Changes In Blood Pressure Values Research Articles

Secular trends and age-specific distribution of blood pressure in Japanese adolescents aged 12-18 years in 2000-2019.

Adolescent blood pressure is a predictor of future risk for hypertension and cardiovascular diseases, and therefore its status needs to be accurately determined. However, limited evidence is available regarding the secular trends and distribution of adolescent blood pressure. In the present study, we assessed the secular trends and age-specific distributions of blood pressure in Japanese adolescents aged 12-18 years by using data drawn from 20 years of annual health checkups conducted between 2000 and 2019. Participants underwent health checkups every year for three years at the same school and the data were divided into four 5-year cycles: 2000-2004, 2005-2009, 2010-2014, and 2015-2019. From a total of 124,460 records (33,496 individuals) retrieved, 3000 records (3000 individuals) from each year-cycle were randomly selected to avoid duplicating data from the same individuals. In the study period, in males systolic blood pressure showed a decreasing trend over time, whereas in females diastolic blood pressure showed an increasing trend. Subgroup analyses by school category (junior/senior high school) and by obesity category showed similar blood pressure trends as in the overall analysis. Age-specific blood pressure values in Japanese adolescents increased with age in males but not in females. Thus, different patterns of change in blood pressure values over the past 20 years were observed between males and females. Age-specific blood pressure distributions are also presented. Together, these findings will be useful for understanding blood pressure trends among adolescents.

Effectiveness of peer mentoring and self-monitoring to improve blood pressure control in a vulnerable population in Argentina: Pragmatic randomized open-label controlled trial.

To evaluate the effectiveness of blood pressure (BP) self-monitoring and peer mentoring to improve the control of hypertension in clinical practice in primary care centers (PCCs) located in low-resource settings in Argentina. An individual randomized controlled trial was carried out to test two different approaches based on behavioral interventions in PCCs in Argentina. Hypertensive adults were randomly assigned to one of three arms: BP self-monitoring, peer mentoring, and usual care. The primary outcome was the change in BP values from baseline to the end of follow-up at 3 months. A qualitative approach of participants' experiences of the peer mentoring arm was also conducted. A total of 442 participants with hypertension were included in the study. Self-monitoring and peer mentoring interventions did not show a significant difference in BP control compared to usual care. However, this trial showed an improvement regarding antihypertensive medication adherence among those assigned to the peer mentoring intervention compared to the control at the end of follow-up (p = 0.031). Self-monitoring and peer mentoring interventions did not demonstrate to be effective in BP control compared to usual care. Implementing a peer support strategy was demonstrated to be feasible and effective in improving medication adherence in this population.

Both LBBP and LVSP significantly improve ventricular dyssynchrony and effectivity of LV performance compared to RV apical pacing in heart failure patients with LBBB and an indication to CRT

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): Supported by the Ministry of Health of the Czech Republic, grant number NU21-02-00584 and by the project National Institute for Research of Metabolic and Cardiovascular Diseases (Programme EXCELES, ID Project No. LX22NPO5104) - Funded by the European Union – Next Generation EU. Background Left bundle branch pacing and left septal myocardial pacing (LVSP) are novel methods of CRT in patients with heart failure. However, their exact impact on ventricular synchrony visualized by noninvasive assessment and the LV performance effectivity is unknown. Aims To compare ventricular synchrony and a change in blood pressure values between nonselective left bundle branch pacing (nsLBBP), LVSP, and RV apical pacing (RVAP) in heart failure patients. Methods In patients with CRT indication and LBBB, a lead was placed in the left septal area, where the transition between nsLBBP and LVSP was observed during decremental output pacing. Another lead was placed in the RV apex. UHF-ECG was used to assess ventricular synchrony during RVAP, nsLBBP, and LVSP. Dyssynchrony parameter e-DYS was calculated as an absolute value of the time difference between the first and last activation. Systolic blood pressure measurements were obtained invasively from the radial artery during VVI pacing at rates ten beats/minute higher than spontaneous rhythm. The protocol included multiple transitions between RVAP, nsLBBP, and LVSP. Results The study protocol was finalized in six patients; mean age 67 years, LVEF 33%, 3 had ischemic cardiomyopathy, and QRSd during spontaneous LBBB was 172±8 ms. QRSd was prolonged to 182±10ms during RVAP and shortened to 145±12 ms and 149±13 ms during nsLBBP and LVSP, respectively. The dyssynchrony parameter e-DYS shortened from 46±18 ms during RVAP to 1±16 ms during nsLBBP and 12±13 ms during LVSP, p < 0.05 for RVAP vs. nsLBBP and LVSP, and p = 0.4 for nsLBBP vs. LVSP. Both nsLBBP and LVSP led to a significant increase in the systolic blood pressure compared to RVAP (9±1 mmHg and 10±1 mmHg for nsLBBp and LVSP vs. RVAP, p < 0.001, respectively. nsLBBP produced slightly higher systolic blood pressure than LVSP (mean difference 2±1 mmHg, p = 0.005. Conclusion In patients with LBBB and CRT indication, both nsLBBp and LVSP significantly reduce ventricular dyssynchrony and lead to better effectivity of the LV performance compared to RV apical pacing.

A Multi-Parameter Fusion Method for Cuffless Continuous Blood Pressure Estimation Based on Electrocardiogram and Photoplethysmogram

Blood pressure (BP) is an essential physiological indicator to identify and determine health status. Compared with the isolated BP measurement conducted by traditional cuff approaches, cuffless BP monitoring can reflect the dynamic changes in BP values and is more helpful to evaluate the effectiveness of BP control. In this paper, we designed a wearable device for continuous physiological signal acquisition. Based on the collected electrocardiogram (ECG) and photoplethysmogram (PPG), we proposed a multi-parameter fusion method for noninvasive BP estimation. An amount of 25 features were extracted from processed waveforms and Gaussian copula mutual information (MI) was introduced to reduce feature redundancy. After feature selection, random forest (RF) was trained to realize systolic BP (SBP) and diastolic BP (DBP) estimation. Moreover, we used the records in public MIMIC-III as the training set and private data as the testing set to avoid data leakage. The mean absolute error (MAE) and standard deviation (STD) for SBP and DBP were reduced from 9.12 ± 9.83 mmHg and 8.31 ± 9.23 mmHg to 7.93 ± 9.12 mmHg and 7.63 ± 8.61 mmHg by feature selection. After calibration, the MAE was further reduced to 5.21 mmHg and 4.15 mmHg. The result showed that MI has great potential in feature selection during BP prediction and the proposed multi-parameter fusion method can be used for long-term BP monitoring.

Biostatistical Analysis on the Regulation of Blood Pressure

Background: Hypertension is one of the most common diseases in the current era. With the increase in life pressures, the number of people with high blood pressure is constantly increasing. Multiple types of medical drugs are used to treat high blood pressure, but despite their use in treatment, they have many side effects, so with the beginning of the twentieth century, the World Health Organization sought to urge the use of alternative medicine in the treatment of many diseases because of its characteristics that make it superior on medical drugs, the most important of which is that it has no side effects. The purpose of this study was to determine the effectiveness of Fashareen on the regulation of blood pressure. Material and Methods: The study was designed to include hypertensive patients, where 30 participants were taken from OPD of government and private hospitals in Faisalabad according to the inclusion and exclusion criteria of the study. Consent was taken from individuals for an assessment and intervention procedure. A recommended dose of 1 tablet of Fashareen twice a day was given to the patients in 12 hours a part period, and after that, we collected the data again from the patient’s e.g. Blood pressure and heartbeats. Results: Significant change in blood pressure values after the treatment in a group in addition to a significant decrease in heart rate values after the treatment in a group Conclusion: Fashareen is quite effective in controlling blood stress.

A literature review of pharmacist’s impact on lifestyle modifications among obese, hypertensive patients

Abstract Objectives Previous trials have confirmed a positive relationship between obesity and hypertension. The purpose of this article is to identify the impact of pharmacists in lifestyle adherence among obese, hypertensive patients. Methods A literature search was performed at an academic institution using secondary databases, PubMed/MEDLINE and EBSCOhost. Reviews, observational and experimental reports published in English between 2010 and 2020 were included. Terms searched were pharmacy, pharmacist, lifestyle modifications, adherence, compliance, hypertension, obesity, consultation, intervention. Effect on lifestyle modifications consisted of change in blood pressure values, weight, body mass index, diet/sodium intake and/or exercise. Key findings Six hundred seventy-five articles were reviewed with 10 meeting inclusion criteria. The role of a pharmacist has a positive impact on compliance in lifestyle adherence with obese, hypertensive patients. Additionally, age, gender marital status, education, monthly income, knowledge level and beliefs of hypertension and co-morbidities all can affect adherence to lifestyle modifications. Conclusions The pharmacist has a vital role in the management of hypertension and obesity through frequent interactions with patients to increase adherence to lifestyle modifications.

PARACHUTING - BUNGEE - MENTAL STRAIN WITH DISSIMILAR CARDIAC AND METABOLIC IMPACT

Objective: Parachuting and bungee jumping result in heavy mental strain with dissimilar cardiac and metabolic impact. In addition changes in blood pressure values and electrolyte metabolism may occur. Therefore it was of interest to study blood pressure and ionized magnesium values as stress markers. Design and method: Out of 100 microlitres of capillary blood from 23 parachuters and of 15 bungee jumpers sampled before and after the jump, blood glucose and ionized magnesium concentrations were determined by a NOVA Phox-M device, distributed by TECOM, Austria. Blood pressure values were measured by Beurer Instrumentation, Ulm, Germany. Results: 1. Parachuting: Sytolic and diastolic blood pressure values increased significantly after the jump (p < 0.01). Heart rate did not change significantly. Blood glucose and ionized magnesium values decreased significantly from initially high normal values (p < 0.01). 2. Bungee jumping: Also no difference in heart rate, but a slight fall in systolic and a significant fall in diastolic blood pressure values after the jump were noted (p < 0.01). Blood glucose increased from already high basal levels and ionized magnesium values decreased significantly (p < 0.01). Conclusions: Outright stress determines the sympathoadrenal anticipation, epinephrine challenge should be not dissimilarly high. However, a longer anxiety period during the para-jump proceedings could lead to time dependent contrary reactions in blood pressure, magnesium and glucose levels, all of them stress markers of different sensibility. Taken together:

Usefulness of ABPM and bioimpedance for the treatment and control of hypertension in patients on chronic haemodialysis

IntroductionHypertension is very common in haemodialysis (HD) patients, and is associated with increased morbidity and mortality rates.The goals of our research were to: 1. Measure blood pressure (BP) during HD sessions; 2. Study BP in between HD sessions with 44-h Ambulatory Blood Pressure Monitoring (ABPM); 3. Evaluate changes in treatment after the ABPM; 4. Perform bioimpedance spectroscopy (BIS) on all patients and, in those hyper-hydrated or hypertensive according to ABPM, assess for changes in BP after adjusting the dry weight; 5. Identify factors associated with average systolic and diastolic BP measured by ABPM. Material and methodsProspective observational study, which included 100 patients from our dialysis unit. We measured BP before and after the HD sessions for two weeks and then, mid-week, we attached the ABPM device to the patients for 44 h. Before starting the following dialysis session, we performed BIS. A second ABPM was performed on hyper-hydrated patients and patients hypertensive according to ABPM to evaluate changes in BP values. ResultsAccording to the ABPM, 65% of patients had daytime BP > 135/85 mmHg, 90% night-time BP > 120/70 mmHg and 76% average BP > 130/80 mmHg; 11% had a dipper pattern, 51% non-dipper and 38% riser. The average systolic and diastolic BP readings were 4.7 mmHg (3.8%) and 1.1 mmHg (1.64%) higher on the second day. The dose of antihypertensive medication had to be lowered in 6% of patients, 9% had to stop taking it, 28% needed increased doses and 17% had to add a new drug. The pre-HD diastolic BP best matched the ABPM. After performing the bioimpedance and adjusting dry weight, there was a statistically significant decrease in all BP values. The univariate analysis showed that the average systolic BP was higher in patients with a high-calcium dialysis bath, more antihypertensive drugs and higher doses of EPO. The multivariate analysis showed significant association for EPO and number of drugs (p < 0.01). The average diastolic BP was higher in younger patients and patients with lower Charlson index, lower body mass index and less diuresis, those on higher doses of EPO and non-diabetics. The linear regression study showed age (p < 0.005), body mass index (p < 0.03) and EPO (p < 0.03) as significant variables. ConclusionsOur study shows: 1. The variability of hypertension criteria according to use of BP values from during the HD session or ABPM; 2. The variability of BP in the interdialysis period; 3. That the pre-dialysis diastolic BP best corresponds with the ABPM. 4. That the use of both BIS and ABPM improves the control of BP; 5. That the dose of EPO is the most important factor associated with hypertension in our patients.

Utilidad del MAPA y bioimpedancia para el tratamiento y control de la HTA en pacientes en hemodiálisis crónica

IntroductionHypertension is very common in haemodialysis (HD) patients, and is associated with increased morbidity and mortality rates.The goals of our research were to: 1. Measure blood pressure (BP) during HD sessions; 2. Study BP in between HD sessions with 44-hour Ambulatory Blood Pressure Monitoring (ABPM); 3. Identify differences between the BP recorded during HD and with the ABPM; 4. Evaluate changes in treatment after the ABPM; 5. Perform bioimpedance spectroscopy (BIS) on all patients and, in those hyper-hydrated or hypertensive according to ABPM, assess for changes in BP after adjusting the dry weight; 6. Identify factors associated with average systolic and diastolic BP measured by ABPM. Material and methodsProspective observational study, which included 100 patients from our dialysis unit. We measured BP before and after the HD sessions for two weeks and then, mid-week, we attached the ABPM device to the patients for 44 hours. Before starting the following dialysis session, we performed BIS. A second ABPM was performed on hyper-hydrated patients and patients hypertensive according to ABPM to evaluate changes in BP values. ResultsAccording to the ABPM, 65% of patients had daytime BP > 135/85 mmHg, 90% night-time BP > 120/70 mmHg and 76% average BP > 130/80 mmHg; 11% had a dipper pattern, 51% non-dipper and 38% riser. The average systolic and diastolic BP readings were 4.7 mmHg (3.8%) and 1.1 mmHg (1.64%) higher on the second day. The dose of antihypertensive medication had to be lowered in 6% of patients, 9% had to stop taking it, 28% needed increased doses and 17% had to add a new drug. The pre-HD diastolic BP best matched the ABPM. After performing the bioimpedance and adjusting dry weight, there was a statistically significant decrease in all BP values. The univariate analysis showed that the average systolic BP was higher in patients with a high-calcium dialysis bath, more antihypertensive drugs and higher doses of EPO. The multivariate analysis showed significant association for EPO and number of drugs (p < 0.01). The average diastolic BP was higher in younger patients and patients with lower Charlson index, lower body mass index and less diuresis, those on higher doses of EPO and non-diabetics. The linear regression study showed age (p < 0.005), body mass index (p < 0.03) and EPO (p < 0.03) as significant variables. ConclusionsOur study shows: 1. The variability of hypertension criteria according to use of BP values from during the HD session or ABPM; 2. The variability of BP in the interdialysis period; 3. That the pre-dialysis diastolic BP best corresponds with the ABPM. 4. That the use of both BIS and ABPM improves the control of BP; 5. That the dose of EPO is the most important factor associated with hypertension in our patients.

Protocol reproducibility for users with arterial hypertension attended in Basic Health Care Units

Protocols have been adopted as a strategy to improve the rates of follow-up and control of arterial hypertension (AH). The scope of this study was to verify the reproducibility of a protocol for consultation and follow-up of the user with AH in Basic Health Care (BHC) units. It involved a methodological study, carried out from January to August of 2016, with 160 users with AH. The reproducibility occurred in the dimension of indicators of health, psychosocial, signs of changes in blood pressure values, occurrence of complications and test performance. The protocol was applied by nurses at two different times, with interval according to the participant's return visit. The concordance was evaluated by the Kappa (κ) and Intraclass Correlation Coefficient (ICC) coefficients according to the type of variable. The κ intra-examiner ranged from 0.673 to 0.984 and inter-examiners from 0.515 to 0.985. The ICC intra-examiner scored from 0.785 to 0.998 and inter-examiner from 0.845 to 0.999. The mean of the anthropometric measures and the pressures presented a difference < 1 between the examiners at times 1 and 2. The protocol presented good reproducibility and high reliability, being able to be replicated and used in the follow up consultation of the user with AH attended in BHC units.

Use of Enhanced Data Visualization to Improve Patient Judgments about Hypertension Control.

Objective. Uncontrolled hypertension is driven by clinical uncertainty around blood pressure data. This research sought to determine whether decision support-in the form of enhanced data visualization-could improve judgments about hypertension control. Methods. Participants (Internet sample of patients with hypertension) in 3 studies (N = 209) viewed graphs depicting blood pressure data for fictitious patients. For each graph, participants rated hypertension control, need for medication change, and perceived risk of heart attack and stroke. In study 3, participants also recalled the percentage of blood pressure measurements outside of the goal range. The graphs varied by systolic blood pressure mean and standard deviation, change in blood pressure values over time, and data visualization type. Results. In all 3 studies, data visualization type significantly affected judgments of hypertension control. In studies 1 and 2, perceived hypertension control was lower while perceived need for medication change and subjective perceptions of stroke and heart attack risk were higher for raw data displays compared with enhanced visualization that employed a smoothing function generated by the locally weighted smoothing algorithm. In general, perceptions of hypertension control were more closely aligned with clinical guidelines when data visualization included a smoothing function. However, conclusions were mixed when comparing tabular presentations of data to graphical presentations of data in study 3. Hypertension was perceived to be less well controlled when data were presented in a graph rather than a table, but recall was more accurate. Conclusion. Enhancing data visualization with the use of a smoothing function to minimize the variability present in raw blood pressure data significantly improved judgments about hypertension control. More research is needed to determine the contexts in which graphs are superior to data tables.

YETİŞKİN KRONİK HASTALARDA ALLAH’A BAĞLANMA, DUYGU DURUMU VE YAŞAM MEMNUNİYETİ İLİŞKİSİ

An increase in the number of chronic patients were observed to be related to the increase in population every passing year, insufficient sanitary living conditions and other reasons. Due to chronic diseases, tissue losses occur, and due to tissue losses in an organ, organ losses occur. It is seen that the mortality rate due to organ losses is high. One of the chronic diseases of which mortality rate is high is chronic kidney failure. Chronic kidney failure has five stages, and when the disease reaches its final stage, the organ is lost. Patients at this stage become obliged to receive RRT (renal replacement therapy). Among the most common causes of end-stage renal failure are diabetes, glomerulonephritis, and hypertension. The reason why chronic kidney failure is seen as an important health problem worldwide is the high mortality rate associated with it. It is known that about one million people in the world struggle with chronic renal failure, and this makes up approximately 10-16% of the world population. According to the data concerning Turkey in 2018, the number of ESRD (End Stage Renal Failure) patients receiving RRT is 81.055, and its incidence is 149,2, and the prevalence is 988, 4. 60.643 of these patients received hemodialysis treatment, 3.192 of them received peritoneal dialysis treatment, and 17.220 of them received transplantation treatment. The number of patients who started continuous RRT in 2018, including pediatric patients, is 12.232. Due to chronic kidney failure or dialysis treatment, it is likely that patients develop physical, social, psychological and mental problems. In these patients, pain, cramping, change in blood pressure values, development of comorbidity due to CKD (chronic kidney failure), sleep disorders, forgetfulness, dementia, sexual dyfunctions, treatment compliance problems, depression, anxiety and panic disorders and problems in socializing are among the most common issues. In some studies, it was discovered that there is a relationship between both anxiety disorder and depression with insecure attachment patterns. Based on this data, it can be asserted that attachment patterns that’s developed in close relationships affect the psychological state of individuals. Children who develop positive relationships with an attachment figure, and who are securely attached to an attachment figure perceive themselves as beloved and valued individuals. They deem other individuals as reliable, supportive and responsible. Children who develop negative relationships with an attachment figure, and develop an insecure attachment pattern to an attachment figure do not deem themselves worthy of love. They perceive other individuals as unreliable and inconsistent. Kirkpatrick emphasizes four cases in respect to an affair of interpersonal attachment. (1) The individual wants to be close to the attachment figure when he is afraid, in troublesome situations or in case of danger. (2) The attachment figure is reliable because it provides the individual with protection. (3) Attachment figure is consistent in his behavior. (4) The presence of the attachment figure is continuous. Kirkpatrick explains the phenomenon of attachment to God based on these four cases. In some studies, conducted on attachment and life satisfaction, it was determined that there is a relationship between attachment and life satisfaction. Anxiouslyattached individuals experience intensive fear of rejection and abandonment by others, and have negative emotions. Individuals who have attachment avoidance refrain from close relationships, need more independent action, and have high selfconfidence. Individuals who are securely attached tend to have a closer relationship, as they have positive and emotional thoughts about themselves as well as others. In a study on adaptive and maladaptive perfectionism as agents in adult attachment patterns, depression, hopelessness, and life satisfaction, it was determined that there is a positive relationship between adaptive perfectionism and life satisfaction, whereas there is a negative relationship between adaptive perfectionism and depression, hopelessness, and insecure (anxious and avoided) attachment. On the other hand, there is a negative relationship between maladaptive perfectionism and life satisfaction, whereas there is a positive relationship between depression, hopelessness and insecure attachment patterns. In another study, it was found out that individuals who struggle with stress-causing emotions, and who have secure attachments to God have less psychological problems, and higher life satisfaction levels. It can be said that there is a relationship between the emotional state of the chronic patients, and their attachment styles and life satisfaction. In our study, it was found out that dialysis patients with positive emotions developed more secure attachment patterns, and have higher life satisfaction.

Consumption of Aged White Wine under a Veil of Flor Reduces Blood Pressure-Increasing Plasma Nitric Oxide in Men at High Cardiovascular Risk.

Background: Hypertension remains the largest attributable risk factor of cardiovascular disease (CVD), and a reduction of cardiovascular events is linked to diminished elevated blood pressure (BP) values. High alcohol intake is a common cause of hypertension, but some studies have suggested that moderate wine consumption may reduce BP and increase plasma nitric oxide (NO) due to its polyphenol content. Objective: The aim of the present study was to compare the effects of Andalusian aged white wine (AWW) under a veil of flor, an alcoholic beverage with a moderate polyphenol content, with those of gin, an alcoholic beverage without polyphenols, on BP and plasma NO in men at high cardiovascular risk. Methods: This study was designed as an open, randomized crossover-controlled trial in which 38 high-risk male volunteers, aged 55 to 80, received 30 g of ethanol daily in the form of AWW or gin. This was carried out over the course of three weeks, after a two-week washout period. At baseline and after each intervention period, BP, anthropometric parameters, and plasma NO were measured; food intake was also recorded, and physical activity was monitored. Results: Compared to gin, AWW significantly reduced systolic and diastolic BP (p ≤ 0.033; both) and increased plasma NO levels (p = 0.013). Additionally, changes in BP values observed after AWW significantly correlated with increases in plasma NO. No changes in food intake, physical activity, body weight, or waist were observed between the two intervention periods. Conclusions: Moderate daily consumption of AWW may be useful to reduce elevated BP due to an increase of NO synthesis. This effect could be attributed to grape-derived compounds in AWW, such as polyphenols, which are not present in gin.

Attenuated flow-induced dilatation of middle cerebral arteries is related to increased vascular oxidative stress in rats on a short-term high salt diet.

Recent studies have shown that high salt (HS) intake leads to endothelial dysfunction and impaired vascular reactivity in different vascular beds in both animal and human models, due to increased oxidative stress. The objective of this study was to assess vascular response to flow-induced dilatation (FID) and to elucidate the role of vascular oxidative stress/antioxidative capacity in middle cerebral arteries (MCAs) of HS-fed rats in vitro. The novelty of this study is in demonstrating impaired flow-induced dilatation of MCAs and down-regulation of vascular antioxidant genes with HS intake, leading to increased levels of oxidative stress in blood vessels and peripheral lymph organs, which together contribute to impaired FID. In addition, results show increased oxidative stress in leukocytes of peripheral lymph organs, suggesting the occurrence of inflammatory processes due to HS intake. Recirculation of leukocytes might additionally increase vascular oxidative stress in vivo. The aim of this study was to determine flow-induced dilatation (FID) and the role of oxidative stress/antioxidative capacity in isolated, pressurized middle cerebral arteries (MCAs) of high salt (HS)-fed rats. Healthy male Sprague-Dawley rats (11weeks old) were fed low salt (0.4% NaCl; LS group) or high salt (4% NaCl; HS group) diets for 1week. Reactivity of MCAs in response to stepwise increases in pressure gradient (Δ10-Δ100mmHg) was determined in the absence or presence of the superoxide dismutase (SOD) mimetic TEMPOL and/or the nitric oxide synthases (NOS) inhibitor N(ω) -nitro-l-arginine methyl ester (l-NAME). mRNA levels of antioxidative enzymes, NAPDH-oxidase components, inducible (iNOS) and endothelial nitric oxide synthases (eNOS) were determined by quantitative real-time PCR. Blood pressure (BP), antioxidant enzymes activity, oxidative stress in peripheral leukocytes, lipid peroxidation products and the antioxidant capacity of plasma were measured for both groups. FID was reduced in the HS group compared to the LS group. The presence of TEMPOL restored dilatation in the HS group, with no effect in the LS group. Expression of glutathione peroxidase 4 (GPx4) and iNOS in the HS group was significantly decreased; oxidative stress was significantly higher in the HS group compared to the LS group. HS intake significantly induced basal reactive oxygen species production in the leukocytes of mesenteric lymph nodes and splenocytes, and intracellular production after stimulation in peripheral lymph nodes. Antioxidant enzyme activity and BP were not affected by HS diet. Low GPx4 expression, increased superoxide production in leukocytes, and decreased iNOS expression are likely to underlie increased oxidative stress and reduced nitric oxide bioavailability, leading to impairment of FID in the HS group without changes in BP values.

Pressão arterial e atenção farmacêutica: o cuidado faz a diferença

Introduction: Systemic Arterial Hypertension (SAH) is known as the main risk factor for cerebrovasculardisease, coronary artery disease, chronic kidney failure, and peripheral vascular disease. If not properlytreated, SAH can result in severe consequences to vital organs such as heart, brain, and kidneys, thusconstituting one of the most severe problems of public health. Accordingly, the use of medication therapyand educational campaigns for changes in lifestyle are considered a necessary aspect for the SAH control.Object: This study aims to determine the change in blood pressure values among users receiving pharmaceuticalcare. Methods: A prospective, controlled study to evaluate the effect of the practice of pharmaceuticalcare on blood pressure control in hypertensive patients, conducted at the Teaching Pharmacyof the Municipal University of Sao Caetano do Sul (USCS). The Dader method was used. Results: For18 arterial hypertension drug users, the average age was 69.7 ± 8.9 years. One hundred and twenty activeingredients were prescribed to these users, with an average of 6.7 ± 3.8 drugs per prescription. The systolicblood pressures of the studied group at the end of follow-up showed an average reduction of 23.8 mmHg(p<0.002). Conclusion: The pharmaceutical care, carried out systematically by pharmacists trained forthis purpose, can effectively contribute to the control of blood pressure of medication users.

To evaluate alteration of salivary sodium and potassium level in hypertensive patients with and without medication

Aim: to study the alterations of sodium and potassium in saliva with change in blood pressure values and to estimate sodium and potassium level in saliva in controls and hypertensive’s with the comparison and correlation of their changes. Materials and methods: 58 patients of age group between 30-70 years with 43 hypertensives and 15 controls were examined in medicine department Rajendra Institute of Medical Sciences, Ranchi for a period of about 5 weeks(one month) and unstimulated saliva was collected before and after treatment with antihypertensive drugs. Results: The hypertensive patients were characterized with significantly elevated levels of potassium ion(p=0.000) and less remarkable increase of sodium ion (p=0.24) after one month treatment as compared to controls. Also the salivary potassium ion was more marked in patients under Atenolol antihypertensive drug. Conclusions: The result may be related to the hypothesis of chronic adrenergic over stimulation of the salivary glands in hypertensive patients. Salivary concentrations of sodium and potassium ion can be used as a valuable marker and diagnostic aid in hypertensive patients.

"Non-dipping" is equally frequent in narcoleptic patients and in patients with insomnia.

Narcolepsy with cataplexy (NC) is a neurological sleep disorder characterized by very low or undetectable concentration of hypocretin-1 in the cerebrospinal fluid. It has been recently found that patients with NC have disturbed circadian pattern of blood pressure, with more frequent non-dipping, compared to healthy controls. It has been hypothesized that lack of hypocretin may lead to increase in nocturnal blood pressure. This increase may result also from disturbed sleep architecture regardless of the deficiency of hypocretin. The aim of this study was to compare changes in values of daytime and nighttime blood pressure in NC patients and in patients with disturbed nocturnal sleep due to other sleep disorders. We have retrospectively compared polysomnographic and clinical data of 8 NC patients and 7 age- and sex controls suffering from insomnia. We have compared sleep architecture, mean blood pressure values and dipping pattern in both groups. The groups did not differ in terms of disturbances of sleep architecture. We have not found any statistical differences in values of daytime and nocturnal blood pressure. Non-dipping was equally frequent in both groups (87.5 and 85.7 %). Our results suggest that observed abnormalities in circadian changes of blood pressure values result from disturbed sleep architecture than from deficiency of hypocretin. Patients with sleep disorders should be carefully observed for the presence of increased blood pressure and other vascular risk factors.

Impact of Whole Body Cryotherapy at -110°C on Subjects with Arterial Hypertension.

Whole body cryotherapy (WBC) in a cryo-chamber as a medical treatment was first established in Japan in the 1980s, later in Central Europe, and is now becoming more popular also in the United States. The exposure to extreme, non-physiological environmental conditions in a cryo-chamber at -110°C may exceed the normal adaption capacity. The aim of this study was to investigate the effects of WBC on blood pressure (BP) readings in adult subjects with rheumatic disorders and normal or moderately elevated BP. A sample of 23 subjects (8 female, 15 male) which were recruited according to their pathology between the age of 35 and 69years undergoing 21 WBC applications was divided into three groups: a group of subjects with anti-hypertensive therapy, a group of subjects with mild arterial hypertension without medical treatment, and a normotensive control-group. A total of 483 BP readings were taken immediately before and after each WBC application. The systolic and diastolic BP were recorded, and the mean arterial pressure, and the amplitude of BP were calculated. A statistically significant rise of BP after WBC was found in the whole sample and in the normotensive group. Over the course of time, no significant change of BP behavior was observed, except for normotensive subjects, who showed a wider range in their systolic BP values. Generally accepted exclusion criteria were applied, and in our sample group WBC was safe with respect to unwanted BP alterations for adult subjects under 70years-regardless of a pre-existing untreated mild or pharmacologically treated arterial hypertension. Greater changes of BP values might infrequently occur, so an individual monitoring of subjects is necessary.

Influência do treinamento resistido em hipertensos – relato de caso

Introdução: Exercícios resistidos podem promover adaptações favoráveis na função cardiovascular, e têm sido utilizados em programas de reabilitação cardíaca. Objetivos: Neste estudo, objetivou-se estudar os efeitos do exercício resistido sobre a pressão arterial (PA), índices preditores de gordura corporal e qualidade de vida (QV) em indivíduos hipertensos. Métodos: Foram analisados dados de quatro indivíduos hipertensos e sedentários, submetidos a duas avaliações, pré e pós 18 sessões de exercícios resistidos. Resultados: Os resultados não apontaram alterações nos valores de PA. A QV apresentou melhora em todos os voluntários, e a variável relação cintura/quadril (RC/Q) sofreu redução em 50% da amostra. Conclusões: Conclui-se que o treinamento resistido não influenciou nas variáveis estudadas; entretanto, houve melhora na qualidade de vida dos voluntários.

Clinical evaluation of enalapril maleate and furosemide usage in dogs with degenerative myxomatous mitral valve, CHF functional class Ib

Degenerative myxomatous mitral valve (DMMV) is a heart disease of high incidence in small animal clinical medicine, affecting mainly older dogs and small breeds. Thus, a scientific investigation was performed in order to evaluate the clinical use of the medicines furosemide and enalapril maleate in dogs with this disease in CHF functional class Ib before and after the treatment was established. For this purpose 16 dogs with the given valve disease were used, separated into two groups: the first received furosemide (n=8) and the second received enalapril maleate (n=8) throughout 56 days. The dogs were evaluated in four stages (T0, T14, T28 and T56 day) in relation to clinical signs, hematological, biochemical and serum assessment, which included serum angiotensin converting enzyme (ACE) and aldosterone, as well as radiography, electrocardiography, Doppler-echocardiography and blood pressure. The results regarding the clinical, hematological and serum chemistry evaluations revealed no significant changes in both groups, but significant reductions in the values of ACE and aldosterone in the group receiving enalapril maleate were verified. The radiographic examination revealed reductions of VHS values and variable Pms wave of the electrocardiogram in both groups, but no changes in blood pressure values were identified. The echocardiogram showed a significant decrease of the variables LVDd/s in the studied groups and the FS% in animals that received only enalapril. Therefore, analysis of results showed that monotherapy based on enalapril maleate showed better efficiency of symptoms control in patients with CHF functional class Ib.