Blood Pressure In Supine Position Research Articles

Color Doppler and Ankle-brachial Index in the Diagnosis of Peripheral Artery Disease in Type II Diabetic Subject

Objective: To determine the association of color doppler and ankle-brachial index (ABI) in the diagnosis of peripheral artery disease in type ii diabetic subject.
 Methods: The study was carried out at ultrasound department of Advanced Radiology Clinic (ARC), Karachi, from January 2020 to December 2020. Patients of diagnosed diabetes mellitus for at least 4 years of either gender between 30-70 years of age were included. All patients were instructed to avoid heavy exercise, smoking and caffeinated beverages before the examination for at the minimum of two hours. All the cases underwent Standard Doppler examination of lower limb peripheral arteries performed by radiologist having experience of more than 10 years. Spectral waveform analysis was evaluated and presence of Biphasic flow or monophasic flow on color Doppler was labelled as peripheral artery disease. The ABI was computed for each patient by measuring the systolic blood pressure in supine position starting with the right arm then proceeding towards right leg, left leg, and finally for the left arm. ABI is a ratio obtained from dividing the higher of the ankle blood pressures for each leg by the highest of the right and left arm’s brachial systolic blood pressures. It was labelled as peripheral artery disease if the value was <0.9. This information along with the demographics was entered in the Performa by the researcher. Data was analyzed by using SPSS Version 26.
 Result: Mean age of enrolled participants was 58.21±6.74 year. There were 78.6% were males and 21.4% were females; mean duration of diabetes was 11.24±5.62 years. Out of all 121 cases were diagnosed color doppler and 118 cases found positive on ABI. Although ankle-brachial index shows almost similar diagnosis like color doppler ultrasound in the assessment of peripheral arterial disease (P-0.649).
 Conclusion: This study concludes that ankle-brachial index is a feasible, non-invasive technique almost similar to color Doppler ultrasound method for the detection of peripheral arterial disease. The ankle-brachial index technique is most important in periphery areas where color Doppler ultrasound is not available.

Different levels of blood pressure, different benefit from dual antiplatelet therapy in minor stroke or TIA patients

The study aimed to evaluate whether the benefits of dual antiplatelet therapy would be influenced by blood pressure (BP) levels, among acute minor stroke or transient ischemic attack (TIA). In CHANCE (Clopidogrel in High-Risk Patients with Acute Nondisabling cerebrovascular Events) trail, Patients were stratified by systolic BP (SBP) and diastolic BP (DBP) level measured on admission, respectively, using the supine position BP within 24 hours after symptoms onset. The primary efficacy outcome was stroke recurrence, bleeding was the safety outcome. Patients with SBP ≥ 140 mmHg, dual antiplatelet treatment could reduce the risk of stroke recurrence significantly (HR 0.654, 95% CI 0.529–0.793, p < 0.001) than mono antiplatelet therapy. And patients with DBP ≥ 90 mmHg, clopidogrel-aspirin significantly reduced the risk of recurrent stroke (HR 0.588, 95% CI 0.463–0.746, p < 0.001), compared with aspirin alone. However, in patients with SBP < 140 mmHg or DBP < 90 mmHg, no significant difference was observed between clopidogrel plus aspirin and aspirin alone. there was no difference in bleeding episodes by treatment assignment across categories of SBP or DBP. Patients with SBP ≥ 140 mmHg or DBP ≥ 90 mmHg after minor stroke or TIA got more benefits from dual antiplatelet therapy. Bleeding risk from dual antiplatelet treatment did not increase among patients with higher BP level on admission.

Blood pressure changes and polycyclic aromatic hydrocarbons in outdoor workers.

Everyday outdoor workers are exposed to chemicals including the polycyclic aromatic hydrocarbons (PAHs). The aim of the study is to evaluate the relationship between hydroxypyrene and blood pressure in outdoor workers. 374 subjects of both sexes entered the study. We evaluated the assay of urinary hydroxypyrene (1-HOP); their blood pressure (BP) was measured in upright position and in the supine position and the correlation between the levels of 1-HOP and BP was assessed using Pearson test and linear multiple regression. The results obtained show that in the total sample the levels of urinary 1-OHP are negatively associated with systolic and diastolic BP in supine position and in upright position. The significance is maintained despite the stratification of the sample according to age; in non-smokers we found a negative relationship between 1-OHP and differential blood pressure, both systolic and diastolic. The results of the study suggest that occupational exposure to PAHs may be able to significantly influence the blood pressure probably acting on the autonomic nervous system.

EARLY AUTONOMIC CHANGES IN PATIENTS WITH NEWLY DIAGNOSED ARTERIAL HYPERTENSION: PP.25.05

Objective: The autonomic nervous system plays a key role in the regulation of blood circulation and its abnormal function is a major factor involved in the early phases of essential arterial hypertension. The objective of the study was to assess the differences between short-term variation in heart rate and blood pressure in healthy individuals and in a group of patients with newly diagnosed mild essential arterial hypertension. Design and Method: Three continuous 5-minute measurements of the ECG and blood pressure in supine position with different breathing patterns (spontaneous breathing, paced breathing 0.1 Hz and 0.33 Hz), were applied at 2 groups of subjects: young healthy (YH, 31 subjects, 13 female) and patients with newly diagnosed mild arterial hypertension (HT, 29 subjects, 12 female). Analyzed parameters: heart rate (HR), heart rate variability spectral power in low frequency (HRVlf) and high frequency (HRVhf) power bands, systolic pressure (SBP), diastolic pressure (DBP) and baroreflex sensitivity (BRS). Results: Mean HR [beat/min] over groups YH/HT at 0.1Hz breathing is 69.9/73.2 (p = NS), during spontaneous breathing 66.1/72.9 (p = NS), and 0.33Hz breathing 67.1/72.8 (p = NS); mean HRVlf [ms2/1000] at 0.1Hz is 17.9/8.5 (p < 0.01), during spontaneous breathing 3.8/2.0 (p = NS) and at 0.33Hz 2.2/0.8 (p < 0.05); mean HRVhf [ms2/1000] at 0.1 Hz is 2.4/1.3 (p = NS), during spontaneous breathing 2.6/1.3 (p = NS) and at 0.33 Hz 2.1/0.7 (p = NS); mean BRS [ms/mmHg] at 0.1 Hz is 17.3/11.2 (p < 0.01), during spontaneous breathing 10.6/8.3 (p = NS) and at 0.33 Hz 9.9/5.9 (p < 0.05). Conclusions: Increased risk of cardiac mortality is closely connected to decreased HRV and BRS as the markers of the short-term circulation control dysfunction. There are no significant differences between both groups in HRVlf, HRVhf and BRS during spontaneous breathing. Group differences in HRVlf and BRS are more significant (p < 0.01) at 0.1Hz breathing than during 0.33Hz breathing (p < 0.05). The 0.1Hz paced breathing is simple and convenient approach to amplify inter-groups differences of the cardiovascular control detected by the HRVlf and BRS in early stages of hypertension.

Differences in blood pressure readings between supine and sitting positions in hypertensive patients

Objective — The objective of this study was to investigate the impact of postures on blood pressure (BP) readings in patients with hypertension.Methods and results — BP was measured in 1,487 hypertensive patients in sitting and supine positions. The systolic (SBP) and diastolic (DBP) BP in supine position was 2.9 ± 7.8 mmHg and 0.9 ± 5.4 mmHg higher, respectively, than in the sitting position (P< 0.001). The greatest difference between supine and sitting SBP was found in those aged between 30 and 39 years (3.6 ± 6.8 mmHg), and in those who were older than 80 years (5.3 ± 7.9 mmHg).A greater difference between the supine and sitting DBP was identified in the groups > 60-years of age. Multivariate regression analysis showed that age and sex were independent predictors for the increment of BP in the supine position.Conclusion — There is a significant difference between supine and sitting SBP and DBP, with age and sex being the most important predicting factors.

DAMPAK PEMBERIAN KALSIUM TERHADAP TEKANAN DARAH IBU HAMIL DI BOGOR

The Effect of Food Calcium Supplementation on the Blood Pressure Level of Pregnant Women in Bogor District. Study on the calcium supplementation to prevent the increase of blood pressure level of pregnant women was conducted in 6 Community Health Centers in Bogor District. Seventy-seven pregnant women between 18-23 weeks of pregnancy were included in this study. They were randomly assigned to receive 2 kinds of food (biscuit and syrup) which contain 700 mg of calcium for the intervention group and 200 mg for the control group. The subjects were asked to consume every 5 days in a week for 16 weeks. The results shows that no significant different in body weight, clinical status and biochemical status, calcium in urine and feces between 2 group. The energy and calcium intake were still below the indonesian RDA level. Diastolic blood pressure in supine position was decreased by 1.4 mg Hg in intervention group and 0.9 mg Hg in control group after 16 weeks of the study. However there was no significant difference between intervention and control group. This study observed there was a tendency that calcium supplementation maintains diastolic blood pressure level. Keywords: calcium, blood pressure, pregnant women.

Antihypertensive effect of a non-peptide angiotensin II receptor antagonist, MK954, in patients with essential hypertension

We examined the chronic effects of MK954, a novel orally active angiotensin II receptor antagonist, on blood pressure and renal function in 8 patients with essential hypertension for 2-4 weeks. All patients, four men and four women, 48.0 +/- 15.3 year-old (mean +/- SD), were hospitalized and given normal sodium diet (NaCl 10 g/day). After a control period with placebo for one week, MK954 was administered orally at 8 AM every day. The initial dose of MK954 was 12.5 mg/day, then the dose was increased up to 100 mg/day until diastolic blood pressure fell below 90 mmHg. The average dose was 59.4 +/- 43.7 mg/day. Casual blood pressure in supine position decreased significantly from 161.0 +/- 6.6/95.0 +/- 3.5 mmHg to 145.8 +/- 8.1/83.3 +/- 3.7 mmHg without any change in pulse rate. Non-invasive ambulatory blood pressure monitoring revealed that once daily administration of MK954 lowered blood pressure for 24 hours but did not affect circadian rhythm or variability of blood pressure. Reduction of blood pressure was slightly greater during day time than during sleeping time. Unlike a peptide angiotensin II antagonist, there was no pressor action of MK954 as agonist. No significant alternations were observed in body weight, serum electrolytes, creatinine clearance, urine volume or urinary excretion of sodium. Plasma renin activity (PRA) rised significantly after MK954 treatment but plasma aldosterone concentration (PAC) did not change. The reasons why PAC was not reduced are unclear. The doses of MK954 employed in this study might be insufficient to inhibit adrenal angiotensin II receptor. In conclusion, MK954 has long acting hypotensive effect in essential hypertension without affecting renal function.