Blood Pressure In Women Research Articles

Association Between Lactation and Postpartum Blood Pressure in Women with Preeclampsia.

Preeclampsia affects 3% to 8% of all pregnancies. There are two distinct subtypes; early- (<34 weeks) and late-onset (≥34 weeks). Each subtype is associated with increased risk of cardiovascular disease. Lactation has been shown to improve cardiovascular outcomes. The purpose of this study was to describe lactation practices among women with each subtype of preeclampsia and determine the association between lactation and blood pressure at the initial postpartum visit. This retrospective cohort study included 246 subjects; 120 early- and 126 with late-onset preeclampsia who gave birth to live singleton newborns at a large suburban tertiary referral center in south central Pennsylvania between January 2012 and June 2016. Electronic health records were reviewed and data abstracted. Univariate and bivariate analyses were conducted. There was a significant difference in breastfeeding intent (p = .004) as well as rate of breastfeeding at maternal hospital discharge (p< .001) by preeclampsia subtype. However, there was no difference in rate of breastfeeding at the initial postpartum visit (p = .21) between subtypes. There was a significant difference in systolic (p = .03) and diastolic (p = .04) blood pressure between those breastfeeding and those who were not breastfeeding at the initial postpartum visit. Healthcare providers should provide women with preeclampsia clear and consistent messaging about importance of breastfeeding during pregnancy and the postpartum period on its association with improved neonatal outcomes, and specifically education on the cardioprotective benefit of sustained lactogenesis.

The prone position in healthy pregnant women and in women with preeclampsia \u2013 a pilot study

BackgroundThe prone position is rarely used in medical settings in pregnancy. There is no published information about the prone position in women with preeclampsia. This study examined the feasibility and acceptability of the prone position in pregnant women, and the short-term effect of the prone position on blood pressure (BP) in term healthy pregnant women and in women with preeclampsia.MethodsAfter ethics approval, written consent and trial registration (ACTRN:12615000160538 registered 18/02/2015, date of first participant enrolled 03/03/2015), 50 healthy term pregnant women and 15 women with preeclampsia had BP, heart rate (HR), oxygen saturation (SpO2), respiratory rate (RR), fetal heart rate (FHR) and comfort levels measured in two positions: left lateral, and prone. Measurements were after five minutes rest in each position.ResultsMean ± SD age, gestation and body mass index for healthy pregnant women was 33 ± 4.1 years, 38 ± 1.0 weeks and 27 ± 3.2 kg.m− 2 and for women with preeclampsia was 32 ± 4.7 years, 36 ± 3.4 weeks, 31 ± 5.6 kg.m− 2 respectively. No clinically significant changes occurred in healthy pregnant women in the prone position. Systolic BP was reduced in the prone position in women with preeclampsia (P = 0.019, mean difference − 6.6 mmHg, 95% confidence interval − 11.9 to − 1.3 mmHg). 33% of women with preeclampsia experienced a 10 mmHg or greater reduction in systolic BP in the prone position. 42% of healthy pregnant women and 47% of women with preeclampsia preferred the prone position to lateral.ConclusionsThis is the first study to examine the prone position in women with preeclampsia. For short periods of time the prone position is feasible and comfortable in pregnant women including those at term. The prone position may reduce systolic BP in women with preeclampsia without obvious adverse effects. Larger studies with women lying for longer periods in the prone position are required. Pregnancy should not be a contraindication to the prone position for short periods of time.Trial registrationACTRN:12615000160538

Validation of the Omron HBP-1300 in pregnancy for medium-arm and large-arm circumferences according to the British Hypertension Society protocol.

The aim of this study was to validate the Omron HBP-1300 oscillometric blood pressure (BP) device according to the British Hypertension Society validation protocol, in pregnant women of both medium-arm and large-arm circumferences. BP was measured sequentially in 72 women of any gestation requiring the use of a large-size (N=36, arm circumference ≥33 cm) or medium-size cuff (N=36, arm circumference <33 cm) alternating between a mercury sphygmomanometer and the Omron HBP-1300 device. The Omron HBP-1300 is accurate in pregnancy with a mean device-observer difference of 3±6 and 1±6 mmHg for systolic BP and 2±5 and 3±6 mmHg for diastolic BP in women requiring the use of the medium and large cuff, respectively. The Omron HBP-1300-automated BP device can be recommended for use in pregnant women with medium-arm or large-arm circumferences.

298. Effect of non-steroidal anti-inflammatory drugs (NSAIDs) on blood pressure in the post-partum period: A randomised controlled trial

Introduction NSAIDs can cause an elevation in blood pressure (BP) in women outside of pregnancy when taken acutely and chronically. It is unclear if NSAIDs have a similar effect on BP in women with uncomplicated pregnancies. Objective Assess the effect on blood pressure (BP) of oral NSAIDs compared to placebo in healthy women following caesarean section. Methods A multicentre, prospective, stratified randomization (with minimisation), double blind parallel placebo controlled trial was undertaken in 4 Australian metropolitan hospitals. Commencing immediately post operatively after the caesarean section, women received either diclofenac orally, 50 mg three times a day with food or placebo for a maximum of 5 days. BP was measured by ambulatory BP measurement as well as ward based BP. Women with HDPs during pregnancy and unable to tolerate opioids were excluded. Data was analysed with STATAv14. Results A total of 284 women were randomised and the results of 270 women were analysed – 136 women in the placebo and 134 in the NSAID group. Women were well matched at baseline. The use of NSAIDs statistically but not clinically significantly reduced the ABPM measured systolic BP compared to placebo −2.2 mmHg (95%CI −4.4 mmHg to −0.1 mmHg; p = 0.04) over the 5 days post-partum. The diastolic BP was also lower in the NSAID group compared to placebo −1.5 mmHg (95%CI −2.8 mmHg to −0.14 mmHg; p = 0.03). No women required treatment for hypertension as assessed by usual clinical practice. Discussion NSAIDs do not elevate blood pressure after term caesarean in women with uncomplicated pregnancies.

Blood pressure responses after resistance exercise session in women living with human immunodeficiency virus/acquired immunodeficiency syndrome.

The aim of this study was to verify blood pressure (BP) responses after a single resistance exercise session in women with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Twelve patients underwent a resisted exercise session. BP, heart rate, and rate pressure product were evaluated before and during 120 min after the session. Mean cardiovascular values before and after the session were similar (P>0.05). Analysis of the individual data revealed that for 120 min after exercise, 5 and 4 patients presented a reduction in systolic and diastolic BP of ≥4 mmHg, respectively. The clinical characteristics of the patients appear to influence BP responses after exercise. Individual data showed that some of the HIV+ women demonstrated a clinically significant decrease in BP. Although a single resistance exercise session does not decrease BP in women with HIV/AIDS, individual data present heterogeneity and individual characteristics seem to influence BP reduction after a single session of resistance exercises.

Effect of Peripheral Heart Action on Body Composition and Blood Pressure in Women with High Blood Pressure

ObjectivesExercise is non-medical treatment and low-risk strategy for people with hypertension. Therefore, the aim of this study was to evaluate the effect of peripheral heart action (PHA) on body composition and blood pressure in women with high blood pressure.MethodsTwenty women (age = 38 - 46 years, BMI = 21 - 31 kg/m2) who had high blood pressure (135/88 mm Hg) volunteered to participate. Ten were randomly selected and submitted to 32 PHA exercise sessions. The remaining 10 participants served as a non-exercise control group. Systolic (SBP) and diastolic blood pressure (DBP), skinfold, and 1RM tests of maximum strength were determined before and after 36 exercise sessions.ResultsSBP and DBP were decreased significantly (P < 0.05) in the PHA group but not in the non-exercise control group. Furthermore, the training group made significant improvements in test of one-repetition maximum and body composition compared to the control group (P < 0.05).ConclusionsResistance exercises using the PHA approach can be considered as a low-risk treatment for people with high blood pressure in order to improve blood pressure, increase muscular strength, and enhance overall fitness.

Eating patterns of Australian adults: associations with blood pressure and hypertension prevalence

PurposeEating patterns have been linked to obesity, an established risk factor for hypertension; however, their contribution to hypertension is poorly understood. This study aimed to examine associations of frequency of meals, snacks and all eating occasions (EO), and temporal eating patterns, with blood pressure (BP) and hypertension.MethodsDietary data collected via two 24-h recalls during the 2011–2012 Australian National Nutrition and Physical Activity Survey (n = 4482 adults, ≥ 19 years) were analysed. Frequencies of EO, meals, and snacks were calculated. Temporal eating patterns were determined using latent class analysis. Multivariate regression models assessed associations of eating patterns with systolic BP (SBP), diastolic BP (DBP), and hypertension prevalence.ResultsAmong men, a higher snack frequency was inversely associated with DBP [β = − 0.59, 95% confidence interval (CI) (− 1.12, − 0.07)] and hypertension [odds ratio (OR) 0.86, 95% CI (0.75, 0.98)] after adjustment for covariates and BMI. However, these associations disappeared after additional adjustment for total energy intake and overall diet quality. Among women, a temporal eating pattern characterized by a later “lunch” meal was associated with SBP [β = 2.45, 95% CI (0.05, 4.84)], DBP [β = 1.69, 95% CI (0.25, 3.13)], and hypertension [OR = 1.49, 95% CI (1.00, 2.22)], when compared to a “conventional” eating pattern.ConclusionsIn this study, an inverse association found between snack frequency and BP among men disappeared after adjustment for dietary factors and a “later lunch” pattern was associated with higher BP in women. Future research is needed to understand the relationship and potential mechanistic pathways between eating patterns and BP.

Effects of Acute Resistance Exercise on Heart Rate Variability and Central Blood Pressure in Women

Effects of Acute Resistance Exercise on Heart Rate Variability and Central Blood Pressure in Women

The Effect of Normotensive Antenatal Blood Pressure of Women with Chronic Hypertension on Neonatal Weight [31R

INTRODUCTION: Our objective was to determine if birth weight of infants of women with chronic hypertension is affected by range of antepartum blood pressure. METHODS: A retrospective chart review of patients with chronic hypertension at a single tertiary care center was completed. The difference in birth weight between women with mean antenatal blood pressures in the systolic range of &lt;140 mmHg verses &gt;140mmHg was assessed. A second analysis to assess mean antenatal diastolic blood pressure of &lt;90mmHg versus &gt;90 mmHg was completed. Chi squared analysis was utilized, with a P-value of &lt;.05 used to indicate statistical significance. RESULTS: Data from 148 women with a diagnosis of chronic hypertension was analyzed. This analysis included both those taking antihypertensive medications and those who were not medicated. There was a significant difference in birth weight in normotensive (&lt;140mmHg systolic or &lt;90 mmHg diastolic) versus hypertensive pregnancies, with normotensive women bearing larger children. Median birth weight for those who had normotensive systolic blood pressures was 3,005g versus 2,450g for those who had hypertensive average systolic blood pressures (P=.008). Median birth weight was 2,997.5g for those with normotensive diastolic pressure averages versus 1,857.5g who were hypertensive (P&lt;.001). CONCLUSION: Women with chronic hypertension in pregnancy deliver larger babies when blood pressures are in the normotensive range during the antepartum period.

The Role of Growth Differentiation Factors 11 and 15 (GDF11, GDF15), Eotaxin-1 (CCL11) and Junctional Adhesion Molecule a (JAM-A) in the Regulation of Blood Pressure in Women with Essential Hypertension

The Role of Growth Differentiation Factors 11 and 15 (GDF11, GDF15), Eotaxin-1 (CCL11) and Junctional Adhesion Molecule a (JAM-A) in the Regulation of Blood Pressure in Women with Essential Hypertension

Study of heat shock protein gene 70 (HSP70) expression and its polymorphous marker (+ 1267A> G) in women under exposure to a long-term stress.

There was studied the HSP70 gene and its polymorphic marker + 1267A> G (rs754888705) in the HSP70 gene expression in32 women under long-term stress, which was caused by inpatient treatment of their oncologic child. A control group included 25 women without long-term stress factors. There was studied a correlation between the expression level of the HSP70 gene in women and their high blood pressure (BP) episodes. The average duration of stress in the group of children's mothers was 7.3 (2.5-11.5) months. Anxiety level according to HADS in the main group was significantly increased and amounted to 8.7 (7-10) points, in the control group 5 (2-7) points. Depression level in the main group was significantly higher and amounted to 7.7 (7-9) points, in the control group 3.3 (1-5) points. Comparison of the HSP70 gene expression level in blood of young women of the main study group with expression level of this gene in the control group showed a statistically significant predominance of HSP70 gene expression in the main group. The episodes of high BP in women who were under stress conditions did not influence the expression level of the HSP70 gene. Analysis of the alleles of the polymorphic marker frequency in the gene HSP70-2 1267A> G (rs754888705) in the main and control groups showed a statistically significant predominance of allele A in the group of mothers under stress, and predominance of the allele G in the control group. Comparative analysis of the polymorphic marker genotype frequencies in the gene HSP70-2 1267A> G (rs754888705) showed that the AA genotype is significantly more frequent in mothers with episodes of BP increase compared to women without it. An increased level of the HSP70 gene expression in peripheral blood leukocytes in mothers with a life-threatening disease of their child indicates the damaging effect of long-lasting psychoemotional stress at the cellular level and activation of the protective reaction mediated by HSP70. Studying of the genotype AA characteristics of the polymorphic marker A1267G (rs754888705) of the HSP70-2 gene in women under long-lasting stress will let us evaluate the role of genetic factors in hypertensive reactions development.

Effects of different hormonal contraceptives in women's blood pressure values.

To identify evidence in the literature of the relationship between the use of different hormonal contraceptive methods and alterations in women's blood pressure values. This is an integrative literature review, consisting of ten scientific articles published in PubMed and BVS, between 2012 and 2016, selected by keywords, available fully and free of charge, in English, Portuguese, or Spanish. The articles showed that exogenous estrogen helps in the activation of the renin-angiotensin-aldosterone system causing hypertensive effects even in small doses; and that combined use with drospirenone reduces these effects. Routes of administration without passage through the liver and use of isolated progestin showed promising results in reducing the effects on blood pressure. There is evidence in the literature of pressure alterations associated with different hormonal contraceptives and that personal history of morbidities are to be considered in an attempt to reduce the effects on the cardiovascular system.

Changes in Circadian Rhythm due to Possibly Sympathetic Nerve Disorders in Patients with Preeclampsia as Assessed by Ambulatory Blood Pressure Monitoring

Objectives: Women with hypertensive disorders of pregnancy (HDP), including both preeclampsia (PE) and gestational hypertension (GH), show fluctuations in BP during the day. This study aimed to assess characteristic changes in BP by Ambulatory blood pressure (BP) monitoring (ABPM) in HDP patients in comparison with PE and GH.Study design: Among the 106 pregnant women who exhibited hypertension by clinic BP (CBP), 24-hour ABPM were performed. ABPM determined HDP in 79 women (PE, n=43) and GH, n=36), and white coat hypertension (WCH) in 27 women.Main outcome measures: The following aspects were analyzed with the circadian rhythms of BP and pulse: 1) changes in BP at night-time and 2) multiple regression percent rhythm (PR, correction coefficient by Cosinor analysis).Results: Mean BP by 24-hour ABPM was higher in women with PE and GH compared to those with WCH. In systolic BP (SBP), most women with PE and GH were riser or non-dipper. Half of the women with PE and GH experienced a loss of circadian rhythm of SBP (PR<0.16). In women with circadian rhythm (PR ≥0.16), normal maximal SBP at daytime (acrophase time from 12:00 to 18:00) was observed in only 9 of 43 women with PE and 9 of 36 women with GH. Furthermore, PR of pulse was lower in women with PE, but not in those with GH or WCH.Conclusions: Our findings suggest that the circadian rhythm of BP in women with PE may be abnormal due to possibly sympathetic nerve disorders.

Effect of Peripheral Heart Action on Body Composition and Blood Pressure in Women with High Blood Pressure

Objectives: Exercise is non-medical treatment and low-risk strategy for people with hypertension. Therefore, the aim of this study was to evaluate the effect of peripheral heart action (PHA) on body composition and blood pressure in women with high blood pressure. Methods: Twenty women (age = 38 - 46 years, BMI = 21 - 31 kg/m2) who had high blood pressure (135/88 mm Hg) volunteered to participate. Ten were randomly selected and submitted to 32 PHA exercise sessions. The remaining 10 participants served as a non-exercise control group. Systolic (SBP) and diastolic blood pressure (DBP), skinfold, and 1RM tests of maximum strength were determined before and after 36 exercise sessions. Results: SBP and DBP were decreased significantly (P &lt; 0.05) in the PHA group but not in the non-exercise control group. Furthermore, the training group made significant improvements in test of one-repetition maximum and body composition compared to the control group (P &lt; 0.05). Conclusions: Resistance exercises using the PHA approach can be considered as a low-risk treatment for people with high blood pressure in order to improve blood pressure, increase muscular strength, and enhance overall fitness.

Abstract 125: Elevated Muscle Sympathetic Nerve Activity is Associated With Higher Aortic and Carotid Stiffness Independent of Blood Pressure in Women

Central arterial stiffness, a significant contributor to the development of hypertension and cardiovascular disease with aging, is linked to elevated muscle sympathetic nerve activity (MSNA) in men. However, the extent to which MSNA is associated with central arterial stiffness in women is unknown. Given that the age-related increase in MSNA and arterial blood pressure (BP) occurs at a steeper rate among women compared to men, we tested the hypothesis that resting MSNA is more strongly correlated with central arterial stiffness in women than in men. Also, because of the parallel age-related increase in MSNA, we further hypothesized that the relation between MSNA and central arterial stiffness would not be independent of age. MSNA (microneurography), aortic stiffness (carotid-femoral pulse wave velocity, CFPWV), and carotid β-stiffness (carotid tonometry and ultrasound) were assessed in 54 healthy men (n=29; 19-72 yrs; 30 ± 1 kg/m 2 ; systolic BP: 128 ± 3 mmHg) and women (n=26; 26-64 yrs; 29 ± 2 kg/m 2 ; systolic BP: 116 ± 3 mmHg). No differences between men and women were observed for CFPWV (Men: 7.0 ± 0.3 vs. Women: 6.8 ± 0.4 mmHg, P=0.747) and carotid β-stiffness (Men: 7.6 ± 0.8 vs. Women: 7.6 ± 0.5 mmHg, P=0.975). Mean BP was lower in women compared to men (Men: 93 ± 3 vs. Women: 85 ± 2 mmHg, P=0.021) and MSNA tended to be lower in women compared to men (Men: 25 ± 3 vs. Women: 20 ± 2 bursts/min, P=0.091). After adjusting for mean BP and HR (partial correlation), CFPWV was significantly correlated with MSNA in men (R=0.44, P=0.021) and women (R=0.58, P=0.004). Interestingly, further adjustment for age abolished the association between CFPWV and MSNA in men (R=0.01, P=0.968), but not in women (R=0.43, P=0.046). A moderate relation between carotid β-stiffness and MSNA was observed in men (R=0.37, P=0.063) and women (R=0.44, P=0.034), but was abolished after adjusting for age (Men: R=-0.001, P=0.995; Women: R=0.26, P=0.245). These preliminary data demonstrate that MSNA is positively correlated with central arterial stiffness in women and men independent of BP. Furthermore, abolishment of the relation between MSNA and CFPWV in men only when adjusting for age suggests that the association between MSNA and central arterial stiffness may be more robust in women.

Body Size Predicts Cardiac and Vascular Resistance Effects on Men's and Women's Blood Pressure.

Key Points Summary We report how blood pressure, cardiac output and vascular resistance are related to height, weight, body surface area (BSA), and body mass index (BMI) in healthy young adults at supine rest and standing.Much inter-subject variability in young adult's blood pressure, currently attributed to health status, may actually result from inter-individual body size differences.Each cardiovascular variable is linearly related to height, weight and/or BSA (more than to BMI).When supine, cardiac output is positively related, while vascular resistance is negatively related, to body size. Upon standing, the change in vascular resistance is positively related to size.The height/weight relationships of cardiac output and vascular resistance to body size are responsible for blood pressure relationships to body size.These basic components of blood pressure could help distinguish normal from abnormal blood pressures in young adults by providing a more effective scaling mechanism.Introduction: Effects of body size on inter-subject blood pressure (BP) variability are not well established in adults. We hypothesized that relationships linking stroke volume (SV), cardiac output (CO), and total peripheral resistance (TPR) with body size would account for a significant fraction of inter-subject BP variability.Methods: Thirty-four young, healthy adults (19 men, 15 women) participated in 38 stand tests during which brachial artery BP, heart rate, SV, CO, TPR, and indexes of body size were measured/calculated.Results: Steady state diastolic arterial BP was not significantly correlated with any index of body size when subjects were supine. However, upon standing, the more the subject weighed, or the taller s/he was, the greater the increase in diastolic pressure. Systolic pressure strongly correlated with body weight and height both supine and standing. Diastolic and systolic BP were more strongly related to height, weight and body surface area than to body mass index. When supine: lack of correlation between diastolic pressure and body size, resulted from the combination of positive SV correlation and negative TPR correlation with body size. The positive systolic pressure vs. body size relationship resulted from a positive SV vs. height relationship. In response to standing: the positive diastolic blood pressure vs. body size relationship resulted from the standing-induced, positive increase in TPR vs. body size relationship. The relationships between body weight or height with SV and TPR contribute new insight into mechanisms of BP regulation that may aid in the prediction of health in young adults by providing a more effective way to scale BP with body size.

Pregnant Women Positioning in Spinal Anesthesia for Cesarean Section: Integrative Review

Objective: to analyze the scientific evidence on the positioning of pregnant women in spinal anesthesia for cesarean section.&#x0D; Method: an integrative review of the literature in the Scopus, CINAHL, LILACS and PubMed databases using the descriptors "patient positioning", "spinal anesthesia" and "obstetrics" and their synonyms "patient position" and "spinal anesthetics".&#x0D; Results: the sample of 8 articles showed that the fastest onset of blockade in pregnant women occurs in the lateral horizontal decubitus position and in the sitting position with legs downwards. Lateral decubitus with elevated head presented insufficient blockade. Lateral position was related to greater comfort, and its maintenance for 15 minutes before the supine position, after infiltration with the anesthetic was associated with lower incidence of hypotension.&#x0D; Conclusion: Scientific evidence has shown that positioning influences the effect, potentiation and delay of anesthesia, comfort and the pregnant woman's blood pressure, being relevant to the perioperative and obstetric multidisciplinary practice.

Association of NSAIDs with Postpartum Blood Pressure in Women With Hypertensive Diseases in Pregnancy [26L

INTRODUCTION: Based on the Hypertension in Pregnancy Task Force guidelines, we examined if NSAID administration adversely affects blood pressures in the immediate postpartum (PP) period in women with HDP (hypertensive disorders of pregnancy). METHODS: This cross sectional study examined patients with HDP who delivered at our institution from April 2012 to April 2015. Mean systolic (SBP) and diastolic (DBP) blood pressures over the first 24 hours were compared by NSAID exposure using Student's t-test or Chi-square test of proportions. Multivariable linear regression was used to adjust for confounding. Exploratory repeated measures analyses were performed. RESULTS: 130 subjects with HDP were identified; 103 (79%) were exposed to NSAIDs. Mean SBP in NSAID exposed and unexposed was 132.5 ± 10.7 vs 140.9 ± 10.4 mmHg, respectively (p &lt; 0.01). Mean DBP in NSAID exposed and unexposed was 79.0 0 ± 7.1 and 84.8 ± 8.4 mmHg, respectively (p = 0.01). In multivariable modeling, only magnesium exposure and earlier gestational age remained significantly associated with higher SBP. Of 46 women with severe preeclampsia, 26 (43.5%) were exposed to NSAIDs. Mean SBP in NSAID exposed and unexposed was 137.7 ± 13.0 and 143.7 ± 9.9 mmHg (p=0.09). Repeated measures analysis of blood pressures showed similar results. CONCLUSION: Administration of NSAIDs did not appear to be associated with higher mean SBP or DBP immediately PP. NSAID exposure was associated with significantly lower SBP and DBP. This suggests NSAIDs may not adversely affect BP immediately PP, but a randomized controlled trial is needed to provide higher level evidence.

Risk of incident myocardial infarction by gender: Interactions with serum lipids, blood pressure and smoking. The Tromsø Study 1979–2012

Background and aimsOverall, men have roughly twice the risk of myocardial infarction (MI) compared to women, but what causes this contrast is unclear. Identification of subgroups where the gender contrast in risk is particularly low or high, may provide new insight. In the search for such subgroups, we focus on gender-specific effects of established coronary heart disease (CHD) risk factors. Heterogeneity across age groups is also explored. MethodsPopulation-based prospective study from Tromsø, Norway, comprising 33,859 individuals (51% women); 2746 individuals (854 women) received a diagnosis of MI during follow-up at ages 35–94 years. Incidence rate ratios (IRR) were calculated as estimates of relative risk in Poisson regression analyses. ResultsThe association between total cholesterol and risk of MI was stronger for men than women, and IRR for men vs. women accordingly increased with increasing cholesterol, but the risk was higher for men in all subgroups (IRR in range 1.63–3.27), except among older people with low cholesterol levels. The adverse effect of increasing blood pressure (BP) was stronger for women, and IRR for gender diminished with increasing systolic (from 3.90 to 1.38) and diastolic BP (from 2.87 to 1.54). The gender contrast in risk was also substantially reduced in smokers ≥75 years. Associations with high-density lipoprotein cholesterol (HDL-C) did not differ between genders. ConclusionsGender heterogeneity in associations with total cholesterol but not HDL-C indicates gender differences in associations with non-HDL-C. The stronger association with BP in women may relate to more severe hypertension-induced left ventricular hypertrophy.

The Effect of Entonox on Labour Pain Relief among Nulliparous Women: A Randomized Controlled Trial.

Labour pain is one of the most severe pain in humans. Fear of labour pain is the most dreadful reason for Caesarean Section (CS). Entonox (a mixture of nitrous oxide+oxygen) is a safe inhalational analgesia during labour pain. This study investigated the effect of entonox on pain relief and length of labour in nulliparous women. A clinical trial study was conducted among 120 nulliparous women (60 in intervention and 60 in control group) in 2015 in Atieh Hospital, Hamadan city, Iran. The women were chosen randomly to receive either entonox in the intervention group or oxygen in the control group. For the intervention group, entonox inhalation was introduced at the initiation of pain at each contraction. entonox gas was administrated via a face-mask. This enabled the women to breathe fresh gas in each inspiration. In the control group the oxygen inhalation was given with occurrence of pain at each contraction too. In both groups, the gas administration continued until the end of contraction pain with the patient finally breathing room air. Pain using Visual Analogue Scale (VAS), duration of labour and side effects were compared in two groups. The mean age of women was 25.69 (SD=4.83). There were significant differences between two groups on labour pain at the first, second, third and fourth hours after intervention (p<0.05). Duration of labour in the intervention group (64.80 minutes) was significantly shorter than the control group (98.33 minutes) (p<0.05). There were no significant differences between the two groups on women's blood pressure and neonatal Apgar score. Only dizziness was slightly higher in the intervention group compared to the control group (p<0.05). Entonox provides significant pain relief and it can quickly be implemented during painful labour.