Decrease In Blood Pressure Research Articles

ВЛИЯНИЕ АРТЕРИАЛЬНОГО ДАВЛЕНИЯ НА СНИЖЕНИЕ ГИПЕРТЕНЗИИ ПОСЛЕ БЕРЕМЕННОСТИ: КЛИНИЧЕСКИЙ АСПЕКТ

The study aims to evaluate the effectiveness of self-monitoring of blood pressure using digital technologies in women with hypertension after pregnancy, in order to reduce the risk of long-term cardiovascular complications. Materials and methods. A clinical trial involving 20 women was conducted, divided into two groups randomly. The study was conducted at the Republican Clinical Hospital in Makhachkala. The participants of the experimental group had their blood pressure measured daily and transmitted the data via a mobile application to adjust the dosage of medications. The control group received standard medical support. Results. The average diastolic blood pressure in the intervention group was significantly lower (-5.70 mmHg, P < 0.001), as was the systolic blood pressure (-6.41 mmHg, P < 0.001), compared with the control group. The difference in pressure levels was evident already in the first week and was maintained until the ninth month. Conclusions. Self-monitoring of blood pressure and remote adjustment of antihypertensive drugs lead to a significant decrease in both systolic and diastolic blood pressure in women after childbirth. These methods can be put into practice to improve women's long-term health.

Importance of early use of tolvaptan in hyponatremic acutely decompensated heart failure patients, a retrospective study

BackgroundHyponatremia is one of the complicating findings in acute decompensated heart failure. Decrease in cardiac output and systemic blood pressure triggers activation of renin–angiotensin–aldosterone system, antidiuretic hormone, and norepinephrine due to the perceived hypovolemia. Fluid-overloaded heart failure patients are commonly treated with loop diuretics, acutely decompensated heart failure patients tend to be less responsive to conventional oral doses of a loop diuretic, while other different diuretics could work in different part of nephron circulation system. In this study, we aim to further examine the role of tolvaptan, a vasopressin receptor antagonist, in the treatment of hyponatremia secondary to acutely decompensated heart failure.ResultsA total of 71 patients with hyponatremia secondary to ADHF were included, and all patients were given tolvaptan. 37 patients were administered tolvaptan early (up until 5 th day of admission). 34 patients received tolvaptan after 5 th day of admission mean administration as 6.86 th day, and median administration was 5 th day. Analysis showed lower length of stay in patients receiving early administration of tolvaptan compared to late administration (8.86 ± 5.06 vs 18.5 ± 9.05 p0.001, respectively). Patients with early initiation of tolvaptan also achieved a larger net increase in sodium levels at discharge compared to admission (6.46 ± 6.69 vs 3.68 ± 4.70 p0.048, respectively).ConclusionsEarly administration of tolvaptan in treating hyponatremia in acutely decompensated heart failure patients is associated with a lower length of hospitalization and a higher increase in serum sodium of patients in hyponatremic ADHF patients.

Comparative study on blood pressure and metabolic improvements in hypertensive patients using copper bianstone scraping.

To evaluate the effectiveness and feasibility of the copper bianstone scraping combined with Chinese modified termination hypertension dietary therapy program by comparing and analyzing the improvement of blood pressure, blood lipids and blood glucose in hypertensive patients who received copper bianstone scraping combined with Chinese modified termination hypertension dietary therapy intervention. We selected 160 cases of hypertensive patients from July 2022 to March 2024 for the study. They were divided into 80 cases in the comparison group and 80 cases in the observation group according to whether or not they underwent copper bianstone scraping combined with Chinese modified dietary therapy for termination of hypertension. In the comparison group, conventional Chinese dietary therapy with improved termination of hypertension was used, and in the observation group, copper bianstone scraping combined with Chinese dietary therapy with improved termination of hypertension (DASH) was used on the basis of the comparison group. Differences in vitamin D, Homocysteine and serum calcium levels, blood pressure, blood glucose and lipid levels were compared between the 2 groups. The decreases of glycosylated hemoglobin, fasting blood glucose and 2-hour postprandial blood glucose in the observation group were greater than those in the comparison group; the decreases of blood pressure and BMI in the observation group were greater than those in the comparison group. The difference in comparison was statistically significant (P-value < 0.05). After the intervention, the improvement of homocysteine, vitamin D, serum calcium, albumin, hemoglobin and transferrin in the observation group was greater than that in the comparison group, and the difference was statistically significant (P-value < 0.05). Copper bianstone scraping combined with Chinese modified termination of hypertension dietary therapy in hypertensive patients has a better effect, can effectively improve the patient's blood glucose and lipid levels, improve the nutritional status of the patient, can be promoted in the rehabilitation management of hypertension.

Smaller decrease in late second trimester blood pressure is associated with gestational hypertensive disease development.

We investigated whether a smaller reduction in 2nd trimester blood pressure (BP) is associated with the development of gestational hypertensive disease. We conducted a retrospective cohort study utilizing a clinical database at an urban safety-net hospital. Individuals ages 18-40 with a singleton gestation and 1st trimester prenatal care were included. Those with chronic hypertension were excluded. Systolic BP (SBP), diastolic BP (DBP), & mean arterial pressure (MAP) decrease were calculated. The outcome variable, gestational hypertensive disease (GHDP) included gestational hypertension and preeclampsia with and without severe features. Of N=3,355 individuals that met inclusion criteria, 18% had GHDP. The mean gestational age of 1st trimester and 2nd trimester BP values were 9.8±2.1 and 23.5±2.3weeks. Those with GHDP compared to those without GHDP had a significantly higher mean 1st trimester SBP (p<0.01), DBP (p<0.01), and MAP (p<0.01). Those with GHDP compared to those without GHDP had a significantly smaller decrease between 1st and 2nd trimester SBP (-1.7±12.3 vs -2.9±11.8, p<0.001) and MAP (-2.1±8.4 vs -2.7±7.9, p=0.01). Those with GHDP compared to those without GHDP had a smaller DBP decrease but it was not statistically significant (-2.3±8.7 vs -2.7±8.2, p=0.19). Pregnant individuals who experienced a smaller decrease in SBP and MAP were more likely to develop GHDP. A reduced physiologic drop in 2nd trimester BP may suggest underlying vascular dysregulation. Future studies investigating biological mechanisms driving diminished 2nd trimester BP decline, utilizing non-invasive hemodynamic monitoring, are necessary.

Enhancing the Practicality along with Greenness Sustainability of a High Throughput HPLC-MS/MS Bioanalytical Method for the Simultaneous Determination of Amlodipine, Perindopril, and Its Active Metabolite Perindoprilat in Human Plasma: Application to a Pharmacokinetic Study

Numerous studies have demonstrated the benefits of amlodipine and perindopril combination therapy in decreasing blood pressure and improving outcomes for high-risk patients. In order to assess the pharmacokinetics of the 2 drugs along with perindoprilat; the active metabolite of perindopril, a simultaneous LC-MS/MS quantification method of amlodipine (AML), perindopril (PER) and perindoprilat (LAT) in human plasma has been developed and validated using amlodipine D4, perindopril D4 and perindoprilat D4 as internal standards (ISs), respectively. A simple and fast protein precipitation method was used to analyze the three analytes from K3EDTA human plasma. The chromatographic separation included the use of a mixture of methanol and acetonitrile (80:20, v/v) and 0.2% aqueous formic acid (60:40, v/v) as a mobile phase pumped onto a Zorbax® SB-AQ C18 column. Detection was carried out using a tandem mass spectrometer (MS/MS) in multiple reactions monitoring (MRM) mode. This method exhibited great sensitivity (LLOQ of 0.2 ng/mL for AML and PER and 0.4 ng/mL for LAT), linearity, accuracy (ranging from 97.64% to 110.28%), precision (ranging from 2.54% to 7.60%), and stability. The method showed good linearity over the range of (0.2-10 ng/mL) for AML, (0.2-160 ng/mL) for PER and (0.4-80 ng/mL) for LAT. The average extraction recoveries of AML, PER and LAT samples were between 81.92 % and 85.07%. Total elution time was as low as 3 min only. In addition, to ensure the practicality of the developed method, BAGI tool was applied, and the current method has achieved the highest score among the compared methods. Moreover, the sustainability of the proposed method was evaluated using AGREE tool and RGB 12 paradigm showing remarkable sustainability. The developed method is fast, accurate, sensitive, reproducible, ecofriendly, sustainable and suitable for the determination of the concentration of the cited analytes in human plasma. Moreover, it was applied for the bioequivalence study of a generic product to the innovator.

Decreased blood pressure with acute administration of quercetin in L-NAME-induced hypertensive rats.

Quercetin is known to reduce blood pressure (BP); however, its acute effects are unclear. We investigated the acute effects of quercetin on BP, aortic mechanical properties and vascular reactivity in female Sprague-Dawley (SD) rats. Hypertension was induced using L-NAME (40 mg/kg/day). Quercetin (4.5mg/kg) was administered intravenously. Mechanical properties of the aortae were measured by echo-tracking in normotensive and hypertensive rats. L-NAME and quercetin quantities in the aorta were determined using AP-MALDI-MSI. Vascular reactivity was performed in mesenteric and renal arteries. L-NAME increased BP and PWVβ while decreasing strain. Quercetin decreased BP and ameliorated PWVβ in L-NAME-induced hypertensive rats. Ex vivo, the acetylcholine (ACh)-induced increase in tension at 100 μM was reduced in renal arteries when exposed to quercetin while phenylephrine (Phe)-induced contractile response was augmented. In quiescent rings of renal arteries incubated with L-NAME (10μM) and TRAM-34 (1μM), the ACh-induced vasoconstrictions were inhibited by quercetin. Quercetin resulted in concentration-dependent vasodilation in mesenteric arteries and increased its sensitivity to ACh-induced relaxations. Quercetin lowered BP in L-NAME-induced hypertensive rats, likely due to changes in aortic mechanical properties and relaxation of resistance arteries. Further research is warranted to clarify the acute effects of quercetin on renal arteries in this hypertensive model.

Differentiation between Hypovolemic Shock and Septic Shock in Patients with Unstable Vital Signs after Cesarean Section: A Case Report

Hypovolemic shock and septic shock present similar symptoms, such as increased heart rate and decreased blood pressure. However, the two conditions have different causes, mechanisms, and treatment approaches. Early differentiation between the two conditions can have a positive impact on patient prognosis. In this case, the patient underwent a right ovarian cystectomy due to a teratoma torsion during a previous pregnancy, followed by treatment for a postoperative infection. While recovering, the patient underwent an emergency cesarean section due to sudden severe abdominal pain. After the surgery, unstable vital signs were suggestive of hypovolemia due to massive bleeding from the cesarean section. Therefore, fluid infusion and blood transfusion were initiated. The vital signs did not improve. So, the patient was reassessed. Body temperature and the previously elevated C-reactive protein levels were remeasured. The results of the reassessment indicated a septic condition due to previous infection. The patient was prescribed additional vasopressors and antibiotics for the following week. Subsequently, the patient’s vital signs stabilized, and the treatment was discontinued.

Elevated physical activity at school decreased blood pressure in children aged 10-12 years who were overweight and obese.

We investigated the effect that increased physical activity (PA) sessions had on the blood pressure of school-aged children who were overweight and obese. This Polish pilot, prospective study followed up 148 children from six elementary schools from 10 to 12 years of age. They were divided into two groups, based on parental preferences. The 88 children in the standard group received 4 h of compulsory PA sessions a week, and the 60 in the extended group received 10 h. Their height, body mass and blood pressure were measured and their body mass index (BMI) was calculated. The mean BMI of the standard group remained at the 92nd percentile and decreased in the extended group, from the 95th to the 85th percentile. Between 10 and 12 years of age, the percentage of prehypertensive and hypertensive children in the standard group increased from 39.7% to 48.5% in children who were overweight and from 50.7% to 56.0% in those who were obese. In the extended group, it decreased from 41.4% to 37.0% in those who were overweight and from 51.5% to 45.0% in those who were obese. Increasing organised school PA sessions reduced blood pressure and decreased hypertension and obesity in children aged 10-12 years.

Impact of combined exercise on blood DNA methylation and physical health in older women with obesity.

This study examined the effects of a 14-week combined exercise program on blood DNA methylation (DNAm) and its potential biological pathways in normal-weight, overweight, and obese older women. A total of 41 participants were assessed at baseline, 7 weeks, and 14 weeks into the training. Their whole-blood DNAm profiles were measured using the Infinitum MethylationEPIC BeadChip, alongside physical and biochemical health evaluations. The results showed notable health improvements, with decreases in blood pressure and cholesterol levels in the overweight and obese groups. Blood triglycerides were reduced only in the overweight group. Physical performance also improved across all groups. At 14 weeks, 1,043 differentially methylated positions (DMPs) were identified, affecting 744 genes. The genes were linked to biological processes, such as cellular metabolism, with significant pathway enrichment related to oxidative phosphorylation and chemical carcinogenesis. Additionally, the overweight group experienced significant reductions in methylation levels at eight lipogenesis-related genes. Protein EpiScore analysis revealed decreased levels of CCL11, VEGFA, and NTRK3 proteins at 14 weeks compared to baseline. Despite these significant molecular changes, there was no observable difference in DNAm age after the intervention. This study highlights how combined exercise can modify DNAm patterns in older women, particularly in lipogenesis-related genes, but suggests that further research is needed to understand the full implications for biological ageing.

The metabolically resistant apelin-17 analog LIT01-196 reduces cardiac dysfunction and remodeling in heart failure after myocardial infarction.

To protect patients after myocardial infarction (MI) and preserve cardiac function, the development of new therapeutics remains an important issue. Apelin, a neuro-vasoactive peptide, increases aqueous diuresis and cardiac contractility while reducing vascular resistance. However, its in vivo half-life is very short. We therefore developed a metabolically resistant apelin-17 analog, LIT01-196 and investigated its effects on cardiac function and remodeling in a murine MI model. The selectivity of LIT01-196 towards ApelinR was checked in vitro. Its in vivo half-life was assessed in male Swiss mice by radioimmunoassay. After permanent coronary artery ligation to induce MI, mice received subcutaneous administration of LIT01-196 (MI+LIT01-196, 9 mg/kg/day) or saline (MI+Vehicle) for 4 weeks. LV function was assessed using echocardiography and Millar catheter, vascular density by immunofluorescence and cardiac fibrosis by Sirius red staining. Real-time quantitative PCR measured mRNA expression of HF and fibrosis biomarkers and SERCA2. The in vivo half-life of LIT01-196, a specific and selective ApelinR agonist, was two and a half hours. MI+LIT01-196 mice showed significantly improved LV function, reduced HF biomarkers and enhanced cardiac contractility and SERCA2 expression compared with MI+Vehicle. LIT01-196 treatment almost doubled cardiac vascular density and maintained LV wall thickness post-MI. It also significantly reduced cardiac fibrosis and fibrosis biomarkers, without decreasing arterial blood pressure. Chronic LIT01-196 treatment post-MI improves LV function without decreasing blood pressure, increases cardiac vascular density and reduces cardiac remodeling. This suggests that Apelin-R activation by LIT01-196, may constitute an original pharmacological approach for HF treatment after MI.

Immunomodulation as the main characteristic of vegetable oils: a review

Known for being a functional food, vegetable oil is widely used because of its nutraceutical activity. It notable that one third of all traditional medicines are intended to treat inflammatory disorders. Vegetable oils are basically composed of linoleic and alpha-linolenic acids, which are polyunsaturated fatty acids (PUFA) classified as essential, and monounsaturated fatty acids (MUFA) such as oleic acid, are classified as non-essential. Olive, sunflower, flaxseed, and chia oil are rich in these fatty acids, and their benefits are directly linked to these fatty acid contents. The benefits in their consumption by the population worldwide is proven, mainly promoting the balance of the lipid profile, cardiovascular aspects, decrease in blood pressure, and healing effects when used topically. Most of these benefits come from the immunomodulatory effects of vegetable oils, mainly the anti-inflammatory activities triggered by the unsaturated fatty acids present in these oils.

Implementation of Breathing Exercises at Home in Hypertension Patients in Adults Aged 36-45 Years

Hypertension is one of the diseases of the cardiovascular system that has high mortality and morbidity rates. High blood pressure in hypertensive patients can be treated with pharmacological and non-pharmacological therapy. One of the non-pharmacological therapies is deep breathing relaxation therapy. This study aims to determine the effectiveness of deep breathing relaxation therapy on reducing blood pressure in patients with hypertension. The sample in this study were patients with hypertension in Kelurahan Jawa, RT 19 and RT 26 Samarinda as many as 40 respondents. The design of this study was to use a Cluster-randomized trial design by conducting a cluster randomized controlled trial with a 1:1 community-based intervention and control group. The results of the study above show that the systolic blood pressure value before being given deep breathing relaxation therapy was 160.451 mmHg and the systolic blood pressure after being given deep breathing therapy was 130 mmHg. And the diastolic blood pressure before being given deep breathing therapy was 98 mmHg and the diastolic blood pressure after being given deep breathing therapy was 84.35 mmHg. In this study, the confidence level taken was 95% with 5% (0.05). Based on statistical analysis using paired sample T-test, the systolic blood pressure value was 0.001. This means that the value is smaller than 5% (0.05) so that H0 is rejected, which means that there is an effect of deep breathing relaxation therapy on reducing blood pressure in people with hypertension. The average systolic blood pressure value after being given deep breathing relaxation therapy was 30.46 mmHg and the average diastolic blood pressure after being given deep breathing relaxation therapy was 84.35 mmHg. There was a decrease in the respondents' blood pressure after being given deep breathing relaxation therapy, namely systolic blood pressure of 130 mmHg and diastolic blood pressure of 84.35 mmHg. Based on statistical analysis using paired sample T-test with a confidence level taken at 95% with 5% (0.05), the diastolic blood pressure value was 0.001 and the diastolic blood pressure value was 0.001. This shows that deep breathing relaxation therapy is effective in lowering blood pressure in hypertensive patients. This study recommends that deep breathing relaxation therapy is effective in lowering blood pressure (systolic and diastolic) in hypertensive patients.

Safety of Vericiguat in Patients with Coronary Artery Disease: A Systematic Review and Meta-analysis.

This study aimed to investigate the safety of vericiguat in patients with coronary artery disease. We conducted a comprehensive literature review of the PubMed, ClinicalTrials.gov, and Cochrane Library databases up to 27 March 2024. We included studies that compared vericiguat with placebo in patients with coronary artery disease. Clinical data were extracted, and adverse events were analyzed using Review Manager software (version 5.4) after conducting a quality assessment of the enrolled studies. Three randomized controlled trials involving 151 patients were included in this meta-analysis. Compared with the placebo group, vericiguat treatment resulted in a decrease in systolic blood pressure by 1.4-10 mmHg and diastolic blood pressure by 0.4-6 mmHg, along with an increase in heart rate by 1.8-7 bpm, all of which are clinically insignificant. Vericiguat treatment demonstrated no significant serious adverse events [odds ratio (OR) = 1.97; 95% confidence interval (CI) = 0.39-9.91; P = 0.41]. However, a significant difference in adverse events between the two groups was noted (OR = 4.04; 95% CI = 2.17-7.52; P < 0.001). This meta-analysis suggests that vericiguat is a safe drug for use in patients with coronary artery disease; however, further clinical trials are needed to validate these findings. The study protocol has been prospectively registered in PROSPERO (CRD42024528105).

Physiological impact of oral carbohydrate preload in healthy volunteers.

Oral carbohydrate loading has become a key component of Enhanced Recovery After Major Surgery (ERAS) pathways, with potential improvements in patient comfort, nausea and vomiting, ileus and length of stay. The contribution of each component of ERAS, including carbohydrate beverages, remains unclear. We aimed to determine the impact of standardized oral carbohydrate fluid loading on haemodynamics, stroke volume and gastric state in a group of healthy volunteers. Twenty-three volunteer participants free of known cardiovascular or gastrointestinal disease, consumed 400 mL of a proprietary carbohydrate solution. Heart rate (HR), blood pressure (BP), stroke volume (SV) and gastric cross-sectional area (CSA) were measured with bedside ultrasound at baseline, 30/60/120 min post-ingestion. There were small decreases in HR, BP (<10%) that were statistically significant. There were small increases (<10%) in SV at 30 and 60 min post-ingestion, but SV had returned to baseline by 120 min. There were no changes in SV variation. Gastric CSA increased immediately post-ingestion, then decreased in a linear fashion before returning to baseline by 120 min. In a standard 400 mL dose of a carbohydrate beverage, only small increases in SV could be demonstrated in the first-hour post-ingestion. All patients had largely returned to their baseline SV and gastric CSA state within 2 h post-fluid ingestion. A mild decrease in HR and BP was noted that persisted at 120 min. A 400 mL carbohydrate beverage does not appear to have favourable cardiovascular effects in a healthy population.

Antihypertensive treatment approaches and oxidant-antioxidant system relationship in hypertensive type 2 diabetic patients

A relationship between endothelial dysfunction and oxidative stress has been shown in the pathogenesis of diabetes and/or hypertension. Antihypertensive drugs (angiotensin-converting enzyme inhibitors [ACEi], angiotensin II type 1 receptor blockers [ARB], and third-generation beta-blockers) can improve oxidative stress. This study evaluated the effects of losartan (ARB) treatment alone and combined with cilazapril (ACEi) or carvedilol on oxidative stress and antioxidants in hypertensive type 2 diabetic patients. Thirty of 56 patients completed the study. All patients received 50 mg losartan daily for 6 weeks, then were randomised into three groups for 6 weeks. In the first group, losartan was increased to 100 mg/day, and in the second and third groups, carvedilol or cilazapril was added to losartan 50 mg/day treatment, respectively. Apolipoprotein B malondialdehyde (basal and Δ-MDA), serum paraoxonase (PON) and arylesterase (AE), erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (Gpx) parameters were studied. The characteristics of the three groups were comparable (p&gt;0.05). Blood pressure (BP) decreased significantly in all three groups before and after randomisation in the six-week periods. The largest BP decrease was seen in the ARB+ACEi group (systolic BP: 16.5±7.4 mmHg, diastolic BP: 10.5±2.8 mmHg), and the smallest decrease was seen in the high-dose ARB group (systolic BP: 9±6.1 mmHg, diastolic BP: 3±4.8 mmHg). Throughout the study, no significant changes were detected in basal and Δ-MDA levels and SOD, Gpx, PON and AE activities in inter- and intra-group comparisons. Our observations showed that different antihypertensive therapy approaches effectively lowered BP in hypertensive type 2 diabetics but did not affect oxidant and antioxidant systems in the short term.

The Role of Renal Medullary Bilirubin and Biliverdin Reductase in Angiotensin II-Dependent Hypertension.

Increased circulating bilirubin attenuates angiotensin (Ang) II-induced hypertension and improves renal hemodynamics. However, the intrarenal mechanisms that mediate these effects are not known. The goal of the present study was to test the hypothesis that bilirubin generation in the renal medulla plays a protective role against Ang II-induced hypertension. Twenty-week-old male C57Bl/6J mice were implanted with intrarenal medullary interstitial (IRMI) catheters following unilateral nephrectomy. After this time, biliverdin IXα was specifically infused into the kidney (3.6mg/day) for 3 days before implantation with an osmotic minipump delivering Ang II (1000ng/kg/min). BP was recorded for 3 days, 1 week after minipump infusion, in conscious mice. To further explore the antihypertensive role of renal medullary bilirubin generation, mice with specific deletion of biliverdin reductase-A (Blvra) in the thick ascending loop of Henle (TALH) were generated. At 20 weeks, BlvraTALHKO and control mice (Blvrafl/fl) were infused with Ang II for 2 weeks. IRMI infusion of biliverdin significantly decreased blood pressure compared to mice infused with vehicle (118 ± 4 vs. 158 ± 2 mmHg, p<0.05). Angiotensin-II infusion resulted in significantly higher blood pressure measured in conscious mice 7 days after implantation in BlvraTALHKO as compared to Blvrafl/fl mice (152 ± 2 vs. 140 ± 3 mmHg, p<0.05). Together, these findings show that medullary bilirubin and biliverdin reductase can improve hypertension and that mechanisms that increase bilirubin and biliverdin reductase in the renal medulla could be an effective approach to treat hypertension.

Losartan attenuates sex-dependent hypertension, neuroinflammation, and cognitive impairment in the aging male sprague-dawley rat.

The prevalence of hypertension increases with age and is the leading modifiable risk factor for cognitive impairment and dementia. At present, the neural mechanisms promoting hypertension across the lifespan are incompletely understood. Using the Sprague-Dawley (SD) rat as a model of normal aging, we hypothesized (1) blood brain barrier (BBB) disruption and neuroinflammation in the paraventricular nucleus (PVN) of the hypothalamus enhances sympathetic tone and contributes to age-dependent hypertension, (2) age-dependent hypertension is associated with cognitive impairment, and (3) lowering blood pressure in aged rats with established hypertension improves cognitive function. We found male, but not female, rats develop age-dependent hypertension with enhanced sympathetic tone, BBB disruption, and neuroinflammation in the PVN. Aged hypertensive male rats also showed impairments in recognition and spatial memory. Utilizing pharmacological interventions, blood pressure was lowered in male rats with established hypertension using either losartan (LOS) or hydrochlorothiazide. However, only losartan improved recognition memory. Further, LOS reduced BBB disruption, microglial activation, astrocyte reactivity, and proinflammatory cytokine expression in the PVN which we speculate contributes to a decrease in blood pressure. These data show SD rats develop age-dependent hypertension and cognitive impairment in a sex-dependent manner. However, not all antihypertensive agents improve cognitive function equally as only losartan, an angiotensin II type 1 receptor antagonist (AT1R) improved recognition memory. Thus, AT1R antagonists represent a potential therapeutic approach for treating cognitive decline in the aging population.

A Systematic Review and Meta-Analysis of the Safety and Efficacy of SGLT2 Inhibitors in Chronic Heart Failure in ACHD Patients.

Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have become a first-line therapy for heart failure (HF) in adults. However, data on their use in HF associated with adult congenital heart disease (ACHD) are limited. This systematic review and meta-analysis evaluated the safety, tolerability, and efficacy of SGLT2is in ACHD HF patients, supplementing guideline-directed medical therapy. A comprehensive systematic search and meta-analysis were conducted on studies examining SGLT2i use in ACHD HF patients. The primary endpoint was the change in the New York Heart Association (NYHA) functional class (FC), with secondary endpoints including changes in ventricular function and N-terminal pro B-type natriuretic peptide (NT-proBNP) levels. Additionally, the safety and tolerability of SGLT2is were evaluated. The meta-analysis included eight studies with 287 patients aged 19-67 years (median age 37.5 years). Adding SGLT2is to combined therapies significantly improved NYHA FC (log odds ratio 1.3, 95% confidence interval [CI] 0.37-2.23, p = 0.01) and reduced NT-proBNP levels (mean difference [MD] -0.43, 95% CI -0.70 to -0.16, p < 0.001). A notable decrease in systolic blood pressure was observed (MD -0.32, 95% CI -0.51 to -0.14, p = 0.00). The adverse effect profile was comparable to that seen in routine HF, with fewer HF hospitalizations post-SGLT2i initiation. Urinary tract infections occurred in 14 patients (5%), with no instances of hypoglycemia or ketoacidosis reported. Medication withdrawal due to adverse effects was noted in 19 patients (7%). SGLT2is are well tolerated in ACHD HF patients. Notably, SGLT2is improved NYHA FC and reduced NT-proBNP levels across a diverse ACHD HF patient cohort. However, further prospective, multicenter studies are needed to confirm the safety and efficacy of SGLT2is in this unique patient population.

Decoction of bay leaf (syzygium polyanthum) against the reduction of high blood pressure in 3-month injectable birth control receptors

Introduction: Hypertension or high blood pressure is a serious health problem and has the potential to trigger various complications, such as heart disease and stroke. Bay leaf (Syzygium polyanthum), which is traditionally used as an herbal medicine, is known to contain bioactive compounds such as flavonoids, tannins, and saponins, which have the potential to lower blood pressure. However, research on the effectiveness of bay leaf decoction in 3-month injectable birth control receptors is still limited. Objective: This study aims to evaluate the effect of bay leaf decoction (Syzygium polyanthum) on the reduction of high blood pressure in 3-month injectable birth control receptors. Methods: This study uses a quasi-experimental method with a pre-test and post-test design in one group. A total of 60 respondents who were long-term acceptors of 3-month injectable birth control with high blood pressure were selected purposively. The respondents were given a decoction of bay leaves every day. Blood pressure was measured before and after the intervention using a digital sphygmomanometer. Data were analyzed using a paired t-test to determine the significant difference between blood pressure before and after the intervention. Result: The study showed a significant decrease in systolic and diastolic blood pressure after administering bay leaf decoction. The average decrease in systolic blood pressure was 12 mmHg, and diastolic blood pressure was eight mmHg after 14 days of consumption. The paired t-test showed a p&lt; value of 0.05, indicating a significant difference between blood pressure before and after the intervention. Conclusion: Bay leaf decoction (Syzygium polyanthum) significantly lowers high blood pressure in 3-month injectable birth control receptors. These results suggest that bay leaf can be a potential complementary therapy in the management of hypertension, especially for those who use long-term hormonal contraceptives. Although the results of this study are promising, more research with larger sample sizes and extended intervention periods is needed to confirm these findings and assess the long-term safety of using bay leaf decoction

Effect of Electronic Moxibustion in Patients with IDH: A Randomized Crossover Pilot Study.

Intradialytic hypotension (IDH), a common complication of hemodialysis (HD), is associated with increased cardiovascular risk, morbidity, and mortality. Fatigue is one of the most frequent symptoms of IDH, and deteriorates the quality of life of patients. This study aimed to evaluate the efficacy and safety of electronic moxibustion for improving IDH and its associated symptoms. We prospectively recruited 32 end-stage renal disease patients with IDH who underwent regular HD at our hospital's dialysis center between April 2019 and April 2020. A randomized, controlled, two-arm crossover trial was performed to evaluate the efficacy of adding one-hour electronic moxibustion during HD. The outcome measurements included patients' subjective assessment of the degree of fatigue, recovery time of fatigue from HD, cold intolerance before and after each intervention, frequency of IDH episodes and nursing interventions needed during HD, and blood pressure changes during HD. Thirty (94%) patients completed the study. Intervention with electronic moxibustion improved the degree of fatigue (95% CI, -2.95 to -0.18, p = 0.027), specifically in patients prescribed with midodrine (95% CI, -4.20 to -0.53, p = 0.013). The short-term use of electronic moxibustion during HD did not significantly alter the frequency of IDH or reduce the degree of decrease in blood pressure. Serious adverse effects were not observed. One patient complained of heat, whereas two patients had local transient erythema and pruritus. Electronic moxibustion appears to be safe and efficacious for improving IDH-related fatigue, thus acting as an adjuvant therapy in HD units to enhance patient comfort and treatment adherence. Further studies with larger sample sizes are required to confirm the benefits of this novel technique.