk (RR) regression determined the RR of triage BP overestimation by ≥5mmHg. Overall agreement, sensitivity, specificity, positive predictive value, and negative predictive value of triage BP measurements identifying hypertensive BP were determined. Results130 participants with 347 clinic encounters were included. Mean age was 13.3 years (standard deviation 3.94), 76% were Black, and 58% were male. Overall mean systolic and diastolic BP difference was 8.7 mmHg (95% limits on agreement: -16.66, 34.07) and 4.1 mmHg (95% limits on agreement: -18.56, 26.68), respectively. Triage systolic BP was more likely overestimated by ≥5 mmHg when a large adult (RR=1.49; 95%CI: 1.00, 2.21) or thigh cuff (RR=1.94; 95%CI: 1.08, 3.51) was required compared with when a child/adult cuff was required. Overall agreement in identifying hypertensive BP was 57.6%. Sensitivity (52.6%), specificity (63.4%), positive predictive value (60.8%), and negative predictive value (55.3%) were low across all cuffs. ConclusionsThere was poor agreement between usual triage and standardized BP measurements, with potential for significant clinical implications.

Assessment of Adaptation Potential of Foreign Students Studying in Low- and Midlands Conditions

Assessment of the adaptive potential of students studying in low- and midlands conditions is a very important task, since it allows students to timely identify pathological conditions that precede the development of the disease. The goal of this study is to assess the adaptive capabilities of foreign students studying in low- and midlands conditions. The 260 first-course male students aged 19.55±1.31 years from India were examined. The study was conducted in low mountains (760 m ASL) and middle mountains (1650 m ASL). The index of functional changes (IFCh), as calculated by R. M. Baevsky, took into account factors such as age, height, body weight, heart rate, and blood pressure. A comparative analysis of the indicators of the index of functional changes (IFCh) of foreign students studying in lowlands and midlands revealed significant differences in systolic blood pressure (SBP). In the low mountains group, the value of IFCh was higher than in the middle mountains group. The majority of students (77% in the lowlands and 86% in the midlands) demonstrated a satisfactory level of adaptation. However, a small percentage of students in both the lowlands (6%) and midlands (1%) showed unsatisfactory adaptation. Therefore, the educational environment in the midlands was found to be more favorable for the adaptation of Indian students.

Digital Health Interventions for Hypertension Management in US Populations Experiencing Health Disparities

Hypertension remains a leading factor associated with cardiovascular disease, and demographic and socioeconomic disparities in blood pressure (BP) control persist. While advances in digital health technologies have increased individuals' access to care for hypertension, few studies have analyzed the use of digital health interventions in vulnerable populations. To assess the association between digital health interventions and changes in BP and to characterize tailored strategies for populations experiencing health disparities. In this systematic review and meta-analysis, a systematic search identified studies evaluating digital health interventions for BP management in the Cochrane Library, Ovid Embase, Google Scholar, Ovid MEDLINE, PubMed, Scopus, and Web of Science databases from inception until October 30, 2023. Included studies were randomized clinical trials or cohort studies that investigated digital health interventions for managing hypertension in adults; presented change in systolic BP (SBP) or baseline and follow-up SBP levels; and emphasized social determinants of health and/or health disparities, including a focus on marginalized populations that have historically been underserved or digital health interventions that were culturally or linguistically tailored to a population with health disparities. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Two reviewers extracted and verified data. Mean differences in BP between treatment and control groups were analyzed using a random-effects model. Primary outcomes included mean differences (95% CIs) in SBP and diastolic BP (DBP) from baseline to 6 and 12 months of follow-up between digital health intervention and control groups. Shorter- and longer-term follow-up durations were also assessed, and sensitivity analyses accounted for baseline BP levels. A total of 28 studies (representing 8257 participants) were included (overall mean participant age, 57.4 years [range, 46-71 years]; 4962 [60.1%], female). Most studies examined multicomponent digital health interventions incorporating remote BP monitoring (18 [64.3%]), community health workers or skilled nurses (13 [46.4%]), and/or cultural tailoring (21 [75.0%]). Sociodemographic characteristics were similar between intervention and control groups. Between the intervention and control groups, there were statistically significant mean differences in SBP at 6 months (-4.24 mm Hg; 95% CI, -7.33 to -1.14 mm Hg; P = .01) and SBP changes at 12 months (-4.30 mm Hg; 95% CI, -8.38 to -0.23 mm Hg; P = .04). Few studies (4 [14.3%]) reported BP changes and hypertension control beyond 1 year. In this systematic review and meta-analysis of digital health interventions for hypertension management in populations experiencing health disparities, BP reductions were greater in the intervention groups compared with the standard care groups. The findings suggest that tailored initiatives that leverage digital health may have the potential to advance equity in hypertension outcomes.

Association between pregnancy-related complications and development of type 2 diabetes and hypertension in women: an umbrella review

BackgroundDespite many systematic reviews and meta-analyses examining the associations of pregnancy complications with risk of type 2 diabetes mellitus (T2DM) and hypertension, previous umbrella reviews have only examined a single pregnancy complication. Here we have synthesised evidence from systematic reviews and meta-analyses on the associations of a wide range of pregnancy-related complications with risk of developing T2DM and hypertension.MethodsMedline, Embase and Cochrane Database of Systematic Reviews were searched from inception until 26 September 2022 for systematic reviews and meta-analysis examining the association between pregnancy complications and risk of T2DM and hypertension. Screening of articles, data extraction and quality appraisal (AMSTAR2) were conducted independently by two reviewers using Covidence software. Data were extracted for studies that examined the risk of T2DM and hypertension in pregnant women with the pregnancy complication compared to pregnant women without the pregnancy complication. Summary estimates of each review were presented using tables, forest plots and narrative synthesis and reported following Preferred Reporting Items for Overviews of Reviews (PRIOR) guidelines.ResultsTen systematic reviews were included. Two pregnancy complications were identified. Gestational diabetes mellitus (GDM): One review showed GDM was associated with a 10-fold higher risk of T2DM at least 1 year after pregnancy (relative risk (RR) 9.51 (95% confidence interval (CI) 7.14 to 12.67) and although the association differed by ethnicity (white: RR 16.28 (95% CI 15.01 to 17.66), non-white: RR 10.38 (95% CI 4.61 to 23.39), mixed: RR 8.31 (95% CI 5.44 to 12.69)), the between subgroups difference were not statistically significant at 5% significance level. Another review showed GDM was associated with higher mean blood pressure at least 3 months postpartum (mean difference in systolic blood pressure: 2.57 (95% CI 1.74 to 3.40) mmHg and mean difference in diastolic blood pressure: 1.89 (95% CI 1.32 to 2.46) mmHg). Hypertensive disorders of pregnancy (HDP): Three reviews showed women with a history of HDP were 3 to 6 times more likely to develop hypertension at least 6 weeks after pregnancy compared to women without HDP (meta-analysis with largest number of studies: odds ratio (OR) 4.33 (3.51 to 5.33)) and one review reported a higher rate of T2DM after HDP (hazard ratio (HR) 2.24 (1.95 to 2.58)) at least a year after pregnancy. One of the three reviews and five other reviews reported women with a history of preeclampsia were 3 to 7 times more likely to develop hypertension at least 6 weeks postpartum (meta-analysis with the largest number of studies: OR 3.90 (3.16 to 4.82) with one of these reviews reporting the association was greatest in women from Asia (Asia: OR 7.54 (95% CI 2.49 to 22.81), Europe: OR 2.19 (95% CI 0.30 to 16.02), North and South America: OR 3.32 (95% CI 1.26 to 8.74)).ConclusionsGDM and HDP are associated with a greater risk of developing T2DM and hypertension. Common confounders adjusted for across the included studies in the reviews were maternal age, body mass index (BMI), socioeconomic status, smoking status, pre-pregnancy and current BMI, parity, family history of T2DM or cardiovascular disease, ethnicity, and time of delivery. Further research is needed to evaluate the value of embedding these pregnancy complications as part of assessment for future risk of T2DM and chronic hypertension.

Penerapan Edukasi Kesehatan Diet Dash terhadap Kepatuhan Dan Tekanan Darah Pasien Hipertensi

This study aims to determine the influence of dietary approaches to stop hypertension (DASH) health education on dietary compliance and blood pressure in hypertensive patients located in the Kertasemaya Health Centre Working Area, Indramayu Regency. The research method used Quasi Experimental Pre-Post Test with Control Group by providing health education to the intervention group. Consecutive sampling was selected in sampling with inclusion criteria, namely 160-190 mmHg systole blood pressure, 90-100 mmHg diastole blood pressure, no disease complications, and adult age. The exclusion criteria for this study were those who did not participate in DASH diet health education activities and experienced cognitive impairment and conditions of decreased consciousness. The results showed that there were significant differences in dietary compliance, systole, and diastole blood pressure in the intervention group before and after provided DASH diet health education (p &lt; 0,005). It is concluded that DASH diet health education affects dietary compliance and systole and diastole pressure of hypertensive patients. Keywords: DASH Diet, Hipertension, Diet Adherence, Blood Pressure

Nocturnal blood pressure dipping, blood pressure variability, and cognitive function in early and middle-aged adults.

Higher nighttime blood pressure (BP), less BP dipping, and higher BP variability have been linked with worse cognitive function in the elderly. The goal of this study is to explore whether this relationship already exists in early and middle adulthood. We further examined whether ethnic differences between African Americans and European Americans in BP parameters can explain ethnic differences in cognitive function. 24-h ambulatory BP monitoring and cognitive function were obtained from 390 participants (average age: 37.2 years with a range of 25-50; 54.9% African Americans; 63.6% females). We observed that higher nighttime BP, decreased dipping, and higher variability were significantly associated with lower scores on the Picture Sequence Memory Test. Significant negative associations between variability and overall composite scores were also observed. No significant associations between average 24-h or daytime BP and cognitive function were observed. Ethnic differences in nighttime diastolic pressures and dipping can explain 6.81% to 10.8% of the ethnicity difference in the score of the Picture Sequence Memory Test (ps<.05). This study suggests that the associations of nighttime BP, dipping, and variability with cognitive function already exist in young and middle-aged adults. Ethnic differences in nighttime BP and dipping can at least partially explain ethnic differences in cognitive function. The stronger association of these parameters with cognitive function than daytime or average BP in this age range raises the importance of using ambulatory BP monitoring for more precise detection of abnormal BP patterns in young adulthood.

CORRELATION OF BLOOD PRESSURE CHANGES IN RESPONSE TO SUSTAINED ISOMETRIC EXERCISE WITH RESPECT TO BODY MASS INDEX IN ADULTS OF HASSAN, KARNATAKA

Objective: The prevalence of obesity is increasing among Indians. Body mass index (BMI) marker of obesity might affect the pressure response to exercise. The present study was undertaken to correlate the blood pressure response to isometric exercise with BMI among males and females. Method: This cross-sectional study comprised 100 male and 100 female subjects 20–40 years old depending on the set inclusion and exclusion criteria. Anthropometric parameters weight, height measured, and blood pressure recorded before exercise. Then subjects were asked to execute isometric hand grip strength at 30% of their maximum voluntary contraction and blood pressure was recorded before the release hand grip. Data were analyzed by the mean and standard deviation of systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP). An unpaired t-test was to compare blood pressure parameter changes in isometric exercise between males and females. Pearson’s coefficient of correlation test was used to correlate blood pressure response with BMI in males and females. Statistical significance was fixed at a p&lt;0.05. Result: In both males and females, SBP, DBP, and MAP were increased after exercise. There is a significant positive correlation between DBP response to isometric exercise with BMI among males and females. Conclusion: This knowledge about the variation of blood pressure response to isometric exercise with BMI is essential for the physicians to educate overweight and obese individuals to adopt a healthy lifestyle to prevent future cardiovascular morbidity.

Effect of aspirin on blood pressure in hypertensive patients: a systematic review and meta-analysis

IntroductionAspirin is widely used for secondary prevention in patients with hypertension. However, previous studies mainly focused on the preventive effects of aspirin, and there has been a lack of reliable evidence on whether taking aspirin affects blood pressure This study aimed to investigate whether aspirin would affect the blood pressure in patients with hypertension.MethodsPubMed, Cochrane database, Embase, Scopus and Medline databases were searched until September 2023. For continuous variables (e.g., blood pressure reduction), the mean difference (MD) was selected as the effect magnitude indices. We used the Cochrane Collaboration’s Risk of Bias tool to assess the risk of bias.ResultA total of five studies were included, comprising 20,312 patients. We found that aspirin did not affect SBP (MD = -0.78, 95% CI: − 2.41, 0.84). A similar result was found for DBP (MD = -0.86, 95% CI: − 2.14, 0.42).ConclusionThis study showed no significant difference in blood pressure between the aspirin and control groups, suggesting that aspirin does not affect blood pressure.

The 10Hz dynamic response of a fluid-filled pressure monitoring system is a novel alternative to the fast flush test and indicative of unacceptable systolic pressure overshoot.

The standard method for qualitatively evaluating the dynamic response is to see if the gain of the amplitude spectrum curve approaches 1 (input signal = output signal) over the frequency band of the blood pressure waveform. In a previous report, Watanabe reported that Gardner's natural frequency and damping coefficient, which are widely used as evaluation methods, do not reflect the dynamic response of the circuit. Therefore, new parameters for evaluating the dynamic response of pressure monitoring circuits were desired. In this study, arterial pressure catheters with length of 30, 60, 150, and 210 cm were prepared, and a blood pressure wave calibrator, two pressure monitors with analog output and a personal computer were used to analyze blood pressure monitoring circuits. All data collection and analytical processes were performed using step response analysis program. The gain at 10 Hz was close to 1 and the systolic blood pressure difference was small in the short circuits (30 cm, 60 cm), and the gain at 10 Hz was 1.3-1.5 in the 150 cm circuit and over 1.7 in the 210 cm circuit. The difference in systolic blood pressure increased in proportion to the length of the circuit. It could also be inferred that the gain at 10 Hz should be less than 1.2 to meet a clinically acceptable blood pressure difference. In conclusion, the gain at 10 Hz is sufficiently useful as an indicator to determine the correct systolic blood pressure.

Extremity Joint Range of Motion Exercise on Intradialytic Blood Pressure Control in Hemodialysis Patients

Changes in blood pressure during hemodialysis is an important point that must be a concern. The occurrence of hypotension and intradialytic hypertension can have an impact on reducing the adequacy of dialysis, decreasing kidney function, and can even affect the patient's quality of life. Among the non-pharmacological interventions that are considered safe and effective in the management of intradialytic blood pressure control are intradialytic exercises, one of which is range of motion exercises for the extremities. To determine the effect of extremity joint range of motion exercises on intradialytic blood pressure control in hemodialysis patients. This research used a quasi-experimental pre-test and post-test control group design using cluster sampling with a purposive sampling technique with a sample size of 46 respondents (23 intervention and 23 control group respondents) with Wilcoxon test data analysis. in the intervention group the average systolic blood pressure before and after intradialytic exercise was -6.42mmHg, the diastolic blood pressure difference was -2.38mmHg with p value of systolic and diastolic blood pressure p=&lt;0.05, In the control group systolic blood pressure p= 0.024 with a difference of 2.4, independent t test results mean systolic blood pressure 2.88mmHg and diastolic blood pressure mean 1.12mmHg with p value both P&gt;0.05. Extremity joint range of motion exercises can affect blood pressure in the intervention group.

Effect of Crataegus Extract on the Relief of Heart Palpitation and Anxiety in Teenagers: An Interventional Quasi-Experimental Study

Background: Heart palpitation is a common complaint defined as an unpleasant or abnormal heartbeat feeling. This study aimed to investigate the effectiveness of Crataegus extract on the relief of heart palpitations and anxiety in adolescents. Methods: This is an interventional quasi-experimental study performed from February 19, 2016 to February 19, 2017 on 120 adolescents aged 13 to 19 years with a complaint of heart palpitations, referring to heart clinic in Afshar Hospital of Yazd. The participants' demographic information, heartbeat feeling, Hamilton anxiety scaling, blood pressure, heartbeat rate, and electrocardiogram (ECG) were recorded. Patients were first treated with 20 drops every 8 hours for three days and then 25 drops every 8 hours for one month with Crataegus edible drops. They were then re-evaluated for heart palpations and anxiety. Results: Of 120 adolescents referring to Afshar Hospital with heart palpitations, 98 of participants (81.7%) experienced improvement. Mean differences in systolic blood pressure, heart rate, and anxiety scores before and after treatment with Crataegus extract decreased significantly by 1.71, 8.52, 6.55, respectively, but the mean difference in diastolic blood pressure increased by 1.46 (P&lt;0.05). Conclusion: According to the results, Crataegus extract might be effective in reducing palpitation and anxiety in adolescents. Further studies are suggested to approve the results of the study.