Differences In Blood Pressure Research Articles

Prevalence, Incidence, and Risk Factors of Nephropathy in Patients with Prediabetes: Family History of Diabetes Mellitus Is Not Associated with Increased Risk of Nephropathy

Background: Nephropathy, a vascular complication of hyperglycemia in patients with diabetes mellitus (DM) and prediabetes, is the leading cause of chronic kidney disease. Objectives: This study aimed to investigate the incidence and prevalence of nephropathy and its risk factors in patients with prediabetes, with a particular focus on exploring the association between a family history (FH) of DM and nephropathy. Methods: In this retrospective study, we examined the medical records of 819 patients with prediabetes referred to the Isfahan Endocrine and Metabolism Research Center in 2004. We compared the prevalence of nephropathy in 2019 to baseline levels and assessed factors such as FH of DM in first-degree relatives and other nephropathy-related factors among patients with and without nephropathy. Results: The prevalence of nephropathy increased from 39% to 60.6% over 15 years, with a cumulative incidence of 21.6% and a mean annual incidence of 2.4%. There were differences in diastolic and systolic blood pressure, lipid markers, fasting and postprandial glucose levels, and glomerular filtration rate between patients with and without nephropathy; however, these differences were not statistically significant (P-value ≥ 0.05). Male sex (Odds ratio [OR]: 1.8), age (OR: 1.02), and Body Mass Index (BMI) (OR: 1.05) were significantly associated with nephropathy (P-value < 0.05). No significant association was found between a positive FH of DM and nephropathy (P-value = 0.638). Conclusions: Our findings indicate that a FH of DM is not associated with an increased risk of nephropathy in patients with prediabetes. Instead, sex, age, and BMI play a more significant role. Therefore, these factors may be more critical in guiding preventive and treatment measures.

Sex-based differences in the blood pressure responses to muscle metaboreflex activation are consistent between limb and respiratory muscle.

The purpose of this study was to compare sex-based differences in the mean arterial blood pressure (MAP) response to limb and inspiratory metaboreflex activation, during relative and absolute workloads. Healthy males (M; n=9) and females (F; n=8) completed pulmonary function testing, forearm volume and circumference measurements, and bouts of limb and inspiratory muscle exercise. The exercises performed included bouts of rhythmic handgrip exercise (RHG) and inspiratory pressure threshold loading (PTL) to task failure, performed in a randomized order, and separated by 30 minutes of rest. Participants performed both RHG and PTL at predetermined relative (R) and absolute (A) workloads while cardiopulmonary measurements were recorded continuously. A time-dependent rise in MAP was observed in all participants, regardless of sex, muscle, or workload (p<0.001). MAP was greater in males than females during all exercise bouts regardless of muscle group or workload (p<0.001). The change in MAP from baseline was also greater in males (R-RHG: ∆31±12 mmHg; R-PTL: ∆31±9; A-RHG: ∆35±6; A-PTL: ∆30±7) than females (R-RHG: ∆21±7 mmHg; R-PTL: ∆13±7; A-RHG: ∆21±7; A-PTL: ∆14±3) (p<0.001). Results from this study show that when the forearm and diaphragm perform the same relative or absolute work, the blood pressure response is statistically similar, and both responses are greater in males than females. The findings from the present study suggest that the sex-based difference in the response to metaboreflex activation is similar between the limb and respiratory musculature.

Effects of Antihypertensive Therapy During Pregnancy on Postpartum Blood Pressure Control.

To compare differences in postpartum blood pressure (BP) control (BP below 140/90 mm Hg) for participants with hypertension randomized to receive antihypertensive treatment compared with no treatment during pregnancy. This study was a planned secondary analysis of a multicenter, open-label, randomized controlled trial (The CHAP [Chronic Hypertension and Pregnancy] trial). Pregnant participants with mild chronic hypertension (BP below 160/105 mm Hg) were randomized into two groups: active (antihypertensive treatment) or control (no treatment unless severe hypertension, BP 160/105 mm Hg or higher). Study outcomes were BP control below 140/90 mm Hg (primary) and medication nonadherence based on a composite score threshold (secondary) at the 6-week postpartum follow-up visit. Participants without follow-up BP measurements were excluded from analysis of the BP control outcome. Participants without health care professional-prescribed antihypertensives at delivery were excluded from the analysis of the adherence outcome. Multivariable logistic regression was used to adjust for potential confounders. Of 2,408 participants, 1,684 (864 active, 820 control) were included in the analysis. A greater percentage of participants in the active group achieved BP control (56.7% vs 51.5%; adjusted odds ratio [aOR] 1.22, 95% CI, 1.00-1.48) than in the control group. Postpartum antihypertensive prescription was higher in the active group (81.7% vs 58.4%, P<.001), and nonadherence did not differ significantly between groups (aOR 0.81, 95% CI, 0.64-1.03). Antihypertensive treatment of mild chronic hypertension during pregnancy was associated with better BP control below 140/90 mm Hg in the immediate postpartum period.

Impact of a Precision Intervention for Vascular Health in Middle-Aged and Older Postmenopausal Women Using Polar Heart Rate Sensors: A 24-Week RCT Study Based on the New Compilation of Tai Chi (Bafa Wubu).

(1) Background: This study utilized a 24-week intervention incorporating heart rate sensors for real-time monitoring of intervention training, aiming to comprehensively assess the effects of Tai Chi on vascular endothelial function, atherosclerosis progression, and lipid metabolism. The insights gained may inform personalized non-pharmacological interventions to enhance the management of cardiovascular health in this population to provide sustainable benefits and improve quality of life. (2) Methods: Forty postmenopausal middle-aged and elderly women were randomly assigned to an exercise or control group. The exercise group underwent a 24-week Tai Chi (BaFa WuBu) training intervention with real-time heart rate monitoring using Polar sensors. Pre- and post-intervention assessments included body composition, blood pressure, vascularity, and blood parameters measured with the Inbody 720, Vascular Endothelial Function Detector, and Arteriosclerosis. Data were analyzed using SPSS 26.0 and mixed-design ANOVA to assess the effects of time, group, and their interactions on study outcomes. (3) Results: After training through 24 weeks of Tai Chi (BaFa WuBu) intervention, compared with the control group, systolic blood pressure in the exercise group was significantly lower (p < 0.05), and the difference between left and right arm pulse pressure, left and right ankle mean arterial pressure, left and right side baPWV, left and right side ABI, TC, TG, LDL, and blood pressure viscosity were all very significantly lower (p < 0.01), and the diastolic blood pressure was significantly higher (p < 0.05). Compared with baseline values in the exercise group, systolic blood pressure, right and left arm pulse pressure difference, right and left ankle mean arterial pressure, right and left side baPWV, right and left side ABI, TC, TG, LDL, and blood pressure viscosity decreased very significantly (p < 0.01) and diastolic blood pressure and FMD increased very significantly (p < 0.01) in the exercise group after the intervention. (4) Conclusions: In our study, a 24-week Tai Chi (BaFa WuBu) program significantly improved vascular health in middle-aged and older postmenopausal women. This simplified Tai Chi form is gentle and effective, ideal for older adults. Regular practice led to reduced vascular obstruction, improved lipid metabolism, and enhanced vascular endothelial function, crucial for preventing vascular diseases. The real-time heart rate sensors used were pivotal, enabling precise monitoring and adjustment of exercise intensity, thereby enhancing the study's scientific rigor and supporting Tai Chi (BaFa WuBu) as a beneficial therapeutic exercise.

Effect of Dietary Enrichment with Hempseed (Cannabis sativa L.) on Blood Pressure Changes in Growing Mice between Ages of 5 and 30 Weeks

Dietary hempseed (Cannabis sativa L.) reduces blood pressure in adults and animal models of hypertension; however, whether hempseed consumption throughout early life reduces adult blood pressure is not known. This study tested the hypothesis that hempseed enrichment versus a control diet modifies the age-dependent pattern of blood pressure changes in growing female C57BL/6 mice and results in lower adult blood pressure. From ages 5 to 30 weeks, early post-weaning to mid-adulthood, mice were fed either a control AIN-93G (0%), 50 g/kg (5%), or 150 g/kg (15%) hempseed-supplemented diet (n = 8 per group). Biweekly measurements of systolic, diastolic, and mean arterial pressure were collected using the tail-cuff method. Mice fed 5% or 15% hempseed versus the control diet exhibited no significant differences in systolic, diastolic, or mean arterial blood pressure (repeated measures ANOVA main effect of diet, p &gt; 0.05). Blood pressure did not differ significantly between diet groups in adulthood (p &gt; 0.05). However, mice fed a control or 5% hempseed, but not 15% hempseed, diet exhibited blood pressure changes across age marked by significant increases during early adulthood (weeks 11–17) versus early post-weaning (week 5) (p &lt; 0.05). In conclusion, long-term dietary hempseed enrichment at 5% and 15% concentrations during development does not reduce adult blood pressure, but a 15% dose blunts the temporary increase in blood pressure during early adulthood seen in mice fed a control diet.

A prospective birth cohort study on the association between gestational blood pressure and neurodevelopment in 2-year-old children

Objective: To investigate the association between gestational blood pressure and neurodevelopment in 2-year-old children. Methods: Based on the"Wuhan Healthy Baby Birth Cohort", 3 754 mother-infant pairs were enrolled in this study. Based on multiple blood pressure measurements during pregnancy, the mean, cumulative, and variability of blood pressure throughout the entire pregnancy and each trimester were calculated. Blood pressure variability was evaluated using standard deviation (SD), coefficient of variability (CV), and variability independent of mean (VIM). Follow-up testing of neurodevelopment in infants and young children at the age of two was conducted to obtain the Mental Development Index (MDI) and the Psychomotor Development Index (PDI). The multivariate linear regression and generalized estimation equation were used to analyze the association between gestational blood pressure data and neurodevelopmental index. Results: The age of 3 754 pregnant women was (29.1±3.6) years, with a pre-pregnancy BMI of (20.9±2.7) kg/m² and a gestational age of (39.3±1.2) weeks. The birth weight of 3 754 children was (3 330.9±397.7) grams, and the birth length was (50.3±1.6) centimeters. The results of the multivariate linear regression analysis showed that after adjusting for relevant confounding factors, the mean blood pressure, cumulative blood pressure, standard deviation of blood pressure, coefficient of variation of blood pressure, independent blood pressure variability of systolic blood pressure, diastolic blood pressure, and pulse pressure throughout pregnancy were negatively associated with the MDI and PDI scores of 2-year-old children. The analysis results of the generalized estimation equation showed that after adjusting for relevant confounding factors, the average systolic blood pressure in the first, second, and third trimesters was negatively associated with MDI/PDI. The negative association between cumulative blood pressure and MDI/PDI was only found in the first trimester. The negative association between blood pressure variation during pregnancy and MDI/PDI was mainly concentrated in the second and third trimesters. Conclusion: There is a negative association between gestational blood pressure and the neurodevelopmental index of 2-year-old children.

Effects of Telmisartan on Intraocular Pressure, Blood Pressure, and Ocular Perfusion Pressure in Normal and Glaucomatous Cats.

To determine the effect of telmisartan on intraocular pressure (IOP), blood pressure (BP), and ocular perfusion pressure (OPP) in normal and glaucomatous cats. A four-week study was conducted in six normal adult cats, followed by a longer six-month study performed in 37 cats with spontaneous glaucoma and 11 age-matched normal cats. Telmisartan (1 mg/kg/day) or placebo-vehicle were administered orally once daily. IOP was measured by rebound tonometry. BP readings were obtained by oscillometric method. OPP was calculated as mean arterial pressure (MAP) - IOP. IOP and BP were obtained three times a week for the first study and weekly for the second study. Baseline IOP was significantly higher, and OPP was significantly lower in glaucomatous cats than in normal cats (P < 0.0001). These differences between glaucomatous and normal cats persisted throughout the study, regardless of treatment (P < 0.001). No significant differences in IOP, BP, or OPP were detected between any study phases in the first, normal feline cohort or between telmisartan- and placebo-treated glaucomatous cats at any timepoint in the second study. Oral telmisartan was well tolerated and did not have a detrimental effect on BP or OPP in cats but did not lower IOP or improve OPP in cats with glaucoma. While showing telmisartan could not be used as a sole therapy for IOP lowering, our data affirmed a lack of detrimental effects of telmisartan on BP and OPP in a translationally-relevant, spontaneous, large animal glaucoma model.

Relationships between ankle blood pressure indices and major adverse cardiovascular events in people with and without type 2 diabetes

BackgroundThe relationship between ankle blood pressure (BP) and cardiovascular disease remains unclear. We examined the relationships between known and new ankle BP indices and major cardiovascular outcomes in people with and without type 2 diabetes.MethodsWe used data from 3 large trials with measurements of ankle systolic BP (SBP), ankle-brachial index (ABI, ankle SBP divided by arm SBP), and ankle-pulse pressure difference (APPD, ankle SBP minus arm pulse pressure). The primary outcome was a composite of cardiovascular mortality, myocardial infarction, hospitalization for heart failure, or stroke. Secondary outcomes included death from cardiovascular causes, total (fatal and non-fatal) myocardial infarction, hospitalization for heart failure, and total stroke.ResultsAmong 42,929 participants (age 65.6 years, females 31.3%, type 2 diabetes 50.1%, 53 countries), the primary outcome occurred in 7230 (16.8%) participants during 5 years of follow-up (19.4% in people with diabetes, 14.3% in those without diabetes). The incidence of the outcome increased with lower ankle BP indices. Compared with people whose ankle BP indices were in the highest fourth, multivariable-adjusted hazard ratios (HRs, 95% CI) of the outcome for each lower fourth were 1.05 (0.98–1.12), 1.17 (1.08–1.25), and 1.54 (1.54–1.65) for ankle SBP; HR 1.06 (0.99–1.14), 1.26 (1.17–1.35), and 1.48 (1.38–1.58) for ABI; and HR 1.02 (0.95–1.10), 1.15 (1.07–1.23), and 1.48 (1.38–1.58) for APPD. The largest effect size was noted for ankle SBP (HRs 1.05 [0.90–1.21], 1.21 [1.05–1.40], and 1.93 [1.68–2.22]), and APPD (HRs 1.08 [0.93–1.26], 1.30 [1.12–1.50], and 1.97 [1.72–2.25]) with respect to hospitalization for heart failure, while only a marginal association was observed for stroke. The relationships were similar in people with and without diabetes (all p for interaction > 0.05).ConclusionsInverse and independent associations were observed between ankle BP and cardiovascular events, similarly in people with and without type 2 diabetes. The largest associations were observed for heart failure and the smallest for stroke. Including ankle BP indices in routine clinical assessments may help to identify people at highest risk of cardiovascular outcomes.Graphical abstractAnkle blood pressure indices and incidence of major cardiovascular outcomes. Expanded MACE, a composite of death from cardiovascular causes, myocardial infarction,hospitalization for heart failure, or stroke. BP, blood pressure; CV, cardiovascular; HHF, hospitalization for heart failure; HR, Hazard ratio (for the lowest fourth of blood pressure indice compared to the highest); MACE, major adverse cardiovascular events; MI, myocardial infarction; Total, fatal and non-fatal MI or stroke.

The association of sex differences in ambulatory blood pressure with cardiovascular events and mortality in dialysis patients.

Male patients with pre-dialysis chronickidneydisease(CKD) have worse ambulatory blood pressure(BP) control than females; this is associated with higher mortality. Male hemodialysis patients have higher ambulatoryBP levels than females. This analysis aimed to investigate the association of sex differences in ambulatory BP with cardiovascular events and mortality in hemodialysis individuals. 129 male and 91 female hemodialysis patients with valid 48-h BP monitoring were followed for 53.4 ± 31.1 months. The primary endpoint was cardiovascular mortality; the secondary endpointwas a composite of cardiovascular death, non-fatal myocardialinfarction, non-fatal stroke, resuscitation after cardiacarrest, heartfailure-hospitalization, coronary or peripheral revascularization. Cumulativefreedom from the primary endpoint was lower for women (logrank-p = 0.032), while cumulative-freedom from the secondary endpoint did not differ significantly between-groups (logrank-p = 0.644). The crude risk for cardiovascular mortality was significantly higher in women (HR = 1.613, 95% CI[1.037, 2.509]). The crude risk for the combined endpoint was not different between the two groups (HR = 0.918, 95% CI[0.638, 1.320]). After adjusting for major risk factors (age, diabetes, dialysis vintage, coronary disease and hemoglobin) no significant differences in the risk for both the primary and the secondary endpoint were observed between women and men (primary: HR = 1.295 (95% CI[0.808, 2.078]), secondary: HR = 0.763 (95% CI[0.521, 1.118])). After additional adjustment for 44-h systolicBP the above relationships did not alter (primary: HR = 1.329 (95% CI [0.826, 2.137]), secondary: HR = 0.808 (95% CI [0.551, 1.184])). In conclusion, female hemodialysis patients have higher crude but similar adjusted cardiovascular mortality rates compared to male counterparts. In contrast to pre-dialysis CKD, the neutral relationship between gender and adverse cardiovascular outcomes in hemodialysis is not further affected by ambulatory BP.

Abstract P407: Sex and age differences in cardiovascular health in youth referred for hypertension disorders at baseline: A SUPERHERO Registry analysis

Background: The prevalence of hypertension (HTN) and other cardiovascular (CV) disease risk factors (e.g., target organ injury (TOI), obesity, dyslipidemia, hyperglycemia) are increasing steadily in youth. In adults, sex and age differences are established, but remain unknown in children (1–12 years) and adolescents (≥13 years). Objective: Determine sex and age differences in blood pressure (BP) severity, TOI, and CV health in youth referred for HTN disorders. Design/Methods: Cross-sectional analysis of baseline data from the Study of the Epidemiology of Pediatric Hypertension (SUPERHERO), a multisite retrospective Registry of youth referred to subspecialty care for HTN disorders using EHR data. Inclusion criteria were an initial subspecialty clinic visit for HTN disorders identified by ICD-10 codes from 1/1/2016–12/31/2023 and age &lt;19 years. Exclusion criteria were kidney failure on dialysis, kidney transplantation, or pregnancy by ICD-10 codes. The exposures were sex and age at the index visit. Outcomes were BP severity at the index visit based on age, sex, and height-based U.S. guidelines, obesity by BMI or weight-for-length percentiles, and dyslipidemia, hyperglycemia, and TOI (heart and kidney-specific) by ICD-10 codes. We estimated the associations with unadjusted generalized linear models; our directed acyclic graphs did not identify any open, biasing paths necessitating adjustment for confounding factors . Results: Of the 9,356 participants, mean age ± SD was 12.8 ±4.5 years, 36% (n=3,372) were female, 56% (n=5,261) were adolescents, 23% (n=2,162) had stage 2 HTN, 5% (n=451) had TOI (2% heart, 3% kidney), 60% (n=5,655) had obesity, 9% (n=834) had dyslipidemia, and 10% (n=944) had hyperglycemia. Despite less BP severity, females had a higher risk of kidney TOI (RR 1.49, CI: 1.19 to 1.86), hyperglycemia (RR 1.48, CI: 1.3 to 1.68), and number of CV health risk factors (RR 1.1, CI:1.01 to 1.19). Compared to children, adolescents were more likely to have worse BP severity (RR 1.7, CI: 1.6 to 1.8) and HTN (RR 1.1, CI:1.1 to 1.2), and less risk for dyslipidemia (RR: 0.8, 0.7 to 0.9) Conclusions: In a large multisite cohort of youth referred for HTN disorders, females had a 49% higher risk of TOI and 48% greater risk for hyperglycemia despite lower BP severity. Adolescents had more severe BP and HTN compared to children. Next steps in this study include investigating age and sex differences in ambulatory BP and laboratory and echocardiogram data.

An Investigation of the Correlation Between Retinal Nerve Fiber Layer Thickness with Blood Biochemical Indices and Cognitive Dysfunction in Patients with Type 2 Diabetes Mellitus.

The study aimed to explore the correlation between retinal nerve fiber layer thickness (RNFLT) with blood biochemical indicators and cognitive dysfunction in patients with type 2 diabetes mellitus (T2DM) and the possible mechanism, thereby providing more theoretical basis for the occurrence and prevention of diabetes related complications. Eighty T2DM patients treated in our hospital from March 2022 to September 2022 were selected as the study subjects, and the clinical data of the patients were retrospectively analyzed. All patients underwent fundus fluorescein angiography (FFA) to analyze the changes in retinal blood vessels. Patients who met the inclusion criteria were divided as the diabetic retinopathy (DR) group (n=46) and simple diabetes group (n=34). The RNFLT, blood biochemical indexes and changes in cognitive functions of the patients were detected. The correlation between RNFLT with blood biochemical indexes and cognitive dysfunction was analyzed. Compared with the simple diabetes group, patients in the DR group had much lower mean, nasal, inferior and superior thicknesses (P<0.01). There existed no significant difference in blood pressure, body mass index (BMI), blood lipids (triglycerides, cholesterol, low-density lipoprotein, high-density lipoprotein) between the two groups (P>0.05). Compared with the simple diabetes group, patients in the DR group had much higher fasting blood glucose (FBG), hemoglobin A1c (HbA1c), fasting insulin (FINS), insulin resistance (HOMA-IR) index, apolipoprotein B (ApoB)/apolipoprotein A1 (ApoA1) (P<0.001). Besides, the DR group had sharply lower scores on the Mini-Mental State Examination (MMSE) scale and higher levels of the Trail Making Test-A (TMT-A) and TMT-B (P<0.001). Spearman correlation analysis confirmed that the mean RNFLT was negatively correlated with the levels of FBG, HbA1c, HOMA-IR index, TMT-A and TMT-B (P<0.05), positively correlated with the score of mini-mental state examination (MMSE) (P<0.05), and was no significant correlation with FINS and ApoB/ApoA1 (P>0.05). DR patients had significantly reduced RNFLT, elevated levels of blood glucose related indicators, and cognitive dysfunction. There existed a correlation between RNFLT and FBG, HbA1c, HOMA-IR index, TMT-A, TMT-B and MMSE.

Abstract 66: Early-Life Sodium Restriction Programs Salt-Sensitivity of Autonomics and Blood Pressure in Adult C57BL/6J Mice

Extremely premature birth is a risk factor for sodium (Na) depletion due to renal immaturity and urine Na losses. We have proposed that Na depletion in preterm infants mechanistically contributes to their increased risk for cardiovascular and metabolic disease observed in adulthood, potentially due to changes during hypothalamic development. In humans, the hypothalamus matures between 20-25 weeks of gestation; in mice, this developmental window occurs between postnatal day (PD) 21 and PD42. Previously, we demonstrated in mice that dietary Na restriction from PD21 to PD42 induced long-lasting increases in energy expenditure via exaggerated autonomic activity. Therefore, we hypothesized that restricting dietary Na from PD21 to PD42 would similarly induce programmed changes in cardiovascular control via changes in autonomic and neurohypophyseal functions. Male C57BL/6J mice were provided a customized low (0.04%, n=7) or supplemented (0.30%, n=8) Na version of the soy protein-free Teklad 2920x diet from PD21 to PD42, after which they were returned to the standard (0.15% Na) 2920x diet. Radiotelemetric blood pressure (BP) transducers were implanted at 7-8 weeks of age. At 10 weeks of age, no differences in BP or heart rate (HR) were noted between groups. All animals were switched to a high (1%) Na diet at 12 weeks of age. At 16 weeks of age, systolic BP was not altered in the 0.30% Na group but significantly increased in the 0.04% Na group compared to the week 10 baseline (24h avg: +6±2 mmHg, p&lt;0.05). Ganglionic block with chlorisondamine or β-adrenergic block with propranolol reduced heart rate (HR) to a greater extent (each p&lt;0.05) in the 0.04% group. Conversely, muscarinic block with atropine resulted in a smaller increase in HR in this group (p&lt;0.05). Urine elimination rates of aldosterone (0.30%: 1.96±0.44 vs 0.04%: 2.92±0.064 ng/d) and copeptin (0.30%: 0.16±0.03 vs. 0.04%: 0.14±0.02 ng/d) were similar between groups. Finally, at 18 weeks of age, all mice received the angiotensin AT 1 R antagonist losartan in drinking water. This caused a greater BP reduction in the 0.04% group at 20 weeks (24h avg: -12±2 vs -19±2 mmHg, p&lt;0.05). Together, these data indicate that dietary Na restriction during hypothalamic development programs increased salt sensitivity of BP via a mechanism involving AT 1 R and characterized by increased sympathetic yet decreased parasympathetic activity.

Effect of crataegus oxyacantha on high blood pressure: A randomized single-blind controlled trial

BackgroundHawthorn (Crataegus laevigata) is a traditional herbal treatment for cardiovascular diseases. It contains bioactive compounds that may have cardiovascular benefits. Despite encouraging laboratory studies, additional clinical trials are required to confirm hawthorn's efficacy in treating hypertension. MethodsThis randomized controlled trial (RCT) was conducted on patients with high blood pressure (BP) who met the inclusion criteria. A total of 110 participants were randomly assigned to either the intervention group (n=55) or the control group (n=55). The intervention group received standard antihypertensive therapy plus Crataegus drops, while the control group received only standard antihypertensive therapy. BP was measured at baseline and weeks 6, 12, and 16. Adherence to treatment was evaluated using a checklist. Data were analyzed using intention-to-treat analysis and repeated measures ANOVA (p-value=0.05). ResultsThe results indicate that at week 6, the mean systolic blood pressure (SBP) and mean arterial pressure (MAP) were significantly higher in the Crataegus group compared to the control group (p=0.02 and p=0.03, respectively). However, no significant differences were observed at weeks 12 and 16. Notably, the mean values of SBP and MAP decreased significantly in the Crataegus group at 12 and 16 weeks compared to week 6. ConclusionCrataegus may decrease SBP and MAP more significantly than diastolic blood pressure (DBP). However, except for SBP at six weeks, there were no significant differences in BP between the control and Crataegus groups. Additional research with a larger sample size is required to better understand the potential of Crataegus as a treatment for hypertension.

Abstract P410: Association Between Maternal Magnesium and Offspring Blood Pressure at 4 Years of Age: A Birth Cohort Study

Background: The potential influence of maternal magnesium levels during gestation on offspring's blood pressure remains largely unexplored. Objective： We aim to investigate the association of maternal magnesium concentrations during early pregnancy and child’s blood pressure at four years of age. Methods: Using data from the Shanghai Birth Cohort, this study analyzed the data from 1129 mother-child pairs. Results: Maternal blood magnesium concentrations were inversely associated with blood pressure of offspring at 4 years of age. Each 1mmol/L increment in maternal magnesium was correlation with 3.03 mmHg (95% CI -4.77 to -1.29, P =0.001) decrease of systolic blood pressure and 1.72 mmHg (95% CI -3.22 to -0.23, P =0.024) decrease of diastolic blood pressure in children after adjusting for covariates. Moreover, maternal magnesium concentrations were associated with incident high blood pressure (OR = 0.40, 95% CI, 0.17 to 0.95, P =0.037) of offspring. Exploratory maternal pre-pregnancy body mass index stratified analyses found that the negative regression coefficient (β) of maternal magnesium and child blood pressure was greater in the overweight/obese group than in normal weight group or underweight group ( P for systolic blood pressure difference 0.014, P for diastolic blood pressure difference 0.019). Conclusions: Our data suggest higher maternal magnesium concentrations are associated with lower blood pressure levels and reduced risk of high blood pressure in children. Our findings highlight the importance of maternal Mg levels during pregnancy, especially for the mothers who are overweight or obese.

Abstract P311: Revisiting unattended vs attended automated office blood pressure measurements: A systematic review and meta-analysis

Background: Standardized automated office blood pressure (AOBP) measurement is now widely accepted as the preferred method for monitoring blood pressure (BP). However, disagreements persist amongst expert societies as to the need to perform AOBP in an unattended manner, where the patient is left alone in a quiet room. In 2019, two meta-analyses aiming to quantify the differences between unattended and attended BP showed opposite results. prompting the publication of several more studies on this subject. Our objective was thus to reassess the BP differences between unattended and attended AOBP when performed with the same device and an identical measurement protocol. Methods: This systematic review with meta-analysis was conducted according to the PRISMA guidelines and is registered on PROSPERO. Studies were included if both unattended and attended AOBP were measured on the same participants in a randomized or alternating sequence manner during a single visit with the same device and an identical measurement protocol apart from attendance status. Four databases were searched (Embase, Medline, Web of Science, Google Scholar). The primary outcome was the difference between unattended and attended systolic (SBP) and diastolic (DBP) BP, expressed as weighted mean differences (95% confidence interval) using random-effects models. Results: From 8,088 screened studies, data was extracted from 15 studies which met the inclusion criteria (n=1,747 participants). In the pooled analysis, the attended compared with unattended BP was higher for SBP by 2.7 mmHg (95%CI 0.6 to 4.7) and DBP by 0.9 mmHg (95%CI 0.1 to 1.8). In leave-one out analyses, results were similar except when excluding the study with the most extreme BP difference (Chotruangnapa 2023) where the difference became non-significant. Conclusion: Standardized attended AOBP measurements result in slightly higher readings than unattended AOBP. Whether such small differences translate into clinically significant changes in management of BP remains uncertain. Therefore, standardized attended AOBP could be viewed as a reasonable option for BP measurement in a real-life clinical setting.

Evaluation of Virtual Care in Kidney Transplant Recipients in the Early Posttransplant Period.

Though virtual care was widely adopted during the COVID-19 pandemic, evidence to support its use in kidney transplant recipients early after transplantation is limited. We conducted a retrospective cohort study comparing post kidney transplant outcomes in patients who received in-person transplant care before the COVID-19 pandemic with those who received mainly virtual transplant care during the COVID-19 pandemic. The usual-care group included 69 patients who received a kidney transplant from March 1, 2019 to September 1, 2019, and the virtual-care group included 64 patients who received a kidney transplant from September 1, 2020 to March 1, 2021. At 6 months, five patients in the usual-care group and three patients in the virtual-care group died. There was one graft loss and one episode of acute rejection in the usual-care group, and two episodes of acute rejection in the virtual-care group (p = 0.60). Estimated glomerular filtration rate was higher for patients in the virtual-care group (59mL/min/1.73m2 vs. 52mL/min/1.73m2, p = 0.046) and serum creatinine was not different (138 µmol/L vs. 127µmol/L, p = 0.27). There was no difference in mean blood pressure or hospitalizations. Outcomes were similar among recipients of a kidney transplant prior to the COVID-19 pandemic when care was mainly in person and during the pandemic when care was mainly virtual, without a signal of harm. Patient and donor selection may have led to unmeasured differences between groups.

Effects of Tactile Massage in Improving Older Residents' Psychological Health in Long-Term Care Facilities: A Randomised Controlled Trial.

Loneliness, anxiety and depressive symptoms are common among older residents in long-term care facilities (LTCFs), which can negatively impact their quality of life and increase mortality rates. Addressing these psychological health issues is an important task for nursing staff. There is a need for easy and accessible interventions to improve older residents' negative emotions. Tactile massage (TM) is a form of touch therapy that induces oxytocin, which can help individuals feel relaxed, experience pleasure and reduce anxiety. TM can also provide a sense of security and care for individuals. This study aimed to evaluate the effects of TM in improving older residents' psychological health in LTCFs. In this study, we applied a two-arm randomised controlled trial research design. We used convenience sampling to enrol 55 older residents in three long-term care facilities who were randomly assigned to an intervention group and a comparison group. The intervention group received TM by research assistants on both hands for 15 min per time, twice a week for 4 weeks and the comparison group received regular care. Data were collected before and after the intervention. Generalised estimating equations (GEEs) were used to evaluate the effectiveness of the intervention. There were no significant differences in loneliness, anxiety, depressive symptoms, happiness, ear temperature, heart rate or diastolic blood pressure between the two groups after the intervention. However, the intervention group had significant improvements in comfort (B = 0.86, p < 0.001), relaxation (B = 1.00, p < 0.001), respiratory rate (B = -0.16, p = 0.021) and systolic blood pressure (B = - 4.17, p = 0.002) compared to the control group. TM can help older residents who live in LTCFs feel relaxed and comfortable. TM can be easily implemented as it requires no tools. We recommend that nursing staff and healthcare professionals incorporate TM as part of their care routines. They also can encourage family members to perform TM on residents during their visits to enhance residents' comfort and relaxation. The Consolidated Standards of Reporting Trials (CONSORT) checklist was used for this paper. ClinicalTrials.gov (NCT05052138).

P007 HIGH PREVALENCE OF HYPOTENSION IN OLDER ADULTS ON AMBULATORY BLOOD PRESSURE MONITORING (ABPM)

Background: Hypertension, a prevalent public health concern, disproportionately affects older adults. Effective blood pressure (BP) control is crucial to preventing cardiovascular complications such as heart attack, stroke, and heart failure. In recent years, there has been a discussion about the optimal BP control strategies in older adults (1). While some studies advocate for intensive BP control, others emphasize the importance of considering individual patient characteristics, such as age and frailty (2,3). Objective: This study aims to describe the prevalence of hypotension in ambulatory blood pressure monitoring (ABPM) in older adult patients compared to younger patients. Methods: This cross-sectional descriptive study analyzed ABPM records from 2018 to 2024 at a cardiovascular institution in Colombia. The difference in systolic (SBP) and diastolic (DBP) blood pressure was evaluated according to the age group (younger or older than 80 years) to determine the presence of hypotension in older adults defined as pressure less than 90/60 mmHg. Normality was assessed using the Kolmogorov-Smirnov test. Comparisons of continuous variables across age categories were performed using the non-parametric Mann-Whitney U test. For categorical variables, the Chi-square test was employed. Results: Among the 653 participants, 57.3% (374) were women. The average age was 63 years, with 60 patients (9.18%) being over 80 years old. Table 1 shows a significant difference in systolic and diastolic blood pressure (SBP and DBP) between the age groups. Notably, 47.5% of patients over 80 had SBP less than 130 mmHg, and a high prevalence (84.7%) had DBP less than 90 mmHg. DBP below 60 mmHg was more common in this age group. Additionally, 20 older adults had SBP between 130-139 mmHg. Conclusions: This study demonstrates a high prevalence of hypotension, especially low DBP, in older adults. Considering these findings, re-evaluating current blood pressure control targets for older adults is crucial to avoid overtreatment and minimize the risk of complications like symptomatic hypotension and falls.

P111 INTER-ARM DIFFERENCE IN SYSTOLIC BLOOD PRESSURE AMONG YOUNG POPULATION IN ABEOKUTA, NIGERIA

Background and Objective: Inter-arm blood pressure differences (IABPD) are linked to higher cardiovascular mortality and morbidity. Unfortunately, the profile and associated risk factors of IABPD in sub-Saharan Africa, particularly Nigeria are poorly studied. This study aims to determine the profile and associated correlates of systolic IABPD among the participants in the profile of anthropometry and psychosocial issues on campus (TERRACE) study, a cohort of young persons on selected tertiary educational campuses in Abeokuta metropolis aged 16-35years. Methods: This was a cross-sectional study. Basic demographic, anthropometric, and clinical data were collected. Brachial Blood Pressure (BP) were recorded in both arms, using validated electronic devices. Three standard measurements were performed on both arms. The IABPD was defined as the absolute value of the difference in systolic blood pressure(SBP) between the left and right arms of BP averages. Significant IABPD ≥10 mmHg. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 23. The level of statistical significance was set at &lt;0.05. Results: A total of 301 participants with age, 21.8±4.9 years and female proportion of 65.1%. The mean±SD of neck circumference, weight, height, right SBP, left SBP were 26.2 ± 3.6 cm, 58.0 ± 10.0 kg, 164.1 ± 10.4 cm, 112.9± 11.6mmHg and 112.0 ± 11.1 mmHg respectively. The median systolic IABPD was 0.6 mmHg, and the prevalence of significant systolic IABPD is 9.0% (11.4% in males and 7.7% in females, p- value: 0.275). Among our participants, there were 6.0%, 2.3% and 0.7% with a systolic IABPD in the ranges: 10-14.9mmHg, 15-19.9mmHg and ≥ 20mmHg respectively. The proportion with dominantly high right SBP was 54.4% in males compared to females (41.9%), p- value: 0.209. There was a correlation between height and IABPD (r2=0.177, p-value=0.002) Conclusion: Our study found that this young population have high IABPD, suggesting increased cardiovascular risk. Routine measurement in both arms is advised.

Abstract 45: Deletion of a 4-bp noncoding genomic segment orthologous to human rs1882961 results in sex-divergent changes in salt-induced hypertension in Dahl salt-sensitive rats

Most single nucleotide polymorphisms (SNPs) associated with human blood pressure (BP) are in noncoding regions of the genome and have small effect sizes in the general population. Functional studies in a controlled model system are essential to ascertain the effect of these noncoding loci on blood pressure. Such direct testing is challenging and largely absent, contributing to a critical gap between genetic discoveries and physiological understanding. We reasoned that physiological studies in genetically engineered and phenotypically permissive animal models would help to address this critical gap. We tested the hypothesis by studying the noncoding SNP rs1882961. The T allele of rs1882961, which has a frequency of approximately 30% in the European population, is associated with 0.23 mmHg higher systolic blood pressure in humans. We mapped the human rs1882961 SNP to the rat genome and used CRISPR/Cas9 to delete a 4-bp segment encompassed the rs1882961 orthologous site in the genome of the Dahl salt-sensitive (SS) rat (SS-Δrs1882961). Male SS-Δrs1882961 -/- rats exhibited significantly higher mean arterial pressure (MAP) and systolic and diastolic blood pressures (SBP and DBP) than wild-type littermates after the rats were fed a high-salt (4% NaCl) diet for 14 days (156.6 ± 5.9 vs 149.3 ± 5.1 mmHg for MAP, 179.4 ± 7.8 vs 171.9 ± 6.0 mmHg for SBP, and 133.2 ± 4.6 vs 125.1 ± 4.5 mmHg for DBP; n=7 for SS-Δrs1882961 -/- and 9 for wild-type, p&lt;0.05). In contrast, MAP, SBP, DBP, and pulse pressure of female SS-Δrs1882961 -/- rats were significantly lower than wild-type littermates on a high-salt diet (139.8 ± 1.8 vs 149.5 ± 4.7 mmHg for MAP, 159.3 ± 2.5 vs 172.3 ± 6.0 mmHg for SBP, 116.8 ± 1.5 vs 124.5 ± 3.7 mmHg for DBP, and 42.5 ± 1.6 vs 47.7 ± 2.3 mmHg for pulse pressure; n=8 for SS-Δrs1882961 -/- and 7 for wild-type, p&lt;0.05). The difference in systolic blood pressure reached more than 10 mmHg in female rats. Urinary albumin and protein levels of SS-Δrs1882961 -/- rats after 14 days on a high-salt diet tended to be higher in male and lower in female compared with wild-type littermates. The remarkable effects on BP as well as the sex-divergent changes resulted from a 4-bp noncoding segment deletion around rs1882961 orthologous site indicate that noncoding genomic segment may have profound impact on phenotypes on permissive genomic background and with informative stressors.