Blood Pressure Profile Research Articles

The metabolic profiles of patients with autologous hematopoietic stem cell transplantation with graft versus host disease.

e24010 Background: Graft versus host disease (GvHD) is a serious inflammatory complication of hematopoietic stem cell transplant (HSCT) and a leading contributor to morbidity and mortality in HSCT patients. Previous studies have identified increased risk of cardiovascular death in HSCT patients who develop GvHD and characterized echocardiographic changes associated with chronic GvHD. However, details of the metabolic derangements in HSCT patients who develop GvHD remain poorly studied. Methods: This is a retrospective study of patients who underwent HSCT at H. Lee Moffitt Cancer Center and later developed severe chronic GVHD at 1 year. Metabolic data including weight, blood pressure, and lipid profile were recorded at baseline and at 1 year after HSCT. Results: Between January 1, 2010, and December 31, 2020, 1805 patients who received allogeneic HSCT were reviewed. At 1 year, 371 patients (20.5%) had severe GVHD. Compared to baseline, patients had higher total cholesterol (209 vs 183 mg/dL, P < 0.001), high-density lipoprotein (61 vs 47 mg/dL, P < 0.001), and triglycerides (211 vs 163 mg/dL, P < 0.001) at 1 year of follow up. Low-density lipoprotein values were not significantly different (107 vs 102 mg/dL, p = 0.15). Patient weight was significantly less at 1 year (163 vs 183 lbs, p < 0.001). Although blood pressure was not significantly different between baseline and 1 year, more patients were placed on antihypertensive medications at 1 year (50% vs 31%). Conclusions: This study finds that patients who undergo allogeneic HSCT and subsequently develop severe GVHD are at risk for metabolic derangements that may worsen cardiovascular health. We specifically demonstrate an increased need for antihypertensive therapy and elevations in total cholesterol and serum triglycerides. Further research is needed on the impact of these derangements on major adverse cardiac events and the role of cardiovascular risk factor management in these patients.

Effect of Nuts on Anthropometric and Glycemic Indexes and Blood Pressure in Secondary Cardiovascular Prevention: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Nut-enriched diets have a positive impact on cardiovascular risk factors, such as body mass, blood pressure, and fasting blood glucose. However, studies in individuals undergoing secondary cardiovascular prevention show controversial results. This systematic review with meta-analysis assessed the effect of nut supplementation on anthropometric, glycemic, and blood pressure indices in patients with atherosclerotic cardiovascular disease, as well as the frequency of adverse events. Six databases were used for the search-PubMed, Cochrane Library, EMBASE, BVS (Biblioteca Virtual da Saude), Web of Science, and ClinicalTrials.gov-until February 2023, with no language restrictions. The Cochrane Handbook for Systematic Reviews of Interventions methodology and the PICOS (Population, Intervention, Comparison, Outcome, Setting/design) strategy were used. Seven independent reviewers were involved in data extraction and resolution of disagreements. Certainty of the evidence was evaluated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. From 5187 records identified, 6 publications containing data referring to 5 randomized clinical trials (n = 436) were included in the final analyses. The nuts evaluated were almonds, pecans, Brazil nuts, and mixed nuts, with portions that varied between 5 g and 85 g (median: 30 g/day). The intervention period varied between 6 and 12 weeks. The nuts had no effect on fasting glucose and anthropometric indices, although the certainty of the evidence for most of these outcomes was low or very low. They also had no effect on systolic (mean difference [MD]: -1.16 mmHg [95% CI, -5.68 to 3.35], I2 = 0%-moderate certainty of evidence) or diastolic (MD: 0.10 mmHg [95% CI, -2.30 to 2.51], I2 = 0%-high certainty of evidence) blood pressure. It was not possible to aggregate data on adverse events. Nut supplementation had no effect on blood pressure, fasting glucose, or anthropometric profile in the context of atherosclerotic cardiovascular disease. PROSPERO registration no. CRD42020163456.

#1182 Arterial hypertension and chronic obstructive pulmonary disease—problems of choice of therapy

Abstract Background and Aims The development of hypertension in COPD is based on the early formation of endothelial dysfunction in the small and large circulatory circles, increased sympathetic activity with an imbalance in the synthesis of catecholamines, a violation of the role of the lungs in the metabolism of vasoactive substances, oxidative stress, chronic systemic inflammation, an imbalance in the renin-angiotensin-aldosterone system (RAAS). There are few studies confirming the role of RAAS components in the pathogenesis of cardiovascular changes in patients COPD. The activity of angiotensin converting enzyme (ACE) increases with hypoxia, which may play an important role in increasing the degree of systemic hypertension. An increase in the function of the RAAS is possible both under the direct influence of hypoxia and indirectly through activation of the sympathoadrenal system. To evaluate the efficacy and tolerability of the angiotensin II receptor antagonist valsartan (Nortivan) at a dose 80-160 mg per day in patients with hypertension of 1-2 degrees and COPD of stage II-IV. Method The study design is a local, open, incomparable study on the efficacy and safety of the drug Nortivan in patients with hypertension in combination with COPD. We examined 18 patients with stage II-IV in remission, suffering from grade I and II hypertension, determined in accordance with the generally accepted classification of blood pressure levels (VNOK, 2010). Results The criteria for exclusion from the study were the presence in patients of complications of hypertension, coronary heart disease, decompensated chronic pulmonary heart, endocrine diseases requiring drug correction, kidney pathology, chronic heart failure, oral steroid therapy. 10 days in the last 6 months before inclusion in the study, oncological diseases and any other conditions that could interfere with the interpretation and evaluation of the results of the study. Patients who had not previously received antihypertensive treatment were included in the study immediately, and the rest underwent a washing period for 2 weeks. Patients received Nortivan as antihypertensive therapy for 24 weeks. The effectiveness of therapy was controlled by daily monitoring blood pressure. The choice of quality criteria for the effectiveness of therapy parameters SMAD is associated with literature data and own observations on the prevalence of diurnal blood pressure profiles in patients with hypertension and COPD with no decrease or increase in blood pressure at night, when office blood pressure figures are to a lesser extent reflect the effectiveness of antihypertensive therapy. The initial dosage was 80 mg/day. With insufficient hypotensive effect, the dose of the drug was doubled at the 4th week of treatment. The basic COPD therapy did not change throughout the study period and included anticholinergic drugs (ipratropium bromide, tiotropium bromide), beta2-adrenomimetic (fe-noterol) or a combination thereof. Initially and after 24 weeks of treatment, a complete laboratory examination was performed: a clinical blood test, a biochemical blood test. The thickness of the intima-media complex of the carotid arteries and ECG was also studied. The criterion The safety of the therapy was assessed by the indicators of respiratory function, daily pulse oximetry. Conclusion The use of the drug Nortivan has shown high efficacy and safety in patients Grade I–II hypertension in combination with stage II-IV COPD. A statistically and clinically significant normalization of SMAD indicators with correction of pathological types of daily curves due to a decrease in the number of patients with an increase in or the absence of a decrease in blood pressure during the night period. The safety of using the drug in the clinical group with bronchial obstruction syndrome was confirmed by the dynamics of ventilation indicators according to spirometry and the results of daily pulse oximetry, which showed the absence of exacerbation of hypoxia during therapy.

#2990 Prevalence and risk factors of altered control of BP during the night in a large hemodialysis population investigated by 48 hours ABPM

Abstract Background and Aims Altered BP control during the night (non-dipping, reverse dipping and nocturnal hypertension) is recognized as a powerful risk factor for death and CV events in the hemodialysis (HD) population. However, these alterations have been described in relatively small studies and the epidemiology and risk factors for subtypes non-dipping and nocturnal hypertension are still poorly characterized in the current literature. We investigated the problem in a large Registry (The EURECAm Registry) that is the sole that adopted state of the art 48 h ABPM recording in the HD population. Method We included in this analysis 534 HD patients, enrolled in 7 centers, led by members of the EURECA-m working group, in 3 European countries. 48 h ABPM was measured by using well validated instruments (AAMI/ESH/ISO). As recommended by the European Society of Hypertension guidelines, recordings were made at 15-minute intervals during the day and 30 minutes during the night. Hypertension was defined as 48 h blood pressure (BP) >130/80, nocturnal hypertension as a nighttime BP >120/70 mmHg, non-dipping as a night/day systolic BP fall <10% and reverse dipping as a night/day ratio >1. Results Among 534 HD patients, 317 were hypertensive and. 217 normotensive. As many as 274 patients were non-dippers (51%), 32% were reverse dippers, and 381 (71%) had nocturnal hypertension. Of note, forty-one per cent of non-dippers, 37% of reverse dippers and 19% of patients with nocturnal hypertension were normotensives. As expected, the majority of reverse dippers (87%) had frank nocturnal hypertension. In a combined analysis of non-dippers and reverse dippers, as compared to dippers, these patients more frequently exhibited atrial fibrillation and had lower Heart Rate both pre-dialysis (72± 11 vs 77±13 bpm, P = 0.004) and post-dialysis (74± 13 vs 78±14 bpm, P = 0.03) and lower serum albumin (3.9±0.4 vs 4.0±0.3 g/dL, P = 0.02) but did not differ for age and gender. Conclusion In a large cohort of HD patients investigated by the state-of-the-art technique, 48 h ABPM alterations in the nocturnal BP profile were almost universal, and nocturnal hypertension was the more prevalent alteration, followed by non-dipping and reverse dipping. These alterations were independent of age and gender. Long-term, granular follow-up analyses are warranted to identify the prognostic value of these alterations.

Can smartphone-based diabetes control apps improve cardiovascular risk among patients with diabetes? A systematic review and meta-analysis

Despite being the most prevalent complication, cardiovascular risk factors such as blood pressure, weight, and lipid profile have been less considered in digital health studies. The aim of this systematic review and meta-analysis was to gather evidence regarding the impact of digital health applications on cardiovascular risk factors in patients with diabetes. Literature search was conducted following the PRISMA guideline on September 4, 2023, using databases including PubMed, Scilit, Scopus, Embase, and Web of Science, with a pre-planned combination of keywords. Selected studies were original research reporting the influence of smartphone applications on cardiovascular risk factors in diabetic patients. Standardized mean differences (SMD) between the intervention and control groups were analyzed using fixed or random-effects models. Eighteen studies met the criteria, consisting of 1152 patients in the intervention group and 1072 patients in the control group. The results of the meta-analysis showed that the smartphone applications significantly controlled systolic blood pressure (SMD: -5.03 mmHg; 95%CI: -7.018, -3.041, p<0.001). There was no significance effect on weight, body mass index, total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c) and diastolic blood pressure. In the subgroup analysis, triglycerides were lower in the intervention group compared to the control group (SMD: -0.459%; 95%CI: -0.787, -0.132, p=0.006). Publication bias and the limited number of studies suggest that the evidence from this study is in moderate level. In conclusion, smartphone apps are not only effective in aiding blood sugar control but also in preventing cardiovascular issues in diabetic patients. Further research is still needed to confirm these findings.

The effect of increased fruit and vegetable consumption on blood pressure and lipids: a pooled analysis of six randomised controlled fruit and vegetable intervention trials.

Increasing fruit and vegetable (FV) consumption is associated with reduced cardiovascular disease risk in observational studies but with little evidence from randomised controlled trials (RCTs). The impact of concurrent pharmacological therapy is unknown. To pool data from six RCTs to examine the effect of increasing FV intake on blood pressure (BP) and lipid profile, also exploring whether effects differed by medication use. Across trials, dietary intake was assessed by diet diaries or histories, lipids by routine biochemical methods and BP by automated monitors. Linear regression provided an estimate of the change in lipid profile or BP associated with a one portion increase in self-reported daily FV intake, with interaction terms fitted for medication use. The pooled sample included a total of 554 participants (308 males and 246 females). Meta-analysis of regression coefficients revealed no significant change in either systolic or diastolic BP per portion FV increase, although there was significant heterogeneity across trials for systolic BP (I2= 73%). Neither adjusting for change in body mass index, nor analysis according to use of anti-hypertensive medication altered the relationship. There was no significant change in lipid profile per portion FV increase, although there was a significant reduction in total cholesterol among those not on lipid-lowering therapy (P < 0.05 after Bonferroni correction). Pooled analysis of six individual FV trials showed no impact of increasing intake on BP or lipids, but there was a total cholesterol-lowering effect in those not on lipid-lowering therapy.

Real-World Clinical Experience of Oral Semaglutide in a Secondary Diabetes Clinic in the UK: A Retrospective Observational Study.

Oral semaglutide improves cardiovascular risk factors in people with type 2 diabetes (T2D) in clinical trials, though real-world evidence is limited. We aimed to determine the real-world impact of oral semaglutide on routinely collected clinical data in our practice. People with T2D initiated on oral semaglutide in secondary care diabetes clinics at two hospital sites in Wales (United Kingdom) were included. Data were collected on reasons for oral semaglutide initiation and changes in bodyweight, blood pressure, glycemic control, and lipid profiles over follow-up at 3-6months, and at 6-12months. Data were collected to determine the safety of oral semaglutide. Seventy-six patients were included, with a median age 59.3 [51.4-67.6] years, and 38 (50.0%) patients were female. The most common reasons for oral semaglutide were need for weight loss and improved glycemia (69.8%), and improved glycemia alone (25.0%). Oral semaglutide associated with significantly reduced bodyweight (- 3.3kg), body mass index (BMI) (-0.9kg/m2), glycated hemoglobin (HbA1c) (- 11mmol/mol), and total cholesterol (- 0.4mmol/l) by 3-6months follow-up. At 6-12months, there was a significant reduction in systolic blood pressure (- 7.0mmHg), in addition to sustained reductions in other metabolic parameters. By 12months, 18 (23.6%) patients had discontinued the drug, largely resulting from gastrointestinal disturbance, but there were no serious events in this cohort. Oral semaglutide was effective in improving cardiovascular risk factors in this real-world population living with T2D, and no serious events were identified related to oral semaglutide in this patient group.

High Compliance with the Lifestyle-Modification Program "Change 10 Habits" Is Effective for Obesity Management.

Low compliance (LC) with lifestyle modification is a very common obstacle in obesity management. The purpose of the current study was to investigate the effectiveness of obesity management according to compliance with a lifestyle-modification program. The "Change 10 Habits" program was administered four times over 12 weeks. Eighty-seven participants were divided into LC and high compliance (HC) groups for analysis after intervention. Then, to assess the program's effectiveness based on compliance, we conducted t-tests and linear regression modeling. In week 12, the scores of two dietary habits-specifically, "eat three meals regularly, adequate amount" and "do not eat after 9:00 PM"-were significantly higher in the HC group than in the LC group. Changes in leg and total body fat percentages were significantly improved in the HC group (-0.2%±0.3% vs. 0.9%±0.3%, P<0.05; -0.1%±0.3% vs. 1.1%±0.5%, P<0.05, respectively). The body mass index was also significantly lower in the HC group than in the LC group (26.7±1.8 kg/m2 vs. 27.7±2.1 kg/m2, P<0.05) at final follow-up. Finally, the systolic blood pressure, triglyceride, and very-low-density lipoprotein cholesterol values of the HC group also decreased significantly (from 117.9±12.2 to 114.3±15.0 mmHg, P<0.05; from 121.7±74.9 to 105.7±60.9 mg/dL, P<0.05; and from 24.3±15.0 to 21.1±12.2 mg/dL, P<0.05, respectively). HC with the study program effectively improved the dietary habits, body fat composition, blood pressure, and lipid profile of adults with mild obesity.

NIGHT-TO-DAY BLOODE PRESSURE RATIO FROM 7 DAY/24H AMBULATORY BLOOD PRESSURE MONITORIN IN PATIENTS WITH CORONARY HEART DISEASE

Objective: Impairment of night-to-day blood pressure (BP) ratio led to an increase in cardiovascular outcomes. The aim of the present study was to examine night-to-day BP ratio variability in two repeated 7 day/2h ambulatory BP monitoring (AMBP) in patients with coronary heart disease (CHD). Design and method: The 20 patients with CHD were under therapy with ACE inhibitors, beta blockers and statins. The AMBP was in every patient provided twice and AMBP lasted 7 days/ 24-h repeatedly. The 20 patients were divided in subgroup 1 and 2. Subgroup 1 was monitored before and after 3months of cardiovascular rehabilitation 3 times a week. Subgroup 2 was monitored before and after usual every day activity. We evaluated night-to-day BP ration in 24-h in BP profile and 7 day mean value before and after cardiac RHB in SBP and DBP in subgroup 1 and also subgroup 2. Results: The mean values of night-to-day in SBP ration evaluated from 7 day/24-h AMBP in subgroup 1 with cardiovascular rehabilitation in the 1st monitoring: was 12.0±1.85%, in 2nd AMBP 8.4±1.89% (not significant). The mean values of night-to-day DBP ratio evaluated from 7 day/24-h AMBP in subgroup 1was in 1st monitoring: was 13.7±1.54%, in 2nd monitoring was 11.4±1.34% (not significant). The mean value of night to day SBP ratio evaluated from 7 day/24 hour AMBP in subgroup 2 was 1st monitoring was 17.3±2.23%, in 2nd monitoring was: 18.8±1.16% (not significant). The mean values of night to day DBP ratio evaluated from 7 day /24 hour AMBP in subgroup 2 was in 1st monitoring was 19.6±2.66%; 2nd monitoring: 20.7±1.33% (not significant). Conclusions: In patients with CAD night-to-day BP ration from 7 day/24 h AMBP varied in one BP in 24-h profile and also in mean values from 7 day/24-h AMBP in both subgroups in values from1st and 2nd BP measurement. We have not found significant difference between the subgroup 1 before and after cardiac rehabilitation. We have not found significant difference in repeated measurement in subgroup 2 with usual activities between repeated measurements.

EFFICACY OF A PSYCHOTHERAPEUTIC GROUP ON PATIENTS WITH OBESITY AND HYPERTENSION

Objective: To evaluate the effectiveness of (brief obesity group therapy) BOG as a psychological treatment compared to a control group (CG) in reducing weight, BMI and blood pressure and metabolic profile in patients with obesity and heart disease. To evaluate the effectiveness of the BOG on improving repertoires for coping with stressful situations related to obesity. Verify changes in behaviors that cause emotional suffering and relief from suffering based on the perception of participating patients. Design and method: Controlled clinical trial with patients with obesity and cardiovascular (CV) disease (hypertension, coronary artery disease and/or heart failure). Method: Clinical data (weight, BMI, blood pressure (BP), blood glucose, cholesterol levels, triglycerides) were collected from the electronic medical records before and after the intervention in BOG e CG. Quantitative variables (clinical data and coping strategies) expressed by means and standard deviations were compared by the T-Student test. Qualitative variables (behaviors causing emotional suffering, emotional reactions) were analyzed by thematic content analysis and Wilcoxon test Results: Thirty-eight patients with obesity and CV disease were studied, 19 for each group. After the BOG group therapy, there was a significant (p&lt;0.05) reduction in BMI, weight, and systolic BP of the patients (Before: 39±6 kg/m2, 102±22 kg, 149±24 mmHg vs. after 34±7 kg/m2, 91±24 kg, 132±13 mmHg). In CG, there was a significant (p&lt;0.05) increase in BMI, weight and systolic BP (Before: 35±5 kg/m2, 91±27 kg, 161±28 mmHg vs. after 36±5 kg/m2, 93±21 kg, 171±31 mmHg). We did not observe significant differences in laboratory variables in both groups. It was observed an improvement in the use of active coping, positive reinterpretation and self-distraction and a reduction in the use of maladaptive copings of self-blame, denial and behavioral disinvestment. A reduction in negative feelings, an increase in positive feelings and an attenuation of the desire to eat were identified. Conclusions: BOG was effective and brought clinical benefits in patients with obesity and CV disease, with significant reductions in weight, BMI and systolic BP, in addition to improvements in psychological aspects. It should be considered as a psychological treatment.

Factors influencing optimal diabetes care and clinical outcomes in Thai patients with type 2 diabetes mellitus: a multilevel modelling analysis

BackgroundIncreasing levels of poor glycaemic control among Thai patients with type 2 diabetes mellitus (T2DM) motivated us to compare T2DM care between urban and suburban primary care units (PCUs), to...

RELATIONSHIP OF DAILY BLOOD PRESSURE PROFILE AND ARTERIAL STIFFNESS

Objective: To study the blood pressure daily profile in patients with hypertension (HNT) depending on the pulse wave velocity (PWV). Design and method: We studied 88 treated patients with HNT. The ambulatory BP monitoring (ABPM) was recorded with a Medicom-combi device (Russia) using the oscillometric method. PWV was determined using the SphygmoCor (AtCor Medical Pty Ltd, Australia). Statistical analysis was performed using the SPSS 24.0 software package. Results: Patients were divided into 2 groups depending on PWV level: the first group had a PWV &lt; 10 m/s, and the second group had a PWV &gt; 10 m/s. The mean PWV in the groups was 7.79±1.38 vs. 14.13±1.85 m/s, respectively (p&lt;0.007). Office SBP and DBP didn’t differ between groups. Patients of the second group had significantly higher mean daily SBP (113.64±16.64 vs 128.23±16.91 mm Hg, p=0.0001), mean daytime SBP (116.77±8.99 vs 129.36±7.8 mm Hg, p=0.0001), and mean nighttime DBP (66.26±9.7 vs 71.64±7.1 mm Hg, p=0.04). The load index (LI) of daytime and nighttime SBP was higher in patients with PWV &gt; 10 m/s. LI of SBP daytime: 9.72±15.82% vs. 27.74±35.24%, respectively, p = 0.001. LI of SBP nighttime: 18.34±26.44% vs. 44.2±38.81%, respectively, p = 0.001. Variability and nocturnal falls of SBP and DBP also didn’t differ between the groups. The number of dippers by SBP and DBP was higher in patients with normal PWV, but not significantly: 18% and 12% vs. 13% and 9%, SBP: χ2 = 0.04, p = 0.83; DBP: χ2 = 0.19, p = 0.45. The number of non-dippers by SBP and DBP was significantly higher in the first group: 65% and 66% vs. 50% and 50%; SBP: χ2 = 4.6, p = 0.032; and DBP: χ2 = 5.25, p &gt; 0.05. However, the number of night-pickers by SBP and DBP significantly prevailed in the second group: 17% and 19% vs. 36.4% and 32%, respectively; SBP: χ2 = 9.2, p = 0.003, DBP: χ2 = 5.58, p = 0.019. There were no over-dippers in both groups. Conclusions: Hypertensive patients with high PWV values had more pronounced disorders in their daily blood pressure profile.

FEMALE GENDER: AN INDEPENDENT PREDICTOR OF HIGH NORMAL BLOOD PRESSURE IN LONG -TERM ADULT SURVIVORS OF CHILDHOOD, ADOLESCENT AND YOUNG ADULT CANCER

Objective: Determine the blood pressure profile in longterm adult survivors of childhood, adolescent and young adult cancer. Determine predictive factors for abnormal blood pressure figures in these patients. Design and method: 104 patients aged over 18, who had received chemotherapy with or without mediastinal radiotherapy for the treatment of neoplasia diagnosed and treated before the age of 21. High blood pressure was defined by a SBP &gt; = 140 mmHg and/or DBP &gt; = 90 mmHg or by the use of antihypertensive drugs. High normal blood pressure corresponded to a SBP between 130 mmHg and 139 mmHg and/or a DBP between 85 and 89 mmHg. Results: Male predominance (56.7%) with a sex ratio of 1.3. Mean current age 25.12 +/-5.40 years, age at diagnosis 13.4 ±5.13 years, duration since end of treatment of cancer 10.67 +/-5.80 years, BMI 22.77 ±4.66 kg/m2, male waist circumference (WC) 82.7 ±12.6 cm, female (WC) 78.6 ± 10.4 cm, SBP 114.5 ±11.7 mmHg, DBP 74.2 ±7.4 mmHg. Chemotherapy alone 80.8%, chemotherapy + mediastinal radiotherapy 19.2%, anthracyclines 100%, platinum salts 32%, corticoids 9%. Low HDL-cholesterol 44.7%, high normal blood pressure 24.3%, abdominal obesity 15.8%, hypertriglyceridemia 9.7%, obesity 8.7%, prediabetes 6.9%, fasting plasma glucose &gt; = 110 mg/dl 6.9%, metabolic syndrome (MS) 3.8%. Multivariate study: Gender (OR = 3.32 95% CI 1.11 - 9.92 p=0.03) - MS (OR = 0.07 95% CI 0.06 - 0.81 p=0.03). Conclusions: Nearly a quarter of the patients in our study (24%) had a high normal blood pressure, which was associated with female gender and the presence of metabolic syndrome. These results confirm the need for early screening of cardiovascular risk factors, particularly hypertension, in long-term adult survivors of childhood, adolescent and young adult cancer.

FEATURES OF THE DAILY BLOOD PRESSURE PROFILE IN PATIENTS WITH ARTERIAL HYPERTENSION AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Objective: To study the features of the daily blood pressure profile (DBPP) in patients with combination of arterial hypertension (AH) and chronic obstructive pulmonary disease (COPD). Design and method: The study included 47 patients (average age 53.1±2.5 years), 31 women, 16 men with hypertension I-II degrees. Patients were divided into 2 groups: with COPD (n=22) and without COPD (n=25). Duration AH in the group of patients with COPD was 6.5±0.54 years, without COPD 5.1±0.66 years. Exclusion criteria's were: symptomatic hypertension, cerebrovascular accidents in history, valvular heart disease, severe rhythm and conduction disorders, endocrine disorders, severe pathologies of the liver and kidneys, receiving systemic glucocorticosteroids actions. All patients underwent a study of pulmonary function (RPF) and SMAD recorders. Applied the following patient classification scheme: “dippers” (Daily index (DI) from 10 to 20%); “nondippers” (DI from 0 to 10%); “overdippers” (DI&gt;20%); “nightpickers” (DI&lt;0). Results: We identified a direct correlation between the level of PBP and age patients with a combination of hypertension and COPD during all monitoring periods (r=0.629, p=0.000 (days), r=0.645, p=0.000 (day), r=0.564, p=0.000 (night)). The same dependence was noted in individuals with hypertension without lung pathology (r=0.298, p=0.021 (days), r=0.266, p=0.04 (day), r=0.346, p=0.007 (night)). Thus, we not only did not identify significant differences in the level of PBP, but also noted general regular features of its dynamics with increasing age of patients of both groups. Comparative assessment of the heart rhythm. DBP also showed significant intergroup differences. Thus, we have established the predominance of “dippers” among patients with AH without lung pathology (51.9%), while among persons with a combination of hypertension and COPD, adequate nocturnal decrease in blood pressure was observed slightly more than in a third of patients (37.4%, p=0.125). Besides, among these patients a significantly higher number of “night pickers” was identified (25% vs. 7.5%, p=0.002), the number of “nondippers” and there were “overdippers” in the compared groups was approximately the same. Conclusions: Presence of COPD in patients with hypertension worsens the course of the latter, which is expressed in a significant predominance of “nightpickers” and “non-dippers” patients.

BLOOD PRESSURE CONTROL AND CIRCADIAN RHYTHM AMONG PATIENTS WITH PROGRESSIVE GLAUCOMA – PRELIMINARY RESULTS

Objective: Blood pressure (BP) control, postural changes and daily variability in patients with progressive glaucoma. Design and method: The study included 55 patients with different duration of open-angle glaucoma who had disease progression during the visit qualifying for this observational study. During two separate visits with 7 to 14 days interval, an ophthalmological and the clinical examination (standardized questionnaire, three BP measurements, orthostatic test, 24hour ABPM) were performed. The criterion for hypertension (HT) control in treated patients aged 80 years and over was office BP &lt;150/90 mmHg. Postural hypotension was defined as a drop in systolic BP (SBP) of at least 20 mmHg and/or a drop in diastolic BP (DBP) of at least 10 mmHg within 1, 3, or 5 minutes after standing. The validated devices were used to obtain BP measurements. Results: The mean age of patients was 69 years, most subjects were over 60 years of age; 40% were men, 75% were treated for hypertension (HT). ∗Data from ABPM are currently available for 39 patients. Patients with glaucoma progression noted in the short course of the disease (&lt;5 years) were more likely to have uncontrolled HT in the office setting; in ABPM also had higher daytime SBP and greater daily SBP variability, although no statistical significance was observed. In turn, the oldest patients with long-term (&gt;10 years) progressive glaucoma had too low nighttime SBP and DBP values. Conclusions: Conclusions. The results indicate an unfavorable prognostic impact of insufficient HT control and daily BP variability in people with a few years of glaucoma history. In the oldest patients, too low BP levels throughout the 24-hour period may contribute to its progression. Since most our patients had ABPM performed for the first time, emphasis should be placed on more frequent monitoring of circadian BP profile in glaucoma patients, especially among the oldest.

Effect of Mat Pilates Training on Blood Pressure, Inflammatory, and Oxidative Profiles in Hypertensive Elderly.

To determine the effects of mat Pilates training on blood pressure, inflammatory, and antioxidative markers in hypertensive elderly people, 34 hypertensive subjects aged 60-75 years were randomly divided into a control group (CON; n = 17) and a mat Pilates training group (MP; n = 17). The CON participants conducted normal daily activities and participated in neither organized exercises nor sports training, while those in the MP group received mat Pilates training for 60 min three times/week for 12 weeks. Parameters including blood pressure, cardiovascular function, nitric oxide (NO), tumor necrotic factor-alpha (TNF-α), superoxide dismutase (SOD), and malonaldehyde (MDA) were collected at baseline and the end of 12 weeks. The MP group had significantly decreased blood pressure, improved cardiovascular variables, decreased MDA and TNF-α, and increased NO and SOD compared with the CON group and the pre-training period (p < 0.05). In conclusion, these findings demonstrate the positive effects of 12 weeks of mat Pilates training in terms of reducing blood pressure and increasing blood flow related to improvements in anti-inflammatory and antioxidative markers in hypertensive elderly people. Mat Pilates training might be integrated as an alternative therapeutic exercise modality in clinical practice for hypertensive elderly individuals.

Two-Month Consumption of Orange Juice Enriched with Vitamin D3 and Probiotics Decreases Body Weight, Insulin Resistance, Blood Lipids, and Arterial Blood Pressure in High-Cardiometabolic-Risk Patients on a Westernized Type Diet: Results from a Randomized Clinical Trial.

This study examined the effects of orange juice (OJ) supplemented with vitamin D3 (2000 IU) and probiotics (Lacticaseibacillus casei Shirota and Lacticaseibacillus rhamnosus GG, 108 cfu/mL) on cardiometabolic risk factors in overweight and obese adults following a Westernized-type diet. Fifty-three high-risk individuals were randomly assigned to one of two groups. Over 8 weeks, one group consumed a vitamin D3 and probiotic-enriched OJ and the other regular OJ (control). Diets remained unchanged and were documented through food diaries. Measures of metabolic and inflammatory markers and blood pressure were measured at the start and end of the study. Post-intervention, the enriched OJ group showed the following significant metabolic improvements (without changes in triglycerides, inflammation, or central blood pressure): reduced fasting insulin, peripheral blood pressure, body weight (-1.4 kg 95% CI: -2.4, -0.4), energy (-270 kcal 95% CI: -553.2, -13.7), macronutrient (dietary fat -238 kcal 95% CI: -11.9, -1.0; carbohydrates -155 kcal 95% CI: -282.4, -27.3; sugars -16.1 g 95% CI: -11.9, -1.0) intake, and better lipid profiles (total cholesterol -10.3 mg/dL 95% CI: -21.4, 0.9; LDL-C -7 mg/dL 95% CI: -13.5, -0.5). The enriched OJ led to weight loss, less energy/macronutrient consumption, improved lipid profiles, and increased insulin sensitivity after 8 weeks in those following a Westernized diet, thus indicating potential benefits for cardiometabolic risk. This study was a part of FunJuice-T2EDK-01922, which was funded by the EU Regional Development Fund and Greek National Resources.

Performance of Home-Based and Ambulatory Blood Pressure Monitoring in Obese Children and Their Correlation With End Organ Damage.

The increasing prevalence of childhood obesity has led to a corresponding increase in hypertension among children, necessitating early identification of subclinical target organ damage for accurate cardiovascular risk assessment. However, in the pediatric population, there is a paucity of literature comparing ambulatory and home blood pressure monitoring, and this knowledge gap is exacerbated by limited access to ambulatory blood pressure monitoring (ABPM) facilities, particularly in developing countries, where pediatricians often resort to home blood BP monitoring as the preferred option. In this cross-sectional study with 60 obese children (aged 5-18 years) at tertiary health care in central India, we aimed to comprehensively characterize blood pressure profiles, including office, ambulatory, and home, and investigated their correlations with indicators of end-organ damage. Among 60 children, 26 (43.3%) participants were found to be hypertensive based on 24-hour-ABPM evaluation. Masked hypertension (MH) and white coat hypertension (WCH) were observed in 21.6% and 13.3%, respectively. Surprisingly, 20% of participants were identified as hypertensive through 7-day home BP monitoring (HBPM). A notable discordance of 36.6% was between HBPM and ABPM results. Moreover, 26.7% of the children had end-organ damage, with higher odds associated with night-time systolic ambulatory hypertension in the adjusted regression model (OR = 1.06, 95% CI: 1.03-1.10, P < 0.001). The study highlights 24-hour ABPM's vital role in classifying hypertensive status, especially in high-risk children. The diagnostic performance of HBPM shows poor sensitivity in detecting MH and lower specificity in identifying WCH compared to ABPM. This limitation translates to missed opportunities for early preventive interventions.

Baroreflex dynamics during the rest to exercise transient in acute normobaric hypoxia in humans

PurposeWe hypothesised that during a rest-to-exercise transient in hypoxia (H), compared to normoxia (N), (i) the initial baroreflex sensitivity (BRS) decrease would be slower and (ii) the fast heart rate (HR) and cardiac output (CO) response would have smaller amplitude (A1) due to lower vagal activity in H than N.MethodsTen participants performed three rest-to-50 W exercise transients on a cycle-ergometer in N (ambient air) and three in H (inspired fraction of O2 = 0.11). R-to-R interval (RRi, by electrocardiography) and blood pressure profile (by photo-plethysmography) were recorded non-invasively. Analysis of the latter provided mean arterial pressure (MAP) and stroke volume (SV). CO = HR·SV. BRS was calculated by modified sequence method.ResultsUpon exercise onset in N, MAP fell to a minimum (MAPmin) then recovered. BRS decreased immediately from 14.7 ± 3.6 at rest to 7.0 ± 3.0 ms mmHg−1 at 50 W (p < 0.01). The first BRS sequence detected at 50 W was 8.9 ± 4.8 ms mmHg−1 (p < 0.05 vs. rest). In H, MAP showed several oscillations until reaching a new steady state. BRS decreased rapidly from 10.6 ± 2.8 at rest to 2.9 ± 1.5 ms mmHg−1 at 50 W (p < 0.01), as the first BRS sequence at 50 W was 5.8 ± 2.6 ms mmHg−1 (p < 0.01 vs. rest). CO-A1 was 2.96 ± 1.51 and 2.31 ± 0.94 l min−1 in N and H, respectively (p = 0.06). HR-A1 was 7.7 ± 4.6 and 7.1 ± 5.9 min−1 in N and H, respectively (p = 0.81).ConclusionThe immediate BRS decrease in H, coupled with similar rapid HR and CO responses, is compatible with a withdrawal of residual vagal activity in H associated with increased sympathetic drive.

Habitual coffee consumption and office, home, and ambulatory blood pressure: results of a 10-year prospective study.

Heterogeneous are the results of the published studies aimed at determining the long-term effects of habitual coffee consumption on blood pressure (BP). Specifically, no data are available on the longitudinal association between habitual coffee consumption and office, home and 24 h BP profile and variability. In 1408 subjects recruited in the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study, followed for a 10 year follow-up period and classified as coffee consumers and nonconsumers (self-reporting), we prospectically investigated the association between habitual coffee consumption and office, home and 24-h ambulatory BP; 24-h BP variability; and development of a new hypertensive state. Data were also analysed according to gender. When data were adjusted for confounders habitual coffee nonconsumers and consumers displayed similar long-term BP changes during the follow-up in office, home, and ambulatory BP. No difference was found between heavy and moderate coffee consumers. Furthermore, also new-onset hypertension and patterns of BP variability were superimposable in coffee nonconsumers and consumers, independently on confounders including gender, number, and characteristics of the antihypertensive drug treatment. The present study, which is the first longitudinal investigation never performed examining in a prospective fashion the long-term (10 year) effects of coffee consumption on office, home, and ambulatory BP, provides conclusive evidence that habitual coffee consumption is associated with neutral effects on in-office and out-of-office BP values and related variabilities. This is the also the case for the new-onset hypertensive state.