Diastolic Blood Pressure Measurements Research Articles

Retinal microvascular complexity comparing mono- and multifractal dimensions in relation to cardiometabolic risk factors in a Middle Eastern population.

Metrics that capture changes in the retinal microvascular structure are relevant in the context of cardiometabolic disease development. The microvascular topology is typically quantified using monofractals, although it obeys more complex multifractal rules. We study mono- and multifractals of the retinal microvasculature in relation to cardiometabolic factors. The cross-sectional retrospective study used data from 3000 Middle Eastern participants in the Qatar Biobank. A total of 2333 fundus images (78%) passed quality control and were used for further analysis. The monofractal (Df ) and five multifractal metrics were associated with cardiometabolic factors using multiple linear regression and were studied in clinically relevant subgroups. Df and multifractals are lowered in function of age, and Df is lower in males compared to females. In models corrected for age and sex, Df is significantly associated with BMI, insulin, systolic blood pressure, glycated haemoglobin (HbA1c), albumin, LDL and total cholesterol concentrations. Multifractals are negatively associated with systolic and diastolic blood pressure, glucose and the WHO/ISH cardiovascular risk score. Df was higher, and multifractal curve asymmetry was lower in diabetic patients (HbA1c>6.5%) compared to healthy individuals (HbA1c<5.7%). Insulin resistance (insulin≥23 mcU/mL) was associated with significantly lower Df values. One or more fractal metrics are in association with sex, age, BMI, systolic and diastolic blood pressure and biochemical blood measurements in a Middle Eastern population study. Follow-up studies aiming at investigating retinal microvascular changes in relation to cardiometabolic risk should analyse both monofractal and multifractal metrics for a more comprehensive microvascular picture.

The effect of Nigella sativa supplementation on cardiovascular risk factors in obese and overweight women: a crossover, double-blind, placebo-controlled randomized clinical trial.

To assess the effect of Nigella sativa (N.S) oil supplements on CVD risk factors in a crossover design for the first time. Obese and overweight healthy women were randomized to receive N.S oil (2000mg/day) and placebo. This intervention period lasted for 8weeks and separated by a 4-week washout period. An iso-caloric diet was given to every individual throughout the study. Blood pressure, lipid profile, atherogenic indices and liver enzymes were measured. Pkcross procedure was performed for statistical analyses using Stata software. Cohen's d was estimated as effect size for all outcomes to measure the magnitude of the effects. Thirty-nine participants completed the study. Capsules of N.S increased serum high-density lipoprotein cholesterol (Cohen's d = 0.47, P = 0.009), reduced low-density lipoprotein cholesterol (Cohen's d = -0.33, P = 0.031), reduced TC/HDL-C ratio (as an atherogenic index, Cohen's d = -0.9, P < 0.001), reduced serum glutamic-oxaloacetic transaminase (Cohen's d = 0-0.5, P = 0.038) and reduced systolic blood pressure (Cohen's d = -0.4, P < 0.001). There was no effect on diastolic blood pressure measures (P = 0.96). The overall improvements in cardiovascular disease (CVD) risk factors showed beneficial effects of N.S supplements among adults with obesity to prevent possible cardiovascular diseases. More studies with different designs and in other populations are suggested to clarify the exact effects of N.S as a complementary therapy for modulating CVD risk factors in individuals with overweight and obesity. Iranian Registry of Clinical Trials, IRCT20180528039884N1, Registered on February 15th, 2019.

Validation of Omron HBP-1100-E Professional Blood Pressure Measuring Device According to the American Association for the Advancement of Medical Instrumentation Protocol: The PERSIAN Guilan Cohort Study (PGCS).

BackgroundBlood pressure (BP) measurement accuracy is critical to the diagnosis and management of hypertension. The aim of the present study was to validate the Omron HBP-1100-E professional blood pressure measuring device in accordance with the American Association for the Advancement of Medical Instrumentation in Iranian adults.Materials and MethodsSimultaneous blood pressure auscultator measurements were obtained by two observers using mercury sphygmomanometers as a reference, sequentially with a measurement by using the Omron HBP-1100-E device. Absolute device-reference blood pressure differences were categorized into three error categories (within 5, 10, and 15 mmHg), and mean device-reference blood pressure difference (standard deviation) was calculated and evaluated using the American Association for the Advancement of Medical Instrumentation criteria.ResultsA total of 85 participants (250 paired readings) were enrolled to the study. 26.8%, 55.6%, and 79.6% of the device-reference blood pressure differences agreed to within 5, 10 and 15 mmHg, respectively, for systolic blood pressure, and 39.6%, 69.2%, and 81.6% of measurements for diastolic blood pressure, respectively, and failed to pass the protocol criteria. The mean device-reference blood pressure difference was 8.0 ± 13.1 mmHg for systolic BP and 2.2 ± 11.3 mmHg for diastolic BP, and was >5.0 ± 8.0 mmHg (required criteria).ConclusionOmron HBP-1100-E professional blood pressure monitor is not desirable for measuring the BP for Iranian adults as it overestimates blood pressure in this population.

Higher Blood Vascular Cell Adhesion Molecule-1 is Related to the Increased Risk of Cardiovascular Events in Chronic Obstructive Pulmonary Disease.

BackgroundVascular cell adhesion molecule-1 (VCAM-1) is associated with vascular-related inflammation and atherosclerosis. This study aimed to evaluate whether VCAM-1 can be used for an indication of increased risk of CV events in patients with COPD.MethodsSerum VCAM-1 levels were measured in 163 COPD patients. All COPD patients were prospectively followed up for a median period of 48 months (range=3–54). Cox proportional hazard analysis was performed to evaluate the prognostic value of serum VCAM-1 for predicting CV events.ResultsSerum VCAM-1 levels were higher in COPD patients with CV events than in those without CV events (1174.4±365.3 ng/mL vs 947.8±293.2 ng/mL; P<0.001). The logistic regression analysis revealed that serum VCAM-1 (OR=1.750; 95% CI, 1.324–2.428; Ptrend=0.0012) was independently associated with CVD (cardiovascular disease) history after adjusting for age, sex, BMI, current smoker, current drinker, admission systolic and diastolic BP, LVEF and laboratory measurements in patients with COPD at baseline. The Kaplan–Meier analysis demonstrated that the rate of CV events was higher in COPD patients with serum VCAM-1 levels above the median (517.3 ng/mL) than in those with VCAM-1 levels below the median. The Cox proportional hazard analysis revealed that serum VCAM-1 (HR=2.617; 95% CI, 1.673–5.328; Ptrend<0.001) may be an independent prognostic factor for CV events in the COPD patients.ConclusionOur results suggested that serum VCAM-1 was significantly and independently associated with CV events in COPD patients. The inflammatory marker may help clinicians predict CV complications early.

Abstract P186: Position Effects Blood Pressure Measurement During Pregnancy

Hypertension in pregnancy is a leading cause of maternal morbidity and mortality. Studies demonstrate that body positions affect the blood pressure (BP) measurements and have led to guidelines for proper positioning by the ACC and AHA. However, studies excluded pregnant women and did not include all common patient positions, such as semi-Fowlers. These studies cannot be applied to pregnant women due to dynamic cardiovascular changes in pregnancy. We measured BP in pregnant women in inpatient and outpatient settings in various positions. These BPs were compared to the published ACC/AHA guideline position: seated with arms and feet supported. Trained team members used an aneroid sphygmomanometer and stethoscope and/or a validated electronic BP machine. There is no significant difference between BP measurements using a sphygmomanometer/stethoscope vs. an electronic BP machine in the ACC/AHA guideline position (systolic p=0.60 diastolic p=0.91). There was not a significant difference in either systolic or diastolic means in the semi-Fowlers position (at 45 degrees measured by goniometer) (systolic=0.60 diastolic=0.95). Positioning did affect the diastolic BP measurement in the seated without support position (p=0.01) and both the systolic (p&lt; 0.001) and diastolic (p&lt;0.001) measurements in the left lateral recumbent position. Our data demonstrate that an accurate BP measurement in pregnancy is dependent upon patient position. Monitoring BP position in left lateral recumbent may mask an elevated BP. This study also suggests that it may be possible to substitute semi-Fowlers position for reliable BP measurements when chair sitting is not practical, such as labor.

Impact of Long-Term Burden of Body Mass Index and Blood Pressure From Childhood on Adult Left Ventricular Structure and Function.

BackgroundData are limited regarding the relationship between the life‐course burden of risk factors and adult cardiac function. This study sought to examine the impact of long‐term burden of body mass index (BMI) and blood pressure (BP) levels on changes in adult left ventricular (LV) structure and function in a community‐based cohort.Methods and ResultsThe longitudinal study cohort consisted of 1108 adult patients (726 White; 41.9% men; mean age, 48.2 years in the last survey) who had been examined 4 to 16 times for BMI and BP and echocardiographic LV structure and function in adulthood, with a mean follow‐up period of 38.8 years. The area under the curve was used as a measure of long‐term burden of BMI and BP. Adult LV mass index was significantly associated with childhood and adulthood BMI and systolic BP (SBP), and their area under the curve values (β=0.07–0.37; P<0.05 for all). Adult LV ejection fraction was negatively associated with childhood BMI (β=−0.08), adult BMI (β=−0.07) and BMI area under the curve (β=−0.07) (P<0.05 for all); the effects of SBP measures were not significant. Adult E/A ratio was negatively associated with adulthood SBP (β=−0.13; P<0.01) and total area under the curve of SBP (β=−0.13; P<0.01). E/e′ ratio was positively associated with BMI and SBP measures. The effects of diastolic BP measures were substantially similar to those of SBP measures. Participants with LV hypertrophy, eccentric hypertrophy, and concentric hypertrophy had significantly lower LV ejection fraction and higher E/e′ ratio.ConclusionsThese observations provide strong evidence that early‐life adiposity and BP levels and their life‐course cumulative burdens are associated with subclinical changes in adult LV structure and function in the general population.

Association between long-term pulse pressure trajectories and risk of end-stage renal diseases in incident malignant hypertensive nephropathy: a cohort study.

The trajectories of pulse pressure (PP) might affect the prognosis of malignant hypertensive nephropathy (MHN). We aimed to describe the association between PP trajectories and the future risk of end-stage renal disease and to identify and compare the associated patient characteristics of any distinct trajectory patterns in MHN patients. Patients with newly diagnosed biopsy-proven MHN 2010-2015 were included. Latent class growth analysis was applied to the PP measured over 3 years prior to biopsy to identify distinct trajectories. Concurrent systolic blood pressure, diastolic blood pressure, plasma creatinine, and 24-h urine protein measurements for each trajectory group were modelled using generalized estimating equations. The risk of end-stage renal disease (with kidney replacement therapy as a proxy) was estimated using Logistic regression. Two hundred three patients were included (median-age 34 years, and 19.7% female). A two-group cubic model was optimal, with trajectories distinguished by the rate of PP and absolute level at final measurement. Trajectory Group-1 (n = 84) was characterized by 'first-increased-then-decreased' PP and trajectory Group-2 (n = 119) was characterized by 'first-decreased-then-increased' PP over 3 years prior to biopsy. Systolic and diastolic blood pressures, plasma creatinine, and 24-h urine protein were differed by the trajectory group. Baseline characteristics differed substantially between trajectory groups. Compared with Group-1, Group-2 had a 66% greater risk of developing into end-stage renal disease in the subsequent 3 years. Two distinct 3-year trajectories for PP exist with MHN. Early introduction of intensive antihypertensive treatment might delay the development of end-stage renal disease among patients with malignant hypertension.

Education across the life-course and hypertension in adults from Southern Brazil.

The present study examines the association between life-course socioeconomic position (SEP) and hypertension (SAH), focusing on the health impacts of childhood SEP (SEPc), adult SEP (SEPa), as well as SEP mobility. Data from the Brazilian EpiFloripa Cohort Study (n = 1,720; 56% women; 55% <= 30 years) were analyzed. SAH was determined by the average of two measures of systolic and diastolic blood pressure, previous medical diagnosis or use of anti-hypertensive medication (43% of the sample was hypertensive). The main independent variables were: SEPa - participants' level of education; SEPc - parental educational attainment; and SEP mobility - the socio-economic trajectories from SEPc to SEPa. Five logistic regressions models were adjusted for sex, age or income, and were compared among each other. High SEPa was associated with a 37% reduction in the odds of SAH compared to low SEPa. High SEP over the life course was associated with 34-37% lower odds of SAH compared to persistent low SEP. Mobility models explained more of the outcome variance than the sensitive period model. The results reinforce the importance of education in the risk of SAH and the relevance of a socioeconomic mobility approach for the analysis of social inequalities in health.

Clinical evaluation of arterial blood pressure in anesthetized dogs by use of a veterinary-specific multiparameter monitor.

To compare noninvasive blood pressure (NIBP) measurements with invasive blood pressure (IBP) measurements of arterial blood pressure (ABP) in anesthetized dogs as obtained with a veterinary-specific multiparameter monitor. 21 client-owned healthy female dogs anesthetized for routine ovariohysterectomy. ABP measurements were obtained with a single veterinary-specific multiparameter monitor via a pneumatic cuff placed over the medial dorsal metatarsal artery (NIBP) and a transducer connected to a catheter placed in the contralateral artery (IBP). The 224 paired ABP measurements (complete data set) were categorized into 3 subsets-hypotension, normotension, and hypertension-on the basis of invasive measurements of mean arterial blood pressure (MAP). The NIBP and IBP measurements of systolic and diastolic arterial blood pressure (SAP and DAP, respectively) and MAP were compared. NIBP measurements were frequently lower than IBP measurements. The greatest underestimation was for the hypertension subset of NIBP measurements, with biases for SAP of 15.7 mm Hg, DAP of 14.1 mm Hg, and MAP of 12.0 mm Hg. Considering the complete data set, precision was acceptable (SD of the differences between paired measurements ≤ 15 mm Hg for DAP [9.0 mm Hg] and MAP [12.1 mm Hg]); however, precision was not acceptable for SAP (SD, 18.6 mm Hg). NIBP measurements with the studied veterinary-specific multiparameter monitor generally agreed with IBP measurements during hypotensive and normotensive periods for anesthetized healthy female dogs undergoing routine ovariohysterectomy. However, inaccuracies, frequently underestimations, were observed during periods of hypertension, and therefore, NIBP measurements should be interpreted cautiously.

Clinical Evaluation of a High-fidelity Upper Arm Cuff to Measure Arterial Blood Pressure during Noncardiac Surgery.

In most patients having noncardiac surgery, blood pressure is measured with the oscillometric upper arm cuff method. Although the method is noninvasive and practical, it is known to overestimate intraarterial pressure in hypotension and to underestimate it in hypertension. A high-fidelity upper arm cuff incorporating a hydraulic sensor pad was recently developed. The aim of the present study was to investigate whether noninvasive blood pressure measurements with the new high-fidelity cuff correspond to invasive measurements with a femoral artery catheter, especially at low blood pressure. Simultaneous measurements of blood pressure recorded from a femoral arterial catheter and from the high-fidelity upper arm cuff were compared in 110 patients having major abdominal surgery or neurosurgery. 550 pairs of blood pressure measurements (5 pairs per patient) were considered for analysis. For mean arterial pressure measurements, the average bias was 0 mmHg, and the precision was 3 mmHg. The Pearson correlation coefficient was 0.96 (P < 0.0001; 95% CI, 0.96 to 0.97), and the percentage error was 9%. Error grid analysis showed that the proportions of mean arterial pressure measurements done with the high-fidelity cuff method were 98.4% in zone A (no risk), 1.6% in zone B (low risk) and 0% in zones C, D, and E (moderate, significant, and dangerous risk, respectively). The high-fidelity cuff method detected mean arterial pressure values less than 65 mmHg with a sensitivity of 84% (95% CI, 74 to 92%) and a specificity of 97% (95% CI, 95% to 98%). To detect changes in mean arterial pressure of more than 5 mmHg, the concordance rate between the two methods was 99.7%. Comparable accuracy and precision were observed for systolic and diastolic blood pressure measurements. The new high-fidelity upper arm cuff method met the current international standards in terms of accuracy and precision. It was also very accurate to track changes in blood pressure and reliably detect severe hypotension during noncardiac surgery.

Associations between body mass index, waist circumference, waist circumference to-height ratio, and hypertension in an Algerian adult population.

The aim of our study was to analyze the associations between anthropometric measures and high blood pressure (HBP) in Algerian patients. A cross-sectional study was conducted among 785 adults with normal BMI (248), overweight (253), and obese (284), who were assessed with measurement of systolic and diastolic blood pressure, weight, height, and waist circumference (WC). Body mass index (BMI) and waist circumference-to-height ratio (WHtR) were calculated. We released receiver operating characteristic (ROC) curves for each anthropometric parameter to assess its discriminant power predictive of HBP in patients. Obese had a higher mean weight, WC, WHtR, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose (FG), total cholesterol (TC), and triglycerides (TG) than overweight and normal weight. The prevalence of hypertension and diabetes was higher in obese than overweight and normal weight. Results showed that obesity increased the risk of hypertension by a factor of 1.54 (95% CI [1.15, 2.06], (p = 0.004). Pearson's correlation data analysis showed that there was no relationship between systolic blood pressure and anthropometric parameters (BMI, WC, and WHtR). Only DBP was negatively associated with WHtR in the overweight group. All these parameters had areas under the curve between 0.409 and 0.618.The cutoff value of anthropometric WHtR parameters associated with the risk of hypertension was higher among women than men regardless of the BMI group considered. Contrary to the data of the literature, the discriminating power of anthropometry in the prediction of the HBP is limited or absent whatever the value of the BMI.

Hypertension and Alzheimer's disease: indirect effects through circle of Willis atherosclerosis.

Hypertension is common among older adults and is believed to increase susceptibility to Alzheimer’s disease, but mechanisms underlying this relationship are unclear. Hypertension also promotes circle of Willis atherosclerosis, which contributes to cerebral hypoperfusion and arterial wall stiffening, two potential mechanisms linking hypertension to Alzheimer’s disease. To examine the role of circle of Willis atherosclerosis in the association between hypertension and Alzheimer’s disease neuropathology, we analysed post-mortem neuropathological data on 2198 decedents from the National Alzheimer’s Coordinating Center database [mean (standard deviation) age at last visit 80.51 (1.95) and 47.1% female] using joint simultaneous (i.e. mediation) modelling. Within the overall sample and among Alzheimer’s dementia decedents, hypertension was indirectly associated with increased neuritic plaques and neurofibrillary tangles through its association with circle of Willis atherosclerosis. Similar indirect effects were observed for continuous measures of systolic and diastolic blood pressure. These results suggest that hypertension may promote Alzheimer’s disease pathology indirectly through intracranial atherosclerosis by limiting cerebral blood flow and/or dampening perivascular clearance. Circle of Willis atherosclerosis may be an important point of convergence between vascular risk factors, cerebrovascular changes and Alzheimer’s disease neuropathology.

Continuous blood pressure measurement from one-channel electrocardiogram signal using deep-learning techniques.

Continuous blood pressure (BP) measurement is crucial for reliable and timely hypertension detection. State-of-the-art continuous BP measurement methods based on pulse transit time or multiple parameters require simultaneous electrocardiogram (ECG) and photoplethysmogram (PPG) signals. Compared with PPG signals, ECG signals are easy to collect using wearable devices. This study examined a novel continuous BP estimation approach using one-channel ECG signals for unobtrusive BP monitoring. A BP model is developed based on the fusion of a residual network and long short-term memory to obtain the spatial-temporal information of ECG signals. The public multiparameter intelligent monitoring waveform database, which contains ECG, PPG, and invasive BP data of patients in intensive care units, is used to develop and verify the model. Experimental results demonstrated that the proposed approach exhibited an estimation error of 0.07 ± 7.77 mmHg for mean arterial pressure (MAP) and 0.01 ± 6.29 for diastolic BP (DBP), which comply with the Association for the Advancement of Medical Instrumentation standard. According to the British Hypertension Society standards, the results achieved grade A for MAP and DBP estimation and grade B for systolic BP (SBP) estimation. Furthermore, we verified the model with an independent dataset for arrhythmia patients. The experimental results exhibited an estimation error of -0.22 ± 5.82 mmHg, -0.57 ± 4.39 mmHg, and -0.75 ± 5.62 mmHg for SBP, MAP, and DBP measurements, respectively. These results indicate the feasibility of estimating BP by using a one-channel ECG signal, thus enabling continuous BP measurement for ubiquitous health care applications.

Hemodynamic Adaptations Induced by Short-Term Run Interval Training in College Students.

Perceived lack of time is one of the most often cited barriers to exercise participation. High intensity interval training has become a popular training modality that incorporates intervals of maximal and low-intensity exercise with a time commitment usually shorter than 30 min. The purpose of this study was to examine the effects of short-term run interval training (RIT) on body composition (BC) and cardiorespiratory responses in undergraduate college students. Nineteen males (21.5 ± 1.6 years) were randomly assigned to a non-exercise control (CON, n = 10) or RIT (n = 9). Baseline measurements of systolic and diastolic blood pressure, resting heart rate (HRrest), double product (DP) and BC were obtained from both groups. VO2max and running speed associated with VO2peak (sVO2peak) were then measured. RIT consisted of three running treadmill sessions per week over 4 weeks (intervals at 100% sVO2peak, recovery periods at 40% sVO2peak). There were no differences in post-training BC or VO2max between groups (p > 0.05). HRrest (p = 0.006) and DP (p ≤ 0.001) were lower in the RIT group compared to CON at completion of the study. RIT lowered HRrest and DP in the absence of appreciable BC and VO2max changes. Thereby, RIT could be an alternative model of training to diminish health-related risk factors in undergraduate college students.

Airborne heavy metals and blood pressure: Modification by sex and obesity in the MMDA traffic enforcers’ health study

Epidemiological studies have linked exposure to heavy metals and increased blood pressure (BP). We conducted a repeated measures study to examine the associations between airborne heavy metals and BP, and we looked at effect modification by participant characteristics. We assessed blood cadmium (B–Cd), lead (B–Pb), and mercury (B–Hg), and studied measurements of systolic (SBP) and diastolic (DBP) blood pressure on 140 traffic enforcers from the Metropolitan Manila Development Authority Traffic Enforcers’ Health Study. Linear mixed-effects models with random subject-specific intercepts were fitted to estimate the effect of B-CD, B–Pb, and B–Hg exposure on the percent change in mean SBP and DBP, adjusting for potential confounding factors. Moreover, effect modification by sex and obesity were assessed. B–Pb and B–Cd concentrations were related to increased BP. A unit (1.0 μg/dL) increase in B–Pb was associated with 2.5% [95% confidence interval (CI): 1.3–3.7] and 2.1% (95% CI: 0.7–3.5) increases in mean SBP and DBP, respectively. A similar result was observed for the effect of B–Cd on SBP (2.2% increase, 95% CI: 0.6–3.7) but not on DBP (0.9% increase, 95% CI: −0.9–2.7). However, no association between B–Hg and BP was observed. The associations between B–Pb and both DBP and SBP were stronger among males (SBP: 2.7% increase, 95% CI: 1.5–4.0; DBP: 2.3% increase, 95% CI: 0.8–3.7) versus females, or traffic enforcers who were nonobese (SBP: 2.8% increase, 95% CI: 1.5–4.2; DBP: 2.9% increase, 95% CI: 1.3–4.4) versus obese. In summary, B–Pb and B–Cd are associated with increased BP. B–Pb may both increase SBP and DBP among male, or nonobese traffic enforcers.

Gestational sleep deprivation is associated with higher offspring body mass index and blood pressure.

Study ObjectivesThe objective of this study was to evaluate the association between gestational sleep deprivation and childhood adiposity and cardiometabolic profile.MethodsData were used from two population-based birth cohorts (Rhea study and Amsterdam Born Children and their Development study). A total of 3,608 pregnant women and their children were followed up until the age of 11 years. Gestational sleep deprivation was defined as 6 or fewer hours of sleep per day, reported by questionnaire. The primary outcomes included repeated measures of body mass index (BMI), waist circumference, body fat, serum lipids, systolic and diastolic blood pressure (DBP) levels in childhood. We performed a pooled analysis with adjusted linear mixed effect and Cox proportional hazards models. We tested for mediation by birthweight, gestational age, and gestational diabetes.ResultsGestational sleep deprivation was associated with higher BMI (beta; 95% CI: 0.7; 0.4, 1.0 kg/m2) and waist circumference (beta; 95% CI: 0.9; 0.1, 1.6 cm) in childhood, and increased risk for overweight or obesity (HR; 95% CI: 1.4; 1.1, 2.0). Gestational sleep deprivation was also associated with higher offspring DBP (beta; 95% CI: 1.6; 0.5, 2.7 mmHg). The observed associations were modified by sex (all p-values for interaction < 0.05); and were more pronounced in girls. Gestational diabetes and shorter gestational age partly mediated the seen associations.ConclusionsThis is the first study showing that gestational sleep deprivation may increase offspring’s adiposity and blood pressure, while exploring possible mechanisms. Attention to glucose metabolism and preterm birth might be extra warranted in mothers with gestational sleep deprivation.

Prevalence and Correlates of Food Insecurity in Latino Farm Worker Households in California’s Central Valley

Abstract Objectives The twofold objective of the study was to assess the burden of food insecurity in Latino farm worker households and to identify its correlates in this population. Methods We conducted a secondary analysis using data from the Mexican Immigration to California: Agricultural Safety and Acculturation (MICASA) study, a cohort of Latino farm workers residing in Mendota, California. Interview data from a follow up assessment (when food security was first assessed), and clinical data from a sub-study conducted around the same time were analyzed. Food security was assessed using the U.S. Household Food Security Survey Module: Six-Item Short Form, but only asked to female participants (n = 346). Body mass index (BMI; kg/m2) was measured based on direct weight and height measurements. Abdominal fat was categorized as normal vs high risk (waist circumference &amp;gt;35 inches). Blood pressure was assessed based on two consecutive measures of systolic and diastolic blood pressure, and categorized as normal, elevated or high blood pressure. Depression was measured using a short version of the CES-D scale; a score of ≥10 was used as indication of depressive symptoms. Sociodemographic and acculturation data were also collected. We conducted bivariate analysis and multivariable logistic regression, considering the study survey design. Results Fifty five % of respondents were food secure, while 45% reported food insecurity (39% without hunger and 6% with hunger). In bivariate analysis, food insecurity was associated with income, education, age at immigration, depressive symptoms and season, but not with age, years living in the US, BMI status, blood pressure or abdominal fat. After controlling for income, education and season, those who immigrated younger than 21 y of age had lower odds of reporting food insecurity, while food insecurity was associated with higher odds of depressive symptoms. Conclusions Food insecurity is prevalent among Latino farm worker families. Among women in these families, immigration to US at a younger age seems to protect them from suffering food insecurity, but experiencing it may be associated with poor mental health. Funding Sources The NIOSH, the California Endowment and the UC Davis Western Center for Agricultural Health and Safety.

Efficacy of Text Messaging and Personal Consultation by Pharmacy Students Among Adults With Hypertension: Randomized Controlled Trial.

BackgroundHypertension is one of the leading risk factors for ischemic heart diseases, and high rates of hypertension prevalence have either remained the same or increased in developing countries in recent years. Unfortunately, about 20% to 50% of patients with chronic diseases have been nonadherent to their drug therapy. SMS text messaging and pharmacy student–led consultations have the potential to help patients manage their blood pressure (BP).ObjectiveThe aim of this study was to assess the effectiveness, feasibility, and acceptability of SMS text messaging and consultation to manage the BP of Chinese patients with hypertension.MethodsWe conducted a two-arm cluster randomized controlled trial among patients with hypertension in Xi’an City, Shaanxi Province, China, and recruited 384 patients from 8 community health care centers. Patients were randomized into an intervention group to receive SMS text messages and consultations or into a control group to receive usual care for 3 months. We sent SMS text messages at 3-day intervals and collected data at baseline (including demographics, clinical outcomes, medication complexity, side effects, patient behavior, knowledge about hypertension, BP, and medication adherence) and the 3-month follow-up (including BP, medication adherence, and knowledge about hypertension).ResultsWe assessed 445 patients with hypertension and excluded 61 patients who were not eligible or who had not filled out their questionnaires. The mean age of the patients was 68.5 (SD 7.9) years in the intervention group and 69.4 (SD 9.7) years in the control group, and the sample was primarily female (265/384, 69.0%). Patients in the intervention group showed significant improvements in systolic BP (SBP; mean 134.5 mm Hg, SD 15.5 mm Hg vs mean 140.7 mm Hg, SD 15.2 mm Hg; P=.001), medication adherence (mean 7.4, SD 1.2 vs mean 7.0, SD 1.3; P=.04), and knowledge about hypertension (mean 6.3, SD 0.9 vs mean 5.9, SD 1.2; P=.004) compared with those in the control group. In measures of diastolic BP (DBP), the two arms showed nonsignificant improvements (mean 78.2 mm Hg, SD 9.0 mm Hg vs mean 77.2 mm Hg, SD 10.3 mm Hg; P=.06). In total, 176 patients had controlled BP at the 3-month follow-up (98 patients in the intervention group vs 78 patients in the control group), but it was nonsignificant (P=.08).ConclusionsThe use of SMS text messaging and consultation to manage SBP and improve medication adherence is effective, feasible, and acceptable among Chinese patients with hypertension, although a significant difference was not observed with regard to DBP. It is important to maximize the potential of SMS text messaging and consultation by increasing the feasibility and acceptance of mobile interventions and conduct a cost-effectiveness analysis on this method.Trial RegistrationChinese Clinical Trial Registry ChiCTR1900026862; http://www.chictr.org.cn/showproj.aspx?proj=42717.

Influence of height on blood pressure and hypertension among Bangladeshi adults

BackgroundRecent studies have reported that height is inversely associated with blood pressure and hypertension. However, there is lack of comprehensive findings from Bangladesh in this regard. ObjectiveThe purpose of this study was to explore the association between height and blood pressure in a Bangladeshi population. SettingRural and urban sites from seven divisions of Bangladesh. ParticipantsParticipants were 7932 males and females (aged ≥35 years) evaluated in the 2011 Bangladesh Demographic Health Survey. Participants (n = 7647) who had complete height, weight, systolic and diastolic blood pressure (SBP and DBP) measurements and non-missing medication history, were included in the analysis. MethodsHypertension was defined as an SBP over 140 mmHg or/and a DBP over 90 mmHg, or current use of antihypertensive medication. Difference between SBP and DBP was calculated to get pulse pressure (PP). Multivariate linear and logistic regression models were used. ResultsPP decreased linearly with increasing height among males (−0.11, P < 0.05) and females (−0.19, P < 0.05) after adjusting for age, BMI, living region, type of occupation, wealth index, and highest level of education. SBP decreased linearly with increasing height among only females (−0.14, P < 0.05), after adjusting for age, BMI, living region, type of occupation, wealth index, and highest level of education. No association was found between quartiles of height and prevalence of hypertension. ConclusionsHeight was found to be inversely associated with pulse pressure in both sexes. Studies with longitudinal design are needed to investigate the association between shortness with blood pressure and hypertension.

Arteriovenous Fistula in Dialysis Patients Remains Patent with Strict Control of Blood Pressure

Patency rates of autologous arteriovenous fistulae in patients with end-stage renal failure constitute a serious problem. In the present study, we aimed to evaluate the effect of early stage blood pressure values on fistula patency in patients with autologous arteriovenous fistulae (AVF). Sixty-six patients with end-stage renal failure who were scheduled for autologous arteriovenous fistula were prospectively enrolled in the study. Systolic and diastolic blood pressure measurements were taken for a period of 24 h following the operation. At the end of the first month, patients were evaluated for fistula patency. Higher AVF thrombosis (p = 0.039) was found in patients with high postoperative systolic blood pressure (> 140 mmHg), while higher rates of fistula patency (p = 0.014) where observed in patients with diastolic blood pressure below 80 mmHg. Early-stage low diastolic and normal systolic (< 140 mmHg) blood pressure values were found to have a positive effect on AVF patency. This situation suggests that in patients with arteriovenous fistula formation, rates of fistula patency can be increased with close monitoring and strict control of blood pressure.