Diastolic Blood Pressure In Patients Research Articles

Current State of Ventilator Setting and Their Relationship with Mortality Rate in Patients under Mechanical Ventilation: A Cross-Sectional Study

Background: Given the importance of implementing lung protective strategies to prevent lung injury caused by ventilators and death of patients, it is necessary to monitor the current condition of hospitals and examine the relationship between the parameters set on the ventilators and patient mortality. This study conducted to determine the current state of ventilator setting and their relationship with mortality rate in patients under mechanical ventilation: a cross-sectional study. Methods: This is a cross-sectional study that was conducted between June to December 2020 in one of the hospitals affiliated to Tehran University of Medical Sciences. The initial tidal volume set on the ventilator was recorded for 304 patients under mechanical ventilation and then, their heights were measured and their tidal volumes were determined based on the standard formula. Other parameters set on the ventilator as well as systolic and diastolic blood pressures of patients were also recorded and their survival rate was investigated. The data was analyzed by SPSS software, using descriptive statistics and logistic regression model. Results: Among patients, who were under mechanical ventilation, 77.6% were hospitalized in intensive care units and the rest were hospitalized in general wards. The mean adjusted tidal volume for patients was 472.91 ± 32.13 ml. The mean peak inspiratory pressure and plateau pressure were 28.00±6.98 and 13.88±4.93 CmH2O, respectively. Also, 37.2% of patients died during the hospitalization. The results of adjusted odds ratio based on multivariate logistic regression model for predictors of mortality rate showed that the variables of patients' age [OR=1.040 (1.019-1.062)], the hospital’s general ward in comparison with the ICU [OR=11.379 (5.130-25.240)] and the peak inspiratory pressure [OR=1.072 (1.007-1.141)] had a direct and significant relationship with mortality rate (in all cases P<0.05). Meanwhile, the plateau pressure [OR=0.886 (0.808 -0.972)] had an inverse and significant relationship with mortality rate (P<0.05). Conclusion: Despite the recommendations regarding lung protective strategies, in some cases, some parameters set in the ventilator are outside the recommended levels, which can effect on patients mortality. So monitoring and controlling the implementation of lung protective strategies and paying attention to controlling pressures set on the ventilator are among measures that should be taken in medical centers in order to prevent lung injuries and maintain patient safety.

Delays in receiving Alteplase and related factors in patients with stroke referred to Shahid Beheshti Hospital in Kashan-Iran in 2020-2021.

The benefits of using Alteplase are time-dependent. This study aimed to evaluate delays between the onset of symptoms and the administration of Alteplase and related factors in patients with acute ischemic stroke (AIS). In this cross-sectional study, 60 AIS patients receiving Alteplase were selected by census sampling from July 2020 to July 2021 from the eligible patients referred to Shahid Beheshti Hospital in Kashan, Iran. The data collection tool was a researcher-made questionnaire containing demographic information, time periods from the onset of symptoms to the injection of Alteplase, and associated factors. The required information was collected from the patients, their relatives, their health records, and Kashan Emergency Medical Service (EMS) information system. Data were analyzed in SPSS-16. Eighty-five percent of the 60 patients participating in the study were transferred to the hospital by EMS ambulances. The mean time intervals between different phases were as follows: Onset-To-Door (OTD) time 81.35 ± 33.76 minutes; Door-To-CT (DTC) scan time 16.12 ± 17.46 minutes; Door-To-Needle (DNT) time 51.30 ± 26.14 minutes; and the overall Onset-To-Needle (ONT) time 133.75 ± 39.17 minutes. Also, the mean ONT in people transferred by EMS was about 129 minutes, and the longest prehospital delay in these patients was related to the time between the arrival of the EMS ambulance to the hospital. Marital status and geographical location where the stroke had occurred showed a significant relationship with prehospital delay and pre-hospital notification (PHN) by EMS But there was no relationship between underlying diseases or economic status and prehospital delays; also, the patient's diastolic blood pressure at the time of receiving Alteplase showed a significant relationship with in-hospital delay. The findings of the study showed that the majority of people trust and use EMS ambulances to transfer to the hospital and the time spent in different stages, from the onset of symptoms to the injection of the thrombolytic drug, was in an acceptable range in the patients.

Blood Pressure Response to the Head-Up Tilt Test in Benign Paroxysmal Positional Vertigo.

The vestibular organ is involved in controlling blood pressure through vestibulosympathetic reflexes of the autonomic nervous system. This study aimed to investigate the effect of benign paroxysmal positional vertigo (BPPV) on blood pressure control by the autonomic nervous system by observing changes in blood pressure before and after BPPV treatment using the head-up tilt test (HUTT). A total of 278 patients who underwent the HUTT before and after treatment were included. The HUTT measured blood pressure repeatedly on the day of diagnosis and the day of complete recovery, and the results were analyzed using repeated measures analysis of variance. Regarding the difference in the systolic blood pressure of patients with BPPV, the blood pressure at 1, 2, and 3 min in the upright position after complete recovery was significantly lower than before treatment (p = 0.001, p = 0.001, and p = 0.012, respectively). Blood pressure at 1 and 2 min in the diastolic blood pressure of patients with BPPV in the upright position after complete recovery was significantly lower than before treatment (p = 0.001 and p = 0.034, respectively). This study shows that BPPV increases blood pressure during the initial response to standing in the HUTT.

The effects of curcumin-piperine supplementation on inflammatory, oxidative stress and metabolic indices in patients with ischemic stroke in the rehabilitation phase: a randomized controlled trial

BackgroundStroke is a leading cause of death worldwide, which is associated with a heavy economic and social burden. The purpose of this study was to investigate the effects of supplementation with curcumin-piperine combination in patients with ischemic stroke in the rehabilitation stage.MethodsIn this randomized controlled trial, 66 patients with stroke were randomized into two groups receiving curcumin-piperine tablets (500 mg curcumin + 5 mg piperine) and matched placebo tablets for 12 weeks. High-sensitivity C-reactive protein (hs-CRP), carotid intima-media thickness (CIMT), thrombosis, total antioxidant capacity (TAC), lipid profile, anthropometric indices, blood pressure, and quality of life were assessed before and after the intervention. Statistical data analysis was done using SPSS22 software.ResultsA total of 56 patients with a mean age of 59.80 ± 4.25 years completed the trial. Based on ANCOVA test, adjusted for baseline values, curcumin-piperine supplementation for 12 weeks resulted in significant reductions in serum levels of hs-CRP (p = 0.026), total cholesterol (TC) (p = 0.009), triglycerides (TG) (p = 0.001), CIMT (p = 0.002), weight (P = 0.001), waist circumference (p = 0.024), and systolic and diastolic blood pressure (p < 0.001), and a significant increase in TAC (p < 0.001) in comparison to the placebo. Pain score significantly increased in both groups; however, its increase was significantly higher in the placebo group compared with the intervention group (p = 0.007). No significant changes were observed between the two groups in terms of serum fibrinogen, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and quality of life indices.ConclusionCurcumin-piperine supplementation had beneficial effects on CIMT, serum hs-CRP, TC, TG, TAC, and systolic and diastolic blood pressure in patients with ischemic stroke in the rehabilitation stage.

The effects of blueberry and cranberry supplementation on blood pressure in patients with cardiovascular diseases: A systematic review and meta-analysis of randomized clinical trials.

Blueberries and cranberries are berry fruits with the highest number of randomized clinical trials (RCTs) focusing on blood pressure (BP). This systematic review and meta-analysis of RCTs analyzed the effects of blueberry and cranberry supplementation alone and in concert with systolic BP (SBP) and diastolic BP (DBP) in patients with cardiometabolic diseases. The searches were performed until August 2023 in the following databases: PubMed, Scopus, Web of Science, Cochrane, and Embase. Studies that examined the effects of blueberry or cranberry intake/supplementation were included. The risk of bias was evaluated using the Rob 2 scale. A meta-analysis was performed to estimate the effects of blueberry and cranberry supplementation on BP levels in patients with cardiometabolic diseases. A total of 17 articles were included, from which two found significant results from blueberry and/or cranberry supplementation in reducing BP. Pooled results revealed statistically non-significant reductions of -0.81 mm Hg for SBP (95% confidence interval [CI]: -2.26, 0.63; I2 = 0%) and -0.15 mm Hg for DBP (95% CI: -1.36, 1.05; I2 = 27%). Blueberry and/or cranberry supplementation had neutral effects on SBP and DBP in patients with cardiometabolic diseases, regardless of duration or age. Further high-quality studies are needed to firmly establish clinical efficacy.

Bariatric surgery and blood pressure control in patients with hypertension: a systematic review and meta-analysis

Abstract Background Bariatric surgery remains the most effective method for sustained weight loss in patients with class II or III obesity. However, the effects of bariatric surgery on BP control in obese patients with hypertension are not consistent across studies. Purpose The purpose of this study was to compare the effects of bariatric surgery versus nonsurgical treatment on blood pressure control in patients with hypertension. Methods Randomized controlled trials evaluating the effects of bariatric surgery versus nonsurgical treatment on blood pressure reduction were searched in PubMed, Embase, Cochrane Database and Cochrane Clinical Trials Registry, and nineteen randomized controlled trials (in 1,375 obese patients) were finally included. The primary outcome was the rate of hypertension remission, and the follow-up periods ranged from 12 to 60 months. Results The results showed that bariatric surgery was associated with a higher hypertension remission rate (RR: 4.61, 95% CI: 2.27–9.35, P &amp;lt; 0.0001) and a greater decrease in diastolic blood pressure (WMD: -3 mmHg, 95% CI: -4.28 to -1.72, p&amp;lt;0.00001). However, no significant difference was observed in systolic blood pressure (WMD: -2.4 mmHg, 95% CI: -5.8 to 1, p=0.17). Furthermore, the following metabolic conditions and cardiovascular risk factors were also improved by bariatric surgery in patients with hypertension. Conclusion In conclusion, our study confirmed that bariatric surgery was associated with a higher rate of short-to-medium-term hypertension remission and a greater decrease in diastolic blood pressure for patients with hypertension. Bariatric surgery should be considered in these patients.

Abstract 091: Efficacy Of A Patient-engagement Platform In Reducing Uncontrolled Hypertension In Community Health Clinics

Introduction: Hypertension affects 47% of US adults and can lead to serious sequelae such as myocardial infarction and stroke when uncontrolled. Over 37 million US adults have blood pressure (BP) higher than 140/90 mmHg. Medication to treat hypertension is effective, yet, approximately 50% of patients do not take medication as prescribed and non-adherence to cardioprotective medications increases a patient’s risk of death from 50% to 80%. Objective: To use a novel patient engagement platform to assist federally qualified health centers (FQHCs) in improving BP control. Methods: We enrolled patients treated at FQHCs in a digital hypertension management program. Patients were prompted to submit their BP and responses to questions about medication adherence and potential side effects of medication either daily or weekly in English or Spanish. The responses were prioritized by level of concern. The clinic reviewed these data, in real-time and provided coaching or treatment changes. We analyzed first and last systolic and diastolic BPs of patients who participated for ≥90 days (range 90-721 days) and considered BP &lt;140/90 mmHg to be controlled. Results: The cohort included 2500 patients, 38.6% male, with a mean age of 53.9 years (range 14-100 years) from 43 FQHCs across the US. Of these patients, 30.7% (768 of 2500) had an initial controlled BP and 61.2% (1529 of 2500) demonstrated a final controlled BP measurement. In patients with an initial uncontrolled BP, 55.4% (959 of 1732) had a controlled final BP. The Spanish language version was used by 551 patients, and in this subgroup, 35.2% (194 of 551) and 70.4% (388 of 551) had controlled BPs on initial and final measurements, respectively, with 66.0% (235 of 356) of initially uncontrolled patients having a controlled final BP. Conclusion: This novel hypertension control program, which used technology to gather and prioritize data, facilitating the clinic’s efficient response, improved BP control rates by over 30% in a real-world, underserved population. BP control was higher in the Spanish-speaking population. Remote digital monitoring with intervention improves clinical outcomes without increasing the overall cost of care, thereby promoting value-based care strategies for chronic diseases such as hypertension.

Benzodiazepines Reduce Blood Pressure in Short Term: A Systematic Review and Meta-analysis.

Benzodiazepines, due to their anxiolytic properties, are prescribed to reduce anxiety and insomnia. They might have hypotensive effect via potentiation of the inhibitory effect of gamma-amino butyric acid (GABA) in the central nervous system and vasodilatory properties. However, studies comparing the effect of benzodiazepines in lowering blood pressure (BP) are equivocal. This systematic review and meta-analysis was planned to assess the efficacy of benzodiazepines in reducing blood pressure in short term among hypertensive patients. Various trials and retrospective analysis conducted previously have reported that benzodiazepines cause short- as well as long-term BP reduction in patients with increased anxiety with hypertension. On the other hand, several studies investigating the efficacy of benzodiazepines in patients with hypertension have reported inconclusive results. The primary question about the effect of benzodiazepines in lowering BP remains unanswered. In this meta-analysis of seven studies, benzodiazepines were found comparable to standard drugs in reducing systolic and diastolic BP in patients having hypertension. Although, the mean difference in systolic BP with benzodiazepines and placebo was statistically not significant, the difference can be considered as clinically meaningful. The current review offers preliminary evidence that benzodiazepines may have antihypertensive properties and may be used as add-on antihypertensive in a subset of patients in short term. The existing data are encouraging, but more clinical trials and mechanistic research are required to ascertain the long-term benefits.

Effect of Arabic Qahwa on Blood Pressure in Patients with Stage One Hypertension in the Eastern Region of Saudi Arabia.

Hypertension (HT), which is a condition of increased blood pressure (BP), is a major health problem globally. In Saudi Arabia, morbidity and mortality rates are increasing due to HT. Arabic Qahwa (AQ) is a commonly consumed beverage in Saudi Arabia and has numerous health benefits. We conducted a randomized control trial to investigate the effect of AQ on BP among patients with HT (Stage 1). Based on the inclusion criteria, 140 patients were randomly selected, and 126 patients were followed up. After obtaining demographic information, we assessed the BP, heart rate, and lipid profile before and after the intervention of consuming four cups of AQ daily for four weeks. A paired 't' test was used with a significance level of 5%. In the AQ group, there were significant changes (p = 0.009) in systolic blood pressure (SBP), with means of 134.72 ± 3.23 and 133.14 ± 3.69 observed pre and post-test, respectively. Similarly, the diastolic blood pressure (DBP) pre- and post-test mean scores were 87.08 ± 1.8 and 85.98 ± 1.95, respectively, which also showed significance (p = 0.001). There were also significant changes (p = 0.001) observed in the lipid profile of the AQ group. In conclusion, AQ is effective in reducing SBP and DBP in patients with stage one HT.

Efficacy and Safety Compared between Chlorthalidone and Hydrochlorothiazide for Reducing Systolic and Diastolic Blood Pressure in Patients with Mild-to- Moderate Hypertension: A Randomized Clinical Trial

Objective: Hypertension is the leading cause of morbidity and mortality, and blood pressure (BP) control is shown to reduce the risk of cardiovascular events. The present study aimed to investigate the efficacy and safety of chlorthalidone and hydrochlorothiazide for reducing systolic and diastolic BP in patients with mild-to-moderate hypertension. Materials and Methods: The present study was a randomized clinical trial. Patients 18 years or older with mild-to-moderate hypertension with or without prior antihypertensive medications were enrolled. Patients were randomly assigned to the chlorthalidone or hydrochlorothiazide group. The dose of study medication could be up-titrated at the 6-week. The primary outcomes were the reduction in systolic and diastolic BP, the rate of office BP control at 12 weeks, and the rate of adverse events. Results: Fifty-six patients (mean age of 49.8±11.1 years) and 42.9% male, were included. Forty-three patients (76.8%) had known hypertension. Mean sitting office systolic BP (SBP) and diastolic BP (DBP) at baseline was 153.2±9.6 and 91.8±9.2 mmHg, respectively. The average daily dose of chlorthalidone and hydrochlorothiazide was 16.1±5.8 and 32.4±11.6 mg. The mean reduction in SBP in the chlorthalidone and hydrochlorothiazide groups was 28.7±12.2 and 22.8±13.7 mmHg (p=0.118), and DBP was 14.4±7.5 and 9.1±6.6 mmHg (p=0.011), respectively. The rate of office BP control was significantly greater in the chlorthalidone group at 91.7% versus 61.5% (p=0.013). There was no significant difference in the rate of adverse events between the groups. Conclusion: Chlorthalidone was shown to be more effective than hydrochlorothiazide for office BP control. There was no difference in adverse events. Trial registration: The trial had been registered with the Thai Clinical Trials Registry (TCTR) which complied with WHO International Clinical Trials Registry Platform dataset. The registration number was TCTR20191006002 (06/10/2019). Keywords: Efficacy; Safety; Chlorthalidone; Hydrochlorothiazide; Reducing; Systolic and diastolic blood pressure; Patients with mild to moderate hypertension

Effect of the inferior alveolar nerve block injection versus maxillary infiltration with two local anesthetic agents on cardiovascular parameters: A randomized comparative double-blind clinical trial

Abstract This study aimed to assess the effect of inferior alveolar nerve (IAN) block of the mandible and infiltration anesthesia of the maxilla using lidocaine plus epinephrine or prilocaine with felypressin anesthetic agents on systolic and diastolic blood pressures, heart rate (HR) and peripheral oxygen saturation rate of patients. This randomized double-blind clinical trial evaluated 112 patients in four groups (n=28) based on the jaw (maxilla or mandible) and type of anesthetic agent (lidocaine with epinephrine or prilocaine with felypressin). Groups 1 and 2 received IAN block of the mandible or infiltration anesthesia of the maxilla, respectively, with 2% lidocaine plus 1:80.000 epinephrine. Groups 3 and 4 received IAN block of the mandible or infiltration anesthesia of the maxilla, respectively, using prilocaine with felypressin. Systolic and diastolic blood pressures and HR were measured by an automatic upper arm blood pressure monitor and the percentage of peripheral oxygen saturation rate was measured by a finger pulse oximeter 10 minutes before the injection, immediately after injection, 10 minutes after injection and 20 minutes after injection. The mean diastolic blood pressure showed a greater reduction following the administration of lidocaine with epinephrine, as compared with prilocaine with felypressin (p&lt;0.001). The mean HR showed a significantly greater increase following the administration of lidocaine with epinephrine, as compared with prilocaine with felypressin (p&lt;0.001). The effect of type of anesthetic agent on diastolic blood pressure depended on the type of injection (p=0.033). Administration of 2% lidocaine with 1:80.000 epinephrine, in comparison to prilocaine with felypressin, can cause changes in cardiovascular parameters such as heart rate and diastolic blood pressure in patients undergoing restoration of a maxillary or mandibular molar tooth. Type of injection has no significant effect on cardiovascular parameters.

S-44-6: ASSESSING THE EFFECT OF SIMPLE CARBOHYDRATE RESTRICTED DIET ON BLOOD PRESSURE LEVELS OF HYPERTENSIVE

Objective: In the recent past, various functional foods have been proposed to be effective tools for alleviating hypertension. There is a paucity of evidence on the efficacy of restricted sugar intake in an Indian setting and most evidence comes from non-validated studies. Studies have proposed that sugar acts by decreasing nitric oxide, increasing low-grade inflammation, increasing insulin resistance and promoting obesity. The objective of the study is to assess the efficacy of restriction of simple carbohydrate intake on change in body weight, blood pressure and anthropometry [waist circumference (WC), waist to hip ratio(WHR) and body mass index (BMI)] after 30 days in males with pre-dominant hypertension. Design and Methods: A Case-Control Study with a sample size of 200 urban patients with clinical blood pressure &gt; 140/90 were selected and divided into 2 groups. A 1800kcal/day diet restricted in simple carbohydrates was given and Blood pressure, body weight, anthropometry (height, WC, HC, BMI, WHR, BSL (F, PP) were measured after 30 days. The participants had been following a structured 1800 kcal/day 3 months prior to the carbohydrate-restricted intervention. Complex carbohydrates were allowed. No change in physical activity was initiated. Results: A significant reduction was observed in the intervention group consuming a restricted carbohydrate diet along with a structured diet. Diet recall was taken using food frequency questionnaires and daily pictures of the plate that the participants consumed. Conclusion: A restricted simple carbohydrate diet was found to be effective in weight loss and reduction of systolic and diastolic blood pressure in patients with hypertension. The intervention group has a higher odds ratio and is positively associated with SBP, Weight loss and WC as compared to the control group. The source of simple carbohydrates in the majority of the participants was noted as bakery products, sauces and other hidden sources of carbohydrates. Participants were regularly counselled towards healthy eating and dietary sources of various nutrients.

EVALUATION OF THE ANTIHYPERTENSIVE EFFECT OF THE THYME AMONG PATIENTS SUFFERING FROM HYPERTENSION IN IRAQ.

The aim: of research is to test effectiveness of thyme on patients with high blood pressure and comparing between blood pressure of patients who took thyme and patients who did not among different ages. Materials and methods: This study concerning patients with high blood pressure, (3/2022 to 3/2023). Collecting data was depend on interviewed patients directly to get information. A questionnaire paper includes several questions. Interview included convincing patients to take thyme for 15 days to know how could thyme effect on their blood pressure and over different patients. Results: A significant difference in distribution between male and female within control and treated groups. A significant difference between all age groups when compared control and treated group, and decrease in systolic blood pressure when patients taking own drug plus thyme compared with patients taking own drug alone, but non-significant decrease in systolic blood pressure when compared with control group, a non-significant decrease in systolic blood pressure in patients taking own drug when compared with control group. A significant decrease in diastolic blood pressure when patients taking own drug plus thyme in comparison with patients taking own drug alone, but non-significant reduction in diastolic blood pressure when compared with group which considered control, non-significant decrease in diastolic blood pressure in patients taking own drug when compared with control group. Conclusions: Thyme herbs induce normalization hypertension and keeps blood pressure in usual range. The available clinical trial data provide evidence for the safe utilization of herbal preparations containing Thyme in the treatment of hypertension.

PS-C14-10: THE INFLUENCE OF ARTERIAL HYPERTENSION ON THE PROGRESSION OF OBSTRUCTION IN HYPERTROPHIC CARDIOMYOPATHY

The nature of hypertrophic cardiomyopathy remains unexplored to date, but there is a very reasonable opinion about the genetic transmission of the disease. Given the presence of arterial hypertension in 88% of patients with hypertrophic cardiomyopathy, the issue remains relevant. To date, there is no clear understanding of hypertrophy in hypertrophic cardiomyopathy and hypertensive heart. Objective: To evaluate the effect of arterial hypertension on obstruction in hypertrophic cardiomyopathy. Material and Methods: From 2017 to 2022, 70 patients diagnosed with hypertrophic cardiomyopathy were under observation. Given the obstructive form of hypertrophic cardiomyopathy, 40 patients were operated on, Morrow operation, 30 patients diagnosed with hypertrophic cardiomyopathy without obstructive lesions are under observation, this group will take part in the study. All patients underwent genetic testing. The age of the patients ranged from 18.3 to 80.4 years, the median was 57.3 years; in most cases, pathology occurs in females, 67%, while in men it is 2 times less, 33%. Exclusion criteria for patients with aortic stenosis and “athletic” heart. Complaints were shortness of breath, headaches, dizziness, syncope. Results as a result of studies in 56% of patients test for genetic mutations is positive. Arterial hypertension was detected in 88% of patients. The duration of the disease in patients varied significantly from 1 to 35 years, the interquartile range was from 5.3 to 15.1 years, the median was 10 years. Systolic blood pressure in patients ranged from 92 to 260 mm Hg, the median was 180.5 mm Hg. Diastolic blood pressure in patients ranged from 61 to 130 mm Hg, the median was 90 mm Hg. In patients with a negative genetic analysis, 44%, a long history of arterial hypertension was revealed. Most of the patients were not adherent to therapy, despite the 3rd degree of arterial hypertension, only 13% were constantly taking antihypertensive drugs. Considering these data, we identified relevant data on echocardiography. In patients with a long history of hypertension, an increase in the left atrium, a concentric variant of hypertrophy, can be noted. There is thickening of both the aorta and the aortic valve cusps. Conclusions: The mechanism of development of hypertrophic cardiomyopathy is not completely clear; therefore, the genetic diagnosis of this disease is an integral part. Timely identified and initiated treatment of hypertension can prevent the risks of developing hypertrophy in the future.

PENGARUH KONSUMSI MENTIMUN TERHADAP STABILISASI TEKANAN DARAH PADA PENDERITA HIPERTENSI DI DESA PANAIKANG KECAMATAN PATTALLASSANG KABUPATEN GOWA

Background Hypertension is known by the general public as "high blood pressure" because this condition does indicate high blood pressure. Data from the World Health Organization (WHO) in 2018 shows that around 1.13 billion people in the world have hypertension, meaning that 1 in 3 people in the world is diagnosed with hypertension. The number of people with hypertension continues to increase every year, it is estimated that by 2025 there will be 1.5 billion people affected by hypertension, and it is estimated that every year 10.44 million people die from hypertension and its complications. Indonesia is 31.7% which means almost 1 in 3 populations aged 18 years and over suffers from hypertension, so it is necessary to have herbal handlers to stabilize pressure, one of which is by consuming cucumber juice. The purpose of this study was to determine the effect of cucumber juice in stabilizing blood pressure in patients with hypertension. Methods The methodology in this study uses quantitative research with a quasi-experimental approach with a one control group design with a sample size of 46. The sampling technique in this study uses random sampling using the Wilcoxon test. Result The results showed that the mean diastolic blood pressure before administration of cucumber consumption therapy was 93.48 while the post-test mean value obtained was 90.87, the post-test median value was 90.97. Conclusion The results showed that there was an effect of cucumber consumption on the stability of diastolic blood pressure in patients with hypertension

Effects of high-intensity interval training versus moderate-intensity continuous training on blood pressure in patients with hypertension: A meta-analysis.

This meta-analysis aimed to compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on blood pressure in patients with essential hypertension to explore more suitable training. PubMed, EBSCO, Cochrane Library, Web of Science, CNKI, and VIP databases were searched for randomized controlled trials published between January 2002 and November 2022. Weighted mean differences (WMDs) with 95% confidence intervals (CIs) were selected as the effect scale indices for the evaluation of the differences in post-intervention systolic blood pressure (SBP), and diastolic blood pressure (DBP), heart rate, maximum oxygen uptake (VO2max), and flow-mediated vasodilation. All these were compared using Review Manager 5.3 and Stata 14.0. A total of 13 randomized controlled trials and 442 patients were included. The meta-analyses revealed no statistically significant differences between HIIT and MICT in improving SBP and DBP in patients with hypertension. Subgroup analyses revealed that HIIT was better than MICT in reducing SBP during daytime monitoring (WMD = -4.14, 95%CI: [-6.98, -1.30], P < .001). In addition, HIIT increased flow-mediated vasodilation more than MICT in hypertensive patients (WMD = 2.75, 95%CI: [0.43, 5.07], P = .02). HIIT and MICT have similar effects on the overall resting SBP and DBP in patients with hypertension and prehypertension. However, HIIT is better than MICT at reducing SBP during daytime monitoring. In addition, HIIT can improve vasodilation.

Using changes of left cardiac functional parameters and CPET evaluated the clinical effectiveness of individualized precise exercise overall program management of chronic disease I --Analysis between groups

Objective: To explore and study the clinical usefulness of continuous dynamic recording of left cardiac function changes forevaluation the improvement in patients with chronic disease after 3 months of intensive control of individualized precision exercise overall manage program. Methods: From 2018 to 2021, 21 patients with chronic cardiovascular and cerebrovascular metabolic diseases mainly controlled by our team were selected to complete the cardiopulmonary exercise test (CPET) and Non-invasive synchronous cardiac function detector (N-ISCFD), electrocardiogram, radial pulse wave, jugular pulse wave and cardiogram data were continuously recorded for 50s.According to the titration results under CPET and continuous functional parameters monitoring, a holistic plan with individualized moderate exercise intensity as the core was developed for 3 months of intensive management, and then N-ISCFD data collection was repeatedafter signing the informed consent. All N-ISCFD data were analyzed in the 50s according to the optimal report mode of Fuwai Hospital and 52 cardiac functional indexes were calculated. The data before and after the enhanced control were compared and the paired T-test was used to statistically analyze the changes of groups. Results: Twenty-one patients with chronic diseases (16 male and 5 female) were (54.05±12.77,29~75) years, BMI (25.53±4.04,16.62~31.7) kg/m2.Comparison with baseline,the whole group analysis: ①The body weight, BMI, systolic blood pressure and diastolic blood pressure of patients were significantly decreased(P＜0.01).②CPET Peak VO2 was (64.93±24.22, 26.96~103.48) %Pred before enhanced control, and (85.22±30.31, 43.95~140.48) %Pred after enhanced control, and increased (35.09±27.87, 0.12~129.35) % after enhanced control compared with before enhanced control. The AT, Peak VO2/HR, Peak Work Rate, OUEP, FVC, FEV1, FEV3/FVC% and MVV were significantly increased (P＜0.01) and the Lowest VE/VCO2 and VE/VCO2 Slope were significantly decreased(P＜0.01).③Core indicators of left heart function:Ejection fraction was significantly increased from (0.60±0.12,0.40~0.88) to(0.66±0.09, 0.53~0.87)(P＜ 0.01), by (12.39±14.90,-12.32~41.11)%. The total peripheral resistance was significantly decreased from (1579.52±425.45,779.46~2409.61) G/(cm4·s),to(1340.44±261.49,756.05~1827.01) G/(cm4·s)(P＜0.01), by (12.00±17.27,37.79~28.61) %.The left stroke index, cardiac total power, ejective pressure and left ventricular end diastolic volumewere significantly improved (P＜0.05).The change analysis of each indicator for each patient is shown in the individualized analysis section of this study. Conclusion: Use CPET and continuous functional monitoring we can safely and effectively develop the overall program of individualized exercise in patients with chronic diseases. Long-term intensive management and control can safely and effectively significantly improve the cardiovascular function of patients. Continuous dynamic recording of changes in left and right cardiac functional parameters can be a simple way to supplement CPET to evaluate cardiovascular function.

Integrated Chinese herbal medicine with Western Medicine versus Western Medicine in the effectiveness of primary hypertension treatment: A systematic review and meta-analysis of randomized controlled trials

Ethnopharmacological relevanceIntegrated Chinese herbal medicine (CHM) and Western Medicine (WM) treatments have been used for primary hypertension (PHTN) patients in China. Currently, there are many randomized control trials (RCTs) published regarding the effect of CHM and WM on PHTN, which indicated that combining Chinese with WM was effective and safe for PHTN when compared with WM alone, but the quality of evidence was insufficient, and there is no clear information and summary are available for these RCTs assessing the effectiveness of CHM with WM versus WM in patients with PHTN. ObjectivesThis systematic study and meta-analysis aimed to evaluate the effectiveness and safety of CHM combined with WM in comparison with WM in reducing systolic and diastolic blood pressure for patients with PHTN. MethodsThe information of this study was searched from electronic databases (PubMed, COCHRANE, EMBASE, Ovid, CNKI, VIP, Wanfang, and CBM). The markedly effective and effective terms were according to Guiding Principles for Clinical Research of New Chinese Medicines. Two investigators independently reviewed each trial. The Cochrane risk of bias assessment tool was used for quality assessment, and RevMan 5.4 was used for meta-analysis. ResultsIn this study, a total of 29 studies that included 2623 patients were recorded. The study results displayed that the clinical effectiveness in the treatment of hypertension patients from the integrated medicines was considerably higher than that with WM alone, clinical effective (RR 1.23, 95% CI [1.17, 1.30], P < 0.00001), and markedly effective (ME) in the patients (RR 1.66, 95% CI [1.52, 1.80], and P < 0.00001). Random effect in SBP (MD 7.91 mmHg,[6.00, 983], P < 0.00001) and DBP (MD 5.46 mmHg, [3.88, 6.43], P < 0.00001), a subgroup analysis was carried out based on the type of intervention, duration of treatment, and CHM formulas that showed significance. Furthermore, no severe side effects were reported, and no patients stopped treatment or withdrawal due to any severe adverse events. ConclusionCompared to WM alone, the therapeutic effectiveness of CHM combined with WM is significantly improved in the treatment of hypertension. Additionally, CHM with WM may safely and efficiently lower systolic blood pressure (SBP) and diastolic blood pressure (DBP) in individuals with PHTN. However, rigorous randomized controlled trials with a large sample, high quality, long duration of treatment, and follow-up are recommended to strengthen this clinical evidence.

Association of Hypertension with Raised Serum Homocysteine Levels

Objective: To study the association of hypertension with raised serum homocysteine levels.&#x0D; Study Design: Comparative cross-sectional study.&#x0D; Place and Duration of Study: Army Medical College Rawalpindi in collaboration with Armed Forces Institute of Pathology and Military Hospital Rawalpindi, from Mar to May 2021.&#x0D; Methodology: Total study participants were four hundred in number. Two hundred patients with hypertension aged between 35-55 years were included in Group-1, whereas two hundred non-hypertensive patients with the closest possible age and sex matching were included in Group-2. Strict adherence to inclusion and exclusion criteria was ensured.&#x0D; Results: The mean age of patients with hypertension (Group 1) was 42.60 ± 9.95 years, and without hypertension, i.e., healthy participants (Group 2), was 42.26 ± 10.03 years. Systolic BP was 157.92 ± 8.07 mmHg among Group 1 (hypertensive subjects) and 114.60 ± 4.58 mmHg among Group 2 (healthy participants). Mean diastolic blood pressure in patients with hypertension (Group 1) was 104.95 ± 5.87 mmHg, whereas it was 74.20 ± 4.74 mmHg among non-hypertensive healthy participants (Group 2). Mean serum homocysteine level was significantly correlated with hypertension (p-value &lt;0.001, r=0.804 for systolic and p-value &lt;0.001, r=0.792 for diastolic blood pressure) and was higher in Group 1(20.64 ± 4.40 µmol/L) than that of healthy Group 2(9.48 ± 2.38 µmol/L).&#x0D; Conclusion: Our study concludes that serum homocysteine had a significant positive correlation with hypertension and can be used as an early marker for hypertension assessment in addition to regular blood pressure measurements.

EFFICACY AND SAFETY OF AZILSARTAN IN PATIENTS OF HYPERTENSION WITH DIABETES IN GWALIOR DISTRICT.

Background: Angiotensin receptor blockers are well established drugs for the treatment of hypertension with or without renal disease. Azilsartan is a new angiotensin receptor blocker being used in the treatment of hypertension. Present study is done to evaluate efcacy and safety of azilsartan in patients of hypertension with diabetes mellitus in Gwalior district. Methods: The study was conducted in department of pharmacology, Gajra raja medical college, Gwalior Madhya Pradesh during February 2018 to march 2019. It is a longitudinal, prospective, randomized study and total 90 patients of hypertension with diabetes were enrolled out of which 83 patients completed study with a follow up of 1 year period and were divided equally into two groups. Group I received Azilsartan 40- 80 mg once daily and group II received another drug once daily for 12 weeks. Baseline Systolic blood Pressure and diastolic blood pressure were recorded at the start and then at 4th, 8thand 12th weeks after therapy. Fasting and post prandial blood sugar, HDL, LDL-C , total cholesterol values were recorded at start and after 12 weeks of therapy. All the patients were screened for any adverse drug reactions on each visit. Result: Azilsartan effectively lowered the levels of systolic and diastolic blood pressure from baseline (p=0.00001) conrming the anti- hypertensive efcacy also there was overall signicant improvement in HDL values from baseline (p=0.000) and also signicant improvement was shown in LDL Total cholesterol levels from baseline (p =0.005). There was signicant improvement in FBS and PPBS from baseline (p value 0.00). Conclusion: Azilsartan effectively lowered the levels of systolic and diastolic blood pressure in patients of hypertension with diabetes and the difference was signicant. Azilsartan showed overall improvement in HDL, LDL, TC values with signicant difference in hypertensive with diabetes patients.