Difference In Systolic Blood Pressure Research Articles

Pengaruh Rendam Kaki dengan Air Hangat Campur Kencur terhadap Penurunan Tekanan Darah Lansia Hipertensi Di Desa Pohsanten

<p><em>Elderly is a phase of someone who experiences increasing age where the group is at risk of experiencing health problems. Hypertension is a condition in which a person experiences an increase in high blood pressure which reaches a systolic number of more than 140 mmHg and a diastolic number of more than 90 mmHg. Several treatments for lowering blood pressure can be carried out, one of which is with non-pharmacological actions. This study aims to determine whether or not there is an effect of soaking feet with warm water mixed with kencur on reducing blood pressure in elderly hypertensives in Pohsanten Village. This study used a quasi-experimental design with a non-equivalent control group before-after design. The population in this study were all hypertensive elderly people in Pohsanten Village. Sampling used a purposive sampling technique with 102 research samples, the experimental group totaling 51 people and the control group totaling 51 people were given the intervention of foot soaks with plain water. The analysis of this study used the Wilcoxon test and the Mann-Whitney test. In this study, the results obtained were p value = 0.000 for systolic blood pressure and diastolic blood pressure with a p value = 0.000, meaning that there was an average difference in systolic and diastolic blood pressure before and after the intervention. It can be concluded that there is an effect of soaking feet in warm water mixed with kencur on reducing blood pressure in elderly hypertensives in Pohsanten Village.<strong></strong></em></p>

The Contribution of Declines in Blood Lead Levels to Reductions in Blood Pressure Levels: Longitudinal Evidence in the Strong Heart Family Study.

Chronic lead exposure is associated with both subclinical and clinical cardiovascular disease. We evaluated whether declines in blood lead were associated with changes in systolic and diastolic blood pressure in adult American Indian participants from the SHFS (Strong Heart Family Study). Lead in whole blood was measured in 285 SHFS participants in 1997 to 1999 and 2006 to 2009. Blood pressure and measures of cardiac geometry and function were obtained in 2001 to 2003 and 2006 to 2009. We used generalized estimating equations to evaluate the association of declines in blood lead with changes in blood pressure; cardiac function and geometry measures were considered secondary. Mean blood lead was 2.04 μg/dL at baseline. After ≈10 years, mean decline in blood lead was 0.67 μg/dL. In fully adjusted models, the mean difference in systolic blood pressure comparing the highest to lowest tertile of decline (>0.91 versus <0.27 μg/dL) in blood lead was -7.08 mm Hg (95% CI, -13.16 to -1.00). A significant nonlinear association between declines in blood lead and declines in systolic blood pressure was detected, with significant linear associations where blood lead decline was 0.1 μg/dL or higher. Declines in blood lead were nonsignificantly associated with declines in diastolic blood pressure and significantly associated with declines in interventricular septum thickness. Declines in blood lead levels in American Indian adults, even when small (0.1-1.0 μg/dL), were associated with reductions in systolic blood pressure. These findings suggest the need to further study the cardiovascular impacts of reducing lead exposures and the importance of lead exposure prevention.

Sex Differences in the Relationship between Personal, Psychological and Biochemical Factors with Blood Pressure in a Healthy Adult Mexican Population: A Cross-Sectional Study.

Hypertension is one of the main risk factors related to cardiovascular mortality, being the levels of blood pressure (BP) related to a variety of personal, anthropometric, biochemical and psychological variables; however, the study evaluating the association of all these factors in systolic blood pressure (SBP) and diastolic blood pressure (DBP) in a sample of relatively healthy subjects has not been performed. The aim of the study was to determine the main variables associated with SBP and DPB in a sample of relatively healthy subjects. A total of 171 participants were included, in which personal, anthropometric, positive and negative psychological variables and biochemical variables were measured. We observed that men showed higher levels of SBP and DBP than women, with more differences for SBP. Among the biochemical factors and SBP, we found that albumin and monocytes were positively correlated with it, while potassium, phosphorus and eosinophils were negatively correlated with it. Additionally, schooling was a constant variable negatively correlated with SBP in all samples (global, men and women). Among psychological variables, we observed that emotional perception was negatively correlated with SBP in men's and women's samples, while autonomy was positively correlated with SBP in the men's sample; however, their association was less when compared with the personal and biochemical variables included in the multivariate model. With regard to DBP, we observed that the biochemical variables, hemoglobin, sodium, uric acid and glucose, were positively correlated with DBP in the global sample, while chloride and BUN were negatively correlated with it. In addition, many personal and behavioral variables, including BMI, age and smoking consumption frequency, also correlated with DBP in the global sample. In conclusion, BP is affected by different factors, and these affect each sex differently.

Effect of protocol-based family visitation on physiological indicators in ICU patients: a randomized controlled trial

BackgroundIntensive care unit (ICU) patients often experience significant physiological stress. This study evaluated the effect of a defined family visitation protocol on physiological responses in the ICU.MethodsA randomized, block-randomized clinical trial was conducted on 78 ICU patients at Imam Reza Hospital between February 8, 2017, and August 8, 2017. The intervention group received protocol-based visits, and the control group continued with standard visitation. Block randomization was utilized for group assignments. The primary outcome was the measurement of physiological signs using designated monitoring devices. Data were analyzed using SPSS version 22, employing independent t-tests, Mann-Whitney U test, repeated measures analysis, and Friedman’s test.ResultsThe results showed no significant differences in systolic blood pressure, diastolic blood pressure, mean arterial pressure, respiratory rate, and arterial blood oxygen levels between the two groups. However, heart rate in the intervention group was significantly lower in three stages before, during, and after the meaningful visiting (P = 0.008).ConclusionProtocol-based scheduled family visits in the ICU may reduce physiological stress, as evidenced by a decrease in patients’ heart rate. Implementing tailored visitation protocols sensitive to patient preferences and clinical contexts is advisable, suggesting the integration of family visits into standard care practices for enhanced patient outcomes.Trial RegistrationIRCT20161229031654N2; 25/01/2018; Iranian Registry of Clinical Trials (https://en.irct.ir).

Self-Measured Blood Pressure-Guided Pharmacotherapy: A Systematic Review and Meta-Analysis of United States-Based Telemedicine Trials.

The optimal approach to implementing telemedicine hypertension management in the United States is unknown. We examined telemedicine hypertension management versus the effect of usual clinic-based care on blood pressure (BP) and patient/clinician-related heterogeneity in a systematic review/meta-analysis. We searched United States-based randomized trials from Medline, Embase, CENTRAL, CINAHL, PsycINFO, Compendex, Web of Science Core Collection, Scopus, and 2 trial registries. We used trial-level differences in BP and its control rate at ≥6 months using random-effects models. We examined heterogeneity in univariable metaregression and in prespecified subgroups (clinicians leading pharmacotherapy [physician/nonphysician], self-management support [pharmacist/nurse], White versus non-White patient predominant trials [>50% patients/trial], diabetes predominant trials [≥25% patients/trial], and White patient predominant but not diabetes predominant trials versus both non-White and diabetes patient predominant trials]. Thirteen, 11, and 7 trials were eligible for systolic and diastolic BP difference and BP control, respectively. Differences in systolic and diastolic BP and BP control rate were -7.3 mm Hg (95% CI, -9.4 to -5.2), -2.7 mm Hg (-4.0 to -1.5), and 10.1% (0.4%-19.9%), respectively, favoring telemedicine. Greater BP reduction occurred in trials where nonphysicians led pharmacotherapy, pharmacists provided self-management support, White patient predominant trials, and White patient predominant but not diabetes predominant trials, with no difference by diabetes predominant trials. Telemedicine hypertension management is more effective than clinic-based care in the United States, particularly when nonphysicians lead pharmacotherapy and pharmacists provide self-management support. Non-White patient predominant trials achieved less BP reduction. Equity-conscious, locally informed adaptation of telemedicine interventions is needed before wider implementation.

Effect of a home-based isometric handgrip training programme on systolic blood pressure in adults: A randomised assessor-blinded trial

ABSTRACT Objectives To evaluate the effects of 20 weeks of home-based isometric handgrip training (IHT) compared with usual care on systolic blood pressure (SBP) in adults. Design and participants This was a randomised, controlled, assessor-blinded trial. Participants were randomised to either IHT (intervention group) or usual care (control group). Interventions Participants randomised to the intervention group performed a session of 16 min of effective workout home-based IHT three times per week for 20 weeks. Participants randomised to the control group were asked to continue their daily activities as usual. Outcomes The primary outcome was the difference in SBP between groups over 20 weeks. Secondary outcomes were diastolic blood pressure, heart rate, handgrip strength, and self-administered home blood pressure measures. Results Forty-eight adults (mean [SD] age, 64 [8] years) were included in this trial. The adjusted between-group mean difference in SBP was 8.12 mmHg (95% CI 0.24 to 16.01, p = 0.04) – favouring the usual care group. No differences between groups were found in any of the home blood pressure measurements. Conclusions This trial showed that 20 weeks of home-based isometric handgrip training was not superior compared to the usual care in lowering SBP.

Liraglutide does not increase heart rate of diabetic patients during acute myocardial infarction.

Glucagon-like peptide 1 receptor agonists have been shown to reduce all-cause and cardiovascular mortality in patients with Type 2 diabetes mellitus (T2DM). The probable increase in heart rate hinders its early usage in acute myocardial infarction patients. In our study, we aimed to find out whether the use of liraglutide in patients with acute myocardial infarction as early as at the time of hospitalization would increase the heart rate. This was an observational retrospective study. From December 2020 to August 2021, 200 patients with acute myocardial infarction were included in our study and divided into three groups: T2DM + liraglutide group (n = 46), T2DM + non-liraglutide group (n = 42), and non-T2DM group (n = 112). The primary outcomes were the differences in heart rate. Secondary outcomes were differences in systolic and diastolic blood pressure. There were no significant differences in heart rate among the three groups at admission, the day before the first shot of liraglutide, and before discharge. There was also no significant difference in heart rate between diabetic patients with acute myocardial infarction and those on liraglutide during the hospital stay. And there were no differences of beta-blocker dosages among the three groups. Liraglutide did not affect the blood pressure during acute myocardial infarction. Liraglutide did not increase the heart rate in diabetic patients during acute myocardial infarction and did not lead to an increase in the dose of beta-blockers in the patients. It also had no effect on blood pressure and showed better efficacy in lowering glucose levels without additional hypoglycemic events.

Increased prevalence of metabolic syndrome and non-alcoholic fatty liver disease in children with atopic dermatitis: A case-control study from northern India.

Atopic dermatitis (AD) is a chronic inflammatory skin disorder that affects children worldwide, with potential associations to metabolic syndrome (MetS) and non-alcoholic fatty liver disease (NAFLD). Limited research exists on the interplay between AD, MetS, and NAFLD in the pediatric population. This study aimed to investigate the prevalence and potential relationships among AD, MetS, and NAFLD in children. A case-control study design was employed, recruiting 50 children with AD (median age: 9.5 years) and 50 age- and sex-matched healthy controls (median age: 11.5 years, p = .051). Data on demographic characteristics, clinical features, disease severity, treatment history, anthropometric measurements, and laboratory evaluations were collected. MetS and NAFLD were diagnosed based on established criteria. The prevalence of MetS was significantly higher in children with AD compared with controls (24% vs. 2%, p = .002). Significant differences for systolic blood pressure (p < .001), diastolic blood pressure (p = .012), and waist circumference (p = .040) were observed between AD patients and controls. Children with AD had higher triglyceride levels (p = .005). NAFLD was exclusively seen in moderate to severe AD cases (6% vs. 0%, p = .242). AD severity showed associations with increased body mass index (p = .020). This study highlights the increased prevalence of MetS and the potential association with NAFLD in children with AD. The findings suggest that AD may contribute to the development of metabolic abnormalities at an early age. Further research is needed to elucidate the underlying mechanisms and explore preventive strategies for these interconnected conditions.

Are aneroid and digital sphygmomanometers as reliable and accurate as mercury sphygmomanometers?

Background: The accurate measurement of blood pressure (BP) is crucial for effectively treating hypertension, which stands as a primary risk factor for both cardiovascular disease and premature mortality. The shift from mercury to nonmercury sphygmomanometers in developing countries due to environmental concerns prompts an evaluation of the accuracy of these alternatives. Aims and Objectives: The objectives of this study were to evaluate the precision of non-mercury instruments in diagnosing hypertension and to analyze interarm differences in both systolic and diastolic BP using three different sphygmomanometers. Materials and Methods: Sixty subjects aged 18–25 were included. BP measurements were taken from both arms using different types of sphygmomanometers. Statistical analysis involved paired t-tests, Chi-square tests for correlations, and a significance threshold of P &lt; 0.05. Results: Significant differences in systolic BP readings were observed between the gold standard (mercury manometer) and digital/aneroid devices (P = 0.00). Compared to the mercury manometer, both digital and aneroid devices showed limited accuracy in detecting hypertension. Kappa agreement was moderate at 0.57. Despite high specificity (100%), sensitivity was lower at 44.4%, indicating a risk of missing true positive cases. Both devices exhibited a sensitivity of 25%, with fair to poor agreement (kappa values) in identifying cardiovascular risk compared to the mercury reference. Conclusion: This study underscores the diminished reliability of both aneroid and digital devices in detecting hypertension and assessing cardiovascular risk using specified interarm BP criteria. These findings emphasize the crucial need for further research and caution when relying on non-mercury devices in clinical settings.

Эффективность неонатального скрининга на критические врожденные пороки сердца путем двузонного измерения систолического артериального давления и сатурации

Aim. To evaluate screening methods for critical congenital heart defects (CHD), in particular obstructive aortic arch defects (OАADs), using dual-zone systolic blood pressure (SBP) and oxygen saturation measurements in healthy newborns. Design. A prospective observational study. Material and methods. The study included 12 098 healthy newborns aged 48 (36–50) hours of life, who were screened for critical CHDs using dual-zone measurements of SBP and saturation, as well as using physical methods. Screening for critical CHDs was considered normal if the saturation difference was 2% or less, the saturation was more than 95%, the difference in SBP was 9 mm Hg and less. If the screening was abnormal, echocardiography (ECHO-CG) was performed. The end point of the study was to determine the sensitivity and specificity of screening for OPAADs in healthy newborns using dual-zone measurement of SBP and saturation. Results. 12 037 children had normal screening results. In these children, the difference in pre- and postductal SBP was 0 (standard deviation (σ) = 4.26 mm Hg, and the difference (Me) in saturation was 0 (σ = 0.93%). Dual-zone SBP screening was abnormal in 34 newborns. The difference in their SBP was 11 (10–34) mm Hg. In 16 of these children ECHO-CG did not reveal CHD, and in 4 — critical OAADs — coarctation of aorta was diagnosed. A decrease in peripheral pulsation in the femoral arteries was noted only in children with critical OAADs. Pulse oximetry screening was normal in these children with critical OAADs. Dual-zone saturation screening was abnormal in 16 children. The difference in saturation between them was 3 (3–5)%. In 13 of these children, ECHO-CG did not reveal CHDs, and in 1 child critical CHD was diagnosed — transposition of the great arteries. Also, this child (and another who was healthy) had a decrease in saturation of less than 95%. In 11 newborns, screening was abnormal only due to saturation of 95% or less, but ECHO-CG did not reveal CHDs. The sensitivity and specificity of screening for OAADs using dual-zone SBP measurement was 100 and 80%, and using dual-zone pulse oximetry was 0 and 73.6%, respectively. Conclusions. In newborns with OAADs, a difference in SBP of 10 mmHg is recorded after 36 hours of their life. Dual-zone measurement of SBP is the most highly sensitive and specific method for detecting OAADs in comparison with dual-zone pulse oximetry. Dual-zone measurement of SBP and determination of peripheral pulsation are recommended for inclusion in the neonatal screening protocol for critical CHDs. Keywords: congenital heart disease, neonatal screening for congenital heart defects, aortic coarctation, aortic arch interruption, blood pressure.

Dapagliflozin Does Not Protect against Adriamycin-Induced Kidney Injury in Mice

Introduction: Sodium-glucose cotransporter 2 (SGLT2) inhibitors target SGLT2 in renal proximal tubules and promote glycosuria in type 2 diabetes mellitus in humans and animal models, resulting in reduced blood glucose levels. Although clinical trials have shown that SGLT2 inhibitors attenuate the progression of chronic kidney disease, there have been concerns regarding SGLT2-induced acute kidney injury. In this study, we investigated the effect of SGLT2 inhibitors on adriamycin-induced kidney injury in mice. Methods: Seven-week-old balb/c mice were injected with adriamycin 11.5 mg/kg via the tail vein. Additionally, dapagliflozin was administered via gavage for 2 weeks. The mice were divided into five groups: vehicle, dapagliflozin 3 mg/kg, adriamycin, adriamycin plus dapagliflozin 1 mg/kg, and adriamycin plus dapagliflozin 3 mg/kg. Results: Adriamycin injection reduced the body weight and food and water intakes. Dapagliflozin also decreased the body weight and food and water intakes. Fasting blood glucose and urine volume were not altered by either adriamycin or dapagliflozin. Once adriamycin-induced kidney injury had developed, there were no differences in systolic blood pressure among the groups. Dapagliflozin did not alleviate proteinuria in adriamycin-induced kidney injury. Adriamycin induced significant glomerular and interstitial injury, but dapagliflozin did not attenuate these changes in renal injury. Interestingly, SGLT2 expressions were different between the cortex and medulla of kidneys by dapagliflozin treatment. Dapagliflozin increased SGLT2 expression in medulla, not in cortex. Conclusion: Dapagliflozin had no effect on proteinuria or inflammatory changes such as glomerular and tubular damages in adriamycin-induced kidney injury. Our study suggests that dapagliflozin does not protect against adriamycin-induced kidney injury. More experimental studies regarding the effects of SGLT2 inhibitors on various kidney diseases are needed to clarify the underlying mechanisms.

The Effect of Intraoperative Music on Sedation, Anxiety, and Hemodynamic Responses among Patients Undergoing Lower Segment Cesarean Section under Spinal Anesthesia

Background and Aim: Anxiety levels are high in spinal anesthesia as patients are awake. Sedation has an advantage that patients feel comfortable but if sedative drugs are not used judiciously, they can suppress the cardiovascular and respiratory system, lower core body temperature, or severely lower blood pressure. Music reduces awareness under anesthesia and has antianxiety effects. The effect of music on sedation using bispectral index (BIS) along with anxiety and hemodynamic parameters at different time intervals has been studied. Material and Methods: A hospital-based prospective randomized interventional study was done on 60 patients aged between 18 and 35 years undergoing lower segment cesarean sections. Two groups (music headphones with music and nonmusic headphones without music), each containing 30 subjects, were formed using a simple random technique by the sealed envelope method. The levels of sedation using BIS were measured preoperatively, after giving spinal anesthesia, then every 10 min till the end of surgery. Moreover, hemodynamic parameters were also monitored and recorded preoperatively and every 10 min till the end of surgery. Anxiety was measured using a visual analog score for anxiety preoperatively and postoperatively. Results: The BIS index was significantly lower in the music group compared to the nonmusic group from 20 min after start of surgery to the end of surgery (86.17 ± 4.48 vs. 75.73 ± 3.97, P &lt; 0.001). Anxiety was also significantly lower in the music group than in the nonmusic group (4.03 ± 1.47 vs. 0.50 ± 1.57, P &lt; 0.005). Heart rate (HR) was lower in the music group after 20 min of music therapy compared to the nonmusic group (87.87 ± 11.21 vs. 79.67 ± 6.67, P = 0.004) but there was no statistically significant difference in systolic blood pressure, diastolic blood pressure, mean arterial blood pressure, and saturation of oxygen between two groups. Conclusion: Our data showed that intraoperative music listening under regional anesthesia has effect on sedation, anxiety, and physiological variables. Therefore, music therapy can be used as nonpharmacological intervention for reducing anxiety and sedation during surgery.

A prospective randomized double-blind clinical study to compare the effect of nalbuphine versus fentanyl on attenuation of pressor response during endotracheal intubation and analgesic potential on patients under general anesthesia

Abstract Background: Laryngoscopy and orotracheal intubation often trigger a hemodynamic response, increasing catecholamines and potentially leading to higher morbidity. Fentanyl, with a high safety margin and rapid onset, and Nalbuphine, a µ receptor antagonist and k receptor agonist with minimal respiratory depression and a “ceiling effect,” are commonly used to mitigate this response. Aim: This study compares the efficacy of Fentanyl and Nalbuphine in reducing the pressor response during laryngoscopy and intubation in patients under general anesthesia, monitored by Bispectral Index (BIS). It also evaluates total analgesic requirements, time to first rescue analgesic post-extubation (VAS score), and associated complications. Method: The study was a hospital-based, prospective, double-blind, randomized interventional trial registered under the Clinical Trials Registry - India (CTRI/2022/05/042731). The sample size of 70 patients (35 in each group) was calculated based on alpha error, study power, and the minimum clinically significant difference for MAP after induction. Patients aged 18-65 years with ASA grade I and II and body weight between 40-70 kg were included. Group A received Fentanyl, and Group B received Nalbuphine. Vital parameters were monitored during the surgery, and additional doses of the study drug were administered if the BIS score exceeded 60. Postoperative analgesic effect was evaluated by a blinded anesthesiologist. Results: The demographic characteristics of the study population were similar between the Fentanyl and Nalbuphine groups, as indicated by age, weight, sex, and ASA physical status, there was a statistically significant difference in systolic blood pressure, diastolic blood pressure, mean arterial pressure and heart rate post-intubation, with the Nalbuphine group demonstrating a greater increase compared to the Fentanyl group, which was significant at all time intervals.

Prevalence of type 2 diabetes mellitus and hypertension in patient's visiting the conservative dentistry and endodontics department: a cross-sectional study in Surabaya City.

This descriptive cross-sectional study focuses on the prevalence of hypertension (HTN) and type 2 diabetes mellitus (T2DM) amongst patients who visited the Conservative Dentistry and Endodontics department. Recognizing these incidence statistics is critical for improving endodontic therapy delivery and assuring high-quality dental care with positive treatment outcomes. In advance of getting dental care, all patients visiting the department were advised to get their blood sugar and blood pressure levels checked at random. Measurements were taken with digital equipment, and individuals with high levels were encouraged to seek medical advice before undergoing dental procedures. The obtained data was imported into Excel and analyzed with IBM SPSS software (version 21). The investigation had 1,100 participants (55.8% female and 44.2% male), with an average age of 44.58 ± 12.77 years. Of the individuals, 40.6% were referred for type 2 diabetes, 12.6% for hypertension, and 24.0% for both diseases. There was a significant correlation (p<0.05) between referral status and gender. The average blood pressure and random blood sugar readings were 141.02 mmHg ± 56.28 mmHg (systolic), 79.83 mmHg ± 10.68 mmHg (diastolic), and 126.68 mg/dL ± 15.36 mg/dL, respectively. There was a substantial (p<0.05) difference in mean systolic blood pressure between men and women. Furthermore, age was strongly connected with random blood sugar levels (p<0.05) and systolic and diastolic blood pressure (p<0.05). There were significant (p<0.05) variations in mean blood pressure and blood sugar levels between referred and non-referred individuals. Age had a relationship with higher random blood sugar levels, systolic blood pressure, and diastolic blood pressure. Dentists should consider patient age while planning treatment, as type 2 diabetes mellitus and hypertension require unique techniques to emphasize patient safety and produce excellent outcomes.

Replacing Mercury Sphygmomanometers With Mercury-Free Sphygmomanometers for the National Health Survey in Children: Direct Comparisons Applying Two Types of Mercury-Free Sphygmomanometer.

Blood pressure (BP) measurement using an auscultatory sphygmomanometer is recommended for diagnosing hypertension in children. As mercury sphygmomanometers (MSs) are banned owing to environmental concerns, it is crucial to determine the accuracy of mercury-free sphygmomanometers to replace them. We analyzed the accuracy of these devices to guide the National Survey selection. BP was measured thrice each with MS, auscultatory device (AD), and oscillometric device (OD) in 104 participants aged 10-18 using the National Survey data. The difference in BP was defined as the difference between MS and other devices. The BP differences, correlations, and influencing factors were analyzed. The frequencies of hypertension were also compared. Systolic BP (SBP) and diastolic BP (DBP) differences between MS and AD were 0.88±3.36 mmHg and 0.63±3.95 mmHg, and those between MS and OD were 0.43±5.83 mmHg and 4.57±6.89 mmHg, respectively. The absolute error of <10 mmHg for DBP between MS and OD was 76%. The concordance correlation coefficient between MS and AD was 0.94 for SBP and 0.90 for DBP, and 0.81 and 0.67, respectively for MS and OD. Arm circumference negatively correlated with BP differences except for SBP between the MS and OD. The frequency of hypertension was not different between MS and AD but was underestimated by OD. AD correlated well with MS, while OD did not, especially for DBP. The superiority of AD over OD suggests AD as a possible alternative for MS in the National Survey.

Contributing Factors for the Increased Inter-arm Systolic Blood Pressure Difference in Different Age Groups

Abstract OBJECTIVE To explore the contributing factors for the increased inter-arm systolic blood pressure difference (IASBPD) in young, middle-aged, and elderly people. METHODS A total of 51,428 workers in Kailuan who underwent arteriosclerosis detection of extremities during physical examination from 2010 to 2020 were selected as the subjects. The subjects were divided into 3 groups according to the age segment proposed by the World Health Organization: young, middle-aged, and elderly group. Each age group was subsequently divided into 2 groups according to whether the IASBPD was increased: IASBPD 15 mm Hg and IASBPD &amp;gt;15 mm Hg group. The detection rate of IASBPD &amp;gt;15 mm Hg in each age group was calculated, and the contributing factors of IASBPD &amp;gt;15 mm Hg in different age groups were analyzed via multifactor logistic regression model. RESULTS The detection rate of IASBPD &amp;gt;15 mm Hg was 15.65% in all the subjects, and it was 12.90%, 15.28%, and 20.69% in the young, middle-aged, and elderly groups, respectively (χ2 = 343.83, P &amp;lt; 0.01). In all the young, middle-aged, and elderly groups, the risk factors for IASBPD &amp;gt;15 mm Hg included decreased ankle–brachial index (ABI), elevated body mass index (overweight and obesity), male, elevated brachial–ankle pulse wave velocity (baPWV), and hypertension. Furthermore, elevated high sensitive C-reactive protein (hsCRP) was a risk factor for increased IASBPD in young people (odds ratio [OR] = l.02, 95% confidence interval [CI] 1.00–1.04). And elevated low-density lipoprotein cholesterol (LDL-C) was a risk factor (OR = 1.09, 95% CI 1.03–1.15) for increased IASBPD in middle-aged people, and the high level of education was a protective factor (OR = 0.86, 95% CI 0.79–0.94). Diabetes (OR = 1.29, 95% CI 1.16–1.42) and old age (OR = 1.01, 95% CI 1.01–1.02) were risk factors for increased IASBPD in the elderly people, and high level of education (OR = 0.84, 95% CI 0.74–0.95) and elevated high-density lipoprotein cholesterol (HDL-C) (OR = 0.82, 95% CI 0.72–0.93) were protective factors. CONCLUSIONS The detection rate of IASBPD &amp;gt;15 mm Hg increases with the increase of age in the young, middle-aged, and elderly groups. Decreased ABI, elevated overweight obesity, male, elevated baPWV, and hypertension are common risk factors for increases IASBPD in 3 age groups. Furthermore, elevated hsCRP, elevated LDL-C, diabetes mellitus, and old age are risk factors for increased IASBPD in young, middle-aged, and elderly group, respectively.

Role of Psychological Stress and Choroidal Thickness in Central Serous Chorioretinopathy.

Central serous chorioretinopathy (CSCR) is a disease with a multifactorial aetiology. To evaluate the role of psychological stress and choroidal thickness in patients with CSCR. This was a hospital-based, analytical cross-sectional study, conducted at Christian Medical College, Vellore, India, from 2018 February to 2019 September, after the approval of the Institutional Review Board and Ethics Committee. Patients who satisfied the eligibility criteria of the study, were selected from the outpatient clinics of the Department of Ophthalmology. Twenty-five patients with unilateral CSCR (Group 1 - cases), and 50 age and gender-matched patients without CSCR (Group 2 - controls), randomly selected in a 1:2 ratio, were enrolled after obtaining informed consent. Psychological stress was assessed using Cohen Perceived Stress Scale (PSS-10). All patients had a Swept Source optical coherence tomography scan of the macula. Subfoveal choroidal thickness (SFCT) of both eyes of all participants was measured using a standard protocol. The data were collated and analysed, using Independent samples t-test and Chi-square/ Fisher's exact test, as appropriate, with IBM SPSS Statistics for Windows, version 21 (IBM Corp., Armonk, N.Y., USA). There was a significant difference between the two groups in mean stress scores (p <0.01), as well as stress categories (p <0.01). Although there was no significant difference in the prevalence of hypertension between the two groups (p = 0.33), there was a significant difference both in the mean systolic (p <0.01) and diastolic (p <0.01) blood pressure between the two groups. We found a significant difference between mean SFCT of CSCR eyes (421+/- 78.34 μm) and control eyes (314.24 +/- 52.48 μm, p <0.01), as well as between fellow eyes (396.20 +/- 68.79 μm) and control eyes (314.24 +/- 52.48 μm, p <0.01). However, there was no significant difference in the mean SFCT of CSCR eyes and fellow eyes (p =0.24). The findings reiterate the concept that the underlying pathophysiological changes leading to CSCR involve both the eyes of the patient. Psychological stress and hypertension may be factors that play an important role in the etiopathogenesis of the pachychoroid-related changes leading to CSCR. Stress relief measures, with a holistic approach to management, should be an integral part of the therapeutic strategies for CSCR.

Comparison of Hemodynamic Changes and Their Management Following Subarachnoid Block Between Normotensive and Preeclamptic Women Undergoing Cesarean Section

Introduction. Spinal anesthesia (SA) is widely used for cesarean sections, yet its safety in preeclamptic patients remains uncertain. This study explores the use of subarachnoid block (SAB) in preeclamptic parturients during cesarean sections. Patients and Methods. This study was a single-center hospital-based controlled clinical trial. 30 normotensive and 30 preeclamptic women undergoing cesarean section were included in the study. Heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP) and SpO2 were evaluated at one, three, five, seven, nine, 11, 13, 15, 20, 25, 30, 40, 45, 50, 55 and 60 minutes intervals after giving the block. The independent samples t-test was used for statistical analysis. Results. In the normotensive (group N) vs. preeclamptic (group PE) comparison, significant differences in weight, SBP, DBP, and MAP were noted, with higher values in group PE (p&lt;0.05). Heart rates and oxygen saturation were comparable. Mephentermine consumption was notably higher in normotensive women compared to preeclamptic women (p&lt;0.001). Conclusion. Severe preeclamptic women exhibit significantly higher SBP, DBP, and MAP compared to normotensive women undergoing cesarean section following subarachnoid block. However, SAB does not impact heart rate and oxygen saturation. Importantly, hypotension following spinal anesthesia is less common in severe preeclamptic patients, indicating its potential safety in this group.

Comparison of Home and Office Blood Pressure Devices in the Clinical Setting.

Self-measured blood pressure (SMBP) monitoring is increasingly used for remote hypertension management, but the real-world performance of home blood pressure (BP) devices is unknown. We examined BP measurements from patients' home devices using the American Medical Association's (AMA) SMBP Device Accuracy Test tool. Patients at a single internal medicine clinic underwent up to five seated, same-arm BP readings using a home device and an automated BP device (Omron HEM-907XL). Following the AMA's three-step protocol, we used the patient's home device for the first, second, and fourth measurements and the office device for the third and fifth (if needed) measurements. Device agreement failure was defined as an absolute difference in systolic BP >10 mm Hg between the home and office devices in either of two confirmatory steps. Performance was examined by brand (Omron vs. non-Omron). Moreover, we examined patient factors associated with agreement failure via logistic regression models adjusted for demographic characteristics. We evaluated 152 patients (mean age 60 ± 15 years, 58% women, 31% Black) seen between October 2020 and November 2021. Device agreement failure occurred in 22.4% (95% CI: 16.4%, 29.7%) of devices tested, including 19.1% among Omron devices and 27.6% among non-Omron devices (P = 0.23). No patient characteristics were associated with agreement failure. Over one-fifth of home devices did not agree based on the AMA SMBP device accuracy protocol. These findings confirm the importance of office-based device comparisons to ensure the accuracy of home BP monitoring.

INFLUENCE GIVING INFUSION OF LEMON WATER (Citrus limon) AND CUCUMBER (Cucumissativus L) ON SUFFERER HYPERTENSION IN REGION WORK PUBLIC HEALTH CENTER PUUWATU CITY KENDARI

Hypertension is one of the silent killer diseases that causes the iceberg phenomenon. The prevalence of hypertension increases with age. If this pathological condition does not get treatment quickly and early, it will exacerbate the risk. Based on the results of Riskesdas (2018) in Indonesia the prevalence of hypertension was 31.7%. The prevalence of Hypertension for Southeast Sulawesi Province based on the results of Riskesdas in 2007 was 31.7%, Riskesdas in 2013 decreased to 25% and in Riskesdas in 2018 it rose to 31%. Data on the health profile of Puuwatu Public Health Center, Kendari City, hypertension in adults (20-44 years) in the last 3 years showed that in 2014 there were 284 cases, in 2015 there were 222 cases, in 2016 increased to 419 cases and in 2017 to 498 cases. Infused water is water that is mixed with fruit and then allowed to stand for a few hours until the juices come out . To determine the effect of Infusion of Fruit and Vegetable Water (cucumber and lemon) on Hypertension Patients in the Work Area of Puuwatu Health Center, Kendari City. This type of research is Quasi experimental using a two group pre-post test design with control with a survey approach. This research was conducted on November 5, 2020 to January 29, 2021. The design of this study was to provide Infused Water of fruits and vegetables (cucumber and lemon) to hypertension patients who were previously checked for blood pressure and then given an intervention in the form of giving Infused Water of fruits and vegetables (cucumber 100 g) and 50 grams of lemon plus 250 ml of mineral water) 1 time a day for 8 consecutive days. Blood pressure was checked 4 times after giving Infused Water fruit and vegetable. The sample is all adults who suffer from hypertension totaling 64 people. The sampling technique Purposive sampling. Blood pressure before and after the intervention by giving Cucumber and Lemon Infused Water for 8 days and measuring blood pressure 4 times (every 2 days) that the mean systolic blood pressure before and after the intervention for the case group was 144.4575 mgHg and the control group was 152.155 mgHg and diastolic blood pressure before and after the intervention, the mean for the case group was 90.9375 mgHg and the control group was 96.335 mgHg. The results of independent t-test in cases and controls systolic blood pressure p value = 0.339 ( 0.05) while diastolic p value = 0.374 ( 0.05), that there is no significant difference in systolic and diastolic blood pressure in the two sample groups .then averaged were . the diastolic variable obtained p value = 0.17 (0.05) so it can be said that for systolic and diastolic blood pressure there is an effect.