Higher Mean Systolic Blood Pressure Research Articles

Exploring the Relationship Between Serum Phosphate Levels and Carotid Intima-Media Thickness in Chronic Kidney Disease Patients: A Correlational Analysis.

Background Compelling observational data suggestthat heightened levels of fasting blood phosphate are linked to a higher likelihood of cardiovascular disease, spanning across both the general populace and individuals grappling with chronic kidney disease (CKD). This study aimed to explore the possible correlation between carotid intima-media thickness (CIMT) and blood phosphate levels among those afflicted with chronic renal dysfunction. Objective The primary goal of this study is to determine the potential association between blood phosphate levels and CIMT in patients with CKD. Methodology In the department of nephrology, prospective research was conducted among patients who had a history of CKD. Atotal of 30 patients were included, with 20 males and 10 females. Every case had a thorough physical examination and history. Every patient underwent a laboratory evaluation, which included measurements of the CIMT and renal function testing. At a distance of 1 cm from the carotid bulb, the CIMTwas measured using B-mode ultrasonography. After compilation, the data were examined. Results The majority of the patients, according to this study, were male and over 50 years old. The Stage II patients in the study had a higher mean systolic blood pressure; however, the difference was not statistically significant. Patients with Stage V (D) disease exhibited higher diastolic blood pressure, but not statistically significant. An increase in the mean serum creatinine level that was statistically significant was linked to Stage V (D) renal disease. A higher mean blood urea was linked to Stage V (D) sickness; however, this relationship was not statistically significant. There was no statistical difference in the mean serum calcium levelsbetween the different stages of renal disease. Higher mean blood phosphate levels were linked to Stage III renal disease, but not in a statistically meaningful way. Although it was higher in Stage IV kidney disease, the mean CIMT was not statistically significant between the stages of renal illness. Conclusions Although a positive correlation was shown, a direct relationship between serum phosphate levels was not established by this investigation. The severity of renal disease has been demonstrated to correlate with elevated serum phosphate levels.

The Role of Blood Pressure Control in Prevention of Hematoma After Blepharoplasty.

Hematoma formation after blepharoplasty is serious and potentially vision-threatening, with hypertension being the primary risk factor. The aim of this paper is to assess perioperative blood pressure trends and rates of complication in patients undergoing a strict blood pressure protocol designed to keep perioperative systolic blood pressure below 120 mmHg. A retrospective chart review was performed of 32 patients undergoing face lift with conomitant blepharoplasty from January 2015 to July 2018. For each patient blood pressure readings obtained before, during, and after surgery were reviewed. Two-sample one-tail T-tests were performed, and p values less than 0.05 were considered statistically significant. The mean systolic blood pressure (SBP) for all patients was highest intraoperatively. Patients with known hypertension had higher mean SBPs than patients without hypertension across all phases of care, with a statistically significant difference in immediate preoperative SBP (p=0.05). Males had a higher average blood pressure immediately postoperatively (p=0.05). A previous diagnosis of hypertension in females was associated with a higher immediate preoperative SBP (p=0.07) as well as age over 65 (p=0.07). The overall rate of complications was 37.5%. No patients experienced hematoma. This study demonstrated that keeping blood pressure below 120 mmHg after surgery was an effective method of preventing hematoma after blepharoplasty, even in patients concurrently on anti-coagulative medications. Special attention to blood pressure control should be shown to patients with known risk factors such as a previous diagnosis of hypertension, male sex, or age greater than 65. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Sex-specific associations between the environmental exposures and low-grade inflammation and increased blood pressure in young, healthy subjects

Long-term exposures to environmental factors including airborne as well as noise pollutants, are associated with cardiovascular risk. However, the influence of environmental pollution on the young population is controversial. Accordingly, we aimed to investigate the relationships between long-term exposures to different environmental factors and major cardiovascular and inflammatory parameters and biomarkers in young, healthy subjects. Representative sample of permanent residents of two cities differing in air and noise pollution levels, aged 15–21 years, were recruited. Krakow and Lublin, both located in southern Poland, were chosen in relation to their similarities in demographic and geopolitical characteristics, but differences in air pollution (higher in Krakow) and noise parameters (higher in Lublin). A total of 576 subjects were studied: 292 in Krakow and 284 in Lublin. All subjects underwent health questionnaire, blood pressure measurements and biomarker determinations. Inflammatory biomarkers, such as CRP, hs-CRP, fibrinogen as well as homocysteine were all significantly higher in subjects living in Krakow as opposed to subjects living in Lublin (for hsCRP: 0.52 (0.32–0.98) mg/l vs. 0.35 (0.22–0.67) mg/l; p < 0.001). Increased inflammatory biomarker levels were observed in Krakow in both male and female young adults. Interestingly, significant differences were observed in blood pressure between male and female subjects. Males from Krakow had significantly higher mean systolic blood pressure (127.7 ± 10.4 mm/Hg vs. 122.4 ± 13.0 mm/Hg; p = 0.001), pulse pressure (58.7 ± 8.9 mm/Hg vs. 51.4 ± 12.3 mm/Hg; p < 0.001) and lower heart rate (p < 0.001) as compared to males living in Lublin. This was not observed in young adult females. Long-term exposure to environmental factors related to the place of residence can significantly influence inflammatory and cardiovascular parameters, even in young individuals. Interestingly, among otherwise healthy young adults, blood pressure differences exhibited significant variations based on biological sex.

Association Between Hypertensive Disorders of Pregnancy and Interval Neurocognitive Decline: An Analysis of the Hispanic Community Health Study/Study of Latinos.

To evaluate whether hypertensive disorders of pregnancy, including gestational hypertension, preeclampsia, and eclampsia, are associated with cognitive decline later in life among U.S. Hispanic/Latina individuals. The HCHS/SOL (Hispanic Community Health Study/Study of Latinos) is a prospective population-based study of Hispanic/Latino individuals aged 18-74 years from four U.S. communities. This analysis included parous individuals aged 45 years or older who participated in the HCHS/SOL clinic study visit 1 (2008-2011) neurocognitive assessment and subsequently completed a repeat neurocognitive assessment as part of the Study of Latinos-Investigation of Neurocognitive Aging ancillary study visit 2 (2015-2018). Hypertensive disorders of pregnancy were assessed retrospectively by self-report of any gestational hypertension, preeclampsia, or eclampsia. Cognitive functioning was measured at both study visits with the Brief Spanish-English Verbal Learning Test, Digit Symbol Substitution, and Word Fluency. A regression-based approach was used to define cognitive decline at visit 2 as a function of cognition at visit 1 after adjustment for age, education, and follow-up time. Linear regression models were used to determine whether hypertensive disorders of pregnancy or their component diagnoses were associated with standardized cognitive decline after adjustment for sociodemographic characteristics, clinical and behavioral risk factors, and follow-up time. Among 3,554 individuals included in analysis, the mean age was 56.2 years, and 467 of individuals (13.4%) reported at least one hypertensive disorder of pregnancy. Individuals with hypertensive disorders of pregnancy compared with those without were more likely to have higher mean systolic blood pressure, fasting glucose, and body mass index. After an average of 7 years of follow-up, in fully adjusted models, gestational hypertension was associated with a 0.17-SD relative decline in Digit Symbol Substitution scores (95% CI, -0.31 to -0.04) but not other cognitive domains (Brief Spanish-English Verbal Learning Test or Word Fluency). Neither preeclampsia nor eclampsia was associated with neurocognitive differences. The presence of preeclampsia or eclampsia was not associated with interval neurocognitive decline. In this cohort of U.S. Hispanic/Latina individuals, gestational hypertension alone was associated with decreased processing speed and executive functioning later in life.

Exploring the association between PLGF and pregnancy outcomes

Introduction and Aim: Pregnancy demands vigilant fetal monitoring, yet traditional methods have limitations, leading to research on biomarkers like placental growth factor (PLGF) to enhance predictive accuracy for adverse outcomes. This investigation focuses on assessing the relationship between PLGF levels and pregnancy outcomes in women with suspected preeclampsia. Materials and Methods: A simple longitudinal design was employed, following pregnant women with suspected preeclampsia from enrollment until delivery. The study included 160 subjects, and their characteristics were recorded at admission. PLGF levels were measured, and pregnancy outcomes were assessed. Results: Among the study population, the distribution of pregnancies showed that 45.62% were in the first pregnancy, 40% in the second pregnancy, 11.85% in the third pregnancy, and 2.5% in the fifth pregnancy. The highest PLGF levels were observed in the fifth pregnancy group.Analysis revealed that subjects with NICU admission had a lower mean PLGF value compared to those without NICU admission. Among subjects with low PLGF levels, the mean baby weight was lower by approximately 5.3% when match up to those with normal PLGF levels.Regarding blood pressure, subjects with decreased PLGF levels had a higher mean systolic blood pressure in contrast to those with normal PLGF levels. Conclusion: Lower PLGF levels were associated with NICU admission, lower baby weight, and higher systolic blood pressure in women with suspected preeclampsia. These findings suggest that PLGF levels may have implications for pregnancy outcomes. Additional investigation with expanded sample sizes is necessary to authenticate these discoveries and look into the clinical relevance of PLGF in understanding and addressing preeclampsia.

Comparing Effectiveness and Safety of Intravenous Atropine with Topical Tetracaine in Preventing and Relieving Oculocardiac Reflex in Patients Undergoing Strabismus Surgery: A Randomized Clinical Trial

Abstract Background: Oculocardiac reflex (OCR) is one of the serious complications following surgical therapeutic procedures for strabismus. Various medications have been tested to prevent or mitigate this complication. We aimed to compare the effect of intravenous atropine and topical tetracaine on the incidence and severity of OCR in strabismus surgery. Materials and Methods: In this triple-blind randomized clinical trial study, 120 patients who were candidates for strabismus surgery were randomly assigned to receive intravenous atropine, topical tetracaine, or artificial tears as the control. The incidence of OCR and its severity along with the changes in hemodynamic conditions were compared across the groups. Results: The incidence rate of OCR in the groups receiving atropine, tetracaine, and the control was found to be 17.5%, 25.0%, and 32.5% in the releasing phase without any difference, respectively (P = 0.303); however, it was 2.5%, 7.5%, and 25.0%, respectively, in the cutting phase, indicating a lower rate in the group receiving tetracaine (P = 0.004). Similarly, there was no difference in the severity of OCR across the three study groups in the releasing phase (P = 0.666); however, in the cutting phase, OCR was revealed to be milder in the group receiving atropine as compared to other groups (P = 0.033). Prescribing atropine led to higher mean systolic blood pressure and mean arterial pressure during surgery. Conclusion: The injection of atropine can effectively reduce the incidence of OCR during strabismus surgery and reduce its severity if this reflex occurs.

Cardiometabolic risk profile of young and old adults with diabetes: Pooled, cross-sectional analysis of 42 national health surveys

AimsTo compare levels of cardiometabolic risk factors in young and old adults with diabetes. MethodsPooled analysis of 42 STEPS Surveys (n = 133,717). Diabetes was defined as self-reported diagnosis or fasting plasma glucose ≥ 126 mg/dl. There were two age groups: < 40 and ≥ 40 years. We summarized the mean levels of four cardiometabolic risk factors by country, sex and age group. ResultsIn 11 (men) and seven countries (women), the mean BMI seemed higher in young versus old adults; largest difference was found in men in Qatar (∼6 kg/m2). For waist circumference, such pattern was observed in two (men) and in three (women) countries; largest difference in men in Tuvalu (∼7 cm). Regarding systolic blood pressure, in one country (Myanmar) the mean was higher in young men with ∼8 mmHg difference. Women in the oldest group always had higher mean systolic blood pressure. For total cholesterol, in 13 (men) and five (women) countries the mean was higher in young adults (difference was always <1 mmol/l). ConclusionsLevels of cardiometabolic risk factors in young versus old adults with diabetes were heterogenous across 42 countries and depended on the risk factor. This calls to monitor cardiometabolic risk factors in young adults with diabetes.

Echocardiographic Assessment of the Left Ventricle in Young Prehypertensive Nigerians.

Prehypertension is associated with an increased risk of cardiovascular morbidity and mortality. This risk could partly be explained by the early compromise in left ventricular (LV) structure and function. This study investigated the LV geometry and function in young black prehypertensive subjects. This cross-sectional descriptive study was conducted at the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Echocardiography-derived LV geometry and function were assessed using standardized methods. Prehypertensive subjects had higher mean systolic blood pressure (BP) (130.78 ± 3.57 mmHg vs 111.42 ± 3.54 mmHg, P<0.001), diastolic BP (79.32 ± 4.13 mmHg vs 66.39 ± 4.42 mmHg, P<0.001), body mass index (BMI) (26.24 ± 3.45 kg/m2 vs 22.20 ± 2.21 kg/m2, P<0.001), waist circumference (WC) (86.93 ± 8.73 cm vs 76.73 ± 6.66 cm, P<0.001), fasting blood glucose (FBG) (93.84 ± 7.28 mg/dl vs 90.08 ± 6.26 mg/dl, P<0.001), and dyslipidemia (21.5% vs 6%. P<0.001) compared to normotensive subjects. LV mass index (LVMI) was greater in prehypertensive subjects compared to normotensive subjects {male (106.84 ± 12.34 g/m2 vs 76.07 ± 10.25 g/m2, P<0.001); female (92.06 ± 8.80 g/m2 vs 66.53 ± 7.21 g/m2, P<0.001)}, with abnormal LV geometry recorded in 17.5%. Linear regression analysis showed that waist circumference, systolic BP, serum creatinine level, and urea level were determinants of LVMI. The prevalence of LV diastolic dysfunction was higher in prehypertensive subjects than in normotensive subjects (14.5% vs. 0.5%, P<0.001), with systolic BP {odds ratio (OR) 0.928, confidence interval (CI) 0.834 - 0.969; P=0.016)} and diastolic BP (OR 0.832, CI 0.722 - 0.958; P=0.011) being independent predictors. This study showed that prehypertension in young Black subjects was associated with altered LV geometry and impaired diastolic function, and these changes demonstrated linear progression with increasing systolic BP.

Evaluation of Blood Pressure in Children Treated with Ceftriaxone: A Case-Control Study

Background: In children, high blood pressure can develop into hypertension and its consequences during puberty and adulthood. High blood pressure in children is often secondary to other causes, including renal diseases. Nephrolithiasis is one of the causes of secondary hypertension. The extensive use of cephalosporins in hospitals, particularly ceftriaxone, can result in nephrolithiasis. Therefore, the purpose of this study was to assess the relationship between ceftriaxone treatment and elevated blood pressure in children. Method: The research was conducted as a case-control study over an 18-month period from 2018 to 2019. In this study, blood pressure was measured in 111 children aged 3-13 years who were hospitalized at Amir Kabir Hospital in Arak and received ceftriaxone for at least 48 hours. As a control group, 111 children who did not receive ceftriaxone had their blood pressure measured. The blood pressure levels and percentiles of children in the two groups were then compared. Result: In the case and control groups, the mean age was 5.1±1.61 and 6.04±2.4 years, and the mean height was 109.17±10.71 and 114.86±12.95 cm, respectively. A slightly higher mean systolic blood pressure percentile was observed in the case group (65.59±18.17) than in the control group (65.28±14.51) (P=0.112), and the mean diastolic blood pressure percentile was also slightly higher in the case group (58.89±18.88) than in the control group (54.85±19.28) (P=0.317). The difference in diastolic blood pressure was greater than in systolic blood pressure. However, these detected differences were slight and not statistically significant. Conclusion: This study showed no association between blood pressure levels and ceftriaxone treatment in children older than three years who received the medicine for at least 48 hours. However, additional research is suggested, focusing on the effects of the medicine at higher doses and over a longer period of time following administration.

Association of blood pressure variability and CT-based Leiden score in hypertension patients.

Blood pressure variability (BPV) obtained from ambulatory blood pressure monitoring (ABPM) has been demonstrated to accurately predict the risk of cerebrovascular events and death in hypertension patients, however, the association between BPV and the severity of coronary atherosclerotic plaque remains unclear. Patients with hypertension combined with suspected coronary artery disease (CAD) were collected, who underwent both ABPM and coronary computed tomographic angiography (CCTA) from December 2017 to March 2022. Patients were divided into three groups according to the Leiden score: low-risk group (Leiden score <5), medium-risk group (Leiden score 5-20), and high-risk group (Leiden score >20). The clinical characteristics of patients were collected and analyzed. Univariate Pearson correlation and multivariate Logistics regression were used to determine the association between BPV and the severity of coronary atherosclerotic plaque. A total of 783 patients were included, with the average age of (62.85 ± 10.17) years and 523 males. Patients in the high-risk group had higher mean systolic blood pressure (SBP), nighttime mean SBP and SBP variability (P < 0.05). Leiden score with low risk was associated with 24 h-SBP variability (r = 0.35, P = 0.006) and 24 h-diastolic blood pressure (DBP) loading (r = -0.18, P = 0.027). Leiden score with medium and high risk was associated with nighttime mean SBP (r = 0.23, P = 0.005), 24 h-SBP variability (r = 0.32, P = 0.003), and the decrease of nighttime SBP (r = 0.24, P = 0.019). Multivariate Logistic analysis showed that smoking [odds ratio (OR) = 1.014, 95% confidential interval (CI): 1.0-1.07, P = 0.03], diabetes (OR = 1.43, 95% CI: 1.10-2.26, P = 0.01) and 24 h-SBP variability (OR = 1.35, 95% CI: 1.01-2.46, P = 0.01) were independently associated with Leiden score with medium and high risk. Larger SBP variability in hypertensive patients indicates the higher Leiden score and consequently the more serious coronary atherosclerotic plaque. Monitoring SBP variability has certain significance for predicting the severity of coronary atherosclerotic plaque and preventing its progression.

Androgenetic Alopecia: Traditional Cardiovascular Risk Factors, Metabolic Syndrome, and Component Traits among Nigerian Adults

Androgenetic alopecia (AGA) has been linked to cardiovascular diseases (CVDs) and metabolic syndrome (MetS). Works on AGA, cardiovascular risk factors (CVRFs) and MetS are rare among Nigerians.This study set out to determine the relationship among CVRFs, MetS, and AGA.This is a cross-sectional study done among adults who were 18 years and above in selected communities in Ogbomoso on 260 consenting AGA participants as well as 260 age controls without AGA. They were matched for age and sex using a multistage sampling method. Anthropometric measurements, fasting blood glucose, and lipid profile samples were collected. MetS was diagnosed using International Diabetes Federation criteria. Data were analyzed using IBM SPSS version 20. Ethical approval was gotten before commencement of the study (LTH/OGB/EC/2017/162).Metabolic syndrome in AGA was higher than in controls (8.08% vs. 7.69%, p = 0.742). AGA was significantly associated with elevated mean systolic blood pressure (SBP) (p = 0.008), low High Density Lipoprotein (HDL-c) (p < 0.001), alcohol intake (p < 0.001), dyslipidaemia (p = 0.002), and sedentary lifestyle (p = 0.010). The correlates of AGA severity in male and female gender are age (p < 0.001 and 0.009 respectively), SBP (p = 0.024) and abdominal obesity (p = 0.027) in male gender.AGA in Nigerians is associated with dyslipidaemia, alcohol intake, and sedentary lifestyle. AGA severity is related to age, higher mean SBP, abdominal obesity and low HDL-c in male and age, and Body mass index in females. Nigerians with AGA should be screened for dyslipidaemia and counseled against the use of alcohol and sedentary lifestyle.

Letter in reply: aletter to the editor commenting on the recent publication by AY Avidan and CA Kushida.

Letter in reply: aletter to the editor commenting on the recent publication by AY Avidan and CA Kushida.

P172 Metabolic disorders with non-alcoholic fatty liver disease in people with inflammatory bowel disease

Abstract Background Globally rising rates of obesity and consequent metabolic diseases have been reflected in the inflammatory bowel disease (IBD) population. Non-alcohol fatty liver disease (NAFLD) is a common liver disorder associated with obesity, that occurs more frequently in people with IBD. Methods A prospective single-centre cohort study. In total, we recruited 203 patients from our IBD service in a tertiary academic hospital. 7 participants were excluded due to later diagnosed non-NAFLD liver disease. Following informed consent, participants underwent a fibroscan for liver stiffness (LSM) and controlled attenuation parameter (CAP) measurement, and blood tests for HbA1c and fasting lipids. Basic demographics, past medical history, exercise measured on the Godin-Shepard Leisure Time Physical Activity Questionnaire, physical functioning on SF-36 Questionnaire, blood pressure, CAP and LSM were recorded. T-test and Fishers exact test were used to test for statistical significance as appropriate. Results Of the 196 IBD patients included, 34.7% (n=68/196) had a healthy BMI, 34.7% (n=68/196) were overweight (BMI≥25-29.9), and 30.6% (n=60/196) were obese (BMI≥30). Overall, 16.3% (n=32) had a CAP score &amp;gt;294dB/m consistent with NAFLD, and 2.55% (n=5) had a LSM &amp;gt;8.1kPa consistent with fibrosis. When compared to those without NAFLD, those with NAFLD had higher BMIs, 26.9 vs 32.3 p&amp;lt;0.05. They also had a much higher incidence of diabetes 28.1% vs 0% p=0.0001, higher overall rates of abnormal HbA1C (≥6%), 21.9% (n=7/32) vs 6.4% (n=10/156) p=0.0121, and higher rates of abnormal HbA1c without a diagnosis of diabetes 13% (n=3/23) vs 6.45% (n=10/155) p=0.4043. Additionally, they had non-significant higher mean systolic blood pressure and higher rates of diagnosed hypertension. Compared to those without NAFLD, the NAFLD cohort had higher rates of diagnosed hypercholesterolaemia 34.4% (n=11/32) vs 15.3% (n25/163) p=0.022 and there were higher rates of elevated total cholesterol (&amp;gt;5mmol/L) in those not previously diagnosed with hypercholesterolaemia, 42.9% (n=9/21) vs 31.8% (n=47/148) p=0.3292. Participants with NAFLD also had lower exercise scores 17 vs 24.9 p=0.03543, and lower scores for physical functioning 71.9 vs 83.2 p=0.00676. Of particular note, they had more than double the 10-year risk of myocardial infarction or death determined by the Framingham risk scores for hard coronary heart disease, 2.48% vs 5.75%, p=0.00012. Conclusion Our study shows that people with concurrent NAFLD and IBD have a significant cardiovascular risk profile. With increased awareness of this, metabolic syndrome conditions should be screened for and treatment initiated where appropriate, to decrease cardiovascular related mortality in this cohort.

Meta-analysis of TSH suppression therapy and the risk of cardiovascular events after thyroid cancer surgery.

To investigate the relationship between TSH suppression therapy and cardiovascular events in patients with thyroid cancer after surgery. Pub Med, Web of Science, and Embase databases were retrieved to collect studies related to the risk of cardiovascular events in patients treated with TSH suppression after thyroid cancer surgery. RevMan statistical software was used for meta-analysis. A total of 14 studies were included. The mean heart rate of patients after thyroid cancer surgery was higher than that of the control group (SMD=2.59, 95% CI: -0.37,.54), and the risk of atrial fibrillation was increased compared with the control group (RR = 1.52, 95%CI, 1.28-1.81; I = 63%). Ejection fraction and left ventricular end-diastolic diameter were not significantly different between the two groups, ejection fraction SMD = -0.10, 95% CI: -3.73, 3.52, left ventricular end-diastolic diameter SMD = -0.09, 95% CI: - 1.29, 1.11. Patients with TSH suppression after thyroid cancer had higher mean systolic blood pressure than controls (SMD = 1.97, 95% CI: -1.09, 5.03) and mean diastolic blood pressure (SMD = 1.85, 95% CI: -0.15, 3.85). Meta-analysis concluded that TSH suppression therapy after thyroid cancer surgery increases the risk of atrial fibrillation in patients. In addition, the heart rate, systolic blood pressure and diastolic blood pressure are higher than those in the control group, and there is no significant difference in ejection fraction and left ventricular end-diastolic diameter.

Prevalence of Metabolic Syndrome in Chronic Obstructive Pulmonary Disease and its Correlation with Body Mass Index, Airflow Obstruction, Dyspnea, and Exercise Index and C-Reactive Protein

Context: Chronic obstructive pulmonary disease (COPD) is a widespread reason of disease and death in developing countries like India, although it is preventable, controllable, and treatable. Objectives: We studied the occurrence of metabolic syndrome (MetS) among cases of stable COPD and determined the correlation between stable COPD with MetS and body mass index, airflow obstruction, dyspnea, and exercise (BODE index) and C-reactive protein (CRP) titer. Methods: The study was a case–control analysis conducted on 90 patients from November 2019 to August 2020. Results: Seventy percentage of our case population belonged to Global Initiative for Chronic Obstructive Lung Disease (GOLD) Grade 1 and 2. A significant correlation between forced expiratory volume 1 s (FEV1) with body mass index (BMI), triglycerides (TGs), high-density lipoproteins (HDL), systolic blood pressure (SBP), and fasting blood sugar (FBS) was found. The higher the GOLD grade (lower FEV1), the higher the values of BMI, TG, HDL, SBP, and FBS. A negative association with MetS is related to small study population. Conclusion: Patients with MetS had significantly lower FEV1, higher mean SI, higher mean waist circumference, higher mean BMI, higher mean SBP and diastolic blood pressure, higher FBS, and higher HDL and TG. Patients with MetS showed higher BODE index and CRP titer compared to ones without it. Apart from routine vaccination, assessment of systemic comorbidities for early detection of MetS plays a pivotal role to provide best possible quality of life and utmost care to COPD patients and helps reduce mortality and morbidities of COPD.

Age- and Gender-Related Differences in the Hemodynamic Status of Patients with Mild or Moderate Hypertension.

PurposeThe aim of this study was to use non-invasive impedance cardiography (ICG) to determine the hemodynamic status of patients with grade 1 and grade 2 hypertension in relation to gender and age.Patients and MethodsWe analyse prospectively collected data of 158 patients with grade 1 or grade 2 arterial hypertension. Patients were grouped according to age: 1) <50 years and 2) ≥50 years. Hemodynamic status of patients was assessed by using non-invasive ICG. For the purpose of this study two hemodynamic parameters were used: a) systemic vascular resistance index (SVRI) and b) left cardiac work index (LCWI). The primary endpoint was the hemodynamic status of patients. The secondary endpoint was hypertension-mediated organ damage.ResultsIncreased SVRI was assessed in 80% of patients, more common in the ≥50 years group than in the <50 years group (88.5% vs 64.8%; p < 0.01). The occurrence of increased systemic vascular resistance correlates hierarchically with increasing age. Elevated LCWI (hypervolemia and/or hyperinotropy) was present in 63% of patients, more often in males than females (70.3% vs 57.1%; p < 0.05) as well in those <50 years than in older patients (70.4% vs 59.6%; p < 0.05). Patients with diabetes were less likely to have hypervolemia/hyperinotropy than those without diabetes (46.7% vs 67.2%; p < 0.01). Hypervolemia/hyperinotropy (46.7%) and hypovolemia/hypoinotropy (43.3%) were present in a similar percentage of diabetic patients. Left ventricular hypertrophy was found in 30 patients (19%). Patients with left ventricular hypertrophy were more commonly male (66.7% vs 42.2%; p = 0.016) and had increased systemic vascular resistance (96.7% vs 77.3%; p = 0.015) compared to the patients without left ventricular hypertrophy. Hypertensive retinopathy grade III was found in 14 patients (8.9%). Elevated daytime systolic pressure, diabetes and increased age are independent predictors of grade III hypertensive retinopathy. Patients with reduced renal function had higher mean systolic blood pressure (p < 0.05), were more commonly male (p < 0.01) and older (p < 0.01) than those without reduced renal function.ConclusionAlthough there are certain correlations between hemodynamic disorders and age and gender, specific hemodynamic status of an individual patient with hypertension cannot reliably be predicted on the basis of age and gender. The measurement of hemodynamic parameters by ICG can guide the clinician to select appropriate antihypertensive therapy to the patients’ hemodynamic pathophysiologic condition.

Atatürk Üniversitesi Eğitim Aile Sağlığı Merkezlerine Kayıtlı Hastalarda Diyabetik Retinopati Sıklığı, İlişkili Faktörler ve Diyabetik Retinopati Farkındalığı: Kesitsel Bir Çalışma

Amaç: Çalışmamızda Tip 2 diyabet hastalarımızda diyabetik retinopati (DRP) sıklığını, ilişkili faktörleri ve DRP farkındalık düzeyini değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışma Şubat 2019-Nisan 2020 tarihleri arasında Atatürk Üniversitesi Tıp Fakültesine bağlı Eğitim Aile Sağlığı merkezlerinde (EASM) yürütülmüştür. Kayıtlı 350 diyabet hastasına telefonla ulaşılıp çalışma hakkında bilgi verilerek çalışmaya davet edildi. Yapılan örneklem hesabına göre 18 yaş üstü Tip 2 diyabet tanısı almış 200 hasta çalışmaya dahil edildi. Tip 1 DM olanlar, oftalmolojik cerrahi geçirenler çalışmaya dahil edilmedi. Yüz yüze görüşme ile hastaların sosyodemografik ve klinik özellikleri kaydedilip; DRP farkındalık anketi uygulandı. Hastalar ikinci basamak sağlık kuruluşuna yönlendirildi ve bir göz hekimi tarafından detaylı oftalmalojik muayeneleri yapıldı. Veriler SPSS 20.0.0 ile analiz edildi. Anlamlılık düzeyi p&amp;lt;0,05 kabul edildi. Bulgular: Katılımcıların yaş ortalamaları 56,8±9,9 yıldı, %45,5’i (n=91) kadındı. Hastaların %36’sında (n=48) DRP tespit edildi. DRP’si olanların %60,4’ünde (n=29) mikrohemoraji mevcuttu. Sigara kullananlarda, ileri yaşta, DM tanı süresi fazla, HbA1c ortalaması ve sistolik kan basıncı ortalaması yüksek olanlarda DRP sıklığı daha fazlaydı (p&amp;lt;0,05). Bu değişkenler içinde DM tanı süresi, HbA1c düzeyi ve sigara kullanımı DRP olasılığını tahmin ettiren en önemli değişkenler olarak tespit edildi. 'Şeker hastaları ne sıklıkla göz muayenesi olmalıdır?' sorusuna %33,5 (n=37) oranında yılda bir kez cevabı verilmişti. Katılımcıların %58,5’i (n=117) en son göz muayenesine bir yıldan daha uzun zaman önce giderken; %6,5’i (n=13) hiç göz muayenesi olmamıştı. Bir hekim tarafından göz muayenesi önerilenlerin %20'sine (n=14) aile hekimi tarafından öneri yapılmıştı. Sonuç: Araştırma popülasyonunda DRP oranı yüksek olup; sigara kullananlarda, ileri yaşta, uzun süredir DM olanlarda, HbA1c ve sistolik kan basıncı yüksek olanlarda bu oran daha fazlaydı. Hastalarımızın DRP hakkında bilgi ve farkındalığı yetersizdi. Birinci basamak sağlık hizmeti sunan ve koruyucu hekimlik için kilit noktada bulunan aile hekimlerinin bu konudaki rolü önemlidir. Diyabetik hastalarda DRP gelişimini önlemek için aile hekimleri tarafından verilecek sigara bırakma danışmanlığı ve yakın takiplerle kan şekeri ve kan basıncı regülasyonunun sağlanması oldukça önemlidir.

Hemodynamic differences between women and men with elevated blood pressure in China: A non-invasive assessment of 45,082 adults using impedance cardiography.

Whether there are sex differences in hemodynamic profiles among people with elevated blood pressure is not well understood and could guide personalization of treatment. We described the clinical and hemodynamic characteristics of adults with elevated blood pressure in China using impedance cardiography. We included 45,082 individuals with elevated blood pressure (defined as systolic blood pressure of ≥130 mmHg or a diastolic blood pressure of ≥80 mmHg), of which 35.2% were women. Overall, women had a higher mean systolic blood pressure than men (139.0 [±15.7] mmHg vs 136.8 [±13.8] mmHg, P<0.001), but a lower mean diastolic blood pressure (82.6 [±9.0] mmHg vs 85.6 [±8.9] mmHg, P<0.001). After adjusting for age, region, and body mass index, women <50 years old had lower systemic vascular resistance index (beta-coefficient [β] -31.7; 95% CI: -51.2, -12.2) and higher cardiac index (β 0.07; 95% CI: 0.04, 0.09) than men of their same age group, whereas among those ≥50 years old women had higher systemic vascular resistance index (β 120.4; 95% CI: 102.4, 138.5) but lower cardiac index (β -0.15; 95% CI: -0.16, -0.13). Results were consistent with a propensity score matching sensitivity analysis, although the magnitude of the SVRI difference was lower and non-significant. However, there was substantial overlap between women and men in the distribution plots of these variables, with overlapping areas ranging from 78% to 88%. Our findings indicate that there are sex differences in hypertension phenotype, but that sex alone is insufficient to infer an individual's profile.

The relationship between ambulatory arterial stiffness index and left ventricular diastolic dysfunction in HFpEF: a prospective observational study

BackgroundThe relationship between ambulatory arterial stiffness index (AASI) and left ventricular diastolic dysfunction (LVDD) in patients with heart failure with preserved ejection fraction (HFpEF) is unknown. We aimed to investigate the association between the AASI and LVDD in HFpEF.MethodsWe prospective enrolled consecutive patients with HFpEF in Chongqing, China. Twenty-four-hour ambulatory blood pressure monitoring (24 h-ABPM) and echocardiography were performed in each patient. AASI was obtained through individual 24 h-ABPM. The relationship between AASI and LVDD was analyzed.ResultsA total of 107 patients with HFpEF were included. The mean age was 68.45 ± 14.02 years and 63 (59%) were women. The patients were divided into two groups according to the upper normal border of AASI (0.55). AASI > 0.55 group were more likely to be older, to have higher mean systolic blood pressure and worsen left ventricular diastolic function than AASI group ≤ 0.55. AASI was closely positive related to the diastolic function parameters, including mean E/e′ (r = 0.307, P = 0.001), septal E/e′ (r = 0.290, P = 0.002), lateral E/e′ (r = 0.276, P = 0.004) and E (r = 0.274, P = 0.004). After adjusting for conventional risk factors, AASI was still an independent risk factors of mean E/e′ > 10 in patients with HFpEF (OR: 2.929, 95%CI: 1.214–7.064, P = 0.017), and the association between AASI and mean E/e′ > 14 was reduced (OR: 2.457, 95%CI: 1.030–5.860, P = 0.043). AASI had a partial predictive value for mean E/e′ > 10 (AUC = 0.691, P = 0.002), while the predictive value for mean E/e′ > 14 was attenuated (AUC = 0.624, P = 0.034).ConclusionAASI was positive related to E/e′ in HFpEF and might be an independent risk factor for the increase of mean E/e′.

Puberty Timing and Sex-Specific Trajectories of Systolic Blood Pressure: a Prospective Cohort Study.

Background:Sex differences in systolic blood pressure (SBP) emerge during adolescence but the role of puberty is not well understood. We examined sex-specific changes in SBP preceding and following puberty and examined the impact of puberty timing on SBP trajectories in females and males.Methods:Trajectories of SBP before and after puberty and by timing of puberty in females and males in a contemporary birth cohort study were analyzed. Repeated measures of height from age 5 to 20 years were used to identify puberty timing (age at peak height velocity). SBP was measured on ten occasions from 3 to 24 years (N participants, 4062; repeated SBP measures, 29 172). Analyses were performed using linear spline multilevel models based on time before and after puberty and were adjusted for parental factors and early childhood factors.Results:Mean age at peak height velocity was 11.7 years (SD, 0.8) for females and 13.6 years (SD, 0.9) for males. Males had faster rates of increase in SBP before puberty leading to 10.19 mm Hg (95% CI, 6.80–13.57) higher mean SBP at puberty which remained similar at 24 years (mean difference, 11.43 mm Hg [95% CI, 7.22–15.63]). Puberty timing was associated with small transient differences in SBP trajectories postpuberty in both sexes and small differences at 24 years in females only.Conclusions:A large proportion of the higher SBP observed in males compared with females in early adulthood is accrued before puberty. Interventions targeting puberty timing are unlikely to influence SBP in early adulthood.