Difference In Blood Pressure Reduction Research Articles

Perbedaan Perubahan Tekanan Darah Antara yang Diberikan Jus Mentimun (Cucumis Sativus Linn) dengan Jus Pepaya (Carica Papaya) Terhadap Penderita Hipertensi Primer di Wilayah Kerja Puskesmas Ampenan

Hypertension is the leading cause of death in Indonesia and has a high risk of heart failure, stroke, kidney failure and myocardial infarction. Management of hypertension includes lifestyle changes, diet, stress management and others. In addition, giving cucumber juice and papaya juice is also recommended as a nursing management to lower blood pressure because the content of potassium, magnesium, phosphorus can treat hypertension. The purpose of this study was to determine the difference in blood pressure changes between those given cucumber juice (cucumis sativus linn) and papaya juice (carica papaya) for patients with primary hypertension in the Ampenan Health Center work area. The research method used was a Quasy Experimental study with a pretest-posttest control group design with a quantitative approach in the cucumber juice group and the papaya juice group with a control group without treatment. Random sampling technique was used to obtain 30 respondents divided into 3 groups. The results of the study showed that the results of the dependent t test showed a p value = <0.05 so that there was a difference in blood pressure reduction between those given cucumber juice and those given papaya juice in patients with hypertension.

Smartphone application-based intervention to lower blood pressure: a systematic review and meta-analysis.

Nowadays, the mHealth market is flooded with smartphone applications (apps) lacking validation for blood pressure (BP)-lowering effects and BP measurement accuracy. This systematic review for Guidelines for BP control using digital technologies of the Japanese Society of Hypertension aimed to assess the validation studies of apps. We searched eligible studies in Ovid MEDLINE, Cochrane Library, and Ichushi, focusing on randomized controlled trials and observational studies comparing the effects of smartphone app-based interventions with non-digital healthcare. Random effects models of meta-analysis were employed to estimate the pooled effects of mean BP change and 95% confidence intervals (CIs). Out of 7385 studies screened, 76 studies with 46,459 participants were included. The interventions were significantly associated with a reduction in office systolic and diastolic BP at six months (systolic BP, -2.76 mmHg, 95% CI: -3.94 to -1.58; diastolic BP, -1.23 mmHg, -1.80 to -0.67). Normotensives saw a significant reduction in office systolic BP at three-month (-4.44 mmHg, -6.96 to -1.92), diminishing afterward (six-month, 0.86 mmHg, -2.81 to 4.52; twelve-month, 0.86 mmHg, -2.81 to 4.52). Conversely, hypertensive participants experienced a significant reduction in office systolic BP at both three- and six-month (three-month, -7.71 mmHg, -10.63 to -4.79; six-month, -1.88 mmHg, -3.41 to -0.35), albeit with limited evidence thereafter. A larger BP reduction was observed among participants using apps with wireless transmission of BP measurements (P = 0.047 for interaction), while there was no clear difference in BP reduction according to the presence of other functions. Smartphone app-based interventions may hold the potential to improve BP levels.

Perbedaan Pemberian Jus Apel Hijau dan Air Rebusan Daun Seledri terhadap Tekanan Darah Wanita Menopause Hipertensi di Kabupaten Bojonegoro

Hypertension or high blood pressure is a chronic condition characterized by increased blood pressure on the walls of the arteries. Hypertension is caused by high sodium intake while vegetable and fruit intake is low. This study aims to determine the difference in blood pressure reduction in groups given green apple juice and boiled water from celery leaves in menopausal women who experience hypertension in Bojonegoro Regency. This type of research is quantitative research with a "True experimental" design, with a "Two Group Pre-test and Post-test Design". This sample consisted of 36 respondents who were divided into 18 respondents of green apple juice and 18 respondents of boiled celery leaf water using a purposive sampling technique. Data collection using a Stethoscope Tensimeter measuring instrument and observation sheets will be analyzed using the Paired T-Test and Independent Sample T-Test. The research results were analyzed using the Paired T-Test, it was found that there was a significant difference in systolic blood pressure (p-value = 0.003) and diastolic blood pressure (p-value 0.032) before and after administration of green apple juice. In the celery leaf boiled water group, significant results were also found to reduce systolic blood pressure (p-value = 0.000) and diastolic blood pressure (p-value = 0.017) before and after administering celery leaf boiled water. From the description above, it can be concluded that giving green apple juice and boiled water from celery leaves can significantly reduce systole and diastole. Keywords: green apple, celery, hypertension, menopausal women

Perbedaan Pemberian Jus Apel Hijau dan Air Rebusan Daun Seledri terhadap Tekanan Darah Wanita Menopause Hipertensi di Kabupaten Bojonegoro

Hypertension or high blood pressure is a chronic condition characterized by increased blood pressure on the walls of the arteries. Hypertension is caused by high sodium intake while vegetable and fruit intake is low. This study aims to determine the difference in blood pressure reduction in groups given green apple juice and boiled water from celery leaves in menopausal women who experience hypertension in Bojonegoro Regency. This type of research is quantitative research with a "True experimental" design, with a "Two Group Pre-test and Post-test Design". This sample consisted of 36 respondents who were divided into 18 respondents of green apple juice and 18 respondents of boiled celery leaf water using a purposive sampling technique. Data collection using a Stethoscope Tensimeter measuring instrument and observation sheets will be analyzed using the Paired T-Test and Independent Sample T-Test. The research results were analyzed using the Paired T-Test, it was found that there was a significant difference in systolic blood pressure (p-value = 0.003) and diastolic blood pressure (p-value 0.032) before and after administration of green apple juice. In the celery leaf boiled water group, significant results were also found to reduce systolic blood pressure (p-value = 0.000) and diastolic blood pressure (p-value = 0.017) before and after administering celery leaf boiled water. From the description above, it can be concluded that giving green apple juice and boiled water from celery leaves can significantly reduce systole and diastole.

Effect of handgrip isometric exercise training on reduction of resting blood pressure among individuals of different age groups

Abstract Background: Lifestyle choices, such as smoking, eating habits, alcohol consumption, and physical inactivity, have contributed to a global increase in hypertension throughout younger and older age groups. Isometric exercise is one of the nonpharmacological techniques for treating hypertension. It is less expensive, simpler, and takes less time. Aim: This study aimed to determine how handgrip isometric exercise training affects resting blood pressure (BP) in people of different ages and genders. Materials and Methods: For the study, 75 participants varying in age from 25 to 65 years were recruited. The study examined things including age, gender, maximum voluntary contraction, and BP. Patients who satisfied the study requirements were recruited and their BP variations (systolic BP [SBP] and diastolic BP [DBP]) were measured with a sphygmomanometer. Statistical Analysis: For normally distributed continuous variables, variables are described as mean and standard deviation. To compare SBP and DBP before and after exercise between weeks 1 and 4, the one-way analysis of variance and post hoc Tukey test were utilized. To investigate differences between males and females, an independent t test was used. A paired t test was performed to compare BP levels before and after activity training in the same group. P value of 0.05 was considered to be significant. Result: The study discovered that 4 weeks of isometric handgrip exercise training resulted in a significant decrease in resting BP. The data also show that the difference in resting BP reductions between different ages is not statistically significant (P > 0.05), and there is no statistical difference in BP reduction between males and females. Conclusion: After 4 weeks of isometric handgrip exercise training, resting BP (SBP and DBP) decreased substantially. Furthermore, there is no statistically significant difference in resting BP reduction across age groups or genders, according to this study

Demonstrating the Benefits of Antihypertensive Nighttime Dosing and Indapamide Usage in Hypertension Management.

Background: Uncontrolled hypertension, specifically nocturnal hypertension, increases the risk for significant clinical outcomes. Evidence on the use of nighttime antihypertensives is scant and conflicting. In addition, hydrochlorothiazide continues to be the primary thiazide used despite being the least potent. Objective: The primary purpose of this study was to evaluate instituting nighttime dosing to control hypertension and compare the short-term effectiveness of blood pressure control with indapamide versus hydrochlorothiazide. Methods: This was a retrospective, observational study. Participant inclusion criteria consisted of patients 18 years of age or older, a current diagnosis of hypertension, and hypertension that required medical therapy. The investigator documented whether a patient was taking at least one antihypertensive at night versus all morning medications, as well as the use of indapamide versus hydrochlorothiazide. The patient's baseline and first follow-up blood pressure readings were documented. The primary outcome was to determine whether including nighttime dosing in antihypertensive regimens is more effective than all morning antihypertensive regimens. The secondary outcome was to determine whether indapamide was more effective than hydrochlorothiazide. Results: A total of 64 patients were included in the study. Twenty-eight patients were taking >1 nighttime antihypertensives versus 32 patients on all morning medications. Patients on at least one nighttime medication demonstrated greater systolic blood pressure reduction. There was no difference in blood pressure reduction between indapamide and hydrochlorothiazide. Conclusion: The study findings support the use of nighttime dosing to improve blood pressure management. The results on the effectiveness of indapamide versus hydrochlorothiazide conflict with previous research.

Abstract 13852: Sex Differences in Blood Pressure Reduction and Cardiovascular Outcomes in Patients With Resistant Hypertension Undergoing Radiofrequency Renal Denervation: Global SYMPLICITY Registry DEFINE

Introduction: Hypertension (HTN) prevalence and outcomes differ by sex. Radiofrequency renal denervation (RF RDN) safely reduces blood pressure (BP) in patients with resistant HTN. Hypothesis: After RF RDN, there are no sex-based differences in BP changes and cardiovascular (CV) outcomes. Methods: The Global SYMPLICITY Registry (GSR) DEFINE is an all-comer registry of patients with uncontrolled BP undergoing RF RDN. BP changes (analysis of covariance [ANCOVA] adjusted for baseline BP and age), CV death, stroke, myocardial infarction (MI) rates at 3yrs were compared between sexes with office systolic BP (OSBP) ≥140mmHg, prescribed ≥3 anti-HTN drugs. Results: Patients enrolled up to March 2023 were included (N=2502, female=1062). Females were older (62 vs 59 y; p<0.0001), less likely to have a history of sleep apnea (12.5 vs 25.0% p<0.0001), cardiac disease (45.2 vs 50.3%; p<0.0012) and smoking (19.1 vs 41.3%; p<0.0001). Body mass index, rates of diabetes and chronic kidney disease, number of anti-HTN drugs (5.1±1.5 in both sexes; p=0.88) and 24-hr SBP were similar by sex. Baseline OSBP was higher in females (174±23 vs 169±19mmHg; p<0.0001). After 3yrs, OSBP significantly decreased in both sexes from baseline (female: -21.5mmHg vs male: -20.4mmHg; ANCOVA adjusted difference: 3.2mmHg [95% CI: 0.5 to 6.0; p=0.021]). There was no difference in 24-hr SBP change (Figure 1A) or number of anti-HTN drugs by sex. CV death rate was significantly higher in females (4.1% vs 2.1% vs p=0.024), but MI rate was significantly lower in females (1.3% vs 3.5%; p=0.007). Stroke rate was similar by sex (Figure 1). Conclusion: Females with resistant hypertension referred for RF RDN were older, had higher OSBP with fewer comorbidities compared to males. Despite similar BP reductions up to 3yrs after RF RDN, CV death rate in females was greater than males. These results suggest the need for sex specific analyses and control of HTN in females.

The effect of prenatal yoga and acupressure on lowering blood pressure in pregnant women

<p><strong><em>Background: </em></strong><em>Hypertension in pregnancy is one of the contributors to the maternal mortality rate (MMR) in Indonesia. The combination of yoga and acupressure was expected to help pregnant women in lowering blood pressure.</em><em></em></p><p><strong><em>Objectives: </em></strong><em>This study aimed to test the combination of prenatal yoga and acupressure against blood pressure in pregnant women who had hypertension.</em></p><p><strong><em>Methods: </em></strong><em>This study was a quasi-experiment using a pre-post-test design with control group. The population in this study was all pregnant women in the Depok Regional Health Center. The inclusion criteria for this study included: pregnant women aged > 20 weeks of pregnancy, suffering from hypertension, namely systolic TD ≥140 mmHg and diastolic ≥90 mmHg. As for pregnant women who had a history of preeclampsia, had a history of bleeding in this pregnancy, pregnant women with placenta previa totalis were excluded from this study. The sample was taken by purposive sampling with the number of respondents as many as 30 pregnant women in the intervention group and 30 pregnant women in the control group. Data analysis used SPSS version 20 with descriptive and Chi-square tests for respondent characteristics. Bivariate analysis was analyzed with the Wilcoxon test, while to find out the difference in blood pressure between the two groups, the Mann-Witney U test was used.</em><em></em></p><p><strong><em>Results: </em></strong><em>Statistical results obtained that there was a significant difference in the blood pressure of pregnant women before and after yoga and acupressure. In addition, there were significant differences in blood pressure reduction between the intervention group and the control group.</em><em></em></p><p><strong><em>Conclusions: </em></strong><em>Yoga and acupressure combination was proven to reduce blood pressure. It is hoped that midwives or other health workers could implement it by teaching pregnant women, especially who suffer hypertension</em></p>

Giving Soursop Leaf Extract (Annona Muricata L) to Lower Blood Pressure for Patients with Hypertension

Backgrounds: In Muna Regency, if we look at the prevalence of hypertension incidence data in Katobu District with a population of 31,929 people. In 2016 it was known that the prevalence of hypertension was 80 cases per thousand population, in 2017 there were 145 cases per thousand population, in 2018amounted to 143 cases per thousand population, in 2019 there were 145 cases per thousand population and in 2020 there were 130 cases per thousand population. Based on this, it is interesting for researchers to conduct research on Giving Soursop Leaf Extract (Annona Muricata L) To Lower Blood Pressure For Patients With Hypertension.
 Methods: The type of research conducted is pre-experimental research with a Pretest-Posttest design. The research was carried out in the working area of ​​the Katobu Public Health Center from April to June 2022 totaling 56 people with a sample of 49 people.
 Results: The average hypertension decreased in the first week 177.24, the second week 171.73 and the third week after administration of soursop leaf extract 171.19, the difference in blood pressure reduction of the three treatment groups. Judging from the ANOVA table, the column Sig. obtained P value (P-value) = 0.000.
 Conclusion: There is a significant effect between the administration of soursop leaf extract on reducing blood pressure in patients with hypertension in the working area of ​​the Katobu Public Health Center, Muna Regency.

PERBEDAAN PENURUNAN TEKANAN DARAH PASIEN HIPERTENSI YANG DIBERIKAN TERAPI AMLODIPIN PADA PAGI HARI DAN MALAM HARI DI PUSKESMAS BAYANAN KABUPATEN HULU SUNGAI SELATAN

Research on timing taking amlodipine drugs against decrease in blood pressure showed different results, that’s significant and insignificant effect. Research to identify differences in blood pressure reduction from hypertension patients given amlodipine drug therapy in the morning with night at Puskesmas Bayanan Hulu Sungai Selatan Regency. This research method is obsevasional descriptive with Pre and post test design. There are two groups this design, namely hypertension patients given amlodipine drug therapy in the morning and night, blood pressure measured before and after 10 days of observation, then compared between difference in the decrease in blood pressure of patients given amlodipine drug therapy in the morning and night. The results of respondents given amlodipine drug therapy in the morning experienced average decrease in blood for systole -13.67 mmHg and for diastole -6.33 mmHg. Meanwhile, those given amlodipine therapy at night experienced average decrease in blood for cystole -19 mmHg and for diastole -10.33 mmHg. Wilcoxon sigh test results for blood pressure systole values Asymp.sig. 0.007 and for diastole blood pressure values Asymp.sig. 0.003 or <0.05 which states hypothesis is accepted or there is difference between decrease in blood pressure of hypertension patients given amlodipine drug therapy in the morning and night.

Mechanisms for blood pressure reduction following isometric exercise training: a systematic review and meta-analysis.

Isometric exercise training (IET) is established as an effective antihypertensive intervention. Despite this, the physiological mechanisms driving blood pressure (BP) reductions following IET are not well understood. Therefore, we aimed to perform the first meta-analysis of the mechanistic changes measured following IET. PubMed, Cochrane library and SPORTDiscus were systematically searched for randomized controlled trials published between January 2000 and December 2021 reporting the effects of IET on resting BP and at least one secondary mechanistic parameter following a short-term intervention (2-12 weeks). Eighteen studies with a pooled sample size of 628 participants were included in the final analysis. IET produced significant reductions in resting systolic and diastolic BP of 9.35 mmHg (95% confidence interval [CI] = -7.80 to -10.89, P < 0.001) and 4.30 mmHg (CI = -3.01 to -5.60, P < 0.001), respectively. Mechanistically, IET produced a statistically significant reduction in resting heart rate (mean difference [MD]: -1.55 bpm, CI = -0.14 to -2.96, P = 0.031) and a significant increase in stroke volume (MD: 6.35 ml, CI = 0.35 to 12.60, P = 0.038), with no significant change in cardiac output. Conversely, total peripheral resistance (TPR) significantly decreased following IET (MD: -100.38 dyne s -1 cm 5 , CI = -14.16 to -186.61, P = 0.023), with significant improvements in the low frequency to high frequency heart rate variability ratio (MD: -0.41, CI = -0.09 to -0.73, P = 0.013) and baroreceptor reflex sensitivity (MD: 7.43 ms/mmHg, P < 0.001). This work demonstrates that a reduction in TPR, potentially mediated through enhanced autonomic vasomotor control, is primarily responsible for BP reductions following IET. Furthermore, this novel analysis suggests wall squat interventions to be the most effective IET mode, with clinically relevant differences in BP reductions compared to handgrip and leg extension IET; although future direct comparative research is required.

Effect of Financial Incentives on Hypertension Control: A Multicenter Randomized Controlled Trial in China.

Background:Poorly controlled hypertension is a great challenge to global public health. Incentive approaches, based on behavioral and economic concepts, may improve patients’ adherence to treatment.methods:We conducted a 2-arm randomized controlled trial to test whether financial incentives can help patients with poorly controlled hypertension in China reduce their blood pressure (BP). Participants were randomized 1:1 to the control and intervention groups. All participants received WeChat-based standard education and support for hypertension management. The intervention group received financial incentives, including process- and outcome-based incentives.Results:No statistically significant differences in BP reduction and hypertension control rates were found between the two groups from baseline to 12-month follow-up. Mean systolic BP decreased from 158.7 to 149.8 mm Hg in the intervention group and 159.7 to 149.5 mm Hg in the control group (P=0.639). Mean diastolic BP decreased from 93.7 to 86.6 mm Hg in the intervention group and 93.9 to 86.3 mm Hg in the control group (P=0.667). Hypertension control rates in the intervention and control groups were 20.8% and 15.8%, respectively (P=0.318). Medication adherence was 84.2% in the intervention group and 86.2% in the control group (P=0.705).Conclusions:Financial incentives were effective in the short term for BP control, but a sustained effect of incentive-based BP control was not identified beyond 3 months of intervention. Future studies that focus on identifying the appropriate amount and structure of financial incentives for BP control are warranted.Registration:URL: www.isrctn.org; Unique identifier: ISRCTN13467677.

Difference In The Lower Blood Pressure Of Primary Hypertension Patients Participating In Prolanis And Non Prolanis In The Cipayung District Health Center

Changes in human development at this time greatly affect lifestyles it is a cause of an increase in non- communicable diseases (PTM) one of which is hypertension. Hypertension control has been pursued by the government by implementing a chronic disease prevention program (PROLANIS) through collaboration with BPJS. This study aims to determine the difference in blood pressure reduction in primary hypertension patients who follow prolanis and non prolanis in the Cipayung District Health Center. Pre-experimental research design with static group comparison research. The study population was primary hypertension patients who followed prolanis and non prolanis in the Cipayung District Health Center. Samples were taken by purposive sampling and found 40 people. The collected data is tested statistically by T-test. The results of the study of primary hypertension patients who follow Prolanis have better blood pressure. Statistical test results showed there were differences in blood pressure reduction in primary hypertension patients who followed prolanis and non prolanis (p = 0,000, p &lt;0.05). Nurses provide education to primary hypertension patients who have not yet joined the program to participate in the PROLANIS program.Keyword: Hypertension, Blood Pressure, PROLANIS

52. SUBLINGUAL VERSUS ORAL CAPTOPRIL FOR BLOOD PRESSURE REDUCTION IN HYPERTENSION URGENCY: A SYSTEMATIC REVIEW AND META-ANALYSIS

Background: The use of sublingual captopril has been suggested in hypertension urgency on the assumption of faster absorption and thus more rapid effect on blood pressure than with the oral route. But there are still confusing data regarding the preferential route in literature. Objective: This study aimed to compare the effect of sublingual and oral captopril to reduce blood pressure in hypertension urgency patients. Method: We systematically searched the relevant studies from date of inception to January 2021. Outcomes of interest were blood pressure reduction at 10, 30, and 60 minutes after 25 mg sublingual and oral captopril administration. Results: One RCT and two observational studies comprising 353 patients were included. Systolic blood pressure (SBP) was significantly reduced faster in sublingual group at 10 minutes (mean difference 6.65 [95% CI 1.21, 12.09]; p = 0.02; I 2: 89%) and 30 minutes (mean difference 2.54 [95% CI 0.76, 4.32]; p = 0.005; I 2: 0%) compared to oral group. Mean arterial pressure (MAP) was also reduced more rapidly at 10 minutes (mean difference 3.62 [95% CI 2.78, 4.46]; p &lt; 0.00001; I 2: 0%) and 30 minutes (mean difference 2.12 [95% CI 0.88, 3.36]; p = 0.0008; I 2: 0%) in sublingual group. Our meta-analysis showed no significant difference in blood pressure reduction at 60 minutes between two groups. Conclusion: Sublingual captopril can reduce SBP and MAP more rapidly compared to oral captopril in the first 30 minutes after administration, but the effect was similar at 60 minutes.

Using Technology to Support Self-Managing Hypertension in African Americans

The purpose of this study was to examine the effects of a community and technology-based intervention to support self-managing hypertension in African American (AA). Sixty AA with hypertension were randomly assigned to Coachman (a technology-based intervention) or Enhanced Usual Care. COACHMAN is comprised of blood pressure (BP) monitoring with study issued monitor, six-weeks of web-based education, training to use a medication management application, and nurse counseling. Data were collected on contextual factors (demographics, perceived social support), process factors (hypertension knowledge, self-efficacy, technology use/adoption), and proximal health behaviors (medication adherence, diet, exercise) at baseline, and 8 and 12 weeks. While mean difference in BP reduction was not statistically significant, we found that half of the subjects randomized to the intervention group had an average systolic BP reduction of 13.5 mmHg that we would regard as clinically significant. Interventions that incorporate mHealth can support self-managing hypertension in AA, and improve BP.

PERBEDAAN PENURUNAN TEKANAN DARAH PADA IBU DENGAN PRE EKLAMPSIA YANG DITERMINASI PADA USIA KEHAMILAN KURANG BULAN DAN CUKUP BULAN

Pre-eclampsia is the second leading cause of maternal death worldwide, with the main symptoms of hypertension and proteinuria in pregnant women. Various factors can affect the occurrence of pre-eclampsia and cause serious disease complications and even death. The purpose of this study was to determine the difference in blood pressure reduction in pre-eclampsia mothers who were terminated at the age of less and at term with a comparative analytic study design using a cross sectional approach. The population in this study were all pregnant women with pre-eclampsia who were terminated by caesarean section at preterm and full-term gestation, as many as 56 people. The sampling technique used is stratified proportional random samplingwith as many as 30 people. Through the Independent T-Test statistical test with a significance level of 0.05. The t-count is -3.209 and the significance is 0.003, then Ho is rejected, which means that there is a difference between the decrease in blood pressure in mothers with pre-eclampsia who were terminated at preterm and full-term gestation Keywords: Decrease in Blood Pressure, Pre Eclampsia, Aterm and Preterm

Efficacy of enhanced emergency department discharge for chronic hypertension management – Results of a randomized controlled trial

IntroductionAchieveBP is a randomized controlled trial (RCT) of an education intervention for patients with chronic hypertension who have uncontrolled blood pressure (BP) at discharge from an urban emergency department (ED). The study examined efficacy and moderators of an educational intervention in an RCT on BP control at 180-day post-intervention. MethodsParticipants were recruited from a single, urban ED and randomized to receive or not to receive hypertension education. To minimize potential bias, participants were all started on an evidence-based anti-hypertensive regimen and medications were dispensed directly to participants by the study team. Bivariate analysis was performed to examine differences in sociodemographic characteristics between patients achieving BP control and those who did not. Paired t-test was used to compare the difference of systolic and diastolic BP between baseline and 180 days post-discharge. Multiple logistic regression analysis examined interaction of covariates and intervention on achieving BP control. ResultsOne hundred and thirty-nine participants were randomized into the study. All were African-American with a mean age of 47.6 (SD = 10.8) years; 51% were male, 63% had smoked cigarettes and 15% had diabetes. A total of 66 patients completed the study (47.4%), 44 of whom (67%) achieved BP control. However, there was no difference in BP reduction or control between the two groups. Age and smoking status showed moderation effects on intervention efficacy. ConclusionDespite a neutral effect of our intervention, a high level of BP control was achieved overall, suggesting that the ED may be a viable location for efforts aimed at reducing the impact of chronic hypertension in predominantly African American communities.

Hemodynamic comparison of intravenous push diltiazem versus metoprolol for atrial fibrillation rate control

ObjectiveIntravenous push (IVP) diltiazem and metoprolol are commonly used for management of atrial fibrillation (AF) with rapid ventricular rate (RVR) in the emergency department (ED). This study's objective was to determine if there was a significant difference in blood pressure reduction between agents. MethodsThis was a single-center, retrospective study of adult patients initially treated with IVP diltiazem or metoprolol in the ED from 2008 to 2018. Primary endpoint was mean reduction in systolic blood pressure (SBP) from baseline to nadir during the study period. Study period was defined as time from first dose of IVP intervention to 30 min after last dose of IVP intervention or first dose of maintenance therapy, whichever came first. ResultsA total of 63 diltiazem patients and 45 metoprolol patients met eligibility criteria. Baseline characteristics were similar except for initial ventricular rate (VR) and home beta-blocker use. Median dose of initial intervention was 10 [10−20] mg and 5 [5–5] mg for diltiazem and metoprolol respectively. Mean SBP reduction was 18 ± 22 mmHg for diltiazem compared to 14 ± 15 mmHg for metoprolol (p = .33). Clinically relevant hypotension was similar between groups 14% vs. 16% (p = .86). Rate control was achieved in 35 (56%) of the diltiazem group and 16 (36%) of the metoprolol group (p = .04). ConclusionIVP diltiazem and metoprolol caused similar SBP reduction and hypotension when used for initial management of AF with RVR in the ED. However, rate control was achieved more often with diltiazem.

EFEKTIVITAS MASSAGE EFFLEURAGE DAN TERAPI MUSIK TERHADAP PENURUNAN TEKANAN DARAH PADA IBU BERSALIN DENGAN PRE EKLAMSI

ABSTRACTBackground: According to the Indonesian Health Demographic Survey (IDHS) in 2017, the direct cause of the maternal mortality rate (MMR) of 30% was preeclampsia. Preeclampsia can be treated pharmacologically and non pharmacologically. Non-pharmacological treatment is a natural treatment including effluerage massage and music therapy.Objective: To identify and analyze differences in blood pressure reduction in pre-eclampsia mothers before and after massage effleurage and music therapy in the Kragan II Puskesmas maternity room.Methods: The study design used the Two Group Post Test With Control Design. Sampling by accidental sampling. Sampling in this study were 40 women with preeclampsia. Test results using the Mann-Whitney test.Results: With effluarge massage the average blood pressure value was 22.0 while in music therapy 19.00 and obtained ρ was 0.002 (&lt;0.05). So Ho refused Ha accepted, which means there are differences in the effectiveness of massage effleurage and music therapy to reduce blood pressure in mothers giving birth with pre-eclampsia in health center II.Conclusion: Massage effleurage is more effective when compared to music therapy in reducing maternal blood pressure. It is expected that health workers to implement an effleurage massage program in women with preeclampsia. Keywords: Massage effleurage, Music Therapy, Preeclampsia

Herbal Medicine (Sihogayonggolmoryeo-Tang or Chai-Hu-Jia-Long-Gu-Mu-Li-Tang) for Treating Hypertension:A Systematic Review and Meta-Analysis.

Introduction For situations in which effective and safe natural-derived products to treat hypertension are needed, recent studies suggest that an herbal medicine, Sihogayonggolmoryeo-tang (SYM), can improve both hypertension and concurrent mood symptoms. We aimed to evaluate the effectiveness and safety of SYM in treating hypertension. Methods Thirteen English, Korean, and Chinese databases were comprehensively searched from their inception to May 2020. Randomized controlled trials (RCTs) using SYM as a monotherapy or adjunctive therapy for hypertension were evaluated. The primary outcome was the systolic and diastolic blood pressure (BP). Descriptive analyses of the relevant data were conducted, and where appropriate data were available, a meta-analysis was performed, and the results were presented as a risk ratio or mean difference with 95% confidence intervals. The risk of bias was assessed using the Cochrane risk of bias tool, and the quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Results Seven RCTs with 711 participants were included. Compared with placebo, SYM significantly lowered systolic and diastolic BP and concurrent depression. SYM significantly lowered systolic and diastolic BP compared with active controls; however, subgroup analysis revealed no differences between SYM and antihypertensives. In addition, SYM significantly decreased the level of concurrent depression compared with antidepressants. There was no consistent difference in BP reduction between SYM combined with antihypertensives and antihypertensives alone. No serious adverse events were reported following SYM administration. Most of the included studies had an unclear risk of bias, and the quality of evidence was generally rated “low.” Conclusion Current evidence suggests that SYM may have the potential to lower hypertension and concurrent depressive symptoms without serious adverse events. Additional high-quality, placebo-controlled RCTs should be conducted to confirm the efficacy of SYM.